ABSTRACT
Forty male patients with chronic stable angina pectoris and no prior myocardial infarction were studied by planar thallium scintigraphy with use of circumferential profile analysis. Ischemic defects were assessed by measuring degrees of circumference involved and area of defect. Data were collected for 3 vascular regions in each of 3 views (anterior, 45 degrees and 65 degrees left anterior oblique projection). Patients were then randomized to exercise and control groups, the former training for a period of 1 year using the Canadian Airforce plan for physical fitness. After 1 year, both groups were restudied. Exercise training produced a 34% reduction in degrees of ischemia overall (p less than 0.02), the most significant change being seen on the anterior view (72 degrees +/- 59 degrees before vs 30 degrees +/- 35 degrees after training). Regional analysis showed markedly improved perfusion anterolaterally and apically on the anterior view and anteroseptally on the 65 degrees left anterior oblique view. These improvements support the hypothesis that exercise training improves myocardial perfusion by enhanced collateral function.
Subject(s)
Angina Pectoris/physiopathology , Coronary Circulation/physiology , Exercise/physiology , Adult , Angina Pectoris/diagnostic imaging , Angina Pectoris/prevention & control , Coronary Disease/diagnostic imaging , Coronary Disease/physiopathology , Coronary Disease/prevention & control , Exercise Test , Heart Rate/physiology , Humans , Male , Middle Aged , Physical Education and Training , Physical Fitness , Radionuclide Imaging , Thallium RadioisotopesABSTRACT
A study comparing the chronic effects of propranolol (n = 21) and pindolol (n = 19) on male patients with stable angina pectoris was performed. Left ventricular function was assessed by serial radionuclide ventriculography. Radionuclide ventriculography was performed at rest and during cold pressor test. Both drugs improved symptoms of angina pectoris by at least one division of the New York Heart Association classification. Cold pressor testing caused increases in heart rate and blood pressure in both groups throughout the study. At rest, pretreatment ejection fraction was similar in both groups. During propranolol treatment this rose sequentially from 49% to 55% at 26 weeks. No change in the resting ejection fraction occurred in those taking pindolol. The difference in response between the groups reached significance at 26 weeks. In those with subnormal left ventricular ejection fraction (less than 50%), resting ejection fraction improved significantly throughout treatment with propranolol rising from a basal value of 39% to 51% at 26 weeks. In comparison, pindolol caused no significant change. There is no apparent advantage to intrinsic sympathomimetic activity in terms of preservation or improvement of left ventricular performance in patients with stable angina pectoris prescribed beta-blockers for extended periods of time.
Subject(s)
Adrenergic beta-Antagonists/pharmacology , Sympathomimetics , Ventricular Function, Left/drug effects , Adult , Aged , Electrocardiography , Humans , Male , Middle AgedABSTRACT
The feasibility of using the cold pressor test and the sustained isometric handgrip test as alternatives to dynamic exercise for stressing the heart was investigated. Serial changes in heart rate, blood pressure, and left ventricular performance induced by these tests were studied by radionuclide ventriculography in patients with coronary artery disease and in normal volunteers. Both tests significantly increased heart rate and blood pressure. The reproducibility of serial evaluation of ejection fraction response to cold pressor and isometric handgrip stresses was satisfactory but the sensitivity for detecting coronary artery disease was not. Both stress tests are valuable interventions for the serial evaluation of left ventricular function by radionuclide ventriculography, but they should not be used to detect coronary artery disease.
Subject(s)
Cold Temperature , Coronary Disease/diagnosis , Heart Function Tests/methods , Heart/diagnostic imaging , Isometric Contraction , Muscle Contraction , Adult , Aged , Blood Pressure , Coronary Disease/diagnostic imaging , Coronary Disease/physiopathology , Heart Rate , Humans , Male , Middle Aged , Radionuclide Imaging , Stroke VolumeSubject(s)
Cathartics , Colon , Feces , Picolines , Adolescent , Adult , Barium Sulfate , Citrates , Colon/diagnostic imaging , Enema , Humans , Middle Aged , Organometallic Compounds , Radiography , Therapeutic IrrigationABSTRACT
A simple, economic stainless steel wire fetal scalp electrode is described. Its uneventful use over a 5-year period is reported in the light of several reports of complications arising from the application of both clip and spiral electrodes. The performance of 100 electrodes prepared under controlled conditions was analyzed in terms of both the quality of the rate trace produced and of problems experienced during application. Six electrodes were wasted during preliminary handling but of the 94 used in an attempted application to a fetal scalp, 88.3% were considered successful.
