silent ischemia
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Author(s):  
Katrine Berg ◽  
Kamillla Pernille Bjerre ◽  
Tor Skibsted Clemmensen ◽  
Brian Bridal Løgstrup ◽  
Henning Mølgaard ◽  
...  

Author(s):  
Vlachakis PK ◽  
◽  
Tentolouris A ◽  
Kanakakis I ◽  
Eleftheriadou I ◽  
...  

As smartphone health care technology continues to evolve, many wearable devices are equipped with Electrocardiographic (ECG) recording. Recently, studies examining the possibility of various wearable devices for continuous ECG recording showed their ability to detect ST-segment alterations. It is known that in almost a quarter of people with diabetes, the presentation of an acute coronary syndrome may be atypical or even asymptomatic (“silent”), and it has been associated with adverse prognosis. The precise mechanisms behind the lack of pain in patients suffering from silent myocardial ischemia remain unknown. The attractive hypothesis that clinicians could use a wearable ECG recording to detect and treat earlier patients suffering from silent myocardial ischemia might change the adverse prognosis of those patients. However, before their clinical application, several obstacles should be overcome in order the physicians to obtain an additional powerful tool in the fight against coronary artery disease in people with diabetes.


2021 ◽  
Vol 17 (18) ◽  
Author(s):  
Zeikidze Solomon ◽  
Suladze Andro ◽  
Zeikidze Nikolozi

Goal of the Study is to assess the risk of coronary disease of asymptomatic ischemia in patients with left ventricular moderate dilatation. Methods: The work was based on the results of investigation of 185patients with left ventricular moderate dilatation, aged 35-55 years from the “Tbilisi Heart and Vascular Clinic” contingent. Among them, there are 159 men and 26 women. Results: Patients who suffer from left ventricular moderate dilatation and don’t expose typical symptom of ischemia possibly are in risk of carrying damaged coronary artery. the LV moderate dilatation of the left ventricle can be used for primary diagnosing of silent ischemia. Sensitivity - 0.867(95%CI:0.806-0.927); Specificity – 0.800(95%CI:0.703-0.897); Prognostic value of positive results; 0.889(95%CI:0.832-0.946); Prognostic value of negative results - 0.765(95%CI:0.664-0.866); diagnostic value - 0.843(95%CI:0.791-0.896). Conclusions: In patients with silent ischemia, the coronary disease predictors are: left ventricular moderate dilatation, male gender, dyslipidemia, arterial hypertension, smoking, positive treadmill test, ischemic disease in 1st degree relatives, low tolerance to treadmill test. Thus, we can use the moderate dilatation of the left ventricle for the primary diagnosing of silent ischemia. The test is simple and non-invasive. It is characterized by high sensitivity and specificity and can be used for early diagnosing of silent ischemia and the prevention of cardiac cases.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jorge L Reyes ◽  
Faye L Norby ◽  
Wendy Wang ◽  
Romil Parikh ◽  
Niki C Oldenburg ◽  
...  

Introduction: We recently reported that abnormal P-wave indices (PWI)—ECG markers of atrial cardiomyopathy (AC)—are associated with an increased risk of dementia, independent of atrial fibrillation (AF) and clinical ischemic stroke. The mechanisms, however, remain unclear, but may include silent ischemia. Hypothesis: Abnormal PWI are associated with higher prevalence of cortical infarcts on MRI, suggesting cardioembolism as a potential mechanism. Methods: ARIC-NCS participants (mean age, 72.2±5.3 years; 60% women; 29% black) who underwent 3T brain MRI scans in 2011-2013 were included. Abnormal PWI included P-wave terminal force in lead V1 [(PTFV1) defined as ≥4000 μV*ms] and P-wave duration [(PWD) defined as >120 ms], which were measured from standard 12-lead ECGs. Brain MRI outcomes included cortical infarcts, cerebral microbleeds (CMB), and markers of small vessel disease [white matter hyperintensities (WMH) and lacunar infarcts]. We used weighted multivariable logistic and linear regression analyses. Results: Of the 1,850 participants, 464 had abnormal PTFV1 and 415 had prolonged PWD. After multivariable adjustment including AF, abnormal PTFV1 and PWD were significantly associated with 26-44% increased odds of cortical and lacunar infarcts (Table) . Although PWD was associated with CMB in Model 1, the association was no longer significant after multivariable adjustment. Finally, abnormal PWIs were not associated with WMH after adjusting for stroke and AF (P >0.5). Conclusions: Abnormal PWI are associated with higher prevalence of cortical infarcts, suggesting cardioembolism with silent ischemia as a possible mechanism underlying the association of AC with dementia. More research is needed to evaluate other mechanisms such as cerebral small vessel disease.


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