Predicting the Presence of Serious Coronary Artery Disease Based on 24 Hour Holter ECG Monitoring

2015 ◽  
pp. 95-113 ◽  
Author(s):  
Jan G. Bazan ◽  
Sylwia Buregwa-Czuma ◽  
Przemysław Wiktor Pardel ◽  
Stanisława Bazan-Socha ◽  
Barbara Sokołowska ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ecg Monitoring ◽  
Holter Ecg ◽  
Artery Disease

Continuous ambulatory ECG monitoring during fluorouracil therapy: a prospective study.

1989 ◽  
Vol 7 (4) ◽  
pp. 509-514 ◽  
Author(s):  
S Rezkalla ◽  
R A Kloner ◽  
J Ensley ◽  
M al-Sarraf ◽  
S Revels ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Toxicity ◽  
Ecg Monitoring ◽  
Ecg Changes ◽  
Ambulatory Ecg ◽  
Ambulatory Ecg Monitoring ◽  
St Segment ◽  
Artery Disease ◽  
A Prospective Study

Although there have been anecdotal reports of cardiac toxicity associated with fluorouracil (5-FU) therapy, this phenomenon has not been studied in a systematic fashion. We prospectively performed continuous ambulatory ECG monitoring on 25 patients undergoing 5-FU infusion for treatment of solid tumors in order to assess the incidence of ischemic ST changes. Patients were monitored for 23 +/- 4 hours before 5-FU infusion, and 98 +/- 9 hours during 5-FU infusion. Anginal episodes were rare: only one patient had angina (during 5-FU infusion). However, asymptomatic ST changes (greater than or equal to 1 mm ST deviation) were common: six of 25 patients (24%) had ST changes before 5-FU infusion v 17 (68%) during 5-FU infusion (P less than .002). The incidence of ischemic episodes per patient per hour was 0.05 +/- 0.02 prior to 5-FU infusion v 0.13 +/- 0.03 during 5-FU infusion (P less than .001); the duration of ECG changes was 0.6 +/- 0.3 minutes per patient per hour before 5-FU v 1.9 +/- 0.5 minutes per patient per hour during 5-FU (P less than .01). ECG changes were more common among patients with known coronary artery disease. There were two cases of sudden death, both of which occurred at the end of the chemotherapy course. We conclude that 5-FU infusion is associated with a significant increase in silent ST segment deviation suggestive of ischemia, particularly among patients with coronary artery disease. The mechanism and clinical significance of these ECG changes remain to be determined.

scholarly journals Evaluation of the Prognostic Value of Heart Rate Variability in Elderly Patients with Multivessel Coronary Artery Disease against the Background of Invasive and Non-Invasive Treatment

2021 ◽  
Vol 11 (3) ◽  
pp. 260-264
Author(s):  
Saodat Ya.. Abdullaeva ◽  
Aleksey G. Nikishin Nikishin ◽  
Gusal U. Mullabaeva ◽  
Feruza M. Bekmetova
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Prognostic Value ◽  
Standard Treatment ◽  
Ecg Monitoring ◽  
Multivessel Coronary Artery Disease ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Artery Disease

The purpose of this study was to evaluate the prognostic value of HRV in elderly patients with multivessel coronary artery disease (MVCAD) on the background of invasive and non-invasive treatment. Methods and Results: This study included 254 patients over age 65 with lesions of the left trunk of the left coronary artery in combination with lesions of 2 or more coronary arteries. To assess HRV, all patients underwent 24-hour Holter ECG monitoring at baseline and one year later. Depending on the treatment strategy, patients were divided into 3 groups. Group 1 consisted of 99 patients who, in addition to the standard treatment, underwent PSI (from 1 to 4 stents); Group 2 included 86 patients who, in addition to the standard treatment, underwent CABG (from 2 to 4 shunts); Group 3 included 69 patients who received only optimal drug therapy (ODT). The results have shown that a decrease in HRV is an independent predictor of complications associated with an increase in coronary insufficiency in CAD patients. Such indicators of HRV as SDNN, SDNNi, TP, VLF, and LF have a significant positive predictive value in patients undergoing ODF and/or undergoing PCI. For patients undergoing CABG, at least in the first year after surgery, HRV cannot be considered as an independent prognostic marker. For elderly patients with MVCAD, 24-hour Holter ECG monitoring with subsequent analysis of HRV is recommended to assess the recovery process and pharmacotherapy.

scholarly journals Clinical efficiency of combined pharmacotherapy of сoronary artery disease associated with postmenopausal osteoporosis

2020 ◽  
Vol 24 (4 (96)) ◽  
pp. 65-74
Author(s):  
N. Mykhailovska ◽  
I. Stetsiuk
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Postmenopausal Osteoporosis ◽  
Supraventricular Arrhythmia ◽  
Ecg Monitoring ◽  
Alendronate Sodium ◽  
Group 2 ◽  
Artery Disease ◽  
Basic Treatment ◽  
Group 1

The aim of the study. To evaluate the clinical efficacy of combined pharmacotherapy with alendronate sodium and exogenous L-arginine on the background of basic treatment of patients with coronary artery disease (CAD) associated with postmenopausal osteoporosis (PMOP).Material and methods. A double open, prospective, monocentric clinical study in parallel groups involved 58 women in the postmenopausal period with a diagnosis of coronary artery disease: stable angina pectoris II-III FC, who had PMOP (age 71 (65; 77) years). By the method of block randomization, patients were divided into two groups: 1 group – 27 women who received standard basic therapy; 2 group – 31 women who were prescribed a combination of alendronate sodium and L-arginine hydrochloride according to the scheme on the background of basic treatment. The indices of daily ECG monitoring by Holter, structural and functional state of the heart and blood vessels assessment, levels of biomarkers (osteoprotegerin, osteocalcin, homocysteine, VEGF-A) assessment in patients were obtained at study entry and after 3 months of therapy.Results. According to the results of daily ECG monitoring in the dynamics of treatment in patients of both groups there was a significant decrease in the number of episodes of supraventricular arrhythmia per day (by 11.54% and 34.52%, respectively; p<0.05) and the ratio of LF / HF in active and passive period. In patients of group 2 in contrast to group 1, there was also a significant decrease in the number of episodes of tachycardia per day (1.8 times; p<0.05), an increase in RMSSD (by 74.36%; p<0.05), a decrease in LF (by 54.69%; p<0.05) and an increase in HF (by 73.71%; p<0.05) in both active and passive periods. After 3 months of treatment in patients of the 2nd group showed a significant decrease in the IMC thickness of the right CA by 7.95%, the size of the LP by 16.83% compared to baseline (p<0.05), while the 1st group no significant changes in these indicators were observed. Under the influence of treatment in patients of the 2nd group revealed a significant decrease in the level of VEGF-A (by 25.41%; p<0.05), homocysteine (by 10.72%; p<0.05), osteoprotegerin (2 times ; p<0.05), while in patients of the 1st group there was a significant decrease only in the level of VEGF-A (by 20.09%; p<0.05). In patients of group 2 compared with patients of group 1, after 3 months of treatment there were significantly fewer episodes of ventricular and supraventricular arrhythmias, smaller LF meaning, IMC, LA size and greater HF meaning, probably lower levels of osteocalcin, VEGF-A and osteoprotegerin.Conclusions. The use of combined therapy in patients with coronary artery disease, comorbid with PMOP, contributes to positive changes in the autonomic regulation of cardiac activity, structural adjustment of the heart and vascular endothelium, normalization of the balance of biomarkers of osteoreparation and bone resorption.

Elevated level of circulatory sTLT1 induces inflammation through SYK/MEK/ERK signalling in coronary artery disease

2019 ◽  
Vol 133 (22) ◽  
pp. 2283-2299
Author(s):  
Apabrita Ayan Das ◽  
Devasmita Chakravarty ◽  
Debmalya Bhunia ◽  
Surajit Ghosh ◽  
Prakash C. Mandal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Chronic Inflammation ◽  
Ex Vivo ◽  
Human Subjects ◽  
Critical Role ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tnf Α ◽  
Artery Disease

Abstract The role of inflammation in all phases of atherosclerotic process is well established and soluble TREM-like transcript 1 (sTLT1) is reported to be associated with chronic inflammation. Yet, no information is available about the involvement of sTLT1 in atherosclerotic cardiovascular disease. Present study was undertaken to determine the pathophysiological significance of sTLT1 in atherosclerosis by employing an observational study on human subjects (n=117) followed by experiments in human macrophages and atherosclerotic apolipoprotein E (apoE)−/− mice. Plasma level of sTLT1 was found to be significantly (P<0.05) higher in clinical (2342 ± 184 pg/ml) and subclinical cases (1773 ± 118 pg/ml) than healthy controls (461 ± 57 pg/ml). Moreover, statistical analyses further indicated that sTLT1 was not only associated with common risk factors for Coronary Artery Disease (CAD) in both clinical and subclinical groups but also strongly correlated with disease severity. Ex vivo studies on macrophages showed that sTLT1 interacts with Fcɣ receptor I (FcɣRI) to activate spleen tyrosine kinase (SYK)-mediated downstream MAP kinase signalling cascade to activate nuclear factor-κ B (NF-kB). Activation of NF-kB induces secretion of tumour necrosis factor-α (TNF-α) from macrophage cells that plays pivotal role in governing the persistence of chronic inflammation. Atherosclerotic apoE−/− mice also showed high levels of sTLT1 and TNF-α in nearly occluded aortic stage indicating the contribution of sTLT1 in inflammation. Our results clearly demonstrate that sTLT1 is clinically related to the risk factors of CAD. We also showed that binding of sTLT1 with macrophage membrane receptor, FcɣR1 initiates inflammatory signals in macrophages suggesting its critical role in thrombus development and atherosclerosis.

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