摘要:

Sympathetic Afferents and Cardiac Pain.We analyzed some particular aspects of the peripheral pathways likely to be involved in the mediation of cardiac pain. The functional characteristics and the reflex function of cardiac sympathetic afferent fibers are discussed in relation to the afferent code transmitting nociception. A modified version of the intensity theory based on the extreme excitation of a spatially restricted population of afferent sympathetic fibers is proposed as the most likely mechanism involved in the genesis of cardiac pain.

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01372.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Silent Myocardial Ischemia and Endogenous Pain Modulation.A total of 97 patients with asymptomatic and 69 patients with symptomatic myocardial ischemia and one‐vessel disease were compared with respect to the location of coronary stenosis and left ventricular wall motion abnormalities. All symptomatic and asymptomatic patients exhibited reproducible objective signs of myocardial ischemia in exercise tests, ischemia being always silent in the asymptomatic group. Right coronary artery stenosis (and left circumflex artery stenosis) was more frequently observed in asymptomatic patients, left artery descending stenosis more often in symptomatic patients. Left ventricular wall movement abnormalities with posterobasal or diaphragmatic localization were significantly more often associated with the absence of angina pectoris pain. The present results could contribute to the understanding of the mechanisms underlying the absence of pain in silent myocardial ischemia. A possible explanation for these results would be that stimulation of inhibitory vagal afferents, which are preferentially distributed in the inferior ventricle wall, may play a role of the suppression of pain perception in myocardial ischemi

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01373.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1984.tb01644.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1984.tb01645.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1984.tb01646.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Plasticity of Unconditional Response.Dogs were classically conditioned by presenting them with a 30‐second tone (the conditional stimulus) followed by 1/2‐second shock (the unconditional stimulus). Well‐trained animals respond to presentation of the conditional stimulus with increases in blood pressure and heart rate (the conditional response); the unconditional stimulus produces additional cardiovascular reactions (the unconditional response). In the present experiments, shock delivery increased heart rate<20/min in six of 11 dogs. If the size of the heart rate increase following shock delivery is used as an index of the animal's perception of pain, the relatively small unconditional response in these six animals may indicate a blunting of their perception of the painful nature of the unconditional stimulus. Two additional dogs tested during the acquisition of the conditional cardiovascular response showed a diminution of the unconditional tachycardia as the conditional blood pressure response increased in magnitude. These data thereby tentatively support the concept that learned increases in blood pressure have an antinociceptive effect that, in man, may contribute to the development of hyperte

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01374.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1984.tb01647.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Psychological Correlates of Angina.This paper reviews the research literature on psychological factors that affect the perception of anginal symptoms among patients with coronary artery disease (CAD). Early research in this area established that variables such as anxiety, depression, and somatic preoccupation predict anginal complaints among community samples and patients with CAD. More recent research has focused on the effects of these variables, as well as personality traits, on symptom reporting during actual ischemic episodes. Despite strong evidence of an association between these psychological variables and anginal symptoms, the direction of causality has not been resolved. Furthermore, potentially important interactions between the identified psychological variables and situational or environmental factors remain to be investigated.

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01375.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1984.tb01649.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Behavior and Myocardial Ischemia.Recent ambulatory electrocardiography studies reveal that myocardial ischemia out‐of‐hospital exhibits features that may not be evident during controlled exercise testing. Specifically, out‐of‐hospital ischemia: (1) is more frequently asymptomatic or silent; (2) occurs during a wide variety of mental, as well as physical, activities; (3) is triggered at relatively low heart rate elevations compared to exercise; (4) exhibits a circadian rhythm; and (5) exhibits variability over time. This article reviews recent field and laboratory research suggesting that behavioral factors, including mental stress, may contribute to the typical features of myocardial ischemia out‐of

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01376.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY