Circadian Variation of Total Ischaemic Burden and Its Alteration With Anti-Anginal Agents

Mulcahy, David; Cunningham, David A.; Crean, Peter; Wright, Christine; Keegan, Jennifer; Quyyumi, Arshed A.; Park, Amanda; Fox, Kim

doi:10.1016/s0140-6736(88)92414-2

Cited by 309 publications

(80 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, the preliminary data collected in the TEMS study confirm the importance of silent ischemia, which is, as recently documented, more frequent than painful ischemia [13,14]. Also, the circadian variation of ischemia, painful or silent, was confirmed by our preliminary results.…”

Section: Fig 1 Analog Reports From the Holter Data (Heart Rate Uppsupporting

confidence: 88%

See 1 more Smart Citation

A new semiautomated algorithm to quantify holter-detected myocardial ischemia: Preliminary experience in the trimetazidine european multicenter trial (TEMS)

Detry

Fesler

Berckmans

et al. 1990

Cardiovasc Drug Ther

View full text Add to dashboard Cite

Document VersionPublisher's PDF, also known as Version of Record (includes final page, issue and volume numbers) Please check the document version of this publication:• A submitted manuscript is the author's version of the article upon submission and before peer-review. There can be important differences between the submitted version and the official published version of record. People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website.• The final author version and the galley proof are versions of the publication after peer review.• The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication Citation for published version (APA):Detry, J. M., Fesler, R., Berckmans, T., & Leclercq, P. A. (1990). A new semiautomated algorithm to quantify Holter-detected myocardial ischemia: preliminary experience in the Trimetazidine European Multicenter trial (TEMS). Cardiovascular Drugs and Therapy, 4(4 Suppl.), 841-846. DOI: 10.1007/BF00051290General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal ? Take down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Summary. Holter-detected myocardial ischemia, either painful or painless, is an important issue in the functional and prognostic evaluation of coronary patients. This paper describes one of the first attempts to reliably quantify the duration and severity of the ischemic ST-segment changes over a given period of time; the algorithm described here provides physicians with a global index of ischemia that is the total ischemic area, namely, the integral of ST-segment depression or elevation over time (expressed in mm × min). The diagnostic and prognostic power of this new index remains to be established and to be compared with the actually used simple measurements, i.e., the number and duration of ischemic events.

show abstract

Section: Fig 1 Analog Reports From the Holter Data (Heart Rate Uppsupporting

confidence: 88%

“…Classical techniques rely on the analysis of the number of ischemic episodes and their total duration, and allow the identification of a circadian variation in myocardial ischemia. The latter is strongly reminiscent of the circadian variation of other major markers of CAD, i.e., angina pectoris, myocardial infarction, and ischemic sudden death [12,13].…”

mentioning

confidence: 99%

A new semiautomated algorithm to quantify holter-detected myocardial ischemia: Preliminary experience in the trimetazidine european multicenter trial (TEMS)

Detry

Fesler

Berckmans

et al. 1990

Cardiovasc Drug Ther

View full text Add to dashboard Cite

show abstract

“…101 Histopathological studies also give credence to the idea that recurrent ischemia may cause irreversible myocardial changes 110 related to the development of scarred or fibrotic myocardium, which would act as an ideal substrate for the development of life-threatening arrhythmias, or lead to the development of congestive cardiac failure. But patientbased studies supporting the development of heart failure or arrhythmic disturbance related to the detection of ischemia are lacking.…”

Section: Discussionmentioning

confidence: 97%

“…In fact, ␤-blockers are in most cases superior to calcium antagonists alone in reduction of the total ischemic burden 99,100 and furthermore have been shown to blunt the circadian pattern of transient ischemia, particularly the morning peak of ischemic activity, which closely mirrors the circadian incidence of acute MI and sudden death. 97,101 However, the addition of a calcium antagonist to ␤ blockade has been shown to improve objective measures of ischemia, 102,103 and the combination of both types of agents has been found to be superior to either type alone in reducing ischemia. 99,104 An elegant study by Andrews et al 105 casts some light over the possible mechanism involved in the additive effect of combination therapy.…”

Section: Treatmentmentioning

confidence: 99%

Silent Myocardial Ischemia

2003

View full text Add to dashboard Cite

“…Ann Saudi Med 1994; 14(3) Ischemic vascular events have been reported repeatedly to occur following a circadian rhythm. [1][2][3] Most of these reports deal with myocardial ischemia, 4,5 acute myocardial infarction, 6,7 and sudden cardiac death. 8,9 Similar circadian variation of cerebral ischemia was also reported but with contradictory findings.…”

mentioning

confidence: 99%

Very Early Morning Increase in Onset of Ischemic Stroke

Torun

Özdemir

1994

Annals of Saudi Medicine

View full text Add to dashboard Cite

A study was conducted on 525 consecutive patients ranging in age from 36 years to 86 years to determine whether diurnal variation occurs in the onset of acute ischemic stroke. There was a clear (D max =0.19, P<0.01) diurnal variation with a significant (t=-4.96, P<0.001) peak between four a.m. and six a.m. Strokes occurred more often during the two hours following awakening than during any other time of the day. The peak time of ischemic stroke in our study was about two hours earlier than in previous reports, probably because of the different waking times of the studied populations. We concluded that the time of awakening influences the circadian distribution rather than the time of day itself. Ann Saudi Med 1994;14(3):201-203. S Torun, G Özdemir, Very Early Morning Increase in Onset of Ischemic Stroke. 1994; 14(3): 201-203 Ischemic vascular events have been reported repeatedly to occur following a circadian rhythm.1-3 Most of these reports deal with myocardial ischemia, 4,5 acute myocardial infarction, 6,7 and sudden cardiac death. 8,9 Similar circadian variation of cerebral ischemia was also reported but with contradictory findings. [10][11][12][13][14][15][16] While there are considerable variations in patient populations and methods, most of the previous studies note a peak onset in the morning hours, [17][18][19] particularly at the time of awakening. 20The aim of the present study was to investigate the possibility that acute ischemic stroke (IS) has a circadian variation and IS occurs more often at certain times of the day in Turkish sufferers whose awakening time is probably different from western populations. Material and MethodsProspectively collected data on 525 patients with acute IS, admitted to our Department of Neurology between December 1986 and May 1990 were analyzed. Only the cases in which the diagnosis of IS was ascertained by computed tomography (CT), and only strokes of acute onset in which symptoms reached their maximum in less than eight hours and remained present for more than three weeks were considered.The time of onset of symptoms attributed to IS and the time of awakening were obtained from the patient, family members, or other observers.We considered the time of onset to be the hour in which the patient or an observer first became aware of the event. In patients who first noticed their stroke symptoms on waking, it was presumed that the IS had occurred during sleep. Details of whether the patient was active or at rest when the IS occurred were also recorded.The frequency of symptom onset was tabulated for two hourly intervals in the day beginning one minute after the previous hour (i.e., 12:01 a.m. to 2 a.m., 2:01 a.m. to 4 a.m., etc.). The Student's t-test and Kolmogorov-Smirnov type statistics were used for statistical analysis involving comparison of distributions of IS over a 24 hour period. ResultsOur study included 525 patients with acute IS, consisting of 295 males and 230 females ranging in age from 36 to 86 years (mean age 64.2). There was a clear and significant diur...

show abstract

Circadian Variation of Total Ischaemic Burden and Its Alteration With Anti-Anginal Agents

Cited by 309 publications

References 23 publications

A new semiautomated algorithm to quantify holter-detected myocardial ischemia: Preliminary experience in the trimetazidine european multicenter trial (TEMS)

A new semiautomated algorithm to quantify holter-detected myocardial ischemia: Preliminary experience in the trimetazidine european multicenter trial (TEMS)

Silent Myocardial Ischemia

Very Early Morning Increase in Onset of Ischemic Stroke

Contact Info

Product

Resources

About