Prediction of late arrhythmic events after acute myocardial infarction from combined use of noninvasive prognostic variables and inducibility of sustained monomorphic ventricular tachycardia

Pedretti, Roberto F.E.; Etro, M. D.; Laporta, A.; Braga, Simona Sarzi; Carù, B

doi:10.1016/0002-9149(93)90635-p

Cited by 115 publications

(42 citation statements)

References 31 publications

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“…The physiological implication of this reflex, namely, what role this reflex may play, is unknown. The possibility that the reflex cardioprotectively works thorough the reduction in myocardial oxygen demand or that the resultant high vagal tone prevents the development of serious ventricular arrhythmias is of interest [15,16]; however, there are few available data to support this so far.…”

Section: Exercise Induced Atrio-ventricular (Av) Block During Nuclearmentioning

confidence: 99%

Exercise induced atrio-ventricular (AV) block during nuclear perfusion stress testing: a case report

Sarullo

Accardo

D’Antoni

et al. 2016

Monaldi Arch Chest Dis

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Background. Exercise causes enhanced sympathetic discharge and results in physiologic tachycardia. However, in some patients with a diseased conduction system resulting from acute ischemia, exercise can precipitate heart block. Methods and results. In this report we describe a 51 years old male patient with transient advanced degree atrioventricular (AV) block developed during recovery from exercise stress testing, resolved after the administration of atropine. Nuclear perfusion imaging demostrated stress-induced ischemia of the inferior-apical segments, and recovery of perfusion in the images obtained at rest. Coronarography showed critical stenosis of the right coronary artery, which was treated by percutaneous coronary intervention (PCI) and drug eluting stent (DES) deployment. Conclusion. Nuclear myocardial perfusion imaging provides noninvasive evidence that transient ischemia of the infero- apical segment can result in advanced degree AV block in patient with critical severe right coronary disease.

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Section: Exercise Induced Atrio-ventricular (Av) Block During Nuclearmentioning

confidence: 99%

Exercise induced atrio-ventricular (AV) block during nuclear perfusion stress testing: a case report

Sarullo

Accardo

D’Antoni

et al. 2016

Monaldi Arch Chest Dis

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“…Az M3-ról a disszociáció felezési ideje tiotropiumnál 27 óra, aclidiumnál 10,7 óra, glycopirrhoniumnál 6,1 óra. Az M2-ről a disszociáció felezési ideje tiotropiumnál 2,6 óra, aclidiniumnál 1,8 óra, glycopirrhoniumnál 0,37 óra [45,53,54,55,56,57].…”

Section: Következtetésekunclassified

Van-e cardiovascularis mellékhatásuk az inhalációs antikolinerg szereknek?

Nagy¹

2015

Orvosi Hetilap

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Az összefoglaló célja az inhalációs antikolinerg szerek cardiovascularis veszélyének tárgyalása krónikus obstruktív tü-dőbetegségben. A tiotropium-használat adatainak néhány metaanalízise felvetette ilyen mellékhatások (arrhythmia, angina, szívinfarktus stb.) fokozott lehetőségét. Az összefoglaló áttekinti a retrospektív adatbázis-feldolgozásokat, a randomizált kontrollcsoportos vizsgálatokat és a klinikai vizsgálatok metaanalíziseit. Az adatbázis-vizsgálatok eredményei inkonzisztensek. A legtöbb klinikai vizsgálatban a cardiovascularis mellékhatások incidenciája azonos volt az aktív kezelésű és a placebocsoportban, jellemzően azoknál a betegeknél is, akik előzőleg cardiovascularis betegségben szenvedtek. A metaanalízisekben kevés a bizonyíték vagy egyáltalán nincs arra nézve, hogy összefüggés van az antikolinergek és a cardiovascularis tünetek között. A szerző áttekinti a humán szív kolinergreceptor-altípusait és funkcióját, a szívműködés ezen receptorok útján történő autonóm szabályozását, ezek lehetséges szerepét és az inhalált antikolinerg szerek farmakokinetikai tulajdonságait. Megállapítja, hogy nincs bizonyíték az inhalációs antikolinerg szerek fokozott cardiovascularis ártalmára. Orv. Hetil., 2015, 156(31), 1246-1252. Kulcsszavak: krónikus obstruktív tüdőbetegség, inhalációs antikolinerg szerek, cardiovascularis szövődmények Are there cardiovascular adverse effects of inhaled anticholinergics?The purpose of this review is to discuss the cardiovascular risk associated with inhaled anticholinergics in chronic obstructive pulmonary disease. Several meta-analyses of data for tiotropium raised the possibility of an increased risk for arrhythmia, angina, myocardial infarction, etc. This review includes the data of retrospective studies of databases using databases, randomized controlled trials, and meta-analyses of clinical trials. The conclusions of studies were inconsistent. In most clinical trials the incidence of cardiovascular adverse events was similar in active treatment and placebo groups, especially in patients with previous cardiovascular diseases. Considering meta-analyses, there is little, if any, evidence for the association between anticholinergics and the development of cardiovascular symptoms. The author discusses the presence and function of cholinergic receptor subtypes in human heart, and cardiac functions controlled by the autonomic nervous system via these receptors, their possible role, and pharmacokinetic properties of inhaled anticholinergics. The author concludes that it is not possible to fi nd evidence of increased cardiovascular harm of inhaled anticholinergics.Keywords: chronic obstructive pulmonary disease, inhaled anticholinergics, adverse cardiovascular events Nagy, L. B. [Are there cardiovascular adverse effects of inhaled anticholinergics?]. Orv. Hetil., 2015, 156(31), 1246-1252. (Beérkezett: 2015 elfogadva: 2015. május 18.) Rövidítések cAMP = ciklikus adenozin-monofoszfát; COPD = krónikus obstruktív tüdőbetegség; FEV1 = forszírozott másodpercvolu-men; ISZB = ischaemiás s...

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“…1) VLPs have been more frequently documented in AMI with reduced ejection fraction (EF%) and their prognostic significance is independent of the EF% itself. [2][3][4][5] These VLPs have been recorded in 70 to 90% of patients with sustained and inducible ventricular tachycardia after myocardial infarction, in only 0 to 6% of normal volunteers, and in 7 to 15% of patients after myocardial infarction that do not have ventricular tachycardia. 6) Early administration of beta-blockers (BB) and thrombolytic agents has shown beneficial effects on both short and long-term prognoses in AMI.…”

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confidence: 99%

Effects of a .BETA.-Blocker on Ventricular Late Potentials in Patients With Acute Anterior Myocardial Infarction Receiving Successful Thrombolytic Therapy

et al. 2004

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SUMMARYLate potentials (LP) detected on the signal-averaged electrocardiogram (SAECG) predict arrhythmic events after acute myocardial infarction (AMI). It is also well established that successful thrombolytic therapy reduces the incidence of LP. Our aim was to evaluate the effects of a beta-blocker on LP in patients receiving thrombolytic therapy. We studied 40 patients presenting with anteroseptal AMI (< 6 hours). All patients received thrombolytic therapy and were evaluated with coronary angiography at predischarge. Eighteen patients received metoprolol (5 mg IV on admission followed by 50 mg BID). SAECG recordings were obtained serially using an ART system (40-250 Hz filter, noise < 0.5 mV) prior to thrombolytic therapy, after 48 hours and after 10 days. LP was defined as positive if the SAECG met at least 2 of the Gomes criteria. Changes observed in SAECG recordings after thrombolytic therapy were correlated with angiographic and clinical data with regard to the usage of BB. The frequencies of LP before and after thrombolytic therapy were compared with the McNemar test. There were no significant differences between the clinical characteristics, risk factors, and angiographic findings (including infarct related artery patency and LV functions) of the groups. Baseline SAECG findings were also similar between the groups. The incidence of LP significantly decreased after TT in the BB group, however, this change was not observed in patients who did not receive BB (P = 0.012, McNemar test). Beta-blockers reduce the incidence of LPs following thrombolytic therapy in patients with anterior AMI. This might be explained by the possible beneficial effect of BB on the arrhythmogenic substrate. (Jpn Heart J 2004; 45: 11-21)

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Prediction of late arrhythmic events after acute myocardial infarction from combined use of noninvasive prognostic variables and inducibility of sustained monomorphic ventricular tachycardia

Cited by 115 publications

References 31 publications

Exercise induced atrio-ventricular (AV) block during nuclear perfusion stress testing: a case report

Exercise induced atrio-ventricular (AV) block during nuclear perfusion stress testing: a case report

Van-e cardiovascularis mellékhatásuk az inhalációs antikolinerg szereknek?

Effects of a .BETA.-Blocker on Ventricular Late Potentials in Patients With Acute Anterior Myocardial Infarction Receiving Successful Thrombolytic Therapy

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