AIMS Adenosine stress computed tomography myocardial perfusion imaging (CTP) is an emerging non-invasive method for detecting myocardial ischaemia. Its value when compared with fractional flow reserve (FFR), a highly accurate index of ischaemia, is unknown. Our aim was to determine the diagnostic accuracy of CTP and its incremental value when used with computed tomography coronary angiography (...

OBJECTIVE To see whether transient myocardial ischaemia on ambulatory monitoring after myocardial infarction is associated with ventricular arrhythmias. DESIGN A prospective study. SETTING The coronary care unit, general medical wards, and cardiorespiratory department of a major teaching hospital. PATIENTS 203 consecutive patients without specific exclusion criteria admitted with acute my...

BACKGROUND In animal models of circulatory shock and heart failure concentrations of the endogenous opioid peptide beta endorphin are raised and opioid receptor blockade improves haemodynamic variables and survival. This study was performed to identify whether acute myocardial ischaemia provokes the release of beta endorphin in humans. METHODS Observational study in a university cardiology ce...

BACKGROUND Myocardial ischaemia, a consequence of coronary artery disease, is a major cause of death in patients with end-stage renal disease (ESRD). The pathophysiology and clinical presentation of coronary artery disease in ESRD patients seem to differ from non-ESRD patients with higher implication of myocardial microvascular disease (MMD), higher mortality, fewer myocardial infarctions, less...

BACKGROUND Autonomic neuropathy provides a mechanism for the absence of symptoms in silent myocardial ischaemia, but characterisation of the type of neuropathy is lacking. AIM To characterise and compare autonomic nerve function in patients with silent and symptomatic myocardial ischaemia. METHODS AND RESULTS The Valsalva manoeuvre, heart rate variation (HRV) in response to deep breathing a...

AIMS Thrombopoietin (Tpo) is known for its ability to stimulate platelet production. However, it is currently unknown whether Tpo plays a physiological function in the heart. METHODS AND RESULTS We assessed the potential protective role of Tpo in vitro and in vivo in two rat models of myocardial ischaemia/reperfusion. Tpo receptor (c-mpl) message was detected in the heart using RT-PCR, and th...

One hundred consecutive patients undergoing coronary artery bypass surgery were randomly allocated to a preoperative (24 h) intravenous infusion of isosorbide dinitrate (1.5-15 mg/hr) (50 patients) or to placebo (50 patients). The characteristics of the two groups were similar. Evidence of acute myocardial ischaemia was sought by continuous electrocardiographic Holter recordings and acute myoca...

OBJECTIVE Primary objective of this study was to access utility of exercise treadmill test in type-2 diabetes mellitus patients for detecting silent myocardial ischaemia and associated risk factors. METHODS 75 DM-2 cases were enrolled in study of any age attending medical OPD. All cases were gone through detailed history and TMT procedure. RESULTS There is higher prevalence of SMI in DM-2 p...

Myocardial ischemia (MI) resulting in infarction is an important cause of mortality and morbidity worldwide. Acute ischaemia rapidly impairs myocardial contractile function. Myocardial dysfunction persisting for several hours after transient non-lethal ischaemia, eventually resulting in full functional recovery is termed as myocardial stunning. Hibernation is now thought to be the consequence o...

and the heart, ignoring the possibility that poor cardiac function leads to depression rather than the other way round. The study by van Melle et al. is very important because it shows that the severity of left ventricular dysfunction is significantly related to the severity of depressive symptoms in patients with myocardial infarction. This at least suggests the possibility that heart damage m...