Omega-3 Index and Obstructive Sleep Apnea: A Cross-Sectional Study.

Study Objectives: Erythrocyte levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (Omega-3 Index) were previously found to be associated with obstructive sleep apnea (OSA) at very low levels (< 5.0%) in only one epidemiologic study. OSA has comorbidities, such as arterial hypertension, heart failure, or major depression, also associated with a low Omega-3 Index.

Heart rate variability and ischaemia in patients with coronary heart disease and stable angina pectoris; influence of drug therapy and prognostic value. TIBBS Investigators Group. Total Ischemic Burden Bisoprolol Study.

Aims: Determination of the influence of therapy with bisoprolol and nifedipine on the heart rate variability of patients from the Total Ischemic Burden Bisoprolol Study and examination of the prognostic value.

Methods And Results: Four hundred and twenty-two patients with stable angina were included. The heart rate variability was determined over a period of 24 h.

Prognostic significance of transient ischemic episodes: response to treatment shows improved prognosis. Results of the Total Ischemic Burden Bisoprolol Study (TIBBs) follow-up.

Objectives: The Total Ischemic Burden Bisoprolol Study (TIBBS) follow-up examined cardiac event rates in relation to transient ischemia and its treatment.

Background: It is unclear whether transient ischemia on the ambulatory electrocardiogram has prognostic implications in stable angina and whether medical treatment can improve the prognosis.

Methods: The TIBBS trial was an 8-week, randomized, controlled comparison of the effects of bisoprolol and nifedipine on transient ischemic episodes in patients with stable angina pectoris.

Medical treatment to reduce total ischemic burden: total ischemic burden bisoprolol study (TIBBS), a multicenter trial comparing bisoprolol and nifedipine. The TIBBS Investigators.

Objectives: We compared the effects of bisoprolol on transient myocardial ischemia with those of nifedipine in patients with chronic stable angina.

Background: Both beta-adrenergic blocking agents and calcium antagonists reduce transient ischemic episodes, but comparisons of these agents have been made in only a few larger studies.

Methods: The Total Ischemic Burden Bisoprolol Study (TIBBS) was a randomized double-blind controlled study with two parallel groups; 330 patients from 30 centers in seven European countries with stable angina pectoris, a positive exercise test and more than two transient ischemic episodes during 48 h of Holter monitoring (central evaluation) were included.

Effects of therapeutic ribose levels on human lymphocyte proliferation in vitro.

Ribose has been used successfully in the treatment of ischemic heart disease and muscular enzyme deficiencies, and its administration also facilitates the diagnosis of coronary artery disease by influencing thallium-201 scintigraphy. Concerns about the safety of ribose therapy have been triggered by reports about inhibitory effects of ribose on cell proliferation in vitro. This study examines possible side effects of ribose on human lymphocytes.

Effects of ribose on exercise-induced ischaemia in stable coronary artery disease.

There is no established treatment specifically aimed at protecting or restoring cardiac energy metabolism, which is greatly impaired by ischaemia. Even after reperfusion, myocardial content of ATP remains low for more than 72 h. Long-term post-ischaemic dysfunction and irreversibility of ischaemic damage have been associated with low ATP content.

[Clinical importance of silent ischemia].

Objective signs of myocardial ischemia without angina pectoris or its equivalents define the syndrome of silent myocardial ischemia. Its significance lies in the prevalence and prognostic implications. As a prevalence, asymptomatic coronary heart disease can be found in 2.

Lack of association of migraine with coronary vasospasm.

Previous reports have found an association between coronary vasospasm and migraine. It has been speculated that migraine and variant angina might be manifestations of a generalized vasospastic disorder. To investigate this hypothesis, 74 patients with frequent attacks of migraine were studied using 24-h continuous ambulatory electrocardiography to identify the presence of coronary vasospasm.

[The diagnosis of silent myocardial ischemia. The problems of false-positive findings in the exercise ECG and long-term ECG].

In the case of a disease that produces no complaints, such as silent myocardial ischemia, it is of particular importance not to diagnose--or even to treat--a "pseudo-disease" in a patient with false-positive findings. In assessing whether a finding is false-positive or not, there is no "gold standard" for 24-hour ECG monitoring, since no other technique is capable of detecting transient attacks of ischemia occurring at any time during the day or at night. If only the ECG finding is positive, however, a second independent method is required to confirm the diagnosis.

Multiple lead monitoring during and after PTCA.

We investigated whether optimized ischaemia monitoring during and after PTCA using continuous recording of standardized 12-lead ECG provides additional information regarding the presence and localization of ischaemia. We studied 50 patients undergoing PTCA who received a total of 173 balloon inflations. Chest leads showed not only significantly more frequent ischaemic changes compared with routine limb lead monitoring (116/173 (67%) vs 88/173 (51%)), but in addition, a significantly earlier appearance of changes; 15.

[Angiography and functional results and histologic findings following percutaneous atherectomy in patients with arterial occlusive disease].

In this study we report on the atherectomy technique, acute and long-term data, and histological findings of excised specimens from patients with peripheral vascular disease treated with the Simpson atherectomy catheter. Forty patients with a total of 72 lesions of the iliac (n = 5), superficial femoral (n = 62), and popliteal (n = 5) arteries could be treated; five patients had rest pain and two had gangrene. The primary success rate (of all lesions, including total occlusions and longer stenoses) was over 90%.

[Value of silent myocardial ischemia].

More recent long-term ECG studies in patients with coronary heart disease have resulted in a focusing of interest on silent myocardial ischemia. Diagnostically, ECG changes suspicious for ischemia should always be confirmed by a second criterion. It has been found that differences between silent myocardial ischemia and angina pectoris are to be found mainly in the origination, conduction and perception of pain, and not in the underlying ischemia.

[Treatment of stress-induced and spontaneous myocardial ischemia in coronary disease patients with slow-release gallopamil--preliminary results of an open study].

We studied the effects of slow-release gallopamil two-times 100 mg on exercise-induced ST-segment depression, as well as on the incidence of spontaneous myocardial ischemia detected by long-term ECG monitoring for 48 h in patients with coronary artery disease and stable angina pectoris. Three out of nine patients included in this study had to be excluded (because of frequent ventricular extrasystoles, paroxysmal atrial fibrillation, and development of instable angina pectoris). In all of the remaining six patients, the substance led to a doubling of working capacity (watts X min) evaluated by bicycle ergometry, paralleled by an increase of exercise duration until the occurrence of ST-segment depression greater than or equal to 0.

Continuous bed-side monitoring of the ECG for detection of silent myocardial ischaemia.

In patients with unstable angina pectoris, transient episodes of ischaemia occur frequently and the prognostic implications of those predominantly silent episodes have been shown. The method of Holter tape recording is, however, not ideal for the care of unstable patients: (a) the results of a recording period are only available after this period is finished and subsequent evaluation has taken place; and (b) the sensitivity of monitoring may be increased by recording more than two leads. We have used a portable ECG computer, which monitors the 12-lead ECG every 20 s and records ECGs either when there is consistent ST deviation or at preset intervals (1, 3, 5 min).

Prognostic implications of transient--predominantly silent--ischaemia in patients with unstable angina pectoris.

The occurrence of unstable angina pectoris, despite medical treatment, is generally regarded as an ominous prognostic sign and an indication for invasive diagnosis and revascularization. We investigated 38 consecutive patients with severe unstable angina with a mean of 2.5 days of continuous two-channel, frequency modulated Holter monitoring for ST segment analysis.

Nitrates and calcium antagonists for silent myocardial ischemia.

Continuous Holter monitoring of patients with coronary heart disease can show transient ischemic episodes occurring spontaneously with or without angina throughout the day. A controlled double-blind trial was conducted comparing the effects of isosorbide-5-mononitrate (IS-5-MN) and nifedipine in patients with documented transient ischemic episodes. Seventy-five percent of the ischemic episodes were not accompanied by pain.

Percutaneous removal of atheromatous plaques in peripheral arteries.

The peripheral Simpson "atherectomy" catheter was used to treat 21 patients with a total of 41 stenotic lesions (5 iliac, 35 superficial femoral, and 1 popliteal). 4 lesions were totally occluded and 16 (39%) were calcified. The mean (SD) degree of obstruction was reduced from 82.