ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The acute hemodynamic responses to upright exercise were measured in two patients with nonobstructive hypertrophic cardiomyopathy. In one patient we observed the response following administration of 120 mg of diltiazem, a calcium slow‐channel blocking agent, while in the other the response to 80 mg of propranolol was observed. Despite differences in the patients, the diltiazem was associated with more favorable effects.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;A survey of sexual attitudes and activity was made among 100 patients who had suffered their first myocardial infarction one year previously and subsequently attended a short rehabilitation course that included discussion of sexual matters. Among the 88 who were interviewed, 20 had not been sexually active prior to the infarct and 13 others had not resumed sexual relations within one year. Thirty‐three of the remaining 55 reported decreased coital frequency for reasons that included loss of libido, impotence, and cardiac symptoms. Few patients were affected by anxiety regarding sex. Although appropriate discussion may have alleviated anxiety, discussion did not prevent an overall reduction in sexual activity.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Ventricular arrhythmias (PVCs) were studied with ambulatory ECG monitoring and treadmill testing at three and eight weeks after acute myocardial infarction (AMI) in 68 patients receiving no antiarrhythmic medication or digitalis. ECG monitoring was superior to treadmill testing in assessing PVC prevalence, complexity, and reproducibility after AMI (P < 0.001). The development of angina or ST‐segment depression during exercise testing did not correlate with the presence of PVCs. PVCs were observed by ambulatory monitoring in 54 of 68 patients (79%) at three weeks after AMI and 57 of 68 patients (84%) at eight weeks, with 85% reproducibility for the presence of PVCs. Treadmill testing induced PVCs in 21 of 68 patients (31%) at both three and eight weeks after AMI with 28% reproducibility.Couplets or ventricular tachycardia were detected with treadmill testing in 18% at 3 weeks and in 10% at 8 weeks. No significant change in PVC prevalence or complexity was seen from the third to the eighth week after uncomplicated AMI. A total of 29 patients (43%) had couplets or ventricular tachycardia at three and/or eight weeks after AMI, but 55% of these patients had couplets or ventricular tachycardia only at eight weeks, and 16% showed them at both testing periods. If complex PVCs are to be treated after uncomplicated AMI, ambulatory ECG monitoring should be considered at both three and eight weeks after AMI, because of the high number seen at only one testing period or the other. The observed rate of PVC incidence and severity with time after AMI may reflect the uncomplicated condition of the population studied.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Sixty‐five patients, convalescent from a first transmural myocardial infarction (MI) (anterior [AMI], 24 cases; inferior [IMI], 41 cases), underwent treadmill testing and coronary cineangiography. In those with AMI, angiography showed one‐vessel disease (left anterior descending artery) in 54% of the cases and two‐ or three‐vessel disease in the others. The exercise test was abnormal in only 25% of those patients. The presence of stenosis of the circumflex artery and/or right coronary artery was unsuspected in 63% of the patients. There was a significant stenosis of the anterior descending artery in 51% of the IMI cases. The exercise ECG was normal in 46% of these patients; in 77% of those whose exercise test was abnormal, the anterior descending artery showed significant stenosis.The appearance or increase of ST‐segment elevation (≥1 mm) in the leads over Q waves was proof of a more severe alteration of left ventricular function, as shown by a more marked reduction of the ejection fraction and by a more extended akinetic or dyskinetic area. The occurrence of ST‐segment elevation in the leads facing the infarcted zone and of a significant ST‐segment depression (≥1 mm) in the opposed leads always indicated that another major vessel was involved, but this occurred in only 25% of the cases in this series.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Medically supervised physical conditioning for the treatment of angina pectoris and for the rehabilitation of patients surviving myocardial infarction has gained widespread acceptance as a safe and effective therapeutic modality. However, since economic or logistic constraints may limit the availability of supervised exercise programs for many patients who could benefit from physical conditioning, further data are needed regarding the costeffectiveness and safety of unsupervised exercise programs for coronary patients. For use until such data are available, we have formulated these interim guidelines: patients with low maximal functional capacity, severely depressed left ventricular function, complex ventricular arrhythmias, QT prolongation, exercise‐induced hypotension, or the inability to perform effective self‐monitoring of exercise heart rate are probably at high risk for adverse events during exercise and should be conditioned in a supervised setting; unsupervised exercise may be recommended on an individual basis to patients lacking these characteristics, but it is preferable that this recommendation follow a period of observation, instruction, and training in a supervised program.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;This article, the first in a series on analytic techniques in cardiac rehabilitation, reviews test characteristics and performance. Proper choice and analysis of a test depends heavily upon the type of variable, the distribution, and the prevalence of the variable in the population examined and the clinical goals of the investigation. The indices of sensitivity, specificity, predictive value of positive and negative test responses, and relative risk are reviewed. Examples are selected from the literature of cardiac rehabilitation.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID