Asymptomatic ST elevation myocardial infarction

Anderson, Kenton L.; Shah, Neel; Gallegos, Moises; Chiang, I-Hui

doi:10.1016/j.hrtlng.2018.04.012

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…The AUC of the cloud-based system was higher compared to the sonographer markings (0.99 vs 0.81) and had better accuracy when compared with the ground truth (sonographer readings) (124). This has been represented by the ROC curve shown in Figure 9 (175).…”

Section: Morphology-based Risk Assessment Methodsmentioning

confidence: 91%

Low-cost preventive screening using carotid ultrasound in patients with diabetes

et al. 2020

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Preventive health check in patients with diabetes 1133© 1996-2020 6.2. Debate on the use of CUSIP for CVD risk assessment 6.3. Measurement of Carotid Ultrasound Image-based phenotypes 6.4. Validation of Automated Full-length Measurement 7. Integrated Screening Tools for CVD risk assessment 8. Discussion 8.1. A special note on clinical trials and case reports in preventive screening 8.2. Morphology-based risk assessment methods 8.3. Financial burden of diabetes mellitus in India 8.4. Manifestations 9. Conclusion 10. Disclosures 11. References

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Section: Morphology-based Risk Assessment Methodsmentioning

confidence: 91%

Low-cost preventive screening using carotid ultrasound in patients with diabetes

et al. 2020

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“…The notion that diabetes mellitus population have a high frequency of silent myocardial ischemia than the common population is proven by various studies justifying the reasons of silent or asymptomatic nature of the disease, like the different verge of pain or psychological renunciation but more significantly the role of cardiac autonomic neuropathy that has potential involvement in dysfunction at different point such as the afferent neurons, pain receptors or gate phenomenon of pain [12,13]. There is a reported catastrophe, angina develop at the beginning of ischemia and have an accommodating effect on the diabetic subjects' exercise tolerance [14,15]. Few research findings suggested a link between cardiac autonomic neuropathy and silent myocardial ischemia in patients with diabetes, reporting that irregularities in myocardial pain sensitivity in patients with diabetes are unswervingly related to sympathetic denervation [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…There is a reported catastrophe, angina develop at the beginning of ischemia and have an accommodating effect on the diabetic subjects' exercise tolerance [14,15]. Few research findings suggested a link between cardiac autonomic neuropathy and silent myocardial ischemia in patients with diabetes, reporting that irregularities in myocardial pain sensitivity in patients with diabetes are unswervingly related to sympathetic denervation [12][13][14][15]. The American diabetic association recommends that population with diabetes mellitus should be well-thought-out as a CVS disease equivalent.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus with Silent Myocardial Ischemia: A Single-Center Cross-Sectional Study of Karachi, Pakistan

Siddiq

Memon

Ali

et al. 2021

JPRI

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Background: Previous studies have established the fact that diabetic patients are predominantly inclined towards silent myocardial infarction (SMI). The objective of the present study is to determine the incidence of SMI in diabetes mellitus (DM) patients. Methodology: In this cross-sectional study, patient data was gathered on a predesigned proforma regarding the detailed history of dyspnea, DM and its duration, chest pain either present or not. Those patients who had normal ECG labeled negative for SMI, while those who had either ST-segment elevation or ST-segment deviation on resting ECG were positive for SMI. Study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi- Pakistan. Results: The mean age of the enrolled patients was 54.21±8.65 (40-70) years. Out of 210, majority were female (51.90%).Overall, 94(44.76%) patients were obese, 122(58.09%) were hypertensive, 90(42.85%) had dyslipidemia and 98(46.66%) diabetic patients were smokers. There were 93 (44.3%) DM patients who had SMI. Moreover, 109(51.90%) patients had a family history of myocardial ischemia. Conclusion: The SMI incidence among diabetic patients was found higher in local population. It is proposed that diabetic patients with demonstrated cardiovascular autonomic neuropathy must be screened for the manifestation of SMI.

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“…Водночас наявна ішемія стимулює еферентну ноцицептивну активність, що призводить до збільшення концентрації основного компоненту антиноцицептивної системиβ-ендорфінів. Сьогодні вважається, що патогенетичні механізми больової і безбольової ішемії міокарда однакові, а єдиною відмінністю між ними є наявність чи відсутність больових відчуттів [2,15].…”

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Pathological Turbulence of the Heart Rhythm and Activation of the Antinociceptive System as Predictors of the Complicated Course of Silent Myocardial Ischemia in Patients with Post Infarction Cardiosclerosis According to the Data of Long-term Observation

Merhel,

Sarapuk,

Yusypchuk

et al. 2024

СМ

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To date, the issues of evaluating the course of silent myocardial ischemia (SMI) after a myocardial infarction (MI) taking into account risk factors (RF), evaluating the pathological turbulence of the heart rhythm, the state of activation of the body’s antinociceptive system, which necessitates an in-depth study of this pathology, remain unresolved, as well as new differentiated approaches to the treatment and rehabilitation of the modern category of patients. The objective: to analyze the features of the SMI course in patients with post-infarction cardiosclerosis depending on the RF. Identification of the interdependence between the degree of activation of the sympathoadrenal system and the features of the SMI course in patients with post-infarction cardiosclerosis, as well as the prognostic value for assessing the severity of the course of the disease. Materials and methods. The research was performed on the basis of the Ivano-Frankivsk Regional Clinical Cardiology Center (Ukraine). 154 patients with a silent form of coronary artery disease, which occurred in people with post-infarction cardiosclerosis, were examined. The diagnostic criteria were: episodes of SMI verified with the help of HM ECG and a test with dosed physical load. Results. Significant deviation of the ST segment which was detected during Holter monitoring of the ECG (HM ECG) in patients with SMI episodes does not mean that the absence of pain sensations in the presence of efferent nociceptive stimulation is a sign of the absence of ischemia and does not indicate an easier course of SMI compared to clinically manifest forms of CHD. The average concentration of β-endorphins in patients with lipid metabolism disorders was 4.01±0.02 ng/ml, in the presence of diabetes mellitus this indicator was equal to 4.68±0.03 ng/ml (р<0.01), and in persons with concomitant arterial hypertension it was 4.91±0.02 ng/ml (р<0.05). In subjects with two or more RFs, the similar indicator was the highest and amounted to 5.73±0.03 ng/ml (р<0.01). The point-biserial correlation coefficient was equal to 0.61 (р<0.05), which indicates a sufficiently high probability of the influence of the processes of activation of the antinociceptive system on the risk of myocardial infarction and unstable angina. Conclusions. It has been proven that the presence of postinfarction cardiosclerosis, type 2 diabetes mellitus, dyslipidemia, and arterial hypertension should be considered as factors that increase the risk of complications of coronary artery disease in patients with SMI. In the painless form of CHD, there is a probable increase in β-endorphins in the blood, which indicates the presence of pronounced afferent nociceptive stimulation, the intensity of which depends on the degree of myocardial ischemia. It has been proven that an increase of β-endorphins levels is associated with an increase in the risk of a complicated course of coronary heart disease in patients with silent myocardial ischemia. The presence in patients with SMI of myocardial ischemia, pathological turbulence of the heart rhythm, and activation of the antinociceptive system are extremely important for understanding the main links of the course of SMI and make it possible to base the approach to the therapy of such patients on a differentiated system algorithm that takes into account the discrepancy between the clinical manifestations of the disease and its real impact on coronary perfusion and the condition of the vascular wall.

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Asymptomatic ST elevation myocardial infarction

Cited by 3 publications

References 18 publications

Low-cost preventive screening using carotid ultrasound in patients with diabetes

Low-cost preventive screening using carotid ultrasound in patients with diabetes

Diabetes Mellitus with Silent Myocardial Ischemia: A Single-Center Cross-Sectional Study of Karachi, Pakistan

Pathological Turbulence of the Heart Rhythm and Activation of the Antinociceptive System as Predictors of the Complicated Course of Silent Myocardial Ischemia in Patients with Post Infarction Cardiosclerosis According to the Data of Long-term Observation

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