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, Volume 41, Issue 6, pp 825–831 | Cite as

Silent Myocardial Ischaemia

Implications for Therapy
  • Neal G. Uren
  • David P. Lipkin
Leading Article

Keywords

Chronic Stable Angina Isosorbide Dinitrate Silent Myocardial Ischemia British Heart Journal Silent Ischaemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Anderson HV, Talley JD, Black AJR, Roubin JS, Douglas Jr JR, et al. Usefulness of coronary angioplasty in asymptomatic patients. American Journal of Cardiology 65: 35–39, 1990PubMedCrossRefGoogle Scholar
  2. Bala Subramanian V, Bowles MJ, Khurmi NS, Davies AB, Rafferty EB. Rationale for the choice of calcium antagonsits in chronic stable angina: an objective, double-blind, placebo-controlled comparison of nifedipine and verapamil. American Journal of Cardiology 50: 1173–1179, 1982CrossRefGoogle Scholar
  3. Berliner U, Lendry F, Jette M, Blumchen G. Silent ischemia in postinfarction patients: a 21-month follow-up study. European Heart Journal (Suppl. G): 131–135, 1987Google Scholar
  4. Bonow RO, Bachrach SL, Green MV, LaFreniere RL, Epstein SE. Prognostic implications of symptomatic versus asymptomatic (silent) myocardial ischaemia induced by exercise in mildly symptomatic and in asymptomatic patients with angiographically documented coronary artery disease. American Journal of Cardiology 60: 778–783, 1987PubMedCrossRefGoogle Scholar
  5. Cabin HS. Percutaneous transluminal coronary angioplasty for silent myocardial ischaemia. American Journal of Cardiology 65: 114–115, 1990PubMedCrossRefGoogle Scholar
  6. Cecchi AC, Dovellini EV, Marchi F, Puchi P, Santoro GM, et al. Silent myocardial ischemia during ambulatory electrocardiographic monitoring in patients with effort angina. Journal of the American College of Cardiology 1: 934–939, 1983PubMedCrossRefGoogle Scholar
  7. Chierchia S, Brunelli C, Simonetti I, Lazzari M, Maseri A. Sequence of events in angina at rest: primary reduction in coronary flow. Circulation 61: 759–768, 1980PubMedCrossRefGoogle Scholar
  8. Chierchia S, Lazzari M, Freedman SB, Brumelli C, Maseri A. Impairment of myocardial perfusion and function during painless myocardial ischemia. Journal of the American College of Cardiology 1: 924–930, 1983PubMedCrossRefGoogle Scholar
  9. Cohn PF. Asymptomatic coronary disease: pathophysiology, diagnosis, management. Modern Concepts in Cardiovascular Diseases 50: 55–60, 1981Google Scholar
  10. Cohn PF. Silent myocardial ischemia. Annals of Internal Medicine 109: 312–317, 1988PubMedGoogle Scholar
  11. Cohn PF. Clinical importance of silent myocardial ischemia in asymptomatic subjects. Circulation 81: 691–692, 1990PubMedCrossRefGoogle Scholar
  12. Cohn PF, Brown EJ, Swinford R, Atkins H. Effect of beta blockade on silent regional left ventricular wall motion abnormalities. American Journal of Cardiology 57: 521–526, 1986PubMedCrossRefGoogle Scholar
  13. Cohn PF, Brown Jr EJ, Wynne J, Holman BL, Atkins HL. Global and regional left ventricular ejection fraction abnormalities during exercise in patients with silent myocardial ischemia. Journal of the American College of Cardiology 1: 931–933, 1983PubMedCrossRefGoogle Scholar
  14. Cohn PF, Lawson WE. Effects of long-acting propranolol on AM and PM peaks in silent ischaemia. American Journal of Cardiology 63: 872–873, 1989PubMedCrossRefGoogle Scholar
  15. Dargie HJ, Lynch PG, Krikler DM, Harris L, Krikler S. Nifedipine and propranolol: a beneficial drug interaction. American Journal of Medicine 71: 676–682, 1981PubMedCrossRefGoogle Scholar
  16. Deanfield JE, Maseri A, Selwyn AP, Ribeiro P, Chierchia S, et al. Myocardial ischaemia during daily life in patients with stable angina: its relation to symptoms and heart rate changes. Lancet 2: 753–758, 1983PubMedCrossRefGoogle Scholar
  17. Deanfield JE, Shea M, Ribeiro P, de Landsheere CM, Wilson RA, et al. Transient ST-segment depression as a marker of myocardial ischemia during daily life. American Journal of Cardiology 54: 1195–1200, 1984PubMedCrossRefGoogle Scholar
  18. Deedwania PC, Carbajal EV. Silent ischaemia during daily life is an independent predictor of mortality of stable angina. Circulation 81: 748–756, 1989CrossRefGoogle Scholar
  19. Detre K, Holubkov R, Kelsey S, Cowley M, Kent K, et al. Percutaneous transluminal coronary angioplasty in 1985–1986 and 1977–1981. New England Journal of Medicine 318: 265–270, 1988PubMedCrossRefGoogle Scholar
  20. Distante A, Maseri A, Severi S. Management of vasospastic angina at rest with continuous infusion of isosorbide dinitrate: a double-blind crossover study in a coronary care unit. American Journal of Cardiology 44: 533–539, 1979PubMedCrossRefGoogle Scholar
  21. Droste C, Roskamm H. Experimental pain measurement in patients with symptomatic myocardial ischemia. Journal of the American College of Cardiology 1: 940–945, 1983PubMedCrossRefGoogle Scholar
  22. Epstein SE, Quyyumi AA, Bonow RO. Myocardial ischemia: silent or symptomatic. New England Journal of Medicine 318: 1038–1043, 1988PubMedCrossRefGoogle Scholar
  23. Epstein SE, Quyyumi AA, Bonow RO. Sudden cardiac death without warning: possible mechanisms and implications for screening asymptomatic populations. New England Journal of Medicine 321: 320–323, 1989PubMedCrossRefGoogle Scholar
  24. Erikssen J. Prognostic importance of silent ischaemia during long-term follow-up of patients with coronary artery disease: a short review based on own experience and current literature. Herz 12: 359–368, 1987PubMedGoogle Scholar
  25. Falcone C, de Servi S, Poma E, Campena C, Scine A, et al. Clinical significance of exercise-induced silent myocardial ischemia in patients with coronary artery disease. Journal of the American College of Cardiology 9: 295–299, 1987PubMedCrossRefGoogle Scholar
  26. Feldman T, Resnekov L. Ambulatory ECG recording for detecting silent myocardial ischemia. Cardiovascular Clinics 18: 23–41, 1988PubMedGoogle Scholar
  27. Fleg JL, Gerstenblith G, Zonderman AB, Becker LC, Weisfeldt ML, et al. Prevalence and prognostic significance of exercise-induced silent myocardial ischemia detected by thallium scintigraphy and electrocardiography in asymptomatic volunteers. Circulation 81: 428–436, 1990PubMedCrossRefGoogle Scholar
  28. Fox KM. Silent ischaemia: clinical implications in 1988. British Heart Journal 60: 363–366, 1988PubMedCrossRefGoogle Scholar
  29. Frishman WH. Platelets and anti-platelet therapy in ischaemic heart disease. Current Problems in Cardiology 11: 71–136, 1986CrossRefGoogle Scholar
  30. Frishman WH, Charlap S, Kimmel B, Teicher M, Strom J. Diltiazem compared to nifedipine and combination treatment in stable angina. Clinical Research 34: 198A, 1986Google Scholar
  31. Frishman WH, Teicher M. Antianginal drug therapy for silent myocardial ischemia. American Heart Journal 114: 140–147, 1987PubMedCrossRefGoogle Scholar
  32. Froelicher VF Jr, Yanowitz FG, Thompson AJ Jr, Lancaster MC. The correlation of coronary angiography and the electrocardiographic response to maximal exercise treadmill testing in 76 asymptomatic men. Circulation 48: 597–604, 1973PubMedCrossRefGoogle Scholar
  33. Giagnoni E, Secchi MB, Wu SC, Morabito A, Oltrona L, et al. Prognostic value of exercise EKG testing in asymptomatic normotensive subjects: a prospective matched study. New England Journal of Medicine 309: 1085–1089, 1983PubMedCrossRefGoogle Scholar
  34. Glazier JJ, Chierchia S, Brown MJ, Maseri A. Importance of generalized defective perception of painful stimuli as a cause of silent myocardial ischemia in chronic stable angina pectoris. American Journal of Cardiology 58: 667–672, 1986PubMedCrossRefGoogle Scholar
  35. Gottlieb SO. Silent ischaemia: the American viewpoint. Cardiology in Practice 8(4): 16–24, 1990Google Scholar
  36. Gottlieb SO, Gottlieb SH, Achuff SC, Baumgardner R, Mellits ED, et al. Silent ischemia on Hoher monitoring predicts mortality in high-risk postinfarction patients. Journal of the American Medical Association 259: 1030–1035, 1988PubMedCrossRefGoogle Scholar
  37. Gottlieb SO, Weisfeldt ML, Ouyang P, Achuff SC, Baughman KL, et al. Effect of the addition of propranolol to therapy with nifedipine for unstable angina pectoris: a randomized; double-blind, placebo controlled trial. Circulation 73: 331–337, 1986PubMedCrossRefGoogle Scholar
  38. Gottlieb SO, Weisfeldt ML, Ouyang P, Mellits ED, Gerstenblith G. Silent ischaemia as a marker for early unfavourable outcomes in patients with unstable angina. New England Journal of Medicine 314: 1214–1219, 1986PubMedCrossRefGoogle Scholar
  39. Gottlieb SO, Weisfeldt ML, Ouyang P, Mellits ED, Gerstenblith G. Silent ischemia predicts infarction and death during 2 year follow-up of unstable angina. Journal of the American College of Cardiology 10: 756–760, 1987PubMedCrossRefGoogle Scholar
  40. Gruenzig AR, Senning A, Seigenthaler WE. Nonoperative dilatation of coronary artery sites: percutaneous transluminal coronary angioplasty. New England Journal of Medicine 301: 61–68, 1979CrossRefGoogle Scholar
  41. Hauser AM, Gangadharan V, Ramos RG, Gordon S, Timmis GC. Sequence of mechanical and electrocardiographic and clinical effects of repeated coronary artery occlusion in human beings: echocardiographic observations during coronary angioplasty. Journal of the American College of Cardiology 5: 193–197, 1985PubMedCrossRefGoogle Scholar
  42. Hedblad B, Juul-Moller S, Svensson K, Hanson BS, Isacsson S-O, et al. Increased mortality in men with ST segment depression during 24h ambulatory long-term ECG recording: results from prospective population study ‘Men born in 1914’ from Malmo, Sweden. European Heart Journal 10: 149–158, 1989PubMedGoogle Scholar
  43. Imperi GA, Lambert CR, Coy K, Lopez L, Pepine CJ. Effects of titrated beta blockade (metoprolol) on silent myocardial ischaemia in ambulatory patients with coronary artery disease. American Journal of Cardiology 60: 519–524, 1987PubMedCrossRefGoogle Scholar
  44. Khurmi NS, Bowles MJ, O’Hara MJ, Rafferty EB. Effect of propranolol on indices of intermittent myocardial ischaemia, assessed by exercise testing and ambulatory ST-segment monitoring. Clinics in Cardiology 9: 391–397, 1986CrossRefGoogle Scholar
  45. Langou RA, Huang EK, Kelley MJ, Cohen LS. Predictive accuracy of coronary artery calcification and the abnormal exercise test for coronary artery disease in asymptomatic men. Circulation 62: 1196–1203, 1980PubMedCrossRefGoogle Scholar
  46. Mulcahy D, Keegan J, Crean P, Quyyumi A, Shapiro L, et al. Silent myocardial ischaemia in chronic stable angina: a study of its frequency and characteristics in 150 patients. British Heart Journal 60: 417–423, 1988PubMedCrossRefGoogle Scholar
  47. Mulcahy D, Keegan J, Cunningham D, Quyyumi A, Crean P, et al. Circadian variation of total ischaemic burden and its alteration with anti-anginal agents. Lancet 2: 755–759, 1988PubMedCrossRefGoogle Scholar
  48. Nabel EG, Rocco MB, Barry J, Campbell S, Selwyn AP. Asymptomatic ischemia in patients with coronary artery disease. Journal of the American Medical Association 257: 1923–1928, 1987PubMedCrossRefGoogle Scholar
  49. Nadamanee K, Intarachot V, Josephson MA, Rieders D, Vaghaiwalla Mody F, et al. Prognostic significance of silent myocardial ischemia in patients with unstable angina. Journal of the American College of Cardiology 10: 1–9, 1987CrossRefGoogle Scholar
  50. Oakley GDG, Fox KM, Dargie H, Selwyn AP. An objective assessment of treatment of severe angina: pilot study using nifedipine, propranolol and their combination. British Medical Journal 289: 1540, 1979CrossRefGoogle Scholar
  51. Ouyang P, Chandra N, Gottlieb S. Incidence and importance of early post-infarction silent ischaemia on ambulatory monitoring. Abstract. Circulation 78 (Suppl. II): 11–469, 1988Google Scholar
  52. Passamani E, David KB, Gillespie MJ, Killip T. A randomized trial of coronary artery bypass surgery: survival of patients with a low ejection fraction. New England Journal of Medicine 312: 1665–1671, 1985PubMedCrossRefGoogle Scholar
  53. Pepine CJ. Is silent ischaemia a treatable risk factor in patients with angina pectoris? Circulation 82 (Suppl. II): II–135–II–142, 1990Google Scholar
  54. Quyyumi AA, Wright C, Mockus L, Fox KM. Effect of partial agonist activity in beta blockers in severe angina pectoris: a double blind comparison of pindolol and atenolol. British Medical Journal 289: 951–953, 1984PubMedCrossRefGoogle Scholar
  55. Quyyumi AA, Wright CM, Mockus LJ, Fox KM. How important is a history of chest pain in determining the degree of ischaemia in patients with angina pectoris? British Heart Journal 54: 22–26, 1985PubMedCrossRefGoogle Scholar
  56. Quyyumi AA, Wright C, Mockus L, Shackell M, Sutton GC, et al. The effects of combined alpha and beta blockade in patients with angina pectoris: a double blind study comparing labetalol with placebo. British Heart Journal 53: 47–52, 1985PubMedCrossRefGoogle Scholar
  57. Rocco MB, Nabel EG, Campbell S, Goldman L, Barry J, et al. Prognostic importance of myocardial ischemia detected by ambulatory monitoring in patients with stable coronary artery disease. Circulation 78: 877–884, 1988PubMedCrossRefGoogle Scholar
  58. Rozanski A, Berman DS. Silent myocardial ischemia. American Heart Journal 114: 615–638, 1987PubMedCrossRefGoogle Scholar
  59. Ryan TJ, Faxon DP, Gunnar RM, Kennedy JW, King III SB, et al. Guidelines for percutaneous transluminal angioplasty. Journal of the American College of Cardiology 12: 529–545, 1988CrossRefGoogle Scholar
  60. Selwyn AP, Ganz P. Myocardial ischemia in coronary disease. New England Journal of Medicine 318: 1058–1060, 1988PubMedCrossRefGoogle Scholar
  61. Shell WE, Kivowitz CF, Rubins SB, See J. Mechanisms and therapy of silent myocardial ischemia: the effect of transdermal nitroglycerin. American Heart Journal 112: 222–229, 1986PubMedCrossRefGoogle Scholar
  62. Sigwart V, Grbic M, Payot M. Ischaemia events during coronary artery balloon obstruction. In Rutishauser W & Roskamm H (Eds) Silent myocardial ischaemia, pp. 29–36, Springer-Verlag, Berlin, 1984CrossRefGoogle Scholar
  63. Stern S, Gavish A, Weisz G, Benhorin J, Keren A, Tzivoni D. Characteristics of silent and symptomatic ischemia during daily activities. American Journal of Cardiology 61: 1223–1228, 1988PubMedCrossRefGoogle Scholar
  64. Stern S, Tzivoni D. Early detection of silent ischaemic heart disease by 24-hour electrocardiographic monitoring of active subjects. British Heart Journal 36: 481–486, 1974PubMedCrossRefGoogle Scholar
  65. Theroux P, Waters DD, Halphen C, Debaisieux J-C, Mizgala HF. Prognostic value of exercise testing soon after myocardial infarction. New England Journal of Medicine 301: 341–345, 1979PubMedCrossRefGoogle Scholar
  66. Tzivoni D, Gavish A, Zin D, Gottlieb SO, Moriel M, et al. Prognostic significance of ischemic episodes in patients with previous myocardial infarction. American Journal of Cardiology 62: 661–664, 1988PubMedCrossRefGoogle Scholar
  67. Weiner D, Ryan T, McCabe C, Chaitman B, Sheffield L, et al. Comparison of coronary artery bypass surgery and medical therapy in patients with exercise-induced silent myocardial ischaemia: a report from the Coronary Artery Surgery Study (CASS) Registry. Journal of the American College of Cardiology 12: 595–599, 1988PubMedGoogle Scholar
  68. Weiner DA, Ryan T, McCabe CH, Luk S, Chaitman BR, et al. Significance of silent myocardial ischemia during exercise testing in patients with coronary artery disease. American Journal of Cardiology 59: 725–729, 1987PubMedCrossRefGoogle Scholar
  69. Weiner DA, Ryan TJ, McCabe CH, Ng G, Chaitman BR, et al. Risk of developing an acute myocardial infarction or sudden coronary death in patients with exercise-induced myocardial infarction. A report from the Coronary Artery Surgery Study (CASS) Registry. American Journal of Cardiology 62: 1155–1158, 1988PubMedCrossRefGoogle Scholar
  70. Winniford MD, Johnson SJ, Mauritson DR, Relias JS, Redish GA. Verapamil therapy for Prinzmetal’s angina: comparison with placebo and nifedipine. American Journal of Cardiology 50: 913–918, 1982PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1991

Authors and Affiliations

  • Neal G. Uren
    • 1
  • David P. Lipkin
    • 1
  1. 1.The Royal Free HospitalLondonEngland

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