RESUMEN
UNLABELLED: To determine the diagnostic value of the electrocardiographic exercise testing (EET) in 551 patients with chest pain regarded as definite or probable stable angina pectoris (CAD), results of performed EET were compared with coronary angiography. All patients underwent exercise testing according to the Bruce protocol. The criterion for a positive exercise ST-segment response was > or = 1 mm of horizontal or down sloping depression 80 msec after J-point. The indications for cardiac catheterization in each patient were determined at the discretion of the attending physician. Clinically important coronary artery disease was defined as > 50 per cent narrowing of the diameter of at least one major vessel or > or = 50 per cent of the left main coronary artery. RESULTS: The sensitivity and specificity of EET for detection of CAD were for the entire group, in women and men respectively: 93%, 91%, 94% and 21%, 16%, 27%. CONCLUSION: 1. Indications for EET should be based on prior probability of coronary artery disease. 2. Application of higher than conventional ST depression criteria (> or = 2 mm) lowers sensitivity but increases specificity of EET. 3. Variables determining false positive results are as follows: age, sex (female), low probability of CAD, ST-segment depression in leads: II, III, aVF and mitral valve prolapse. 4. Variables determining false negative results are as follows: high probability of CAD, sex (male) and one vessel disease.
Asunto(s)
Angina de Pecho/etiología , Angiografía Coronaria , Enfermedad Coronaria/diagnóstico , Electrocardiografía , Prueba de Esfuerzo , Adulto , Factores de Edad , Cateterismo Cardíaco , Distribución de Chi-Cuadrado , Enfermedad Coronaria/complicaciones , Enfermedad Coronaria/diagnóstico por imagen , Enfermedad Coronaria/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores SexualesRESUMEN
The relation of resting electrocardiographic (ECG) patterns to angiographic features was assessed in 566 patients with chest pain regarded as definite or probable stable angina pectoris. The indications for catheterization in each patient were determined at the discretion of the attending physician. All patients underwent diagnostic coronary angiography (clinically important coronary artery disease was defined as > or = 70 per cent narrowing of the diameter of at least one major vessel or > or = 50 per cent of the left main coronary artery) and standard 12 lead electrocardiography which was interpreted by 2 cardiologists independently in coordinating centre. The signs of impaired coronary blood flow were assessed by abnormalities of repolarization (among others S-T segment, the T wave), depolarization and presence of disturbances of cardiac rythm. The resting routine electrocardiogram was assigned to one of three categories: normal, nonspecific abnormalities or typical for coronary insufficiency. The typical pattern for ischemia was present in 104 patients (18%), nonspecific abnormalities were present in 185 patients (33%) and electrocardiogram was normal in 277 patients (49%). Sensitivity and specificity of the typical for coronary insufficiency resting ECG was calculated: 23% and 87% respectively for the entire group, 33% and 81% in women, 20% and 93% in men. In the group with normal resting electrocardiographic pattern 55% of patients have significant stenosis in at least one major coronary artery.
Asunto(s)
Enfermedad Coronaria/diagnóstico , Electrocardiografía , Cateterismo Cardíaco , Angiografía Coronaria , Enfermedad Coronaria/complicaciones , Complicaciones de la Diabetes , Femenino , Humanos , Hipertensión/complicaciones , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/diagnóstico , Factores de Riesgo , Sensibilidad y Especificidad , FumarRESUMEN
The metabolic and productive effects of the blood meal and formaldehyde (FA) treated casein supplements (5-10% of crude protein content) given with urea concentrates in sheep and fattening bulls were investigated. The blood meal has a similar composition of essential amino acids (EAA) to casein. The mean solubility of the FA treated casein and the blood meal after 6 hours of incubation in the sterilized rumen contents amounted 10.5% and 8.5% respectively. The average rumen ammonia concentration and plasma urea level was the highest in bulls fed urea ration without protected protein supplement. The supplementation of this ration with blood meal diminished the large daily fluctuation of plasma AA level and increased plasma EAA/NEAA ratio. The blood meal supplement improved the nitrogen retention in sheep (14%) and body gains in bulls (9%) but did not influence digestible coefficients and rumen protein synthesis in sheep.
Asunto(s)
Bovinos/metabolismo , Proteínas en la Dieta/metabolismo , Rumen/metabolismo , Ovinos/metabolismo , Urea/metabolismo , Animales , Proteínas Bacterianas/biosíntesis , Peso Corporal , Caseínas/metabolismo , Digestión , Alimentos Fortificados , Formaldehído/farmacología , Masculino , Nitrógeno/metabolismo , Rumen/microbiología , SolubilidadRESUMEN
In 8 dogs with removed medial prefrontal cortex, the positive and differential classically conditioned leg flexion responses and accompanying heart rate reactions were not changed or slightly reduced. In some animals a transient increase in cardiac responses to shock was also observed.