Angina Pectoris - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

ANGINA PECTORIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AM...

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ANGINA PECTORIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Angina Pectoris: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00068-7 1. Angina Pectoris-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on angina pectoris. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON ANGINA PECTORIS ................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Angina Pectoris............................................................................. 4 E-Journals: PubMed Central ....................................................................................................... 34 The National Library of Medicine: PubMed ................................................................................ 34 CHAPTER 2. NUTRITION AND ANGINA PECTORIS .......................................................................... 81 Overview...................................................................................................................................... 81 Finding Nutrition Studies on Angina Pectoris ........................................................................... 81 Federal Resources on Nutrition ................................................................................................... 82 Additional Web Resources ........................................................................................................... 83 CHAPTER 3. ALTERNATIVE MEDICINE AND ANGINA PECTORIS ................................................... 85 Overview...................................................................................................................................... 85 National Center for Complementary and Alternative Medicine.................................................. 85 Additional Web Resources ........................................................................................................... 94 General References ....................................................................................................................... 98 CHAPTER 4. PATENTS ON ANGINA PECTORIS ................................................................................ 99 Overview...................................................................................................................................... 99 Patents on Angina Pectoris ......................................................................................................... 99 Patent Applications on Angina Pectoris.................................................................................... 101 Keeping Current ........................................................................................................................ 105 CHAPTER 5. BOOKS ON ANGINA PECTORIS .................................................................................. 107 Overview.................................................................................................................................... 107 Book Summaries: Federal Agencies............................................................................................ 107 Book Summaries: Online Booksellers......................................................................................... 109 Chapters on Angina Pectoris ..................................................................................................... 109 CHAPTER 6. PERIODICALS AND NEWS ON ANGINA PECTORIS .................................................... 113 Overview.................................................................................................................................... 113 News Services and Press Releases.............................................................................................. 113 Academic Periodicals covering Angina Pectoris........................................................................ 114 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................. 117 Overview.................................................................................................................................... 117 U.S. Pharmacopeia..................................................................................................................... 117 Commercial Databases ............................................................................................................... 118 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 123 Overview.................................................................................................................................... 123 NIH Guidelines.......................................................................................................................... 123 NIH Databases........................................................................................................................... 125 Other Commercial Databases..................................................................................................... 127 APPENDIX B. PATIENT RESOURCES ............................................................................................... 129 Overview.................................................................................................................................... 129 Patient Guideline Sources.......................................................................................................... 129 Finding Associations.................................................................................................................. 131 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 133 Overview.................................................................................................................................... 133 Preparation................................................................................................................................. 133 Finding a Local Medical Library................................................................................................ 133 Medical Libraries in the U.S. and Canada ................................................................................. 133 ONLINE GLOSSARIES................................................................................................................ 139

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Online Dictionary Directories ................................................................................................... 141 ANGINA PECTORIS DICTIONARY ........................................................................................ 143 INDEX .............................................................................................................................................. 205

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with angina pectoris is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about angina pectoris, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to angina pectoris, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on angina pectoris. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to angina pectoris, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on angina pectoris. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON ANGINA PECTORIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on angina pectoris.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and angina pectoris, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “angina pectoris” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Sudden Hearing Loss and Unstable Angina Pectoris Source: ENT. Ear, Nose and Throat Journal. 74(2): 97-99. February 1995. Summary: Acute sudden sensorineural hearing loss has been extensively described in the literature and is a well-recognized clinical entity. However, the exact etiology for this entity has been difficult to ascertain. This article presents a case report of a patient who had sudden sensorineural hearing loss in conjunction with unstable angina pectoris. The patient's subsequent coronary bypass surgery appeared to have resulted in acute and significant hearing improvement and stabilization. The 75-year-old white man awoke in the morning with complete loss of hearing in his right ear and a sensation of fullness. As the day progressed, he began having vertigo with nausea and vomiting. During the week prior to his loss of hearing, he was undergoing cardiac evaluation. During the day of his loss of hearing, he had a sensation of weakness and heaviness in

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the chest, with pain in the left arm. He also was recovering from herpes zoster in the right leg, however there were no otologic symptoms associated with the condition. The authors note that his medications of Acyclovir and Misoprostol have not been implicated in hearing loss. Eleven months following this episode, the patient was totally asymptomatic as far as vertigo, dizziness, and cardiovascular symptoms were concerned and his hearing levels had stabilized. The authors conclude that this case study implicates a cardiovascular etiology and adds unstable angina pectoris and its complications to the etiology of sudden acute sensorineural hearing loss syndrome. 9 references. (AA-M).

Federally Funded Research on Angina Pectoris The U.S. Government supports a variety of research studies relating to angina pectoris. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to angina pectoris. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore angina pectoris. The following is typical of the type of information found when searching the CRISP database for angina pectoris: •

Project Title: AGE, HYPOTENSIO

EXERCISE,

THERMOGENESIS

AND

POSTPRANDIAL

Principal Investigator & Institution: Seals, Douglas R.; Professor; Integrative Physiology; University of Colorado at Boulder Boulder, Co 80309 Timing: Fiscal Year 2002; Project Start 01-FEB-2000; Project End 31-JAN-2005 Summary: In young adult humans, acute energy intake (feeding) evokes an integrative "postprandial" physiological response which includes an increase in metabolic rate (thermic effect of food intake--TEF) and a number of autonomic nervous system (ANS) and cardiovascular adjustments aimed at providing increased blood flow for digestion (splanchnic vasodilation) while maintaining arterial blood pressure (BP) at preprandial levels. Some older adults with chronic diseases demonstrate a reduced TEF and/or a postprandial fall in BP ("postprandial hypotension"), but it is unknown whether this occurs with age in healthy adults. If the latter is true, some evidence suggests that these changes may not occur with age in adult humans who exercise regularly. The specific aims of the present proposal are to determine if: (1) TEF is lower and postprandial BP declines occur in middle-aged and/or older sedentary adults compared with young adult controls; (2) the lower TEF is due to attenuated postprandial increases in sympathetic nervous system (SNS) activity associated with reduced CNS 2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

Studies

5

sympathoexcitatory responsiveness to acute hyperinsulinemia; (3) the postprandial hypotension also is associated with: a) an attenuated or absent whole-limb and skeletal muscle vasoconstriction; b) a smaller reduction in cardiac vagal modulation of heart rate and an attenuated tachycardia; and c) a lower baseline cardiac vagal tone and arterial baroreflex sensitivity; (4) middle-aged and older adults who exercise regularly do not demonstrate the lower TEF and postprandial hypotension observed with age in sedentary humans, and whether this is associated with augmented SNS responses, CNS sympathetic responsiveness to circulating insulin, limb vasoconstriction, vagallymediated tachycardia, baseline cardiac vagal tone and baroreflex sensitivity; and (5) the reduced TEF and postprandial hypotension associated with sedentary aging are related to elevated adiposity. Because TEF contributes significantly to daily energy expenditure and, therefore, energy balance, the expected results should provide new and clinically important information concerning the effects of sedentary aging, regular exercise and adiposity on TEF in the context of age-related obesity and its metabolic and cardiovascular co-morbidities. Moreover, postprandial hypotension is associated with post-meal dizziness, weakness, syncope, cerebrovascular ischemia, and angina pectoris. As such, the expected results should provide new insight into the effects of sedentary aging, habitual exercise and body fatness on this clinically-important cardiovascular disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ANEMIA NEPHROPATHY

AND

CLINICAL

OUTCOMES

IN

DIABETIC

Principal Investigator & Institution: Mohanram, Anupama; Internal Medicine; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2002; Project Start 01-DEC-2002; Project End 30-NOV-2004 Summary: (provided by applicant): Diabetic nephropathy (DN) is the leading cause of ESRD in the U.S. and cardiovascular (CV) morbidity and mortality are excessive in this population. Preliminary data from the Reduction in Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) trial indicate that anemia is a modifiable risk factor for ESRD and CV morbidity and mortality in type 2 DN. I hypothesize that hemoglobin (Hb) is an independent predictor of both renal and CV disease in this population. The specific aims of this project are to determine if anemia is an independent predictor of 1) ESRD; 2) cardiovascular morbidity (non-fatal CV events defined as hospitalization for heart failure, myocardial infarction, and unstable angina, and mortality (sudden cardiac death, death due to progressive heart failure, myocardial infarction, and other cardiac causes) and 3) hospitalization for revascularization (coronary, peripheral, cerebral, or renal), amputation, and stroke. I will use the RENAAL trial database involving 1,513 Type 2 diabetic patients with nephropathy followed on average for 3.4 years. Cox proportional hazards regression models using baseline and follow-up (Hb) will be employed as the independent variable, and renal disease, cardiovascular disease, and vascular disease outcomes as dependent variables. Power analysis based on observed event rates in the RENAAL trial indicate 95% power to detect a 30% reduction in risk of the primary composite endpoint of doubling serum creatinine, ESRD or death for patients in the highest compared to the lowest quartile of baseline Hb. I expect these results will establish anemia as an independent risk factor for ESRD and cardiovascular morbidity and mortality in type 2 diabetics with progressing renal disease. These data could change practice and lead to new clinical trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Angina Pectoris

Project Title: APOPTOSIS CARDIOMYOPATHY

AND

CONTRACTILITY

IN

ISCHEMIC

Principal Investigator & Institution: Canty, John M.; Professor; Medicine; State University of New York at Buffalo Suite 211 Ub Commons Buffalo, Ny 14228 Timing: Fiscal Year 2002; Project Start 10-JAN-2000; Project End 31-DEC-2003 Summary: Ischemic cardiomyopathy is the most common etiological cause of heart failure but the factors responsible for initiating decompensated LV dysfunction are unknown. Although considerable work has focused on irreversible injury following infarction, many patients have symptoms of heart failure in association with viable dysfunctional or "hibernating" myocardium. Pathological studies support the notion that the degree of dysfunction frequently exceeds the amount of structural fibrosis identified at postmortem exam. Preliminary studies by the applicant have reproduced the physiological features of hibernating myocardium in pigs with a chronic LAD stenosis. While this occurs with normal LV function and without infarction, there is increased regional myocyte apoptosis, a 30 percent loss of myocytes and compensatory myocyte hypertrophy after a period of 3 months. At the molecular level, there is a regional downregulation of SR calcium uptake proteins. These changes, arising from reversible ischemia (i.e. angina pectoris) and with normal global LV function, are identical to the abnormalities found in end-stage heart failure. Thus, the overall hypothesis of this application is that myocyte apoptosis and SR dysfunction arise in areas with chronically reduced coronary flow reserve and are early rather than late events in the pathogenesis of ischemic cardiomyopathy. Aim 1 will define the role of apoptosis mediated myocyte loss and LV remodeling from reversible ischemia in hibernating myocardium. A 2-vessel stenosis model that progresses to global LV dysfunction with LV dilatation and increased LV filling pressure will be used to determine how diastolic stretch and the size of the dysfunctional region modulates apoptosis and LV remodeling. Aim 2 will identify the temporal progression of apoptosis in ischemic and normal regions in relation to the expression of the pro- and antiapoptotic proteins Bax and Bcl-2 which will be quantified in vivo on a regional basis. Aim 3 will define the extent that apoptosis mediated myocyte loss and altered SR protein expression affects the reversibility of function in hibernating myocardium after surgical revascularization and after stimulating angiogenesis with basic fibroblast growth factor (FGF-5). Aim 4 will determine whether apoptosis and altered SR protein expression can be prevented pharmacologically with beta blockade, by stimulating angiogenesis prior to the development of myocyte loss and by overexpressing Bcl-2 in vivo. This integrative approach should provide a better understanding of the events that lead to the progression of ischemic LV dysfunction at a time when therapeutic interventions such as revascularization and in vivo gene transfer can be used to interrupt the progressive myocyte loss, contractile dysfunction and irreversible structural fibrosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BARI II GRANT PROPOSAL FOR ECG CORE LABORATORY Principal Investigator & Institution: Chaitman, Bernard R.; Professor of Medicine and Director, Card; Internal Medicine; St. Louis University St. Louis, Mo 63110 Timing: Fiscal Year 2002; Project Start 15-SEP-2000; Project End 31-MAY-2007 Summary: The revised Bypass Angioplasty Revascularization Investigation (BARI) II study proposes to evaluate treatments for Type 2 diabetic patients with angiographically proven coronary artery disease and stable angina or ischemia. For this rapidly growing

Studies

7

patient population with very poor prognosis and quality of life, revascularization has been less beneficial than in nondiabetics. Using a factorial design, BARI II will compare revascularization combined with aggressive medical anti-ischemia treatment to aggressive medical anti-ischemia treatment alone; simultaneously, BARI II will compare two glycemic control strategies, insulin sensitization versus insulin provision. All patients will have target HbA1c values < 7.5%, and uniform control of hypertension, dyslipidemia and obesity following recommended guidelines. A total of 2,600 patients will be recruited, randomized, treated, and followed at 30 clinical centers. Five-year mortality will be the primary endpoint analyzed by intention-to-treat. The Coordinating Center (CC) will assume responsibility for overall trial operations including clinical site selection, data management using an Internet system, and statistical analysis. Within the CC will be operational units for the management of diabetes control, lipids and hypertension. Detailed data on potential mechanisms of macrovascular events will be collected with centralized evaluations of ECGs, lipids and HbA1c levels. A fibrinolysis core laboratory will explore the effect of glycemic control strategy on the progression and mechanism of vasculopathy, including changes in PAI-1 activity and gene expression. The investigators will evaluate the relative economic costs associated with revascularization approaches and diabetes control (Separate application for the ECG Core, the Fibrinolysis Core and the Economics Core complement this lead application). This 7-year application includes a 6-month protocol finalization phase, 2 years of patient recruitment and an additional 4.5 years of follow-up. BARI II aims to answer critical scientific questions regarding treatment efficacy in Type 2 diabetic patients with stable CAD. The investigators further expect that this collaborative effort will translate into a new practical clinical paradigm that will be used for treatment of Type II diabetic patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BARI II: A TRIAL OF REVASC. & GLYCEMIC CONTROL IN NIDDM Principal Investigator & Institution: Detre, Katherine M.; Professor; Epidemiology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 15-SEP-2000; Project End 31-MAY-2007 Summary: The revised Bypass Angioplasty Revascularization Investigation (BARI) II study proposes to evaluate treatments for Type 2 diabetic patients with angiographically proven coronary artery disease and stable angina or ischemia. For this rapidly growing patient population with very poor prognosis and quality of life, revascularization has been less beneficial than in nondiabetics. Using a factorial design, BARI II will compare revascularization combined with aggressive medical anti-ischemia treatment to aggressive medical anti-ischemia treatment alone; simultaneously, BARI II will compare two glycemic control strategies, insulin sensitization versus insulin provision. All patients will have target HbA1c values < 7.5%, and uniform control of hypertension, dyslipidemia and obesity following recommended guidelines. A total of 2,600 patients will be recruited, randomized, treated, and followed at 30 clinical centers. Five-year mortality will be the primary endpoint analyzed by intention-to-treat. The Coordinating Center (CC) will assume responsibility for overall trial operations including clinical site selection, data management using an Internet system, and statistical analysis. Within the CC will be operational units for the management of diabetes control, lipids and hypertension. Detailed data on potential mechanisms of macrovascular events will be collected with centralized evaluations of ECGs, lipids and HbA1c levels. A fibrinolysis core laboratory will explore the effect of glycemic control strategy on the progression and mechanism of vasculopathy, including changes in PAI-1 activity and gene

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expression. The investigators will evaluate the relative economic costs associated with revascularization approaches and diabetes control (Separate application for the ECG Core, the Fibrinolysis Core and the Economics Core complement this lead application). This 7-year application includes a 6-month protocol finalization phase, 2 years of patient recruitment and an additional 4.5 years of follow-up. BARI II aims to answer critical scientific questions regarding treatment efficacy in Type 2 diabetic patients with stable CAD. The investigators further expect that this collaborative effort will translate into a new practical clinical paradigm that will be used for treatment of Type II diabetic patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BIOSENSE DMR SAFETY & FEASIBILITY INVESTIGATIONAL TRIAL Principal Investigator & Institution: Laham, Roger J.; Associate Professor of Medicine; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: BUPROPION FOR HOSPITALIZED SMOKERS W CORONARY DISEASE Principal Investigator & Institution: Rigotti, Nancy A.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 20-MAR-1999; Project End 28-FEB-2004 Summary: Over 2 million Americans are hospitalized annually with a myocardial infarction (MI) or unstable angina pectoris, two acute, potentially fatal manifestations of coronary heart disease (CHD) that are responsible for substantial morbidity, mortality, and health care costs. Smoking cessation is highly cost-effective and universally recommended for the approximately 20 percent of these patients who smoke. Hospitalization for acute CHD is an excellent time to initiate smoking cessation because it requires temporary tobacco abstinence at the same time that illness increases smokers' motivation to quit. However, at least 40 percent of smokers fail to quit even with the most effective current treatment, cognitive-behavioral counseling that begins in the hospital and continues after discharge. More powerful intervention strategies are clearly needed. Adding pharmacotherapy to counseling, which is standard practice in outpatients, is a new approach that has not been tested in this setting. Concern about the safety of nicotine replacement in MI patients limits its use. A non-nicotine antidepressant, sustained-release (SR) bupropion (Zyban, Wellbutrin SR), has demonstrated efficacy for smoking cessation and was recently FDA- approved for this use. Bupropion appears to be safe in cardiac patients and may have the additional benefit of preventing post-MI depression, an independent predictor of mortality. We propose to test the efficacy and safety of this novel treatment, bupropion SR, for smoking cessation in adult smokers hospitalized with acute CHD. We have designed a randomized, double-blind, placebo-controlled trial to determine whether bupropion SR, initiated in the hospital and continued for 12 weeks, is effective and safe when added to a previously-tested nurse-delivered cognitive-behavioral smoking counseling intervention that begins in the hospital and continues by telephone contact after discharge. Outcomes will be assessed at hospital discharge and 1, 3, and 12 months after the start of treatment. The primary outcome measure is biochemically-confirmed 7-day

Studies

9

point prevalence tobacco abstinence at 1 year follow-up. Secondary objectives are to test whether bupropion SR delays the time to smoking relapse; increases the smoking cessation rate at the end of treatment (3-months); and reduces CHD morbidity and depressive symptoms and improves health-related quality of life over 1 year. If found to be safe and effective, bupropion SR could become a standard part of "secondary prevention" therapy for smokers with acute CHD, a large, high-risk, high-cost patient group. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DYSFUNCTION

CARDIOVASCULAR

CONSEQUENCES

OF

THYROID

Principal Investigator & Institution: Pearce, Elizabeth N.; Medicine; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Although it is known that thyroid disease and cardiovascular health are closely linked, the cardiovascular consequences of thyroid dysfunction remain imperfectly understood. Current evidence suggests that overt and subclinical thyroid dysfunction may cause alterations in lipid levels, in left ventricular size and function, and in endothelial reactivity. These changes may predispose patients to atherosclerosis and to congestive heart failure. The overall hypothesis of this proposal is that abnormal thyroid function is associated with alterations in lipid particle size, in endothelial reactivity, and in cardiac contractility, which result in increased risk for adverse clinical cardiovascular outcomes. In Specific Aim 1, cross-sectional data from the Framingham Heart Study Offspring cohort will be analyzed to determine whether lipid particle size correlates with thyroid function. Additionally, lipid particle subfractions will be measured prospectively in patients who are initially hypothyroid and then become euthyroid after treatment with L-thyroxine to determine whether lipid particle size is altered in overt hypothyroidism. In Specific Aim 2, data from the Framingham original and offspring cohorts will be analyzed longitudinally to determine whether baseline thyroid status predicts cardiovascular disease over follow-up of up to 18 years. In Specific Aim 3, cross-sectional data from the original Framingham cohort will be analyzed to determine whether thyroid function correlates with left ventricular size and function. Data will also be analyzed longitudinally to determine whether baseline thyroid status is an independent predictor of incident congestive heart failure over 16 years of follow-up. Finally, in Specific Aim 4, a clinical study will assess whether L-thyroxine treatment of subclinical hypothyroidism (mild thyroid failure) in patients with congestive heart failure improves echocardiographic markers for left ventricular remodeling and endothelial reactivity. These research projects are designed to provide training in techniques for the cross-sectional and longitudinal analyses of large databases as well as techniques for the design and implementation of clinical studies in an outpatient setting. The pursuit of these projects, in conjunction with formal coursework in biostatistical and epidemiological methods, is intended to foster Dr. Pearce's career as an independent academic clinical investigator with a focus on thyroid disease and epidemiology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CARDIOVASCULAR HEALTH AND ACTIVITY MAINTENANCE PROGRAM Principal Investigator & Institution: Rejeski, W J.; Wake Forest University 1834 Wake Forest Road Winston-Salem, Nc 27106

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Angina Pectoris

Timing: Fiscal Year 2002 Summary: The broad, long-term objective of this study is to develop an intervention for older patients that can be used to increase compliance to physical activity prescriptions in rehabilitation programs with chronic diseases. The goal of the present study is to contrast a traditional 3 month outpatient cardiac rehabilitation program with a lifestyle activity intervention of a long term (12-month) maintenance physical activity. The lifestyle intervention program uses both group and individual behavior change strategies to motivate and teach participants how to self-regulate the level of physical activity in their daily lives. Th primary a priori hypothesis to be evaluated is that the lifestyle group will have a higher weekly frequency and total volume of physical activity at the 12 month assessment period than will participants in the traditional group. Secondary outcomes of interest include 12 month effects of the treatments on physiologic function, disability and health- related quality of life. To this end we will recruit 160 men and women between the ages of 60 and 80 years. Fifty percent of the sample recruited will be women with 20 per cent of the sample being African American. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLINICAL UTILITY OF ENDOTHELIAL FUNCTION IN PAD Principal Investigator & Institution: Vita, Joseph A.; Professor; Boston Medical Center Gambro Bldg, 2Nd Fl, 660 Harrison Ave, Ste a Boston, Ma 02118 Timing: Fiscal Year 2003; Project Start 22-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Peripheral arterial disease (PAD) produces considerable morbidity and mortality, and the precise factors that determine disease progression and the responses to therapy remain largely unknown, In addition to their risk for critical limb ischemia or graft failure, PAD patients also have markedly increased risk for coronary heart disease, particularly during the stress of vascular surgery, It is clear that new approaches are needed for optimal risk assessment and therapy. Targeting endothelial function represents a major new departure from traditional methods for assessing cardiovascular disease risk. The central hypothesis of this proposal is that endothelial dysfunction is a critical mediator of both PAD and coronary heart disease events and measuring endothelial function will enhance both the risk assessment and therapy in PAD patients. Recent studies by the applicants strongly support this contention and establish the prognostic value of endothelial dysfunction in PAD patients undergoing vascular surgery. A key unresolved question is whether reversing endothelial dysfunction will directly reduce risk. This finding would more firmly establish endothelial dysfunction as a mediator of both PAD and coronary heart disease risk and further validate its clinical utility. We propose the following specific aims: 1. To determine whether reversing endothelial dysfunction ameliorates perioperative risk in PAD patients. Patients referred for elective vascular surgery will be treated with high dose atorvastatin (80 mg/day), ascorbic acid (500 mg/day), or placebo in a randomized, double blind, fashion beginning a month prior to surgery and continuing for a month after surgery. Non-invasive assessment of vascular function will be performed at baseline and immediately prior to surgery. Patients will be monitored for cardiovascular events (cardiac death, myocardial infarction, unstable angina, and stroke) in the 30-day postoperative period. The goal is to determine whether improvement in vascular function independently predicts outcome (irrespective of which treatment produces the improvement). 2. To determine whether endothelial dysfunction predicts long-term (2-year) PAD and coronary heart disease risk in PAD patients. 3. To determine whether systemic markers of oxidative stress and inflammation relate to endothelial dysfunction and long-term PAD and coronary heart

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disease risk. This work will provide novel information about the pathogenesis and management of PAD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CORONARY HEART DISEASE: WOMEN'S VALUES, BELIEFS AND COGNITIVE PROCESSES Principal Investigator & Institution: Arslanian-Engoren, Cynthia; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 30-JUN-2007 Summary: Coronary heart disease, which includes acute and old myocardial infarction, angina pectoris, and other acute, subacute, and chronic forms of ischemic heart disease, is the single largest killer of American women. In 1999, 262,391 United States women, of all ethnic and racial groups, lost their lives to coronary heart disease. However, Black women have the highest overall death rates from coronary heart disease, followed by White and Hispanic women. Despite these findings and the fact that women are more likely than men to die after a myocardial infarction, women are less likely than men to seek medical attention after the onset of initial symptoms. Explanations for these delays have been linked to low perceptions of susceptibility to heart disease, the lack of association of initial symptoms as significant indicators of an acute cardiac event, low socioeconomic status, and patient race. While not negating the importance of these variables, they do not speak to the values attitudes or beliefs that underlie women's decision to seek emergency care. Guided by The Health Belief Model, this triangulated, descriptive study will examine the values, beliefs, and cognitive process of a total of 78 women (26 Hispanic, and 26 white) relative to the manifestation and presentation of an acute myocardial infarction, while the quantitative phase will focus on the symptoms women believe most likely indicate an acute myocardial infarction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DETECTING CHANGES IN MYOCARDIAL PERFUSION AND FUNCTION Principal Investigator & Institution: Faber, Tracy L.; Associate Professor; Radiology; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2002; Project Start 15-JUL-2002; Project End 30-JUN-2006 Summary: Coronary heart disease caused 476,124 deaths in 1996 and continues to be the leading cause of death in America today. Over 12 million people alive today have a history of myocardial infarction, angina pectoris, or both. Every year in the US about 5 million perfusion studies are performed to evaluate extent and severity of CAD, thereby enabling clinical decisions regarding diagnosis, prognosis, and therapy for patients with heart disease. Of these, 1 million undergo angioplasty and about 500,000 have bypass surgery, and millions of others undergo drug therapy and or lifestyle changes to prevent progression of cardiac disease. It is widely recognized that computer quantification of myocardial perfusion images improves diagnostic accuracy and enhances confidence and reproducibility of interpretation. Theses quantitative approaches are wellestablished for assessing abnormalities in myocardial perfusion and function. However, they have not been developed or optimized for detecting changes in serial studies of the same patient such as is needed for assessing the effect of interventions, medical therapy, or disease progression. In this project, we will develop and validate computer-based methods to automatically quantify and visualize serial changes in myocardial perfusion and function from perfusion SPECT. The work can be separated into 4 projects: 1) To

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Angina Pectoris

assess changes in myocardial perfusion, 2) to assess changes in myocardial function, 3) to design a virtual heart suitable for creating simulation data for optimizing and analyzing our algorithms, and 4) to validate the methods using both simulations and animal studies. Important subprojects include: a) development of 3-d and 4-d surface detection methods for defining LV endocardial and epicardial surfaces, b) development of algorithms for non-rigid alignment of static and/or dynamic serial SPECT images so that they may be more directly compared, c) development of motion analysis methods using similar non-linear alignment techniques to measure regional myocardial function and also to correct ungated SPECT scans for motion blur, and d) creation of new statistical approaches to determine significant changes in both global and regional perfusion and functional variables. The ultimate goal of this project is to create a clinically useful tool for detecting changes in serial SPECT studies. Most importantly, the tools will be extremely well characterized as to their sensitivity in detecting small changes as well as for overall accuracy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ECONOMICS AND QUALITY OF LIFE IN THE OCCLUDED ARTERY TRI Principal Investigator & Institution: Mark, Daniel B.; Medicine; Duke University Durham, Nc 27710 Timing: Fiscal Year 2002; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: This revised application proposes to establish an Economics and Quality of Life Coordinating Center for the Open Artery Trial, (OAT), a multi-center, randomized trial of late (3-21 days) percutaneous revascularization versus standard medical therapy in 3200 asymptomatic high-risk acute myocardial infarction (MI) survivors and who are found at diagnostic catheterization to have an occluded infarct-related artery. All patients will receive standard medical therapy (including aspirin, beta blockers, ACE inhibitors). Qualifying patient will be randomized in equal proportions to either percutaneous revascularization of the occluded infarct related artery or medical therapy alone. Patients will be recruited into the trial over a 2 year period, with a subsequent minimum follow-up period of 2.25 years. The primary endpoint of the trial is a composite of all cause mortality, non-fatal MI and hospitalization for class IV heart failure. Cost, cost effectiveness and health-related quality of life are secondary endpoints. In collaboration with the Clinical Coordinating Center and the Statistical and Data Coordinating Center, the Economics and Quality of Life Coordinating Center will perform the following major functions: 1) obtain baseline economic status and quality of life data from all patients enrolled at each participating study site at the time of randomization; 2) collect detailed health resource consumption data from the index hospitalization; 3) assess detailed economic, functional status and quality of life outcomes during follow-up telephone contacts by study site coordinators at 4 months, 1 year and 2.25 years after enrollment; 4) assess angina- and heart failure-related functional status by telephone contacts every 4 months during study follow-up; 5) identify all major medical encounters that occur during follow-up and collect detailed health care resource consumption data and cost data for each; 5) compare cost and quality of life outcomes for the two treatment arms according to intention-to-treat; 7) estimate the incremental cost effectiveness ratio for the experimental arm and perform extensive sensitivity analyses. If efficacy is demonstrated for the primary study endpoint, then the economic and quality of life data collected as part of this proposal will clearly be pivotal in determining how the results of this study are viewed and whether the findings of the trial receive widespread implementation. We propose to use

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state-of-the-art methods for measuring cost and quality of life and for estimating cost effectiveness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECT OF TREATMENT W/ AZITHROMYCIN W/ UNSTABLE ANGINA/ACUTE MI Principal Investigator & Institution: Cercek, Bojan; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 905022052 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ENDOTHELIAL VASAMOTOR FUNCTION IN THE FRAMINGHAM STUDY Principal Investigator & Institution: Benjamin, Emelia J.; Associate Professor; Medicine; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2002; Project Start 15-DEC-1998; Project End 30-NOV-2003 Summary: Current research suggests that loss of the vasodilator, anti-thrombotic, and anti-inflammatory properties of the vascular endothelium plays a dynamic role in the pathogenesis of cardiovascular disease. Impaired endothelial function, including impaired nitric oxide-dependent vasodilation is associated with cardiovascular disease risk factors. Further, there is growing evidence that endothelial function can be improved by risk modification. However, the available studies have not definitively resolved the issue of the cross-sectional correlates of endothelial dysfunction because they have been limited to small samples of highly selected patients. For example, it remains unclear whether hypercholesterolemia, hypertension, or elevated glucose levels are independent determinants of endothelial dysfunction. Most importantly, no study has shown a relation between endothelial dysfunction and increased cardiovascular risk. Such a demonstration would increase our understanding of the pathogenesis of cardiovascular disease and aid clinicians in identifying high risk individuals who would benefit most from intervention. Completion of such a study will require assessment of endothelial function in a large, well-characterized population. Recently, a rapid, noninvasive method for assessment of endothelial function was developed using brachial artery ultrasound. Using this method, endothelial function will be examined in about 3,800 men and women of the Framingham Heart Study. The specific objects of this proposal are to: 1. Examine the cross-sectional correlates of endothelial function with known coronary risk factors, 2. Perform cross- sectional analyses on the relation of endothelial function to prevalent cardiovascular disease, 3. Observe the adjusted relation of endothelial function to incident and recurrent cardiovascular events. Our central hypothesis is that the presence of endothelial dysfunction is an independent risk factor for cardiovascular disease events. The Framingham Study is uniquely suited for this proposal by virtue of the single site population-based design, the broad age range of subjects, the availability of extensive antecedent and contemporary risk factor data, expertise in non-invasive imaging and quality control procedures, and the availability of long-term, longitudinal follow-up. The proposed study provides a unique opportunity to assess the prognostic importance of endothelial function and is likely to yield new information that will directly improve the prevention and management of cardiovascular disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Angina Pectoris

Project Title: ESTROGEN, ANGINA, ACTIVITY AND QUALITY OF LIFE IN WOMEN Principal Investigator & Institution: Missik, Eugeria; None; Kent State University at Kent Research & Graduate Studies Kent, Oh 44242 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2004 Summary: Postmenopausal women comprise the largest number of female cardiac patients. Recently recognized vasoactive effects of estrogen have shown to improve coronary blood flow in postmenopausal cardiac women especially during exercise. Our recent pilot study conducted on 37 postmenopausal cardiac women identified some notable trends between women receiving hormone replacement therapy (HRT) and those women not receiving HRT. Women on HRT performed activities of higher intensity for longer periods of time, reported lower severity of angina, and higher quality of life. Studies on the relationship of hormonal status and daily physical activity of cardiac patients are not available. To what extent estrogen replacement therapy (ERT) impacts the daily physical activity of postmenopausal cardiac patients is not known. It is hypothesized that the antischemic effects of estrogen positively impact daily physical activity and quality of life of postmenopausal cardiac women. Therefore, the primary aim of this study is to test a model examining the relationship between ERT use and frequency and severity of angina, daily physical activity, and quality of life. A prospective, comparative and cohort study will be used. Data will be collected on 180 postmenopausal cardiac women at three hospital based cardiac rehabilitation centers in western Pennsylvania. Multiple measures will be used for each construct in the model. Physical activity will be measured by self-report and electronic monitoring using the Tri Trac R3D accelerometer. Angina will be measured by the supplemented Rose Questionnaire, frequency by self-report, and severity by a numerical scale. Quality of life will be measured by using the Medical Outcomes Study, Short Form 36-Items. Structural equation analysis will be used to model the impact of ERT on the dependent variables. A demonstrated positive impact on physical activity may provide an additional rationale for the prudent use of ERT in the optimum management of postmenopausal cardiac patients. Interventions to support the adoption and maintenance of physical activity recommendations by postmenopausal cardiac women are greatly needed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HEART ATTACKS AND TRAFFIC POLLUTION Principal Investigator & Institution: Schwartz, Joel D.; Director of Research & Development; Environmental Health; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 26-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant ): Since the late 1980's, numerous studies have found particulate air pollutant concentrations to be responsible for excess mortality. More recent studies have clarified that most of these deaths are sudden deaths. We have recently shown that particles from traffic are more specifically associated with acute cardiovascular effects. We have also shown the pre-existing diabetes was an important modifier of the particle effect. All of these studies have looked at immediate effects. Two prospective cohort studies have indicated that long-term exposure to particles is also associated with noticeable reductions in life expectancies. To replicate the association between chronic exposure and deaths, and examine the specific role of traffic particles we will conduct a case-control study of myocardial infarctions, using data from the

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Worcester Heart Attack Study. We will use a GIS system to code the latitude and longitude of home and work locations of cases and controls, and fit models relating concentrations of elemental carbon (a tracer for traffic particles) to population density, distance from roadways, and traffic counts in the Worcester MSA. From this, we will assign exposures to each subject. Controls will be sampled from town census books, which are conducted annually in Massachusetts. Controls will be matched by age, sex, and 10 year age group. Socio-economic data will be merged from the block group of the subjects, and questionnaire data will assess smoking history, alcohol consumption, aspirin and other medication use, educational level, height, weight, age, race, exercise, and air conditioner use. We will also ask about the presence of medical conditions, such as diabetes, that may be modifiers of the effect of pollution. Nonlinearities in covariates will be assessed and controlled for using penalized splines, in conditional logistic regressions. A preliminary analysis will use retrospective data, and not obtain questionnaire data. Effect modification by diabetes, prior MI, COPD, smoking, and angina will be tested using interaction terms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HIGH ATHEROSCLEROSIS

DOSE

ALPHA

TOCOPHEROL

AND

CAROTID

Principal Investigator & Institution: Jialal, Ishwarlal; Professor and Chair; Medical Pathology; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 956165200 Timing: Fiscal Year 2003; Project Start 30-SEP-1999; Project End 30-APR-2005 Summary: (provided by applicant): Cardiovascular disease is the leading cause of morbidity and mortality in Westernized populations. Both oxidative stress and inflammation appear to be crucial in atherogenesis. The most consistent data with respect to micronutrient antioxidants and atherosclerosis appears to relate to alpha tocopherol (AT). Studies to date have shown that AT supplementation results in both an antioxidant and anti-inflammatory effect, especially at higher doses (>-800 IU/day). The aim of the present study (RO1AT00005) is to test the effect of supplementation with 1200 IU/day of RRR-AT in a placebo-controlled, randomized double blind trial over 2 years on the progression of carotid atherosclerosis in patients with stable coronary artery disease (angina pectoris or previous myocardial infarction). Subjects (n = 120), as determined by our power calculations, will have to be on the AHA Phase II diet and have an LDL cholesterol <125 mg/dL on diet alone or diet and hypolipidemic drug therapy on at least 2 visits at least 4 weeks apart during the lead in phase. Intimalmedial thickness (IMT) of both carotids, including the common carotid, the bulb and the proximal internal carotid will be determined by high-resolution B-mode sonography. At six month intervals blood samples will be obtained for liver function, creatinine, complete blood count, lipid profile, antioxidants and fatty acid levels, LDL oxidation, plasma soluble cell adhesion molecules (CAMs), C-reactive protein (CRP) and monocyte activity. Also, a 24-hour urine sample will be obtained for F2 -isoprostanes, a measure of in-vivo oxidative stress. IMT will be determined at baseline, 1, 1.5 and 2 years. The mean change in IMT and the rate of progression will be compared between the AT and placebo groups. Isolated LDL will be subjected to copper catalyzed oxidation and the kinetics studied. Isolated monocytes will be activated with lipopolysaccharide and the following activities assayed: superoxide anion release, interleukin-1 beta, TNF-alpha and interleukin-6 release and adhesion to human endothelium. Soluble CAMs will be quantitated by ELISA and CRP will be assayed by a high sensitive assay. AT levels and the parameters of oxidative stress and inflammation will be correlated with changes in

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IMT. This study has the additional novelty of correlating biomarkers of oxidative stress and inflammation with a cardiovascular endpoint and will establish whether high dose AT decreases atherosclerosis progression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HIRUDIN IN ANGINA OR NON-O WAVE INFARCTION Principal Investigator & Institution: Chesebro, James H.; Mount Sinai School of Medicine of Cuny New York, Ny 10029 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HISTAMINE AND ASCORBATE IN ATHEROSCLEROSIS AND CHD Principal Investigator & Institution: Clejan, Sanda; Tulane University of Louisiana New Orleans, La New Orleans, La 70112 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HUMAN FGF 4 GENE TRANSFER IN PATIENTS W/ ANGINA Principal Investigator & Institution: Brinker, Jeffrey A.; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002 Summary: This is a Phase I/II clinical trial. The objective of this study is to evaluate the safety and anti-ischemic effects of adenovirus mediated hFGF-4 gene transfer in patients with stable exertional angina (Class II and Class III) so that a potentially safe and effective dose may be selected for a subsequent study. This is a double-blind, ascending dose, placebo controlled study. Each dose group consists of at least nine active and three placebo patients. The lowest dose (3.2 x 10"9 viral particles) will be studied first. For each dose group, safety observations during the first two weeks are reviewed and safety confirmed for the first patient randomized to active medication before dosing the second patient randomized to active medication. Safety observations for two weeks after the second patient are reviewed and safety confirmed before dosing the remaining patients in each dose group. Sponsor unblinding for all patients is allowed, but the patient, investigator, and his staff all remain blinded throughout the study. Core laboratories read, in a blinded fashion, exercise ECGs, stress echocardiograms, and coronary angiography. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: IMMUNOPATHWAYS IN ACUTE CORONARY SYNDROMES Principal Investigator & Institution: Weyand, Cornelia M.; Professor; Mayo Clinic Coll of Medicine, Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002; Project Start 05-MAY-2001; Project End 30-APR-2006 Summary: (the applicant's description verbatim): Coronary atherosclerosis can be a slowly progressive rather benign disease, or it can cause acute coronary syndromes such as unstable angina, myocardial infarction, and sudden cardiac death. The major cause of acute coronary ischemia is disruption of atherosclerotic plaque with superimposed

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thrombosis. Several factors contribute to plaque erosion, but a critical role has been attributed to plaque inflammation mediated by tissue-infiltrating macrophages and T lymphocytes. In preliminary studies, we have found that patients with unstable angina can be distinguished from patients with stable disease by the expression of an unusual subset of T lymphocytes, CD4+CD28null T cells. CD4+CD28null T cells circulate in the blood, release large amounts of IFN-gamma, and can activate macrophages to produce acute phase proteins and procoagulant substances. Most importantly, they expand to form large clonal populations, likely reflecting stimulation by persistent antigen, such as in chronic infection. CD4+CD28null clonotypes infiltrate into "culprit" but not "nonculprit" lesions in patients with fatal myocardial infarction. This application proposes to examine the hypothesis that abnormal T-cell responses, possibly driven by microbial antigens, are critically involved in plaque instability. Experiments have been designed to search for the antigens recognized in the atheroma and to investigate the costimulatory pathways used by CD4+CD28null T cells in the plaque. Specifically, the contribution of CD47, thrombospondin, and CD36 and of CD4O-ligand interaction in facilitating the cross talk of CD4+CD28null T cells with atheroma-associated cells will be evaluated, and the possible role of cytolytic CD4+CD28null T cells in smooth muscle cell apoptosis and cap destruction will be examined. Because CD4+CD28null T cells are explicitly infrequent in normal donors, we will also explore whether these T cells can be used to identify asymptomatic individuals at risk to develop acute coronary syndromes and to risk-stratify patients presenting in the emergency room with acute onset chest pain. The clinical significance of these two specific aims stems from the potential to identify a novel prognostic marker for acute coronary syndromes and to characterize molecules and pathways with relevance in plaque instability, providing a host of new targets for drug and gene therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPROVED ACTIONS OF NITRATES AND STATINS WITH LARGININE Principal Investigator & Institution: Caldwell, Ruth B.; Professor; Nitrosystems, Inc. 512 Telfair St Augusta, Ga 30901 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-AUG-2004 Summary: (provided by applicant): This project seeks to develop safer, more effective and enduring: 1) nitrate therapy for angina and congestive heart failure using nitroglycerin (GTN) or isosorbide mononitrate (ISMN) and 2) statin therapy [pravastatin (PRA) or simvastatin (SIM)] for unstable angina and stroke, by their combination with L-arginine (L-arginine). Nitrovasodilators are highly effective acutely, but their usefulness for chronic therapy is limited due to the rapid development of tolerance to their vasodilating effects. NitrOSystems, Inc. has discovered an additional endothelial cell (EC)-dependent mechanism of GTN-induced vasodilation and tolerance and that tolerance can be prevented by treatment with supplemental L-arginine. Data show that GTN activates EC nitric oxide synthase (eNOS) to produce NO from its substrate Larginine. It is known that the intracellular supply of L-arginine can become limiting in diseases characterized by vascular dysfunction, that diminished availability of Larginine as a substrate for eNOS can result in EC damage due to formation of superoxide anion (SOA) and other reactive oxygen species and that treatment with supplemental L-arginine can prevent EC dysfunction. Statins or HMG CoA reductase inhibitors, by mechanisms unrelated to lowering lipids, activate eNQS and inhibit platelet aggregation. Formation of SOA is also increased by statins. It is hypothesized that sustained elevated extracellular levels of L-arginine are required for optimal

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Angina Pectoris

therapeutic effects of nitrates and the statins and that supplemental L-arginine will potentiate drug actions by reducing formation of SOA. Specific aims are to: 1. Determine the ability of GTN, ISMN, PRA, SIM to activate NOS and produce SOA in EC and the ability of supplemental L-arginine to prevent SOA formation. 2. Determine the ability of supplemental L-arginine to prevent SOA formation and nitrite tolerance in animals. 3. Develop an IV formulation of GTN in combination with L-arginine and an oral combined sustained release formulation of ISMN and L-arginine. 4. Develop an oral combined sustained release formulation of SIM and L-arginine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPROVING HEALTH BEHAVIOR AND OUTCOMES AFTER ANGIOPLASTY Principal Investigator & Institution: Charlson, Mary E.; Medicine; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: (adapted from investigator's abstract): The principal objective of this randomized trial is to compare the effectiveness of two strategies for motivating behavioral change and improving two-year outcomes, survival free from myocardial infarction, stroke, Class II-IV angina or severe ischemia on non-invasive testing, among patients who have undergone angioplasty or coronary artery stent procedures. The will evaluate whether a novel behavioral intervention based on individualized feedback of risk profiles framed as the opportunity to reduce one's biologic age is more effective in reducing mortality and major cardiovascular morbidity than the standard risk reduction approach, which is framed as the opportunity to avoid future risk of morbidity and mortality. This new strategy is based on the economic theory of net-present value. A total of 660 patients who have completed angioplasty or stenting will be enrolled. Both the net-present value and standard treatment groups will receive a baseline risk evaluation. In both groups the potential areas for health risk behavior change are identical: physical activity, smoking, diet, blood pressure and medications. Control group patients will receive the standard post-procedure approach, which will include being shown their profile on 14 selected cardiovascular risk factors, relative to norms on each factor. They will be asked to choose 2-3 behaviors to change to increase their life span. Experimental group patients will receive their current biological age or "real age" based on their risk profile. They will be asked to choose 2-3 behaviors to change to reduce their biological age and shown the impact each behavior would have on biological age if maintained for 3 months and if maintained for 2 years. During the trial's maintenance phase, patients will be followed every three months, and at each follow-up will have their risk factor profile updated. The net- present value group will receive their updated biological age, and the control group will receive their updated risk factor profile. Final outcomes will be evaluated at two years. This trial is designed to test the effectiveness of the net-present value approach to improving health behavior and longterm outcomes after angioplasty or coronary artery stenting. The long-term objective of this study is to determine whether a net-present value approach for motivating behavior change is effective in improving treatment outcomes, and enhancing quality of life among a group of high-risk patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GUIDELINES

IMPROVING

THE

EVIDENCE

FOR

UNSTABLE

19

ANGINA

Principal Investigator & Institution: Katz, David A.; Medicine; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 31-AUG-2002 Summary: This project aims to improve the evidence base for the AHCPR Unstable Angina Practice Guideline, which challenges clinicians to consider outpatient management for low-risk patients with symptoms suggestive of acute cardiac ischemia (ACI). Capitalizing on the resources of two clinical effectiveness trials of ED decision making, the Acute Cardiac Ischemia Time Insensitive Predictive Instrument (ACI-TIPI) Impact Trial and the nearly completed Sestamibi Scan Clinical Trial, this project will determine whether agreement with guideline recommendations for triage is associated with decreased short-term rates of adverse outcomes (non-fatal myocardial infarction and death) and decreased short-term utilization (ED revisits, readmissions, coronary angiography, and revascularization). Through chart review, we will abstract items necessary to categorize 9191 study patients according to their risk of adverse short term outcomes, based on AHCPR triage guidelines and other unstable angina risk stratification models. For each guideline risk group, we will test the independent contribution of triage disposition to the prediction of adverse outcomes in hierarchical logistic regression models, controlling for the patient-level, physician-level, and hospital-level predictors of adverse outcomes. As unbalanced distribution of these predictors may bias comparisons of adverse outcome in "guideline- concordant" versus "guideline-discordant" triage disposition groups, we will examine two approaches for case-mix adjustment: propensity scores and ACI-TIPI scores. As several other existing instruments, in addition to guidelines, may improve decision-making in acute cardiac care, we will also compute the sensitivity and specificity of the guideline's risk groups in discriminating between patients with and without adverse short-term outcomes, compared to that of other available prognostic models for ACI. The proposed research will provide policymakers with the ability to project the impact of guideline implementation on outcomes, cost, and the use of health care services for patients with symptoms suggestive of unstable angina. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IN VITRO ASSESSMENT OF LIPID PEROXIDATION IN CARDIAC PATIENTS Principal Investigator & Institution: Tsimikas, Sotirios; University of California San Diego La Jolla, Ca 920930934 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INFLAMMATORY MARKERS AND CARDIOVASCULAR PATIENT OUTCOMES Principal Investigator & Institution: Frazier, Lorraine; Biological Sciences; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2006 Summary: (provided by applicant): The candidate, an Associate Professor at the University of Texas Health Science Center at Houston (UT-Houston) School of Nursing,

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Angina Pectoris

is currently a member of an interdisciplinary research team that conducts cardiovascular research. As a postdoctoral fellow in genetics and hypertension, she began participating in an NIH-funded Clinical Research Curriculum that she will complete during the proposed K Award. The long-term goal is to develop a model that will allow continued exploration of genetic, biochemical, and environmental risk factors in patients diagnosed with cardiovascular disease. Educational specific aims are to increase knowledge about cardiovascular disease that will stimulate new research hypotheses of the biochemical markers and related genes, and to increase knowledge in the design and analysis of large clinical cohort studies that will augment the quality of future grants. Environmental support available at UT-Houston includes laboratory support through the Human Genetics Center; educational support through the UT-Houston Medical School Clinical Research Curriculum; and access to patients, abstracting, and long-term follow-up through the TexGen Resource. The Award will support a pilot study to explore the prognostic value of inflammatory markers and related candidate gene variation to predict adverse outcomes in patients with cardiovascular disease. Specific aims of the research are to identify the prognostic value of: 1) novel biomarkers to predict the timing and severity of acute coronary syndrome (ACS), outcomes of: subsequent reperfusion interventions (stent placement, angioplasty, or cardiac bypass surgery), death, stroke, and myocardial infarction (MI), and to test for interactions with demographic/lifestyle and traditional clinical predictors; and 2) DNA sequence variation in the genes encoding the novel biomarkers identified in Aim 1, by assessing the interaction of the sequence variations and biomarkers to predict the timing and severity of the ACS outcomes of: subsequent reperfusion interventions, death, stroke, and MI, and to test for interaction with demographic/lifestyle and traditional clinical predictors. The proposed K award will allow the protected time needed to develop knowledge and skills in design, performance, and analysis of clinical research; to develop clinical knowledge of cardiovascular biomarkers; and to conduct the proposed pilot research in the Texas Medical Center. The pilot data will serve as preliminary data for an RO1 application. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LDL CHOLESTEROL LOWERING RECOMMENDED MINIMUM TARGETS

BEYOND

CURRENTLY

Principal Investigator & Institution: Herrington, David M.; Professor; Wake Forest University 1834 Wake Forest Road Winston-Salem, Nc 27106 Timing: Fiscal Year 2002; Project Start 01-MAR-2002; Project End 28-FEB-2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISMS OF ACTIVATION OF CARDIAC NOCICEPTORS Principal Investigator & Institution: Pan, Hui-Lin; Professor; Anesthesia; Pennsylvania State Univ Hershey Med Ctr 500 University Drive Hershey, Pa 170332390 Timing: Fiscal Year 2002; Project Start 01-APR-1998; Project End 31-MAR-2006 Summary: (provided by the applicant): Patients with myocardial ischemia typically experience angina pectoris. Activation of cardiac sympathetic afferents during ischemia is responsible for conveying cardiac nociception and initiating cardiovascular reflexes, which lead to hemodynamic alterations and arrhythmias. However, the mechanisms of activation of cardiac nociceptors are not fully understood. Endothelin-l (ET-1) and cyclooxygenase-2 products are produced early during myocardial ischemia. but their

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contributions to activation of cardiac nociceptors during ischemia remain uncertain. Therefore, we propose to test the following novel hypotheses: 1. Myocardial interstitial prostaglandins are increased during ischemia due to stimulation of the cyclooxygenase2 pathway, which plays a significant role in activation of cardiac sympathetic afferents during ischemia. 2. Production of ET-1 in myocardial interstitium is increased during ischemia; an increased cardiac interstitial ET- 1 level elicits generation of prostaglandins through cyclooxygenase-2. 3. ET- 1 selectively stimulates ischemically sensitive cardiac afferents through activation of ETA, but not ETB, receptors; the stimulating effect of ET-l on ischemically sensitive cardiac afferents is mediated by prostaglandins due to activation of cyclooxygenase-2. 4. Endogenously produced ET- 1 during myocardial ischemia contributes to ischemic stimulation of cardiac sympathetic afferents. The techniques of cardiac microdialysis and single-unit recording of cardiac sympathetic afferents will be used to explore the mechanisms of generation of prostaglandins and ET-1 during myocardial ischemia, and to study the role of ET-1 and cyclooxygenase-2 in ischemic stimulation of cardiac sympathetic afferents. These studies are important prerequisites for the understanding of the pathophysiological role of ET-1 and prostaglandins in activation of cardiac nociceptors and elaborating the perception of chest pain in patients with myocardial ischemia. Such information could also suggest alternate interventions designed to treat intractable angina pectoris and to limit potentially detrimental cardiovascular reflexes in patients with coronary artery disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: METABOLIC CONSEQUENCES OF HAART IN HIV INFECTION Principal Investigator & Institution: Muschatt, David M.; Tulane University of Louisiana New Orleans, La New Orleans, La 70112 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MOLECULAR MECHANISM OF TRANSDUCING CARDIAC ISCHEMIC PAIN Principal Investigator & Institution: Mc Cleskey, Edwin W.; Senior Scientist/Professor; None; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 01-JUN-2001; Project End 31-MAY-2006 Summary: provided by applicant) Sensory neurons that innervate the heart (cardiac afferents) detect cardiac ischemia, the condition when the heart receives insufficient oxygen. They trigger chest pain-either the acute pain of a heart attack or angina, an intermittent pain caused by coronary artery disease. They also contribute to damaging cardiac reflexes that accompany artery disease. Although it is clear that cardiac afferents transduce cardiac pain, the molecular mechanism(s) is uncertain. The driving hypothesis of this proposal is that cardiac ischemia releases a set of chemical mediators that activate ion channels and receptors on cardiac afferents, thereby triggering pain. The proposal relies heavily on a novel method we developed to fluorescently tag cardiac afferents so they can be distinguished from other kinds of sensory neurons. This is an essential step for identifying molecules that are necessary for cardiac pain but not for other sensations. Our initial work fmds that cardiac afferents have a unique molecular fmgerprint: they express an extremely Sensitive acid-sensing ion channel at grossly high levels. The result underscores the importance of protons created during ischemia as a mediator of cardiac pain. Our specific aims will: 1) definitively identify the particular clone of acid-sensing

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Angina Pectoris

ion channel used by cardiac afferents; 2) fmd whether other putative mediators of cardiac pain act by modulating this channel; 3) explore why there is different expression of channels in the two different populations of cardiac afferents. The experimental methods are single cell electrophysiology and immunocytochemistry. The clinical significance of the project lies in the suppression of angina, which is suffered by some 6 million Americans, is debilitating in some, and which triggers damaging cardiac reflexes in all. The results might also be relevant to other forms of vaso-oclusive pain, notably that of sickle cell anemia. We will identify molecules that trigger cardiac pain, thereby providing new pharmaceutical targets for its treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MYOCARDIAL PROTECTION IN THE AGING HEART Principal Investigator & Institution: Stowe, David F.; Anesthesiology; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532260509 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2005 Summary: It is well established that brief periods of ischemia, i.e. ischemic preconditioning (IPC) offers powerful self-protection of the myocardium from subsequent ischemia/reperfusion injury. However, recent evidence indicate that IPC is severely compromised in humans and animals with advanced age, which group is most likely to suffer from acute angina/myocardial infarct. The mechanisms of this agerelated defect is not well understood. Further more, new pharmacological interventions mimicking IPC which offer effective myocardial protection for the aging heart are not yet available. For this pilot project, our specific aims are a, to investigate the cellular mechanisms of age-related defects in ischemic preconditioning; b. to explore whether brief exposure to volatile anesthetic sevoflurane, i.e. anesthetic preconditioning (APC), offers myocardial protection for the aged heart from ischemia-reperfusion injury. Isolated perfused hearts from young (6 months old) and senescent (28 months old) Fisher 344 rats will be subjected to IPC or APC followed by ischemia and reperfusion. Cytosolic and mitochondrial Ca2+ (detected by Indo-1) and mitochondria metabolism (NADH fluorescence) in left ventricles will be monitored real time with fiber optic probes. Myocardial protection will be evaluated by infarct size, integrity of sarcoplasmic reticulum, mitochondria, myofilaments, sarcolemma, and cytoskeleton using western blots. The specific role of mitochondrial KATP channels and small heat shock proteins in myocardial protection will be explored. These parameters will provide a systematic view of the age-related defect in IPC and show whether APC can effectively protect the aging heart. The long term objectives of this project, as a new research area for this laboratory, are to investigate new interventions which may protect the aged myocardium from ischemia/reperfusion injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEUROLOGICAL AND COGNITIVE OUTCOMES FOLLOWING CABG Principal Investigator & Institution: Mckhann, Guy; None; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 10-SEP-1997; Project End 31-MAR-2004 Summary: (Verbatim from the Applicant's Abstract) In the United States, nearly 650,000 patients undergo coronary artery bypass grafting (CABG) each year. This procedure, although extraordinarily successful in relieving the symptoms of coronary disease, is also associated with a variety of neurologic problems, ranging from stroke to cognitive

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changes and depression, which remains a major cause of morbidity after surgery. Not only has it been estimated that from 30 and 79 percent of patients show cognitive decline from 2 weeks to 2 months after CABG, but our prior (separately funded) studies showed late decline in certain cognitive domains 1 to 4 years later. The cause of these cognitive changes is unclear: it is generally thought to be related to the use of the cardiopulmonary bypass machine in the operating room, but lack of appropriate control groups has precluded ruling out other causes including the effects of general anesthesia, Alzheimer's disease (AD) or depression. Therefore, newer techniques of "off-pump" coronary artery bypass surgery (OPAL), that are similar to CABG but do not use the cardiopulmonary bypass machine, provide a unique opportunity to determine the role of the bypass machine in the development of cognitive problems. The present proposal prospectively compares cognitive outcome in 3 groups of patients with coronary artery disease:-CABG patients (general anesthesia, use of the cardiopulmonary bypass machine)-OPCAB patients (general anesthesia)-Nonsurgical control patients (no surgery or general anesthesia) To address our overall hypothesis that patients undergoing CABG will show cognitive decline that differs in nature and time course from decline in surgical and nonsurgical controls, the following specific aims are proposed. By examining patients with neuropsychological tests chosen to assess different cognitive domains, and measures of depression preoperatively, at 3 months, at 1 year, at 3 years, aim 1 will compare the incidence of cognitive change up to 1 year in the three groups, to determine if decline is specific to CABG. Aim 2 will determine the incidence of change at 3 years after surgery. Aim 3 will clarify the role of depression on cognitive changes and the development of angina after surgery. Aim 4 will evaluate demographic, medical and genetic risk factors associated with cognitive change. The long-term objective of this proposal is to determine the role of the cardiopulmonary bypass machine in cognitive change after CABG with the ultimate purpose of proposing interventions to overcome these adverse effects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NON-TRADITIONAL CARDIOVASCULAR RISK FACTORS IN DM TYPE 2 Principal Investigator & Institution: Reaven, Peter D.; U.S. Carl T. Hayden Vet Affairs Med Ctr Affairs Medical Center Phoenix, Az 85012 Timing: Fiscal Year 2003; Project Start 01-APR-2001; Project End 30-NOV-2004 Summary: (Applicant's Abstract) A predominant consequence of diabetes mellitus type 2 (DM 2) is accelerated development of atherosclerosis related conditions. Conventional cardiovascular risk factors (CVRF) only explain a portion of the excess risk for atherosclerosis in this population. The overall goals of this project are to test whether novel CVRF are related to the presence and development of atherosclerosis and macrovascular events in DM 2 and to determine whether intensive glucose lowering therapy will reduce the levels of these CVRF. Specific short-term primary aims include determining the cross- sectional relationship between baseline levels and the presence of athero- sclerosis as measured by electron beam computed tomography assessment of coronary artery (CAC) and abdominal aortic calcium (AAC) and the prevalence of clinical macrovascular disease. The investigator proposes to take advantage of the study population and framework of the V A Cooperative study of "Glycemic Control and Complications in DM 2" to address these questions in an efficient and cost-effective manner. The Cooperative study is a prospective, two-arm, randomized, controlled, multicenter trial to assess the effects of tight glycemic control, achieved through intensification of treatment, on clinical macrovascular and microvascular complications

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in patients with DM 2 who are in poor glycemic control despite pharmacologic therapy. Cooperative study subjects from multiple sites (340 subjects) will be asked to participate in this additional trial. At their baseline visit, subjects will have additional blood and urine collected for a) VLDL, IDL and LDL subfractions b) measures of in vivo oxidative stress (oxidized-phospholipids on plasma LDL, autoantibodies to epitopes of oxidized LDL, F2-isoprostane levels) c) AGE-LDL levels, and d) markers of endothelial activation/injury (PAI-1, VCAM-1 and ICAM-1) and inflammation (C-reactive protein and fibrinogen). Subjects will also have CAC and AAC determined. After enrollment in the study, participants will have measurements of CVRF repeated at six months. Primary and secondary macrovascular endpoints will be identical to those defined in the VA Cooperative study (Primary: myocardial infarction, cardiovascular death, stroke, congestive heart failure, invasive vascular therapy (coronary or peripheral), and amputation due to ischemic gangrene; Secondary: angina pectoris, transient ischemic attacks, and peripheral artery disease). Statistical methods, depending on the specific aim will include categorical age and sex adjusted analyses, t-tests, and multiple regression models. Long- term (future) aims will include evaluating the prospective relationship of these novel cardiovascular risk factors to the progression of atherosclerosis and the development of macrovascular disease in this same population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PILOT--PERCEPTION OF ANGINAL CHEST PAIN IN CAD Principal Investigator & Institution: Kimble, Laura P.; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2002 Summary: The purpose of this pilot study is to explore relationships between anginal pain, sleep disturbance, and quality of life in coronary artery disease (CAD) patients, focusing on differences in symptom perceptions according to gender and status on the CAD illness trajectory. The Symptom Interactional Framework of sleep alterations and pain will serve as the theoretical base for the study. The study will have a prospective design and will be conducted in the outpatient cardiac catheterization laboratory of Emory Clinic, Emory University. Inclusion criteria include adults of any age, gender, and ethnicity who (a) are able to speak English, (b) have received a new diagnosis of CAD following elective coronary angiography or have received elective coronary angiography to evaluate status of known CAD, and (c) have a history of angina. In order to adequately address the research questions posed, the sample will be stratified by gender and by status on the CAD illness trajectory so that an equal number of males/females and newly diagnosed CAD patients on the CAD illness trajectory so that an equal number of males/females and newly diagnosed CAD patients in patients with a previous history of CAD will be represented in the analyses. A sample size of 84 subjects is proposed. Because effect size estimation is difficult (because difference between newly diagnosed CAD patients and those with a history of CAD have rarely been compared on the proposed study variables), the standard convention of a medium effect size with two- tailed alpha of.05 and a power of.80 was used to calculate sample size. Established data collection instruments will include the Chest Discomfort Diary, the Rose Questionnaire, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the Maastricht Questionnaire. Subjects will answer questions regarding chest pain, sleep disturbances, and vital exhaustion within eight hours following coronary angiography. Initial data analysis will include descriptive statistics on sample characteristics, examination for type and extent of any missing data, and assessment of psychometric properties for all study instruments. Independent samples t- tests and

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Pearson product moment correlations will be used to answer the three research questions. It is likely that more extensive modeling including logistic regression and/or discriminant analysis will be done for the third research question. While the study of sleep disturbances and angina is now a new area of inquiry, the proposed project has the potential to contribute to the literature by including strong conceptualization and measurement of anginal pain and sleep disturbances. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PLATELET FUNCTIONAL GENOMICS IN CARDIOVASCULAR DISEASE Principal Investigator & Institution: Williams, Marlene S.; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 07-JAN-2002; Project End 31-DEC-2006 Summary: (provided by applicant): We hypothesize that inherited variations of platelet adhesive glycoproteins determine platelet reactivity and hence, risk for acute ischemic coronary syndrome. The long-term objective of our project is to validate our hypothesis by measuring platelet function and performing platelet genotyping in patients who present with the acute coronary syndrome. One specific aim of this project involves determining whether platelet aggregation may be used as a measure of platelet hyperfunction in patients with ischemic heart disease. Epinephrine threshold aggregation and whole blood flow cytometry using anti-receptor induced binding site binding on presentation and at a 3-month interval are two methods utilized to determine this specific aim. A second specific aim involves performing platelet genotyping in the patient group and comparing these frequencies to a control group of hospitalized patients. A third specific aim involves correlating index events with platelet function and platelet glycoprotein polymorphism. Finally a determination of whether platelet function and/or platelet glycoprotein genotype can be used to predict subsequent events will be determined by statistical analysis. Follow-up of patients after a three-month interval from presentation is done to assess any difference in platelet function when compared to acute event presentation. If a correlation exists between genetic polymorphisms and the acute coronary syndrome, then several people can be screened and interventions such as smoking cessation, aggressive lipid management and other preventive medical therapies may be instituted for patients who are at greatest risk. The information gleaned from this project can also lead to new ideas for the design of newer medications used for the therapy of the acute coronary syndrome. The candidate?s career goal includes the refinement of basic laboratory skills pertaining to various platelet assays, development of a better understanding of platelet physiology, eventual establishment of an independent platelet laboratory, and advancement to the level of clinical leader in the field of platelet physiology as it applies to the acute coronary syndrome. By following these career goals, the candidate will eventually be able to ask pertinent questions applicable to the acute coronary syndrome and platelet function and become an independent clinical investigator. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RESISTANCE

POLYCYSTIC

OVARY

SYNDROME:

ROLE

OF

INSULIN

Principal Investigator & Institution: Nestler, John E.; Professor and Chairman; Internal Medicine; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2006

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Summary: (provided by applicant): This K24 Mid-Career Investigator in PatientOriented Research Award application is to support the continue development of Dr. John E. Nestler as a clinical investigator and research mentor. Dr. Nestler is Professor of Medicine at Virginia Commonwealth University's Medical College of Virginia, and has been a productive patient- oriented researcher whose research focus has been the pathophysiologic role of insulin resistance in the polycystic ovary syndrome (PCOS), a disorder that affects 6-10% of women of childbearing age. Dr. Nestler also has an established track record of mentorship of young clinical investigators. The broad longterm objective of Dr. Nestler's studies has been to conduct both mechanistic and translational studies exploring the role of insulin resistance in PCOS. The specific studies proposed in this application, which are currently funded by an NIH R0l grant and a U54 grant, are designed 1) to determine the effects of chronic insulin reduction on rates of spontaneous and clomiphene-induced ovulation in women with PCOS who were previously found to be refractory to clomiphene induction; 2) to determine whether reducing the serum insulin concentration beneficially influences gonadotropin secretory dynamics (i.e., decreases luteinizing hormone pulse amplitude and/or pulse frequency) in obese and/or lean women with PCOS; and 3) to explore whether insulin resistance causes an adverse cardiovascular risk profile in postmenopausal women with a history of PCOS during the premenopausal period. These studies will be conducted on the General Clinical Research Center using state-of-the-art methodologies, such as every 10 minute blood sampling for hormone pulse analysis by Cluster, Deconvolution Analysis and Approximate Entropy, and Reaven's steady-state plasma glucose (SSPG) technique for longitudinally monitoring insulin sensitivity. The K24 award will facilitate the completion of these studies, while also making it possible for Dr. Nestler to enhance his personal growth as a clinical investigator and to increase his mentoring activities. It will do so by providing Dr. Nestler with increased protected time, resulting from a decrease in administrative duties and clinical service responsibilities. As a result of the K24 award, Dr. Nestler will be able to devote 80% effort to research, further personal training in clinical research, and the training and mentorship of young investigators. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PRECONDITIONING IMPROVES CORONARY PATENCY Principal Investigator & Institution: Przyklenk, Karin; Professor; Emergency Medicine; Univ of Massachusetts Med Sch Worcester Office of Research Funding Worcester, Ma 01655 Timing: Fiscal Year 2002; Project Start 15-MAY-2002; Project End 30-APR-2005 Summary: (provided by applicant): Evidence from our laboratory has revealed that brief episodes of antecedent 'preconditioning' ischemia, in addition to limiting infarct size: (1) improve coronary artery patency in a canine model of primary hemostasis mimicking unstable angina; and (2) enhance the speed and efficacy of thrombolysis in a canine model of coagulation and persistent thrombotic occlusion. Our results have further implicated release of adenosine from ischemic/reperfused myocardium, and subsequent stimulation of platelet adenosine A2 receptors, as playing a pivotal role in this phenomenon. However, the specific 'distal' molecular mechanisms responsible for these improvements in coronary patency are unknown. Platelet adhesion, activation -and, ultimately, aggregation via the binding of fibrinogen to glycoprotein (GP) llb/lll receptors on adjacent platelets -- represents the underlying 'pathophysiology' of recurrent ischemia in the setting of unstable angina. Thus, our first hypothesis is that the improved coronary patency seen with brief antecedent ischemia/platelet A2 receptor stimulation is achieved by a down-regulation in the expression of adhesion molecules

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and/or ligands involved in the formation and stabilization of platelet aggregates -specifically, GP IIb/IIIa, P-selectin, von Willebrand Factor, PECAM and/or GP Ib. The evolution from an unstable platelet 'plug' to a persistent, fibrin-containing clot involves the thrombin-catalyzed conversion of fibrinogen (the molecular 'bridge' in platelet aggregates) to fibrin, thrombin-mediated activation of Factor XIII and subsequent Factor XIII-catalyzed fibrin cross-linking. Accordingly, our second hypothesis is that brief antecedent ischemia/A2 receptor stimulation elicits -- as a consequence of changes in platelet activation/aggregation and adhesion molecule expression -- modifications in coagulation and thus fibrin polymerization during clot development that facilitate penetration and binding of the lytic agent and thus accelerate thrombolysis. These concepts will be tested via an integrated analysis of both in vivo and in vitro endpoints. First, we will employ in viva canine models of unstable angina and persistent thrombosis to evaluate the effects of brief antecedent ischemia and selective; pharmacologic A2 receptor stimulation on: coronary patency; platelet adhesion molecule expression (by flow cytometry; platelet aggregometry); and Factor XlIlcatalyzed fibrin polymerization (by quantitative light microscopy) in the evolving coronary thrombus. Second, in concurrent studies, we will assess the effects of exogenous A2 receptor stimulation on in vitro, surrogate indices of vessel patency (in vitro platelet aggregation; in vitro thrombosis/thrombolysis). Finally, to address our third hypothesis -- that the favorable effects of A2-mediated signaling observed in our experimental models have potential clinical relevance -- we will conduct an identical in vitro analysis of platelet aggregation and thrombosis/thrombolysis on blood samples obtained from human volunteers. These hypotheses, if confirmed, may ultimately aid in the design of novel therapeutic strategies aimed at enhancing vessel patency in clinical instances of unstable angina and reperfusion for the treatment of acute myocardial infarction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROTEIN STABILITY IN POLYMER DELIVERY SYSTEMS Principal Investigator & Institution: Schwendeman, Steven P.; Associate Professor; Pharmaceutical Sciences; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 15-FEB-2001; Project End 31-JAN-2006 Summary: (Verbatim from the Applicant's Abstract): Protein drugs are currently administered systemically by injections. For individuals requiring chronic therapy, selfadministration with a needle is an unpleasant everyday experience. However, development of injectable biodegradable polymers (e.g., poly(lactide-co-glycolides), PLGA) capable of slowly and continuously releasing proteins for months between injections may provide a realistic alternative to painful daily injections. PLGA delivery systems are also used for local therapy and for delivery of vaccines. The primary obstacle to develop PLGA delivery systems for proteins is the irreversible instability of these agents prior to their release in vivo. The overall goal of these studies is to determine the underlying molecular mechanisms responsible for the instability of proteins in PLGA and to use this information to develop widely applicable stabilization approaches. In this proposal, the pH in the polymer will be manipulated with antacid excipients to improve the stability of model proteins encapsulated in PLGA. This general stabilization approach will then be tested with therapeutic proteins that promote angiogenesis. Slow-release angiogenic agents have important applications for patients with ischemic heart disease (responsible for about 5OO,OOO deaths annually in the U. S.). The ensuing site-specific neovascularization would facilitate myocardial perfusion

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Angina Pectoris

and reduce cardiac complications such as myocardial infarction, angina pectoris, heart failure, and/or sudden cardiac death. Slow-release growth factors may also be useful to improve survival of tissues after implantation of tissue engineering scaffolds. Considering the potential impact of PLGA delivery systems that slowly release native therapeutic proteins, such as those that promote angiogenesis, could have on human health, the importance in resolving the poor instability of proteins encapsulated in PLGAs becomes unmistakable. This proposal will test the following hypothesis: Moisture and acidic pH inside PLGAs during protein release are the two most common stresses responsible for instability of proteins in PLGA delivery systems, including microspheres. Development of methods to regulate pH in the polymer as well as aqueous protein solubility will become widely applicable techniques to stabilize encapsulated proteins. This hypothesis will be tested in the following specific aims: (1) Characterization of physical chemical processes in the polymer microclimate that influence stability and release of encapsulated proteins; (2) Investigation of stability of model proteins in PLGA delivery systems; (3) Application of the stabilization methodology to the delivery of therapeutic angiogenic proteins; and (4) In vivo assessment of the controlled release of biologically active angiogenic proteins. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RISK-ADJUSTMENT OF 1-YEAR HEALTH STATUS OUTCOMES IN CAD Principal Investigator & Institution: Spertus, John A.; St. Luke's Hospital 4401 Wornall Rd Kansas City, Mo 64111 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 31-AUG-2004 Summary: The investigators propose to use an existing, well-established clinical database with baseline and 1-year health status data to describe the physical and mental functioning, angina pectoris burden, quality of life in patients 1-year post hospital discharge for acute coronary syndromes. Two distinctly different clinical sites will be utilized. The Mid-American heart Institute is a high volume, referral center that provides advanced cardiac care. The Truman Medical Center is a city hospital largely serving an indigent, urban patient population. No invasive cardiac procedures are performed there. An observation registry of over 3000 patients will be collected over an 18 months (validation cohort of 1500 between months 12 - 18) will be utilized to: 1) describe baseline and 1-year health status of patients admitted with acute coronary syndromes; 2) describe the association between health status and coronary revascularization; 3) determine if health status provides additional predictive value over standard clinical variables in predicting 1-year mortality; and 4) develop multivariable models of 1-year health status. The investigators highlight that their proposed study is responsive to the stated AHCPR priority areas of "supporting improvement in health outcomes" and "strengthening quality measurement". They also state that risk-adjusted models of health outcomes are both markers of health care quality and may be used to facilitate informed patient decisions. Significant modifications of this application have been made in response to the initial review of this study section. The classification of acute coronary syndromes has now been codified with the selection of the Braunwald classification, and the scanning of the electrocardiograms for reading by board-certified cardiologists. Vital status ascertainment has now been clarified. The discussion of the Truman Medical Center and supported provided to the same has been expanded. Low literacy issues have been addressed and preliminary data have been provided. Also, the lack of detail in the analytical plan has been rectified. Finally, the budgetary impact of the two proposed expert consultants has been neutralized. The investigators

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persuasively argue that their study will likely lead to a truncated set of important predictor variables that will facilitate generalizability of their findings by making implementation of their data collection approach more feasible. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SELF-MANAGEMENT OF CARDIOVASCULAR DISEASE Principal Investigator & Institution: Wurzburg, Gerardine; President; State of the Art, Inc. 4455 Connecticut Ave Nw, Ste B-200 Washington, Dc 20008 Timing: Fiscal Year 2002; Project Start 01-JUL-2000; Project End 31-AUG-2004 Summary: (provided by applicant): This project will provide people diagnosed with cardiovascular disease with a package of two documentary-style videotapes, two booklets, and an interactive web module, that stresses the importance of selfmanagement and to motivate them to do so. The Phase I results showed that people with CVD felt that these materials would be useful and would use the materials themselves. Equally significant were the results from the evaluation with health professionals, who were very enthusiastic about the materials and felt that the content was clear and accurate. As a result of Phase I research, one video/booklet set will target women and the other will target men. The videos will show the lives of people who are successfully self-managing their CVD and will target the viewer's expectancies of selfmanagement and their self-efficacy of performing it. The booklet will outline selfmanagement information and resources. The interactive web module, which will be licensed to existing web sites, fills a gap left by most web resources for people with CVD - management of stress and awareness of depression. It will allow the user to track these conditions that can have a profound effect on their CVD. It will also deliver information about latest CVD research specific to the needs and interests of the user, based on their profile, and allow the formation of an on-line community via bulletin boards and chats. In Phase II, the videotapes, booklets, and web module will be produced from the final creative plans developed from Phase I research. The rough-cuts of the videos, rough drafts of the booklet, and beta version of the web module will be reviewed by our Board of Advisors. After feedback from the advisors is incorporated, the materials will be tested through a number of focus groups. After the final editing and identity production are complete, the materials will be tested using a quasi-experimental control group pretest/posttest design. In Phase III, we will approach service organizations and clinics to distribute the package. Using contacts established in Phase I, and other projects serving the needs of persons with CVD, we have working relationships with many organizations, health care facilities, and pharmaceutical companies who would join in this promotional distribution effort. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SPHINGOLIPIDS AS MARKERS OF CARIDAC ISCHEMIA Principal Investigator & Institution: Sabbadini, Roger A.; Professor; Medlyte, Inc. 5500 Campanile Dr San Diego, Ca 92182 Timing: Fiscal Year 2004; Project Start 01-MAR-2004; Project End 28-FEB-2005 Summary: (provided by applicant): It has recently been appreciated that coronary artery disease (CAD) is aggravated by the inflammatory response. It has been suggested that sphingolipid signaling molecules are mediators of inflammation, particularly in response to pre-inflammatory cytokines such as TNFalpha and IL2. In addition to the putative release of these molecules as part of the inflammatory response, it is possible that sphingolipids are produced as a consequence of ischemia itself, since recent studies

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Angina Pectoris

demonstrate increased sphingolipid production by ischemic heart cells. Thus, we reasoned that sphingolipids produced either by the inflammatory or ischemic processes could indicate myocardial ischemia. Accordingly, we have designed a trial with the aim of showing that the concentrations of serum sphingolipids such as sphingosine-1phosphate (S1P) rise in patients undergoing a stress test whose nuclear imaging results indicate exercise-induced ischemia. Serial blood samples will be obtained before and several times after treadmill testing for the determination of serum sphingolipids. We will compare serum sphingolipid levels with inflammatory biomarkers, CRP and TNFalpha, and standard assessments of ischemia, including positive electrocardiographic and nuclear imaging. Ischemia-negative patients are those with a negative ETT and negative nuclear scans. We will evaluate the specificity and sensitivity of our putative ischemic markers with active ischemia. An additional aim of this Phase I SBIR is to develop monoclonal antibodies suitable for serum testing of patients suspected of cardiac ischemia. The anticipated success will prepare us for a Phase II application in which we will develop the commercial test platform suitable for both clinical laboratory instruments and rapid point-of-care testing. We also intend to conduct follow-on clinical trials of emergency room patients suspected of AMI to determine if serum sphingolipids may be useful in triaging chest pain patients. It is also possible that sphingolipids contribute to the pathophysiology of acute coronary syndrome and that they are responsible for the poor outcomes observed in acute coronary syndrome patients who have elevated serum levels of TNFalpha. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TELE-ELECTROCARDIOGRAPHY IN EMERGENCY CARDIAC CARE Principal Investigator & Institution: Drew, Barbara J.; Physiological Nursing; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): This project which seeks to determine whether individuals who access the "911" emergency medical system (EMS) with acute myocardial infarction (MI) or unstable angina will receive more timely hospital treatment and better outcomes if hospital clinicians are provided with 1) earlier, and 2) more complete ECG information. Earlier EKG information will be achieved in 2 ways: (1) by synthesizing a 12-lead ECG from a rapidly applied 5 electrode configuration, rather than using the cumbersome 10- electrode configuration required for a standard 12 lead ECG, and (2) by transmitting ECGs by cell phone tele-electrocardiography) from the field to the emergency department (ED) rather than waiting to obtain an ECG after hospital arrival. More complete ECG information will be achieved in 3 ways 1) by monitoring continuously rather than recording a one-time ECG, 2) by monitoring all 12 EKG leads, rather than a single lead, and (3) by monitoring with special ischemia detection software, rather than arrhythmia software alone. The software will continuously analyze ST segments in all 12 ECG leads for changes of acute ischemia and will automatically print out ECGs in the ED when ST events occur. This teleelectrocardiography intervention will be implemented as a county wide program in Northern California through Santa Cruz County's EMS. A total of 2,468 subjects will be recruited for this prospective, randomized controlled clinical trial. Subjects will be randomized to one of two groups: 1) the experimental group will have the pre-hospital tele-electrocardiography intervention and 2) the control group will have routine EMS cardiac care. Hypotheses to be tested are that patients randomized to the ST SMART intervention experimental group will, in comparison to patients in the routine EMS control group have: (1) no longer paramedic scene times, despite the acquisition of more

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ECG information, (2) reduced time to treatment for acute coronary syndromes, and (3) fewer adverse outcomes in the hospital and at one year following hospital discharge. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE LONG-TERM BENEFITS OF CARDIAC REHABILITATION IN MEN Principal Investigator & Institution: Todaro, John F.; Miriam Hospital Providence, Ri 029062853 Timing: Fiscal Year 2002; Project Start 01-MAR-2001; Project End 28-FEB-2006 Summary: This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) from NHLBI to enable Mr. John Todaro to develop research expertise in studying gender differences in patients participating in cardiac rehabilitation (CR). John Todaro will work closely with his mentor, Dr. Niaura, and his co-mentors Drs. Marcus, Friedman, and Tilkemeier at the Brown University School of Medicine, as well as with co-mentor Dr. Blumenthal from Duke University. John Todaro's short-term goals are to enhance the theoretical, methodological, and statistical skills that he needs to study gender differences related to CHD and its associated treatments. His long-term goals are to develop an independent laboratory, as well as a network of research collaborators devoted to advancing our understanding of the behavioral aspects of managing CHD and training future clinical researchers. Although CR continues to be a vital component of CHD management for both men and women, much of the research examining CR outcomes has focused its attention on men. The proposed study will examine if men and women experience similar psychological, quality of life, and medical benefits from participation in cardiac rehabilitation. Aim 1 of the proposed study is to compare the long-term psychological and quality of life benefits of CR in men and women. The hypothesis is that, since women are often older, manage multiple comorbid medical conditions, and have fewer sources of social support, women will experience fewer benefits than their male counterparts in terms of improvements in psychological functioning (depression and anxiety) and quality of life. Aim 2 of the proposed study is to compare rates of cardiac morbidity and mortality in men and women participating in CR. The hypothesis is that, since women present with these less favorable premorbid characteristics and, given that women experience fewer psychological benefits from CR, women will experience more episodes of incident heart disease (i.e., angina pectoris, myocardial infarction) and demonstrate higher rates of mortality over a two-year period than men. Aim 3 of the proposed study is to explore the impact of CR on subsequent medical utilization variables including number of clinic visits, number and types of revascularization procedures performed, and number and length of hospitalizations in men and women. Results of the proposed study should increase our understanding of the differential long-term benefits of CR for men and women. These data will assist John Todaro to establish an empirical foundation from which to develop novel interventions to address the specific challenges experienced by women as well as men participating in CR. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TIPI SYSTEMS TO REDUCE ERRORS IN EMERGENCY CARDIAC CARE Principal Investigator & Institution: Selker, Harry P.; Professor of Medicine; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2002; Project Start 15-SEP-2000; Project End 31-AUG-2004

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Summary: As the largest cause of morbidity and mortality in this country, acute cardiac ischemia (ACI: which includes acute myocardial infarction [AMI] and unstable angina pectoris [UAP], which can lead to AMI) is the most common serious condition requiring emergency and acute care. Among the 7 million patients who present to emergency departments (EDs) in this country each year with symptoms consistent with ACI, errors are made both in ED triage and treatment. In ED triage, in this country each year, approximately 12,000 patients with AMI and 14,000 with UAP are mistakenly sent home, which nearly doubles the expected mortality rates for these patients and contributes to the status of missed ACI in the ED as the largest cost category of adult malpractice claims in the US. In ED treatment, although for ED patients with AMI, the lifesaving impact of thrombolytic therapy is directly related to the earliness of its use, many are not treated promptly, and about 90,000 per year are not treated at all. These errors in triage and treatment for ACI are clinically critical to the patient and occur on a scale that makes them public health issue, and thus present important opportunities to reduce medical errors. This project aims to reduce medical errors in ED triage and treatment for ACI based on a time-insensitive predictive instrument information system (TIPI-IS), designed to be attractive to all members of the health care system, by providing real-time, concurrent, and retrospective decision support. This approach rests on TIPI-capable electrocardiograph's ability to compute, for every ED patient upon presentation, a 0-100% probability that a patient truly has ACI, and if having an AMI, the likely outcome benefits of thrombolytic therapy. This project will consist of a beforeafter time- series design to measure the impact of the intervention with stepwise implementation. In Phase 1 the system will be fully implemented at New England Medical Center (NEMC) and revisions made to promote user- friendliness at all levels. In Phase 2, the system will be used in the three main hospitals in the Lifespan System. In Phase 3, Marsh USA will partner with us to distribute this system to its insured hospitals and managed care organizations. This plan thus allows demonstration of the usefulness of the TIPI-IS as an error reduction system, first in a single hospital, then for a group of hospitals, and then in a sample of health care systems nationally. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TOBACCO REDUCTION STRATEGIES FOR PATIENTS WITH CARDIAC DISEASE Principal Investigator & Institution: Joseph, Anne; Associate Professor; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002 Summary: Cigarette smoking promotes atherosclerosclerotic cardiovascular disease (ASCVD), and cessation confers significant health benefits to patients with heart disease. Total abstinence is the goal of current tobacco dependence treatment models, however, it is not accessible to many patients. There is a strong dose-response relationship between the amount smoked and risk for ASCVD, suggesting that for those patients who cannot stop, reducing smoking may be of benefit. Nicotine replacement therapy (NRT) is safe in patients with cardiovascular disease, and limited data suggest that long term NRT is effective at reducing tobacco use and carbon monoxide (CO) exposure. We propose a randomized controlled clinical trial in 180 patients with ASCVD to test the hypothesis that a combined behavioral and pharmacological intervention designed to reduce smoking by at least 50% will 1) reduce cigarette consumption, 2) improve smoking cessation rates, 3) reduce signs and symptoms of ASCVD, 4) improve risk factors for ASCVD, and 5) prove to be cost-effective in terms of cost per quality adjusted life year gained. We will randomly assign subjects from two ambulatory care sites to the

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smoking reduction treatment (SR) group (including a standardized approach to transdermal nicotine, or nicotine gum if not successful reducing using patch) or the control group. Subjects will be followed for a two year period, and will be encouraged to quit at any time if they are ready. We will collect data regarding smoking behavior, exercise tolerance, angina, quality of life, and adverse events; and measure nicotine, cotinine, CO, lipids, and fibrinogen. We will contribute samples to the Biomarker Core project to assess the effect of smoking reduction on other toxin levels. We will conduct an economic analysis of the potential cost-effectiveness of this approach. This study will test whether a long term strategy to reduce cigarette consumption in a medically ill population is safe, effective , and improves health outcomes for smokers who cannot quit. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: WISCONSIN EPIDEMIOLOGICAL STUDY OF CARDIOVASCULAR DISEAS Principal Investigator & Institution: Klein, Ronald; Professor; Ophthalmology and Visual Sci; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 01-FEB-1999; Project End 31-JAN-2003 Summary: This proposal describes a population-based cohort aimed at determining the prevalence and incidence of cardiovascular disease morbidity and mortality in people with Type 1 diabetes of long-duration. For this epidemiologic study, subjects include all insulin-taking persons who: (1) were less than 30 years of age at the time of their diagnosis, (2) had received primary medical care in an 11-county area of south-central Wisconsin, and (3) were first identified in 1979-80. Standardized protocols for examinations and interviews have been employed during the baseline, 4-, 10-, and 14year follow up examinations. Refusal rates have been low. The mean age of the cohort and the long duration of diabetes provide an opportunity to document the prevalence and incidence of coronary heart disease, myocardial infarction, angina, congestive heart failure, stroke, transient ischemic attacks, peripheral vascular disease, and cardiovascular disease mortality in a large population-based group of persons with Type 1 diabetes. Retinal photographs of each study participant were taken at the baseline examination. This will permit us to test the predictive ability of focal and generalized retinal arteriolar narrowing and arterio-venous cross changes (i.e. A/V nicking) for subsequent macrovascular events controlling for other risk factors. These factors include blood pressure, cigarette smoking, serum lipids, body mass index, duration of diabetes, and glycemia. We plan to reexamine this cohort to obtain ECGs, blood lipid fractions not previously measured, and fibrinogen, as well as upper and lower extremity blood pressures, urine specimens, and medical records. This will provide information about silent about silent infarctions and other cardiographic abnormalities as well as previously doctor-diagnosed macrovascular events in longterm survivors of Type 1 diabetes. Study examinations will be performed in a mobile van. Participants will provide two urine specimens for determination of urinary albumin excretion. Fasting blood will be obtained for determination of glycosylated hemoglobin Alc, blood sugar, serum cholesterol, triglycerides, HDL- cholesterol, LDLcholesterol, VDL-cholesterol, LDL particle size, serum creatinine, and fibrinogen. Additional study procedures include measurements of weight and height, waist and hip girth, and brachial and ankle blood pressures. Electrocardiography will also be performed. A questionnaire will be administered Participants will subsequently be interviewed yearly and clinical and hospital records and death certificates will be collected to document new cardiovascular disease events. Findings regarding the

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prevalence and incidence of cardiovascular disease and associated risk factors will be of great public health importance in directing further at preventing these conditions in people with Type 1 diabetes of long duration. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “angina pectoris” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for angina pectoris in the PubMed Central database: •

Investigation of the Physiological Basis for Increased Exercise Threshold for Angina Pectoris after Physical Conditioning. by Sim DN, Neill WA.; 1974 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=301610

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PRINZMETAL'S VARIANT ANGINA PECTORIS WITH NORMAL CORONARY ARTERIOGRAMS: EFFECT OF LONG-TERM RESERPINE TREATMENT. by Hernandez-Casas G, Dear W, Leachman RD.; 1974; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=287486

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THE USE OF NON-INVASIVE TECHNIQUES IN MANAGEMENT OF PATIENTS WITH ANGINA PECTORIS ON ORAL PROPRANOLOL. by Frishman WH, Smithen C, Kligfield P, Killip T.; 1974; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=287487

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Unstable Angina Pectoris and the Progression to Acute Myocardial Infarction Role of Platelets and Platelet-Derived Mediators. by Willerson JT, Yao SK, Ferguson JJ, Anderson HV, Golino P, Buja LM.; 1991; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=326348

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction

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The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with angina pectoris, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “angina pectoris” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for angina pectoris (hyperlinks lead to article summaries): •

A pilot double-blind randomized placebo-controlled study of molsidomine 16 mg once-a-day in patients suffering from stable angina pectoris: correlation between efficacy and over time plasma concentrations. Author(s): Messin R, Fenyvesi T, Carreer-Bruhwyler F, Crommen J, Chiap P, Hubert P, Dubois C, Famaey JP, Geczy J. Source: European Journal of Clinical Pharmacology. 2003 July; 59(3): 227-32. Epub 2003 May 07. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12734607

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A rare cause of coronary obstruction and angina pectoris. Author(s): Peikert T, Goetze S, Ghaffari S. Source: Heart (British Cardiac Society). 2003 September; 89(9): 1120. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12923048

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Acute coronary lesions and troponin elevation in unstable angina pectoris or non-ST elevation acute myocardial infarction. Author(s): Ambrose JA, Gould RB, Zairis MN, DeVoe MC, Nguyen TH, Geagea JP, Arias JH, Prakash AM, Varshneya N, Meraj P, Barua RS. Source: The American Journal of Cardiology. 2002 October 1; 90(7): 770-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12356396

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Acute intravenous L-arginine infusion decreases endothelin-1 levels and improves endothelial function in patients with angina pectoris and normal coronary arteriograms: correlation with asymmetric dimethylarginine levels. Author(s): Piatti P, Fragasso G, Monti LD, Setola E, Lucotti P, Fermo I, Paroni R, Galluccio E, Pozza G, Chierchia S, Margonato A. Source: Circulation. 2003 January 28; 107(3): 429-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12551867

with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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Amyloidosis of epicardial and intramural coronary arteries as an unusual cause of myocardial infarction and refractory angina pectoris. Author(s): Miani D, Rocco M, Alberti E, Spedicato L, Fioretti PM. Source: Ital Heart J. 2002 August; 3(8): 479-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12407826

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Analysis of baseline factors associated with reduction in chest pain in patients with angina pectoris treated by enhanced external counterpulsation. Author(s): Lawson WE, Kennard ED, Hui JC, Holubkov R, Kelsey SF; IEPR Investigators. Source: The American Journal of Cardiology. 2003 August 15; 92(4): 439-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12914875

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Angina pectoris and normal coronary arteries: cardiac syndrome X. Author(s): Crea F, Lanza GA. Source: Heart (British Cardiac Society). 2004 April; 90(4): 457-63. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15020531

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Angina pectoris or myocardial infarction? Pure septal infarction. Author(s): Nagano S, Miyahara K, Sohara H, Tanaka Y, Arima T. Source: J Cardiol. 2002 May; 39(5): 277-80. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12048905

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Angina pectoris prior to myocardial infarction protects against subsequent left ventricular remodeling. Author(s): Solomon SD, Anavekar NS, Greaves S, Rouleau JL, Hennekens C, Pfeffer MA; HEART Investigators. Source: Journal of the American College of Cardiology. 2004 May 5; 43(9): 1511-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15120803

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Angina pectoris without chest pain. Author(s): Phibbs B. Source: Circulation. 2003 August 12; 108(6): E37; Author Reply E37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12912797

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Angina pectoris without chest pain: clinical implications of silent ischemia. Author(s): Stern S. Source: Circulation. 2002 October 8; 106(15): 1906-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12370210

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Angina pectoris: interventional therapies and treatment of restenosis. Author(s): Nair SV, McEwan JR. Source: The International Journal of Biochemistry & Cell Biology. 2003 October; 35(10): 1399-406. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12818236

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Anomalous left coronary artery arising from the right sinus of valsalva in a man with unstable angina pectoris and right coronary artery stenosis. Author(s): Rentoukas E, Alpert MA, Deftereos S, Foukarakis M, Nikas D, Lazaros G, Zacharoulis A. Source: The American Journal of the Medical Sciences. 2002 April; 323(4): 223-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12003379

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Antianginal effects of trimetazidine and left ventricular function improvement in patients with stable angina pectoris. Author(s): Shlyakhto EV, Almazov VV, Nifontov EM, Vakhrameyeva IV, Rudomanov OG, Zakharov DV, Kazarin VV, Vakhrameyeva NV. Source: American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions. 2002; 2(2): 119-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14727987

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Anti-inflammatory effect of atorvastatin (80 mg) in unstable angina pectoris and nonQ-wave acute myocardial infarction. Author(s): Correia LC, Sposito AC, Lima JC, Magalhaes LP, Passos LC, Rocha MS, D'Oliveira A, Esteves JP. Source: The American Journal of Cardiology. 2003 August 1; 92(3): 298-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12888137

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Assessment by radionuclide ventriculography of postischemic regional left ventricular dysfunction in patients with healed myocardial infarction or angina pectoris. Author(s): Tamai T, Konishi T, Nakamura M, Isaka N, Nakano T. Source: The American Journal of Cardiology. 2002 July 1; 90(1): 10-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12088771

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Association between TAFI antigen and Ala147Thr polymorphism of the TAFI gene and the angina pectoris incidence. The PRIME Study (Prospective Epidemiological Study of MI). Author(s): Morange PE, Juhan-Vague I, Scarabin PY, Alessi MC, Luc G, Arveiler D, Ferrieres J, Amouyel P, Evans A, Ducimetiere P; PRIME Study group. Source: Thrombosis and Haemostasis. 2003 March; 89(3): 554-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12624641

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Association between thrombin-activatable fibrinolysis inhibitor (TAFI) and clinical outcome in patients with unstable angina pectoris. Author(s): Brouwers GJ, Leebeek FW, Tanck MW, Wouter Jukema J, Kluft C, de Maat MP. Source: Thrombosis and Haemostasis. 2003 July; 90(1): 92-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12876631

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Associations among oxidized low-density lipoprotein antibody, C-reactive protein, interleukin-6, and circulating cell adhesion molecules in patients with unstable angina pectoris. Author(s): Doo YC, Han SJ, Lee JH, Cho GY, Hong KS, Han KR, Lee NH, Oh DJ, Ryu KH, Rhim CY, Lee KH, Lee Y. Source: The American Journal of Cardiology. 2004 March 1; 93(5): 554-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14996578

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Basing pharmacy counselling on the perspective of the angina pectoris patient. Author(s): Haugbolle LS, Sorensen EW, Gundersen B, Petersen KH, Lorentzen L. Source: Pharmacy World & Science : Pws. 2002 April; 24(2): 71-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12061137

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Beneficial clinical effects of perhexiline in patients with stable angina pectoris and acute coronary syndromes are associated with potentiation of platelet responsiveness to nitric oxide. Author(s): Willoughby SR, Stewart S, Chirkov YY, Kennedy JA, Holmes AS, Horowitz JD. Source: European Heart Journal. 2002 December; 23(24): 1946-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12473257

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Beneficial effect of prodromal angina pectoris is lost in elderly patients with acute myocardial infarction. Author(s): Ishihara M, Sato H, Tateishi H, Kawagoe T, Shimatani Y, Ueda K, Noma K, Yumoto A, Nishioka K. Source: American Heart Journal. 2000 May; 139(5): 881-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10783223

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Beneficial effects of atrial natriuretic peptide on exercise-induced myocardial ischemia in patients with stable effort angina pectoris. Author(s): Lai CP, Egashira K, Tashiro H, Narabayashi H, Koyanagi S, Imaizumi T, Takeshita A. Source: Circulation. 1993 January; 87(1): 144-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8419001

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Benefit of adding low molecular weight heparin to the conventional treatment of stable angina pectoris. A double-blind, randomized, placebo-controlled trial. Author(s): Melandri G, Semprini F, Cervi V, Candiotti N, Palazzini E, Branzi A, Magnani B. Source: Circulation. 1993 December; 88(6): 2517-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8252662

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Benefits of immediate initiation of statin therapy following successful coronary stent implantation in patients with stable and unstable angina pectoris and Q-wave acute myocardial infarction. Author(s): Walter DH, Fichtlscherer S, Britten MB, Auch-Schwelk W, Schachinger V, Zeiher AM. Source: The American Journal of Cardiology. 2002 January 1; 89(1): 1-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11779513

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Bepridil hydrochloride compared with placebo in patients with stable angina pectoris. Author(s): Narahara KA, Singh BN, Karliner JS, Corday SR, Hossack KF. Source: The American Journal of Cardiology. 1992 April 9; 69(11): 37D-42D. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1553890

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Bepridil. A review of its pharmacological properties and therapeutic use in stable angina pectoris. Author(s): Hollingshead LM, Faulds D, Fitton A. Source: Drugs. 1992 November; 44(5): 835-57. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1280569

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Beta-endorphin but not metenkephalin counteracts adenosine-provoked angina pectoris-like pain. Author(s): Sylven C, Eriksson B, Sheps DS, Maixner B. Source: Neuroreport. 1996 August 12; 7(12): 1982-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8905708

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Betaxolol in the treatment of stable angina pectoris. Author(s): Chrysant SG, Bittar N. Source: Cardiology. 1994; 84(4-5): 316-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8187119

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Biphasic relaxation-frequency relations in patients with effort angina pectoris: a new marker of myocardial demand ischemia. Author(s): Umeda H, Iwase M, Izawa H, Nishizawa T, Nonokawa M, Isobe S, Noda A, Nagata K, Ishihara H, Yokota M. Source: American Heart Journal. 2003 July; 146(1): 75-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12851611

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Birth weight and risk of angina pectoris: analysis in Swedish twins. Author(s): Hubinette A, Cnattingius S, Johansson AL, Henriksson C, Lichtenstein P. Source: European Journal of Epidemiology. 2003; 18(6): 539-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12908719

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Bisoprolol in the treatment of chronic stable angina pectoris. Author(s): Terol I, Plaza L, Rodrigo F. Source: Journal of Cardiovascular Pharmacology. 1990; 16 Suppl 5: S208-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11527131

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Blood antioxidants and indices of lipid peroxidation in subjects with angina pectoris. Author(s): Duthie GG, Beattie JA, Arthur JR, Franklin M, Morrice PC, James WP. Source: Nutrition (Burbank, Los Angeles County, Calif.). 1994 July-August; 10(4): 313-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8000152

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BMIPP in angina pectoris. Author(s): Nishimura S, Ohta Y. Source: International Journal of Cardiac Imaging. 1999 February; 15(1): 35-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10453401

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Both endothelium-dependent and endothelium-independent function is impaired in patients with angina pectoris and normal coronary angiograms. Author(s): Chauhan A, Mullins PA, Taylor G, Petch MC, Schofield PM. Source: European Heart Journal. 1997 January; 18(1): 60-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9049516

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Brachial artery flow pattern and clinical backgrounds in patients with angina pectoris. Author(s): Sugawara H, Kubota I, Tomoike H. Source: Angiology. 1998 January; 49(1): 25-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9456161

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Brain natriuretic peptide in the prediction of recurrence of angina pectoris. Author(s): Takase H, Toriyama T, Sugiura T, Ueda R, Dohi Y. Source: European Journal of Clinical Investigation. 2004 February; 34(2): 79-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14764069

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Bronchial asthma causing symptoms suggestive of angina pectoris. Author(s): Kiss D, Veegh W, Schragel D, Bachl C, Stollberger C, Sertl K. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 2003 March; 21(3): 473-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12662004

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Bronchial hyperresponsiveness to acetylcholine in patients with vasospastic angina pectoris. Author(s): Saitoh Y, Sasaki F, Ishizaki T, Miyabo S, Kanamori K, Mifune J. Source: Chest. 1994 February; 105(2): 364-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8306729

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Cardiovascular risk factors for stable angina pectoris versus unheralded myocardial infarction. Author(s): Dunder K, Lind L, Lagerqvist B, Zethelius B, Vessby B, Lithell H. Source: American Heart Journal. 2004 March; 147(3): 502-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14999201

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Chronic therapeutically refractory angina pectoris. Author(s): DeJongste MJ, Tio RA, Foreman RD. Source: Heart (British Cardiac Society). 2004 February; 90(2): 225-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14729809

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Clinical trial simulation using therapeutic effect modeling: application to ivabradine efficacy in patients with angina pectoris. Author(s): Chabaud S, Girard P, Nony P, Boissel JP; HERapeutic MOdeling and Simulation Group. Source: Journal of Pharmacokinetics and Pharmacodynamics. 2002 August; 29(4): 339-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12518708

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Coexistence of familial hypertrophic cardiomyopathy and vasospastic angina pectoris in two brothers. Author(s): Suzuki N, Seto S, Koide Y, Sato O, Hirano H, Kawano H, Yano K. Source: Japanese Heart Journal. 2003 September; 44(5): 775-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14587659

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Comparing systems for costing hospital treatments. The case of stable angina pectoris. Author(s): Larsen J, Skjoldborg US. Source: Health Policy (Amsterdam, Netherlands). 2004 March; 67(3): 293-307. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15036817

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Comparison of coronary artery specific leukocyte-platelet conjugate formation in unstable versus stable angina pectoris. Author(s): Patel PB, Pfau SE, Cleman MW, Brennan JJ, Howes C, Remetz M, Cabin HS, Setaro JF, Rinder HM. Source: The American Journal of Cardiology. 2004 February 15; 93(4): 410-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14969612

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Comparison of effects of nisoldipine-extended release and amlodipine in patients with systemic hypertension and chronic stable angina pectoris. Author(s): Pepine CJ, Cooper-DeHoff RM, Weiss RJ, Koren M, Bittar N, Thadani U, Minkwitz MC, Michelson EL, Hutchinson HG; Comparative Efficacy and Safety of Nisoldipine and Amlodipine (CESNA-II) Study Investigators. Source: The American Journal of Cardiology. 2003 February 1; 91(3): 274-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12565082

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Comparison of effects on markers of blood cell activation of enoxaparin, dalteparin, and unfractionated heparin in patients with unstable angina pectoris or non-STsegment elevation acute myocardial infarction (the ARMADA study). Author(s): Montalescot G, Bal-dit-Sollier C, Chibedi D, Collet JP, Soulat T, Dalby M, Choussat R, Cohen A, Slama M, Steg PG, Dubois-Rande JL, Metzger JP, Tarragano F, Guermonprez JL, Drouet L; ARMADA Investigators. Source: The American Journal of Cardiology. 2003 April 15; 91(8): 925-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12686329

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Comparison of ischemia-modified albumin levels in patients undergoing percutaneous coronary intervention for unstable angina pectoris with versus without coronary collaterals. Author(s): Garrido IP, Roy D, Calvino R, Vazquez-Rodriguez JM, Aldama G, CosinSales J, Quiles J, Gaze DC, Kaski JC. Source: The American Journal of Cardiology. 2004 January 1; 93(1): 88-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14697474

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Comparison of late outcome in patients with versus without angina pectoris having reversible perfusion abnormalities during dobutamine stress technetium-99m sestamibi single-photon emission computed tomography. Author(s): Elhendy A, Schinkel AF, van Domburg RT, Bax JJ, Poldermans D. Source: The American Journal of Cardiology. 2003 February 1; 91(3): 264-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12565080

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Comparison of presentation, perception, and six-month outcome between women and men > or =75 years of age with angina pectoris. Author(s): Kuster GM, Buser P, Osswald S, Kaiser C, Schonenberger R, Schindler C, Amann W, Rickenbacher P, Pfisterer M; Trial of Invasive Versus Medical Therapy in the Elderly Investigators. Source: The American Journal of Cardiology. 2003 February 15; 91(4): 436-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12586259

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Comparison of risk factors in acute myocardial infarction and unstable angina pectoris in patients < or =66 versus >66 years of age. Author(s): Hoshida S, Hayashi T, Kanamasa K, Ishikawa K, Naka M, Kawarabayashi T, Yokoi Y, Matsuda M, Nagai Y, Yamada Y; South-Osaka Acute Coronary Syndrome Study Investigators. Source: The American Journal of Cardiology. 2004 March 1; 93(5): 608-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14996589

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Composition of coronary atherosclerotic plaques in patients with acute myocardial infarction and stable angina pectoris determined by contrast-enhanced multislice computed tomography. Author(s): Leber AW, Knez A, White CW, Becker A, von Ziegler F, Muehling O, Becker C, Reiser M, Steinbeck G, Boekstegers P. Source: The American Journal of Cardiology. 2003 March 15; 91(6): 714-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12633805

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Concentrations of interleukins, interferon, and C-reactive protein in stable and unstable angina pectoris. Author(s): Yamashita H, Shimada K, Seki E, Mokuno H, Daida H. Source: The American Journal of Cardiology. 2003 January 15; 91(2): 133-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12521622

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Coronary arterial remodeling in differing clinical presentations of unstable angina pectoris--an intravascular ultrasound study. Author(s): Iwami T, Nishioka T, Fishbein MC, Luo H, Jeon DS, Miyamoto T, Wakeyama T, Iida H, Takaki A, Oda T, Mochizuki M, Ogawa H, Siegel RJ. Source: Clin Cardiol. 2003 August; 26(8): 384-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12918641

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Coronary vasomotor response is related to the angiographic extent of coronary sclerosis in patients with stable angina pectoris. Author(s): Asselbergs FW, Monnink SH, Veeger NJ, van Boven AJ, van Haelst PL, Jessurun GA, van Gilst WH, Tio RA. Source: Clinical Science (London, England : 1979). 2004 February; 106(2): 115-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956627

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Cost-effectiveness of spinal cord stimulation versus coronary artery bypass grafting in patients with severe angina pectoris--long-term results from the ESBY study. Author(s): Andrell P, Ekre O, Eliasson T, Blomstrand C, Borjesson M, Nilsson M, Mannheimer C. Source: Cardiology. 2003; 99(1): 20-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12589118

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C-reactive protein and ST-segment monitoring by continuous 12-lead electrocardiogram in patients with primary unstable angina pectoris. Author(s): Zairis MN, Ambrose JA, Papadaki OA, Manousakis SJ, Stefanidis AS, DeVoe MC, Handanis SM, Olympios CD, Foussas SG. Source: The American Journal of Cardiology. 2003 March 1; 91(5): 600-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12615271

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D-dimers in relation to the severity of arteriosclerosis in patients with stable angina pectoris after myocardial infarction. Author(s): Tataru MC, Heinrich J, Junker R, Schulte H, von Eckardstein A, Assmann G, Koehler E. Source: European Heart Journal. 1999 October; 20(20): 1493-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10493848

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Declining prevalence of angina pectoris in middle-aged men and women. A population-based study within the Northern Sweden MONICA Project. Multinational Monitoring of Trends and Cardiovascular Disease. Author(s): Glader EL, Stegmayr B. Source: Journal of Internal Medicine. 1999 September; 246(3): 285-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10475996

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Delayed splenic rupture presenting as unstable angina pectoris: case report and review of the literature. Author(s): Allen TL, Greenlee RR, Price RR. Source: The Journal of Emergency Medicine. 2002 August; 23(2): 165-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12359285

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Detecting and differentiating white from red coronary thrombus by angiography in angina pectoris and in acute myocardial infarction. Author(s): Abela GS, Eisenberg JD, Mittleman MA, Nesto RW, Leeman D, Zarich S, Waxman S, Prieto AR, Manzo KS. Source: The American Journal of Cardiology. 1999 January 1; 83(1): 94-7, A8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10073790

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Determination of cardiac troponin I forms in the blood of patients with unstable angina pectoris. Author(s): Giuliani I, Bertinchant JP, Lopez M, Coquelin H, Granier C, Laprade M, Pau B, Larue C. Source: Clinical Biochemistry. 2002 March; 35(2): 111-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11983345

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Diagnosis of coronary vasospasm in patients with clinical presentation of unstable angina pectoris using ergonovine echocardiography. Author(s): Song JK, Park SW, Kang DH, Lee CW, Choi KJ, Hong MK, Kim JJ, Kim YH, Park SJ. Source: The American Journal of Cardiology. 1998 December 15; 82(12): 1475-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9874050

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Dietary factor VII activation does not increase plasma concentrations of prothrombin fragment 1+2 in patients with stable angina pectoris and coronary atherosclerosis. Author(s): Bladbjerg EM, Munster AM, Marckmann P, Keller N, Jespersen J. Source: Arteriosclerosis, Thrombosis, and Vascular Biology. 2000 November; 20(11): 2494-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11073858

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Difference in the in-hospital mortality of unstable angina pectoris between men and women. Author(s): Passos LC, Lopes AA, Costa U, Lobo N, Rabelo Junior A. Source: Arquivos Brasileiros De Cardiologia. 1999 June; 72(6): 669-76. English, Portuguese. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10752173

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Differences between men and women in the management of unstable angina pectoris (The GUARANTEE Registry). The GUARANTEE Investigators. Author(s): Scirica BM, Moliterno DJ, Every NR, Anderson HV, Aguirre FV, Granger CB, Lambrew CT, Rabbani LE, Arnold A, Sapp SK, Booth JE, Ferguson JJ, Cannon CP. Source: The American Journal of Cardiology. 1999 November 15; 84(10): 1145-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10569321

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Differential coronary calcification on electron-beam CT between syndrome X and coronary artery disease in patients with chronic stable angina pectoris. Author(s): Chen LC, Chen JW, Wu MH, Liu JC, Lan GY, Ding PY, Chang MS. Source: Chest. 2001 November; 120(5): 1525-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11713130

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Dipyridamole in chronic stable angina pectoris; a randomized, double blind, placebocontrolled, parallel group study. Author(s): Picano E; PISA (Persantin In Stable Angina) study group. Source: European Heart Journal. 2001 October; 22(19): 1785-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11549300

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Dissociation between improvement in angina pectoris and myocardial perfusion after transmyocardial revascularization with an excimer laser. Author(s): Kavanagh GJ, Whittaker P, Prejean CA Jr, Firth BR, Kloner RA, Kay GL. Source: The American Journal of Cardiology. 2001 January 15; 87(2): 229-31, A9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11152849

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Diuretic therapy and angina pectoris. Author(s): Parker JD. Source: Cardiologia. 1998 March; 43(3): 261-5. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9611853

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Do new biochemical markers of myocardial damage change the concept of unstable angina pectoris? Author(s): Thygesen K. Source: European Heart Journal. 1998 December; 19(12): 1749-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9886715

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Does angina pectoris the week before protect against first acute myocardial infarction in patients with diabetes mellitus? Author(s): Jimenez-Navarro M, Gomez-Doblas JJ, Hernandez Garcia JM, Alonso-Briales J, Garcia Alcantara A, Gomez G, Rodriguez-Bailon I, de Teresa E. Source: The American Journal of Cardiology. 2002 July 15; 90(2): 160-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12106849

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Does coronary artery morphology predict favorable results of intracoronary thrombolysis in patients with unstable angina pectoris? Author(s): Itoh T, Nonogi H, Miyazaki S, Daikoku S, Miyao Y, Morii I, Baba T, Itoh A, Goto Y. Source: Japanese Circulation Journal. 1999 January; 63(1): 13-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10084382

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Drug treatment of stable angina pectoris and mass dissemination of therapeutic guidelines: a randomized controlled trial. Author(s): Beaulieu MD, Brophy J, Jacques A, Blais R, Battista R, Lebeau R. Source: Qjm : Monthly Journal of the Association of Physicians. 2004 January; 97(1): 2131. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14702508

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Drug treatment of stable angina pectoris in the elderly: defining the place of calcium channel antagonists. Author(s): Kumar S, Hall RJ. Source: Drugs & Aging. 2003; 20(11): 805-15. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12964887

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Dynamic changes of QT dispersion as a predictor of myocardial ischemia on exercise testing in patients with angina pectoris. Author(s): Musha H, So T, Hashimoto N, Eto F, Ozawa A, Kunishima T, Murayama M. Source: Japanese Heart Journal. 1999 March; 40(2): 119-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10420873

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Economic consequences of routine coronary angiography in low- and intermediaterisk patients with unstable angina pectoris. Author(s): Desai AS, Solomon DH, Stone PH, Avorn J. Source: The American Journal of Cardiology. 2003 August 15; 92(4): 363-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12914862

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Effect of acute hyperglycemia on the ischemic preconditioning effect of prodromal angina pectoris in patients with a first anterior wall acute myocardial infarction. Author(s): Ishihara M, Inoue I, Kawagoe T, Shimatani Y, Kurisu S, Nishioka K, Umemura T, Nakamura S, Yoshida M. Source: The American Journal of Cardiology. 2003 August 1; 92(3): 288-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12888134

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Effect of age and gender on heart rate recovery after submaximal exercise during cardiac rehabilitation in patients with angina pectoris, recent acute myocardial infarction, or coronary bypass surgery. Author(s): Kligfield P, McCormick A, Chai A, Jacobson A, Feuerstadt P, Hao SC. Source: The American Journal of Cardiology. 2003 September 1; 92(5): 600-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12943886

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Effect of apolipoprotein E alleles and angiotensin-converting enzyme insertion/deletion polymorphisms on lipid and lipoprotein markers in middle-aged men and in patients with stable angina pectoris or healed myocardial infarction. Author(s): Marques-Vidal P, Bongard V, Ruidavets JB, Fauvel J, Perret B, Ferrieres J. Source: The American Journal of Cardiology. 2003 November 1; 92(9): 1102-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14583365

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Effect of atorvastatin (80 mg) on recurrent ischemia in unstable angina pectoris or non-ST-elevation acute myocardial infarction. Author(s): Correia LC, Magalhaes LP, Santana O, Rocha MS, Passos LC, D'Oliveira A Jr, Esteves JP, Sposito AC. Source: The American Journal of Cardiology. 2003 June 1; 91(11): 1355-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12767434

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Effect of atorvastatin on exercise-induced myocardial ischemia in patients with stable angina pectoris. Author(s): Bogaty P, Dagenais GR, Poirier P, Boyer L, Auclair L, Pepin G, Jobin J, Arsenault M. Source: The American Journal of Cardiology. 2003 November 15; 92(10): 1192-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14609594

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Effect of cilostazol on vasomotor reactivity in patients with vasospastic angina pectoris. Author(s): Watanabe K, Ikeda S, Komatsu J, Inaba S, Suzuki J, Sueda S, Funada J, Kitakaze M, Sekiya M. Source: The American Journal of Cardiology. 2003 July 1; 92(1): 21-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12842239

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Effect of enhanced external counterpulsation on dobutamine-induced left ventricular wall motion abnormalities in severe chronic angina pectoris. Author(s): Bagger JP, Hall RJ, Koutroulis G, Nihoyannopoulos P. Source: The American Journal of Cardiology. 2004 February 15; 93(4): 465-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14969625

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Effect of preexisting angina pectoris on left ventricular function following acute myocardial infarction treated with thrombolysis or coronary angioplasty. Author(s): Iglesias-Garriz I, Rodriguez MA, Garrote C, Corral F, Pascual C. Source: The American Journal of Cardiology. 2002 October 1; 90(7): 781-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12356400

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Effect of prodromal angina pectoris on altering the relation between time to reperfusion and outcomes after a first anterior wall acute myocardial infarction. Author(s): Ishihara M, Inoue I, Kawagoe T, Shimatani Y, Kurisu S, Nishioka K, Umemura T, Nakamura S, Yoshida M. Source: The American Journal of Cardiology. 2003 January 15; 91(2): 128-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12521621

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Effect of short-term estrogen with and without progesterone therapy on circulating markers of endothelial activation and injury in postmenopausal women with unstable angina pectoris. Author(s): Chou ET, Schulman SP, Thiemann DR, Sohn RH, Bellantoni MF, Rade JJ. Source: The American Journal of Cardiology. 2003 May 15; 91(10): 1240-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12745110

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Effect of thoracic epidural analgesia on refractory angina pectoris: long-term home self-treatment. Author(s): Richter A, Cederholm I, Jonasson L, Mucchiano C, Uchto M, Janerot-Sjoberg B. Source: Journal of Cardiothoracic and Vascular Anesthesia. 2002 December; 16(6): 67984. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12486646

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Effects of atorvastatin 80 mg daily early after onset of unstable angina pectoris or non-Q-wave myocardial infarction. Author(s): Colivicchi F, Guido V, Tubaro M, Ammirati F, Montefoschi N, Varveri A, Santini M. Source: The American Journal of Cardiology. 2002 October 15; 90(8): 872-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12372577

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Effects of moderate weight loss on anginal symptoms and indices of coagulation and fibrinolysis in overweight patients with angina pectoris. Author(s): Hankey CR, Lean ME, Lowe GD, Rumley A, Woodward M. Source: European Journal of Clinical Nutrition. 2002 October; 56(10): 1039-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12373626

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Effects of preinfarction angina pectoris on infarct size and in-hospital mortality after coronary intervention for acute myocardial infarction. Author(s): Kosuge M, Kimura K, Kojima S, Sakamoto T, Ishihara M, Asada Y, Tei C, Miyazaki S, Sonoda M, Tsuchihashi K, Yamagishi M, Ikeda Y, Shirai M, Hiraoka H, Inoue T, Saito F, Ogawa H; Japanese Acute Coronary Syndrome Study Investigators. Source: The American Journal of Cardiology. 2003 October 1; 92(7): 840-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14516889

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Efficacy of monotherapy compared with combined antianginal drugs in the treatment of chronic stable angina pectoris: a meta-analysis. Author(s): Klein WW, Jackson G, Tavazzi L. Source: Coronary Artery Disease. 2002 December; 13(8): 427-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12544718

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Enhanced external counterpulsation for refractory angina pectoris. Author(s): Sinvhal RM, Gowda RM, Khan IA. Source: Heart (British Cardiac Society). 2003 August; 89(8): 830-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12860848

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Examination of gender bias in the evaluation and treatment of angina pectoris by cardiologists. Author(s): Blum M, Slade M, Boden D, Cabin H, Caulin-Glaser T. Source: The American Journal of Cardiology. 2004 March 15; 93(6): 765-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15019889

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External counterpulsation therapy improves endothelial function in patients with refractory angina pectoris. Author(s): Shechter M, Matetzky S, Feinberg MS, Chouraqui P, Rotstein Z, Hod H. Source: Journal of the American College of Cardiology. 2003 December 17; 42(12): 20905. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14680732

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Factors influencing efficacy of nitrate therapy for stable angina pectoris: a multiple linear regression analysis. Author(s): Jansen R, Niemeyer MG, Cleophas TJ, Zwinderman AH. Source: Angiology. 2000 December; 51(12): 1007-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11132992

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Feasibility of spinal cord stimulation in angina pectoris in patients with chronic pacemaker treatment for cardiac arrhythmias. Author(s): Ekre O, Borjesson M, Edvardsson N, Eliasson T, Mannheimer C. Source: Pacing and Clinical Electrophysiology : Pace. 2003 November; 26(11): 2134-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14622316

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Felodipine (once daily) versus nifedipine (four times daily) for Prinzmetal's angina pectoris. Author(s): Ardissino D, Savonitto S, Mussini A, Zanini P, Rolla A, Barberis P, Sardina M, Specchia G. Source: The American Journal of Cardiology. 1991 December 15; 68(17): 1587-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1746458

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Felodipine and amlodipine in stable angina pectoris: results of a randomized doubleblind crossover trial. Author(s): Koenig W, Hoher M. Source: Journal of Cardiovascular Pharmacology. 1997 April; 29(4): 520-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9156363

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Felodipine in addition to beta-adrenergic blockade for angina pectoris. a multicentre, randomized, placebo-controlled trial. Author(s): Ronnevik PK, Silke B, Ostergaard O. Source: European Heart Journal. 1995 November; 16(11): 1535-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8881845

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Felodipine versus placebo in stable effort-induced angina pectoris in patients inadequately controlled with metoprolol--a dose-finding study. Author(s): Emanuelsson H, Ahlstrom P, Kujacic V, Lundkvist L, Rosenqvist U, Tisell A, Angman K. Source: Journal of Cardiovascular Pharmacology. 1994 August; 24(2): 303-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7526065

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Fibrin generation and digestion in patients with angina pectoris. Author(s): Prisco D, Paniccia R, Francalanci I, Bandinelli B, Filippini M, Bacci F, Rostagno C, Abbate R, Gensini GF. Source: International Journal of Clinical & Laboratory Research. 1995; 25(4): 222-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8788552

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Fibrinolysis/proteolysis balance in stable angina pectoris in relation to angiographic findings. Author(s): Paramo JA, Orbe J, Fernandez J. Source: Thrombosis and Haemostasis. 2001 August; 86(2): 636-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11522015

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Fibrinolytic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. ECAT Study Group. European Concerted Action on Thrombosis and Disabilities. Author(s): Juhan-Vague I, Pyke SD, Alessi MC, Jespersen J, Haverkate F, Thompson SG. Source: Circulation. 1996 November 1; 94(9): 2057-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8901651

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Fibrinolytic variables and cardiovascular prognosis in patients with stable angina pectoris treated with verapamil or metoprolol. Results from the Angina Prognosis study in Stockholm. Author(s): Held C, Hjemdahl P, Rehnqvist N, Wallen NH, Bjorkander I, Eriksson SV, Forslund L, Wiman B. Source: Circulation. 1997 May 20; 95(10): 2380-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9170400

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Five-year incidence of angina pectoris and other forms of coronary heart disease in healthy men aged 50-59 in France and Northern Ireland: the Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study. Author(s): Ducimetiere P, Ruidavets JB, Montaye M, Haas B, Yarnell J; PRIME Study Group. Source: International Journal of Epidemiology. 2001 October; 30(5): 1057-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11689522

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Flow-function mismatch in unstable angina pectoris demonstrated by gated Tl-201 SPECT. Author(s): Fukuchi K, Yasumura Y, Hayashida K, Ishida Y. Source: Clinical Nuclear Medicine. 2001 November; 26(11): 977-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11595873

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Focal myocardial ischemic necroses associated with unstable angina pectoris. Author(s): Dominitz I, Boruchow IB, Hutchins GM. Source: Journal of the American College of Cardiology. 1996 October; 28(4): 910-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8837568

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Follow-up care in general practice of patients with myocardial infarction or angina pectoris: initial results of the SHIP trial. Southampton Heart Integrated Care Project. Author(s): Jolly K, Bradley F, Sharp S, Smith H, Mant D. Source: Family Practice. 1998 December; 15(6): 548-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10078796

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Formation of platelet aggregates after attacks of coronary spastic angina pectoris. Author(s): Miyamoto S, Ogawa H, Soejima H, Takazoe K, Sakamoto T, Yoshimura M, Kugiyama K, Yasue H. Source: The American Journal of Cardiology. 2000 February 15; 85(4): 494-7, A10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10728958

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Fragmin in unstable angina pectoris or in non-Q-wave acute myocardial infarction (the FRIC study). Fragmin in Unstable Coronary Artery Disease. Author(s): Klein W, Buchwald A, Hillis WS, Monrad S, Sanz G, Turpie AG, van der Meer J, Olaisson E, Undeland S, Ludwig K. Source: The American Journal of Cardiology. 1997 September 4; 80(5A): 30E-34E. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9296467

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Free radical markers in patients with angina pectoris and normal coronary angiograms. Author(s): Bridges AB, McNeill GP, Pringle TH, Niblock A, Belch JJ. Source: Cardiology. 1993; 82(1): 7-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8519013

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Frequency of angina pectoris and coronary artery disease in severe isolated valvular aortic stenosis. Author(s): Tansuphaswadikul S, Silaruks S, Lehmongkol R, Chakorn T. Source: J Med Assoc Thai. 1999 February; 82(2): 140-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10087721

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Frequency of postprandial lipemia after a first acute coronary event (unstable angina pectoris or non-ST-segment elevation acute myocardial infarction) and the effects of atenolol on the lipemia. Author(s): Boccalandro F, Farias J, Boccalandro C, Vaisman D. Source: The American Journal of Cardiology. 2002 July 15; 90(2): 153-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12106847

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Functioning and well-being of patients with type 2 diabetes or angina pectoris, compared with the general population. Author(s): Wandell P, Brorsson B, Aberg H. Source: Diabetes & Metabolism. 2000 December; 26(6): 465-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11173717

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Gallbladder disease and angina pectoris. Author(s): French AB. Source: Annals of Internal Medicine. 1992 July 15; 117(2): 172. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1520394

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Gender differences in the reliability of reporting symptoms of angina pectoris. Author(s): Harris RB, Weissfeld LA. Source: Journal of Clinical Epidemiology. 1991; 44(10): 1071-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1941000

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Geriatrics photo quiz. Angina pectoris. Author(s): Gross JS, Shua-Haim JR. Source: Geriatrics. 1996 November; 51(11): 19, 61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8918479

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Giant hiatal hernia presenting with stable angina pectoris and syncope--a case report. Author(s): Akdemir I, Davutoglu V, Aktaran S. Source: Angiology. 2001 December; 52(12): 863-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11775629

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Global headache in angina pectoris. Author(s): Nagori SB. Source: J Assoc Physicians India. 1992 March; 40(3): 212. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1634502

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Glutathione peroxidase activity in serum during acute myocardial infarction and unstable angina pectoris. Author(s): Akyol O, Sencan O, Buyukberber S, Canbolat O, Durak I. Source: Japanese Heart Journal. 1993 September; 34(5): 551-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8301841

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Graphical comparison of coronary arterial culprit lesions in acute myocardial infarction and unstable angina pectoris. Author(s): Namiki N, Uchiyama T, Nagai Y, Yamashina A. Source: Intern Med. 1999 November; 38(11): 849-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10563744

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Haemostasis factors in angina pectoris; relation to gender, age and acute-phase reaction. Results of the ECAT Angina Pectoris Study Group. Author(s): Haverkate F, Thompson SG, Duckert F. Source: Thrombosis and Haemostasis. 1995 April; 73(4): 561-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7495059

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Heart rate dynamics in patients with stable angina pectoris and utility of fractal and complexity measures. Author(s): Makikallio TH, Ristimae T, Airaksinen KE, Peng CK, Goldberger AL, Huikuri HV. Source: The American Journal of Cardiology. 1998 January 1; 81(1): 27-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9462601

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Heart rate reduction in the treatment of chronic stable angina pectoris: experiences with a sinus node inhibitor. Author(s): Frishman WH, Gabor R, Pepine C, Cavusoglu E. Source: American Heart Journal. 1996 January; 131(1): 204-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8554014

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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. Author(s): Weber F, Schneider H, von Arnim T, Urbaszek W. Source: European Heart Journal. 1999 January; 20(1): 38-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10075140

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Heightened free radical activity in angina pectoris. Author(s): Lapenna D, de Gioia S, Mezzetti A, Consoli A, Marzio L, Cuccurullo F. Source: The American Journal of Cardiology. 1993 October 1; 72(11): 830-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8213520

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Hemodynamic interactions of a new beta blocker, celiprolol, with nifedipine in angina pectoris. Author(s): Silke B, Verma SP, Guy S. Source: Cardiovascular Drugs and Therapy / Sponsored by the International Society of Cardiovascular Pharmacotherapy. 1991 August; 5(4): 681-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1679661

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Hemodynamics and exercise tolerance after bisoprolol, nifedipine, and their combination in patients with angina pectoris. Author(s): Schnellbacher K, Bestehorn HP, Roskamm H. Source: Journal of Cardiovascular Pharmacology. 1990; 16 Suppl 5: S201-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11527130

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Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. Author(s): Thompson SG, Kienast J, Pyke SD, Haverkate F, van de Loo JC. Source: The New England Journal of Medicine. 1995 March 9; 332(10): 635-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7845427

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High incidence of angina pectoris in patients treated with 5-fluorouracil. A planned surveillance study with 102 patients. Author(s): Wacker A, Lersch C, Scherpinski U, Reindl L, Seyfarth M. Source: Oncology. 2003; 65(2): 108-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12931015

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High prevalence of angina pectoris in Mexican-American men. A population with reduced risk of myocardial infarction. Author(s): Mitchell BD, Hazuda HP, Haffner SM, Patterson JK, Stern MP. Source: Annals of Epidemiology. 1991 August; 1(5): 415-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1669522

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High thoracic/low cervical, long-term intrathecal (i.t.) infusion of bupivacaine alleviates "refractory" pain in patients with unstable angina pectoris. Report of 2 cases. Author(s): Dahm P, Nitescu P, Appelgren L, Curelaru I. Source: Acta Anaesthesiologica Scandinavica. 1998 September; 42(8): 1010-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9773148

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Higher recurrence rate after coronary angioplasty in unstable angina pectoris. Author(s): Johansson SR, Ekstrom L, Emanuelsson H. Source: Angiology. 1991 April; 42(4): 273-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2014918

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Histologic characteristics of tissue excised during directional coronary atherectomy in stable and unstable angina pectoris. Author(s): Escaned J, van Suylen RJ, MacLeod DC, Umans VA, de Jong M, Bosman FT, de Feyter PJ, Serruys PW. Source: The American Journal of Cardiology. 1993 June 15; 71(16): 1442-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8517393

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Histopathologic evaluation of coronary artery thrombi obtained by directional coronary atherectomy in patients with restenosis-induced unstable angina pectoris. Author(s): Terazawa M, Morimoto S, Hirayama H, Hiramitsu S, Hishida H, Hirai M, Saito H. Source: Japanese Circulation Journal. 2001 June; 65(6): 505-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11407731

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Historical note: Inga Lindgren's paper in 1947 on the effect of cutaneous precordial anaesthesia on the electrocardiogram in patients with angina pectoris and coronary occlusion. Author(s): Berglund E. Source: International Journal of Cardiology. 1999 July 31; 70(2): 195-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10454309

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Historical note: the first control study on treatment of angina pectoris--Inga Lindgren in 1950. Author(s): Bergiund E. Source: International Journal of Cardiology. 1999 July 31; 70(2): 191-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10454308

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Hyperglycemia-induced angina pectoris in a patient with diabetes mellitus. Author(s): Lickerman A, Grover-McKay M, Dellsperger KC. Source: Clin Cardiol. 1997 August; 20(8): 736-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9259169

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Hyperinsulinemia in patients with spastic angina pectoris. Author(s): Miyawaki R, Urabe Y, Furuki T, Miyoshi K, Wakiyama T, Moroe K, Hiroki T. Source: Cardiology. 1997 November-December; 88(6): 503-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9397302

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Hypoglycemia-induced angina pectoris in a patient with diabetes mellitus. Author(s): Duh E, Feinglos M. Source: Annals of Internal Medicine. 1994 December 15; 121(12): 945-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7978720

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Hypothyroidism complicated by angina pectoris: therapeutic approaches. Author(s): Ellyin FM, Kumar Y, Somberg JC. Source: Journal of Clinical Pharmacology. 1992 September; 32(9): 843-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1358924

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Identification of proximal left anterior descending artery stenosis with thallium-201 defect patterns in patients with angina pectoris. Author(s): Yoon JK, Lee KH, Lee EJ, Kim YH, Seo JD, Kim BT. Source: The American Journal of Cardiology. 2004 March 1; 93(5): 549-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14996577

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IL-6 and IL-1 receptor antagonist in stable angina pectoris and relation of IL-6 to clinical findings in acute myocardial infarction. Author(s): Gabriel AS, Ahnve S, Wretlind B, Martinsson A. Source: Journal of Internal Medicine. 2000 July; 248(1): 61-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10947882

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Immediate and long-term clinical outcome after spinal cord stimulation for refractory stable angina pectoris. Author(s): Di Pede F, Lanza GA, Zuin G, Alfieri O, Rapati M, Romano M, Circo A, Cardano P, Bellocci F, Santini M, Maseri A; Investigators of the Prospective Italian Registry of SCS for Angina Pectoris. Source: The American Journal of Cardiology. 2003 April 15; 91(8): 951-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12686334

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Impaired endothelium-dependent vasodilation in the brachial artery in variant angina pectoris and the effect of intravenous administration of vitamin C. Author(s): Hamabe A, Takase B, Uehata A, Kurita A, Ohsuzu F, Tamai S. Source: The American Journal of Cardiology. 2001 May 15; 87(10): 1154-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11356389

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In vivo thrombin generation and activity during and after intravenous infusion of heparin or recombinant hirudin in patients with unstable angina pectoris. Author(s): Merlini PA, Ardissino D, Rosenberg RD, Colombi E, Agricola P, Oltrona L, Ottani F, Galvani M, Bauer KA, Bottasso B, Bertocchi F, Mannucci PM. Source: Arteriosclerosis, Thrombosis, and Vascular Biology. 2000 September; 20(9): 21626. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10978264

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Increased leukocyte activity as a predictor for flow-limiting coronary lesions in patients with angina pectoris. Author(s): Takeshita S, Hashimoto H, Ono Y, Ochiai M, Yokoyama N, Terakura M, Sato T, Isshiki T. Source: Atherosclerosis. 2001 October; 158(2): 477-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11583729

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Increased plasma levels of interleukin-8 in patients with unstable angina pectoris. Author(s): Simiti A, Vida-Simiti L, Cristea A, Olinic N. Source: Rom J Intern Med. 1998 January-June; 36(1-2): 47-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10660968

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Increased plasma levels of the soluble form of Fas ligand in patients with acute myocardial infarction and unstable angina pectoris. Author(s): Shimizu M, Fukuo K, Nagata S, Suhara T, Okuro M, Fujii K, Higashino Y, Mogi M, Hatanaka Y, Ogihara T. Source: Journal of the American College of Cardiology. 2002 February 20; 39(4): 585-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11849855

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Increased plasminogen activator inhibitor activity and diabetes predict subsequent coronary events in patients with angina pectoris. Author(s): Takazoe K, Ogawa H, Yasue H, Sakamoto T, Soejima H, Miyao Y, Kawano H, Moriyama Y, Misumi K, Suefuji H, Kugiyama K, Yoshimura M. Source: Annals of Medicine. 2001 April; 33(3): 206-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11370775

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Increased release of the soluble form of the adhesion molecules L-selectin and ICAM1 but not E-selectin during attacks of angina pectoris. Author(s): Siminiak T, Smielecki J, Dye JF, Balinski M, El-Gendi H, Wysocki H, Sheridan DJ. Source: Heart and Vessels. 1998; 13(4): 189-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10442400

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Incremental prognostic value of serum levels of troponin T and C-reactive protein on admission in patients with unstable angina pectoris. Author(s): Rebuzzi AG, Quaranta G, Liuzzo G, Caligiuri G, Lanza GA, Gallimore JR, Grillo RL, Cianflone D, Biasucci LM, Maseri A. Source: The American Journal of Cardiology. 1998 September 15; 82(6): 715-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9761079

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Inflammatory and hemostatic markers in relation to cardiovascular prognosis in patients with stable angina pectoris. Results from the APSIS study. The Angina Prognosis Study in Stockholm. Author(s): Held C, Hjemdahl P, Hakan Wallen N, Bjorkander I, Forslund L, Wiman B, Rehnqvist N. Source: Atherosclerosis. 2000 January; 148(1): 179-88. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10580184

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Initial historical descriptions of the angina pectoris. Author(s): Khan IA, Mehta NJ. Source: The Journal of Emergency Medicine. 2002 April; 22(3): 295-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11932097

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Intermediate-term clinical outcome following transmyocardial laser revascularization in patients with refractory angina pectoris. Author(s): Landolfo CK, Landolfo KP, Hughes GC, Coleman ER, Coleman RB, Lowe JE. Source: Circulation. 1999 November 9; 100(19 Suppl): Ii128-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10567291

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Interpretive intra- and interobserver reproducibility of rest/stress 99Tcm-sestamibi myocardial perfusion SPECT in a consecutive group of male patients with stable angina pectoris before and after percutaneous transluminal angioplasty. Author(s): Johansen A, Gaster AL, Veje A, Thayssen P, Haghfelt T, Holund-Carlsen PF. Source: Nuclear Medicine Communications. 2001 May; 22(5): 531-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11388575

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Intracoronary electrocardiogram and angina pectoris during percutaneous coronary interventions as an assessment of myocardial viability: comparison with low-dose dobutamine echocardiography. Author(s): Abaci A, Oguzhan A, Topsakal R, Seyfeli E, Yilmaz Y, Eryol NK, Basar E, Ergin A. Source: Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions. 2003 December; 60(4): 469-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14624423

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Intraoperative multiplane transesophageal echocardiography for guiding direct myocardial gene transfer of vascular endothelial growth factor in patients with refractory angina pectoris. Author(s): Esakof DD, Maysky M, Losordo DW, Vale PR, Lathi K, Pastore JO, Symes JF, Isner JM. Source: Human Gene Therapy. 1999 September 20; 10(14): 2307-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10515450

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Involvement of C-reactive protein obtained by directional coronary atherectomy in plaque instability and developing restenosis in patients with stable or unstable angina pectoris. Author(s): Ishikawa T, Hatakeyama K, Imamura T, Date H, Shibata Y, Hikichi Y, Asada Y, Eto T. Source: The American Journal of Cardiology. 2003 February 1; 91(3): 287-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12565084

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Is administration of nitrates an offence in suspected cases of angina pectoris? Author(s): Taneja KC. Source: Indian Heart J. 1998 July-August; 50(4): 473. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9835213

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Isosorbide 5-mononitrate: a review of a sustained-release formulation (Imdur) in stable angina pectoris. Author(s): Gunasekara NS, Noble S. Source: Drugs. 1999 February; 57(2): 261-77. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10188765

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John Fothergill and angina pectoris. Author(s): Proudfit WL. Source: British Heart Journal. 1991 October; 66(4): 322-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1747288

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Lack of antagonism between nicorandil and sulfonylurea in stable angina pectoris. Author(s): Hata N, Takano M, Kunimi T, Kishida H, Takano T. Source: Int J Clin Pharmacol Res. 2001; 21(1): 59-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11708575

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Levels of expression of P-selectin, E-selectin, and intercellular adhesion molecule-1 in coronary atherectomy specimens from patients with stable and unstable angina pectoris. Author(s): Tenaglia AN, Buda AJ, Wilkins RG, Barron MK, Jeffords PR, Vo K, Jordan MO, Kusnick BA, Lefer DJ. Source: The American Journal of Cardiology. 1997 March 15; 79(6): 742-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9070552

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Limitations of spontaneous reperfusion and conventional medical therapy to afford myocardial protection through antecedent angina pectoris in acute myocardial infarction. Author(s): Hashimoto A, Nakata T, Wakabayashi T, Yuda S, Eguchi M, Sasao H, Tsuchihashi K, Shimamoto K. Source: Ann Nucl Med. 1999 October; 13(5): 337-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10582804

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Lipoprotein (a) is increased in acute coronary syndromes (unstable angina pectoris and myocardial infarction), but it is not predictive of the severity of coronary lesions. Author(s): Brunelli C, Spallarossa P, Bertolini S, Balbi M, Barbara C, Masturzo P, Lantieri PB, Pastorini C, Caponnetto S. Source: Clin Cardiol. 1995 September; 18(9): 526-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7489610

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Lipoprotein lipase activity is associated with severity of angina pectoris. REGRESS Study Group. Author(s): Kastelein JJ, Jukema JW, Zwinderman AH, Clee S, van Boven AJ, Jansen H, Rabelink TJ, Peters RJ, Lie KI, Liu G, Bruschke AV, Hayden MR. Source: Circulation. 2000 October 3; 102(14): 1629-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11015339

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Living with angina pectoris--a phenomenological study. Author(s): MacDermott AF. Source: European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology. 2002 December; 1(4): 265-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14622656

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Loading doses of amlodipine safely increase plasma levels during the first days of treatment in patients with angina pectoris. Author(s): Kagaya Y, Ishide N, Funakoshi M, Hoshi N, Shirato K. Source: Cardiovascular Drugs and Therapy / Sponsored by the International Society of Cardiovascular Pharmacotherapy. 1997 September; 11(4): 599-602. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9358965

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Long non-iatrogenic right coronary artery dissection in stable angina pectoris treated with stenting. Author(s): La Vecchia L, Martini M, Javernaro A, Zadro M. Source: G Ital Cardiol. 1999 July; 29(7): 799-802. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10443349

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Long-term (10-year) outcome in patients with unstable angina pectoris treated by coronary balloon angioplasty. Author(s): Halon DA, Flugelman MY, Merdler A, Rennert H, Shahla J, Lewis BS. Source: Journal of the American College of Cardiology. 1998 November 15; 32(6): 1603-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9822085

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Long-term effect of endoscopic transthoracic sympathicotomy on heart rate variability and QT dispersion in severe angina pectoris. Author(s): Tygesen H, Wettervik C, Claes G, Drott C, Emanuelsson H, Solem J, Lomsky M, Radberg G, Wennerblom B. Source: International Journal of Cardiology. 1999 August 31; 70(3): 283-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10501343

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Long-term effects of hormone replacement therapy on symptoms of angina pectoris, quality of life and compliance in women with coronary artery disease. Author(s): Hall G, Pripp U, Schenck-Gustafsson K, Landgren BM. Source: Maturitas. 1998 January 12; 28(3): 235-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9571599

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Long-term follow-up after early intervention with intravenous diltiazem or intravenous nitroglycerin for unstable angina pectoris. Author(s): Gobel EJ, van Gilst WH, de Kam PJ, ter Napel MG, Molhoek GP, Lie KI. Source: European Heart Journal. 1998 August; 19(8): 1208-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9740342

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Long-term outcome in patients treated by intracoronary stenting with ticlopidine and aspirin, and deleterious prognostic role of unstable angina pectoris. Author(s): Angioi M, Danchin N, Alla F, Gangloff C, Sunthorn H, Rodriguez RM, Preiss JP, Grentzinger A, Houplon P, Juilliere Y, Cherrier F. Source: The American Journal of Cardiology. 2000 May 1; 85(9): 1065-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10781753

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Long-term prognosis of patients with clinical unstable angina pectoris without elevation of creatine kinase but with elevation of cardiac troponin i levels. Author(s): Aviles RJ, Wright RS, Aviles JM, McDonald F, Ballman K, Harker-Murray A, Scott C, Lauer MS, Kopecky SL, Jaffe AS. Source: The American Journal of Cardiology. 2002 October 15; 90(8): 875-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12372578

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Losartan and angina pectoris. Author(s): Ahmad S. Source: Texas Heart Institute Journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. 1995; 22(4): 347-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8605440

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Low molecular weight heparins better than unfractionated heparin in unstable coronary artery disease? Unstable angina pectoris/non-Q wave infarction a partly outpatient clinic condition? Author(s): Kauw FH, Cleophas TJ, Kalmansohn RB. Source: Int J Clin Pharmacol Ther. 1998 July; 36(7): 392-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9707355

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Low recurrence of angina pectoris after coronary artery bypass graft surgery with bilateral internal thoracic and right gastroepiploic arteries. Author(s): Bergsma TM, Grandjean JG, Voors AA, Boonstra PW, den Heyer P, Ebels T. Source: Circulation. 1998 June 23; 97(24): 2402-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9641691

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Low-dose dipyridamole infusion acutely increases exercise capacity in angina pectoris: a double-blind, placebo controlled crossover stress echocardiographic study. Author(s): Tommasi S, Carluccio E, Bentivoglio M, Corea L, Picano E. Source: Journal of the American College of Cardiology. 2000 January; 35(1): 83-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10636264

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Lymphocyte activation in angina pectoris. Author(s): Smith-Norowitz TA, Shani J, Weiser W, Schulhoff N, Norowitz K, Lichstein E, Mokhtarian F. Source: Clinical Immunology (Orlando, Fla.). 1999 November; 93(2): 168-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10527693

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Management of patients with angina pectoris by GPs: a study with standardized (simulated) patients in actual practice. Author(s): Saebu L, Rethans JJ. Source: Family Practice. 1997 December; 14(6): 431-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9476072

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Management of unstable angina pectoris and non-Q-wave acute myocardial infarction in the United States and Canada (the TIMI III Registry). Author(s): Anderson HV, Gibson RS, Stone PH, Cannon CP, Aguirre F, Thompson B, Knatterud GL, Braunwald E. Source: The American Journal of Cardiology. 1997 June 1; 79(11): 1441-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9185630

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Medical therapy, symptoms, and the distress the cause: relation to quality of life in patients with angina pectoris and/or hypertension. Author(s): Hollenberg NK, Williams GH, Anderson R. Source: Archives of Internal Medicine. 2000 May 22; 160(10): 1477-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10826461

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Medical treatment of patients with stable angina pectoris referred for coronary angiography: failure of treatment or failure to treat. Author(s): Carasso S, Markiewicz W. Source: Clin Cardiol. 2002 September; 25(9): 436-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12269523

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Medication- and illness-related factual knowledge, perceptions and behaviour in angina pectoris patients. Author(s): Haugbolle LS, Sorensen EW, Henriksen HH. Source: Patient Education and Counseling. 2002 August; 47(4): 281-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12135819

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Mental stress test is an effective inducer of vasospastic angina pectoris: comparison with cold pressor, hyperventilation and master two-step exercise test. Author(s): Yoshida K, Utsunomiya T, Morooka T, Yazawa M, Kido K, Ogawa T, Ryu T, Ogata T, Tsuji S, Tokushima T, Matsuo S. Source: International Journal of Cardiology. 1999 July 31; 70(2): 155-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10454304

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Mibefradil in the treatment of chronic stable angina pectoris: comparative studies with other calcium antagonists. Author(s): Davies GJ, Tzivoni D, Kobrin I. Source: The American Journal of Cardiology. 1997 August 21; 80(4B): 34C-39C. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9286852

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Mibefradil, a T-type channel-selective calcium antagonist: clinical trials in chronic stable angina pectoris. Author(s): Massie BM. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 1998 April; 11(4 Pt 3): 95S-102S. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9607373

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Mibefradil. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in the management of hypertension and angina pectoris. Author(s): Brogden RN, Markham A. Source: Drugs. 1997 November; 54(5): 774-93. Review. Erratum In: Drugs 1998 April; 55(4): 517. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9360062

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Moderate alcohol consumption and risk for angina pectoris or myocardial infarction in U.S. male physicians. Author(s): Camargo CA Jr, Stampfer MJ, Glynn RJ, Grodstein F, Gaziano JM, Manson JE, Buring JE, Hennekens CH. Source: Annals of Internal Medicine. 1997 March 1; 126(5): 372-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9054281

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Monotherapy with amlodipine or atenolol versus their combination in stable angina pectoris. Author(s): Pehrsson SK, Ringqvist I, Ekdahl S, Karlson BW, Ulvenstam G, Persson S. Source: Clin Cardiol. 2000 October; 23(10): 763-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11061055

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Monotherapy with nifedipine GITS compared with atenolol in stable angina pectoris. The Working Group on Cardiovascular Research (WCN). Author(s): de Vries RJ, Dunselman PH. Source: Br J Clin Pract Suppl. 1997 April; 88: 6-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9519501

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Morphologic correlation between atherosclerotic lesions of the carotid and coronary arteries in patients with angina pectoris. Author(s): Saito D, Shiraki T, Oka T, Kajiyama A, Doi M, Masaka T. Source: Japanese Circulation Journal. 1999 July; 63(7): 522-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10462018

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Mortality, risk indicators of death, mode of death and symptoms of angina pectoris during 5 years after coronary artery bypass grafting in men and women. Author(s): Herlitz J, Brandrup-Wognsen G, Karlson BW, Sjoland H, Karlsson T, Caidahl K, Hartford M, Haglid M. Source: Journal of Internal Medicine. 2000 April; 247(4): 500-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10792565

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Mortality, risk indicators, mode and place of death and symptoms of angina pectoris in the five years after coronary artery bypass grafting in patients with and without a history of hypertension. Author(s): Herlitz J, Brandrup-Wognsen G, Karlson BW, Sjoland H, Karlsson T, Caidahl K, Hartford M, Haglid M. Source: Blood Pressure. 1999; 8(4): 200-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10697299

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Multiple versus single coronary plaque ruptures detected by intravascular ultrasound in stable and unstable angina pectoris and in acute myocardial infarction. Author(s): Mintz GS, Maehara A, Bui AB, Weissman NJ. Source: The American Journal of Cardiology. 2003 June 1; 91(11): 1333-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12767427

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Musculo-skeletal pathology in patients with angina pectoris and normal coronary angiograms. Author(s): Frobert O, Fossgreen J, Sondergaard-Petersen J, Hede J, Bagger JP. Source: Journal of Internal Medicine. 1999 March; 245(3): 237-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10205585

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Myocardial Doppler tissue velocity improves following myocardial gene therapy with VEGF-A165 plasmid in patients with inoperable angina pectoris. Author(s): Sylven C, Sarkar N, Ruck A, Drvota V, Hassan SY, Lind B, Nygren A, Kallner Q, Blomberg P, van der Linden J, Lindblom D, Brodin LA, Islam KB. Source: Coronary Artery Disease. 2001 May; 12(3): 239-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11352080

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Myocardial revascularization in patients with multivessel coronary artery disease and minimal angina pectoris. Author(s): Wynne J, Cohn LH, Collins JJ Jr, Cohn PF. Source: Circulation. 1978 September; 58(3 Pt 2): I92-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14740686

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Myocardial turnover of endogenous opioids and calcitonin-gene-related peptide in the human heart and the effects of spinal cord stimulation on pacing-induced angina pectoris. Author(s): Eliasson T, Mannheimer C, Waagstein F, Andersson B, Bergh CH, Augustinsson LE, Hedner T, Larson G. Source: Cardiology. 1998 March; 89(3): 170-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9570430

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Negative stress echocardiographic responses in normotensive and hypertensive patients with angina pectoris, positive exercise stress testing, and normal coronary arteriograms. Author(s): Zouridakis EG, Cox ID, Garcia-Moll X, Brown S, Nihoyannopoulos P, Kaski JC. Source: Heart (British Cardiac Society). 2000 February; 83(2): 141-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10648483

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Neurobiology of atypical presentations among medicare beneficiaries with unstable angina pectoris. Author(s): Friedman EH. Source: The American Journal of Cardiology. 2003 January 1; 91(1): 118-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12505591

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New-onset angina pectoris due to coronary artery aneurysms. Author(s): Rott D, Pecker A, Mazouz B, Banai S. Source: Isr Med Assoc J. 2003 August; 5(8): 603. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12929306

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Nicorandil-induced preconditioning as evidenced by troponin T measurements after coronary angioplasty in patients with stable angina pectoris. Author(s): Sakai K, Yamagata T, Teragawa H, Matsuura H, Chayama K. Source: Japanese Heart Journal. 2002 September; 43(5): 443-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12452302

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Nitrate resistance in platelets from patients with stable angina pectoris. Author(s): Megson IL, Webb DJ. Source: Circulation. 2000 September 12; 102(11): E87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10982555

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Nitrate resistance in platelets from patients with stable angina pectoris. Author(s): Chirkov YY, Holmes AS, Chirkova LP, Horowitz JD. Source: Circulation. 1999 July 13; 100(2): 129-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10402441

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Nonatherosclerotic aneurysm of the left circumflex coronary artery presenting with accelerated angina pectoris: response to medical management--a case report. Author(s): Khan IA, Dogan OM, Vasavada BC, Sacchi TJ. Source: Angiology. 2000 July; 51(7): 595-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10917584

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Noninvasive determination of endothelium-mediated vasodilation as a screening test for coronary artery disease: pilot study to assess the predictive value in comparison with angina pectoris, exercise electrocardiography, and myocardial perfusion imaging. Author(s): Schroeder S, Enderle MD, Ossen R, Meisner C, Baumbach A, Pfohl M, Herdeg C, Oberhoff M, Haering HU, Karsch KR. Source: American Heart Journal. 1999 October; 138(4 Pt 1): 731-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10502220

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N-terminal proatrial natriuretic peptide in angina pectoris: impact of revascularization by angioplasty. Author(s): Klinge R, Jorgensen B, Thaulow E, Sirnes PA, Hall C. Source: International Journal of Cardiology. 1999 January; 68(1): 1-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10077394

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Nuclear factor-kappaB immunoreactivity is present in human coronary plaque and enhanced in patients with unstable angina pectoris. Author(s): Wilson SH, Best PJ, Edwards WD, Holmes DR Jr, Carlson PJ, Celermajer DS, Lerman A. Source: Atherosclerosis. 2002 January; 160(1): 147-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11755932

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Ointments and transdermal nitroglycerin patches for stable angina pectoris. Author(s): Thadani U, Lipicky RJ. Source: Cardiovascular Drugs and Therapy / Sponsored by the International Society of Cardiovascular Pharmacotherapy. 1994 August; 8(4): 625-33. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7848897

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One-year outcome after combined coronary artery bypass grafting and transmyocardial laser revascularization for refractory angina pectoris. Author(s): Stamou SC, Boyce SW, Cooke RH, Carlos BD, Sweet LC, Corso PJ. Source: The American Journal of Cardiology. 2002 June 15; 89(12): 1365-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12062729

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One-year outcome after percutaneous coronary intervention for stable and unstable angina pectoris with or without application of general usage of stents in unselected European patient groups. Author(s): Odell A, Gudnason T, Andersson T, Jidbratt H, Grip L. Source: The American Journal of Cardiology. 2002 July 15; 90(2): 112-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12106838

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One-year results of percutaneous myocardial revascularization for refractory angina pectoris. Author(s): Whitlow PL, DeMaio SJ Jr, Perin EC, O'Neill WW, Lasala JM, Schneider JE, McKeever LS, Ezratty AM, Knopf WD, Powers ER, Shawl FA; Eclipse Investigators. Source: The American Journal of Cardiology. 2003 June 1; 91(11): 1342-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12767430

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Operation for unstable angina pectoris: factors influencing adverse in-hospital outcome. Author(s): Louagie YA, Jamart J, Buche M, Eucher PM, Schoevaerdts D, Collard E, Gonzalez M, Marchandise B, Schoevaerdts JC. Source: The Annals of Thoracic Surgery. 1995 May; 59(5): 1141-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7733710

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Optimum treatment of stable angina pectoris. Author(s): Parmley WW. Source: Cardiovascular Drugs and Therapy / Sponsored by the International Society of Cardiovascular Pharmacotherapy. 1998 April; 12 Suppl 1: 105-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9642483

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Organic nitrate therapy for angina pectoris. Author(s): O'Rourke M. Source: The Medical Journal of Australia. 1994 June 20; 160(12): 803-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8208202

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Organic nitrate therapy for angina pectoris. Author(s): Reid J. Source: The Medical Journal of Australia. 1994 February 7; 160(3): 129, 132-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8295580

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Origin of angina pectoris in patients with high-grade single-vessel coronary artery stenosis undergoing percutaneous transluminal coronary angioplasty. Author(s): Vrachatis AD, Alpert MA, Nikas DJ, Dernellis JM, Georgulas VP, Kafkas NV, Deftereos SG, Zacharoulos AA. Source: The American Journal of Cardiology. 1998 June 1; 81(11): 1345-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9631973

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Outcome of percutaneous transluminal coronary angioplasty in subsets of unstable angina pectoris. A report of the 1985-1986 National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry. Author(s): Bentivoglio LG, Detre K, Yeh W, Williams DO, Kelsey SF, Faxon DP. Source: Journal of the American College of Cardiology. 1994 November 1; 24(5): 1195206. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7930239

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Patients with unstable angina pectoris present increased humoral response against Helicobacter pylori in comparison with patients with aggravated dyspepsia. Author(s): Rechcinski T, Kasprzak JD, Chmiela M, Krzeminska-Pakula M, Rudnicka W. Source: Acta Microbiol Pol. 2002; 51(4): 339-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12708822

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Percutaneous myocardial laser revascularization in patients with refractory angina pectoris. Author(s): Gray TJ, Burns SM, Clarke SC, Tait S, Sharples LD, Caine N, Schofield PM. Source: The American Journal of Cardiology. 2003 March 15; 91(6): 661-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12633794

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Periods of cluster headache induced by nitrate therapy and spontaneous remission of angina pectoris during active clusters. Author(s): Ekbom K, Sjostrand C, Svensson DA, Waldenlind E. Source: Cephalalgia : an International Journal of Headache. 2004 February; 24(2): 92-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14728704

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Prediction of significant left main coronary artery stenosis by the 12-lead electrocardiogram in patients with rest angina pectoris and the withholding of clopidogrel therapy. Author(s): Gaitonde RS, Sharma N, Ali-Hasan S, Miller JM, Jayachandran JV, Kalaria VG. Source: The American Journal of Cardiology. 2003 October 1; 92(7): 846-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14516891

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Predictors of angina pectoris versus myocardial infarction from the Women's Health Initiative Observational Study. Author(s): Hsia J, Aragaki A, Bloch M, LaCroix AZ, Wallace R; WHI Investigators. Source: The American Journal of Cardiology. 2004 March 15; 93(6): 673-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15019867

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Predictors of long-term mortality after hospitalization for primary unstable angina pectoris and non-ST-elevation myocardial infarction. Author(s): Lloyd-Jones DM, Camargo CA, Allen LA, Giugliano RP, O'Donnell CJ. Source: The American Journal of Cardiology. 2003 November 15; 92(10): 1155-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14609588

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Predictors of mortality, coronary angiography, and revascularization in unstable angina pectoris and acute non-ST elevation myocardial infarction (the TIMI III Registry). Author(s): Sharis PJ, Cannon CP, Rogers WJ, McCabe C, Murphy S, Gibson CM, Stone PH, Braunwald E. Source: The American Journal of Cardiology. 2002 November 15; 90(10): 1154-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12423724

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Prevalence of clopidogrel non-responders among patients with stable angina pectoris scheduled for elective coronary stent placement. Author(s): Muller I, Besta F, Schulz C, Massberg S, Schonig A, Gawaz M. Source: Thrombosis and Haemostasis. 2003 May; 89(5): 783-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12719773

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Prognosis in the thrombolysis in myocardial ischemia III registry according to the Braunwald unstable angina pectoris classification. Author(s): Scirica BM, Cannon CP, McCabe CH, Murphy SA, Anderson HV, Rogers WJ, Stone PH, Braunwald E; Thrombolysis in Myocardial Ischemia III Registry Investigators. Source: The American Journal of Cardiology. 2002 October 15; 90(8): 821-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12372567

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Prognostic value of corrected QT-interval prolongation in patients with unstable angina pectoris. Author(s): Gadaleta FL, Llois SC, Lapuente AR, Batchvarov VN, Kaski JC. Source: The American Journal of Cardiology. 2003 July 15; 92(2): 203-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12860225

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QT dispersion ratio in patients with unstable angina pectoris (a new risk factor?). Author(s): Cin VG, Celik M, Ulucan S. Source: Clin Cardiol. 1997 June; 20(6): 533-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9181263

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QT interval dispersion: non-invasive marker of ischemic injury in patients with unstable angina pectoris? Author(s): Doven O, Ozdol C, Sayin T, Oral D. Source: Japanese Heart Journal. 2000 September; 41(5): 597-603. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11132166

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Qualitative and quantitative comparison of amounts of narrowing by atherosclerotic plaques in the major epicardial coronary arteries at necropsy in sudden coronary death, transmural acute myocardial infarction, transmural healed myocardial infarction and unstable angina pectoris. Author(s): Roberts WC. Source: The American Journal of Cardiology. 1989 August 1; 64(5): 324-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2756876

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Refractory to medical treatment but not to nursing care: can we do more for patients with chronic angina pectoris? Author(s): Stewart S. Source: European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology. 2003 September; 2(3): 169-70. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14622623

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Regression of an atherosclerotic coronary artery plaque demonstrated by multislice spiral computed tomography in a patient with stable angina pectoris. Author(s): Sato Y, Inoue F, Yoshimura A, Fukui T, Imazeki T, Kato M, Ono H, Yoda S, Mitsui M, Matsumoto N, Furuhashi S, Takahashi M, Kanmatsuse K. Source: Heart and Vessels. 2003 September; 18(4): 224-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14520493

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Relation of depression to heart rate nonlinear dynamics in patients > or =60 years of age with recent unstable angina pectoris or acute myocardial infarction. Author(s): Vigo DE, Nicola Siri L, Ladron De Guevara MS, Martinez-Martinez JA, Fahrer RD, Cardinali DP, Masoli O, Guinjoan SM. Source: The American Journal of Cardiology. 2004 March 15; 93(6): 756-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15019886

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Relation of ischemia-modified albumin (IMA) levels following elective angioplasty for stable angina pectoris to duration of balloon-induced myocardial ischemia. Author(s): Quiles J, Roy D, Gaze D, Garrido IP, Avanzas P, Sinha M, Kaski JC. Source: The American Journal of Cardiology. 2003 August 1; 92(3): 322-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12888145

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Relation of self-reported angina pectoris to inducible myocardial ischemia in patients with known coronary artery disease: the Heart and Soul Study. Author(s): Gehi AK, Rumsfeld JS, Liu H, Schiller NB, Whooley MA. Source: The American Journal of Cardiology. 2003 September 15; 92(6): 705-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12972112

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Relative benefit of coronary artery bypass grafting versus stent-assisted percutaneous coronary intervention for angina pectoris and multivessel coronary disease in women versus men (one-year results from the Stent or Surgery trial). Author(s): Zhang Z, Weintraub WS, Mahoney EM, Spertus JA, Booth J, Nugara F, Stables RH, Vaccarino V. Source: The American Journal of Cardiology. 2004 February 15; 93(4): 404-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14969611

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Repeated nitrate prescriptions as a potential marker for angina pectoris. A comparison with medical information from the Rotterdam Study. Author(s): Maitland-van der Zee AH, Klungel OH, Stricker BH, van der Kuip DA, Witteman JC, Hofman A, Leufkens HG, de Boer A. Source: Pharmacy World & Science : Pws. 2003 April; 25(2): 70-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12774567

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Reversible ischemic neurological deficit (RIND) due to exercise testing for the diagnosis of angina pectoris. Author(s): Nanke T, Matsumoto N, Wakimoto H, Nakazawa K, Miyake F, Watanabe H, Horiuchi M, Takahashi Y. Source: Japanese Heart Journal. 2003 July; 44(4): 575-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12906039

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Role of adenosine and opioid-receptor mechanisms for pain in patients with silent myocardial ischemia or angina pectoris: a double-blind, placebo-controlled study. Author(s): Sadigh-Lindell B, Sylven C, Berglund M, Eriksson BE. Source: Journal of Cardiovascular Pharmacology. 2003 December; 42(6): 757-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14639098

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Role of single photon emission computed tomography imaging in the evaluation of therapy for angina pectoris. Author(s): Patel AD, Iskandrian AE. Source: American Heart Journal. 2003 June; 145(6): 952-61. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12796749

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Safety profile and tolerability of intravenous AR-C69931MX, a new antiplatelet drug, in unstable angina pectoris and non-Q-wave myocardial infarction. Author(s): Jacobsson F, Swahn E, Wallentin L, Ellborg M. Source: Clinical Therapeutics. 2002 May; 24(5): 752-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12075943

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Selective L-type, T-type, and nonspecific calcium-channel blockers for stable angina pectoris. Author(s): Thadani U. Source: American Heart Journal. 2002 July; 144(1): 8-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12094182

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Serological markers of Chlamydia pneumoniae, cytomegalovirus and Helicobacter pylori infection in diabetic and non-diabetic patients with unstable angina pectoris. Author(s): Altannavch Ts, Roubalova K, Broz J, Hruba D, Andel M. Source: Cent Eur J Public Health. 2003 June; 11(2): 102-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12884557

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Serum levels of vascular endothelial growth factor in patients with angina pectoris and acute myocardial infarction. Author(s): Yin R, Feng J, Chen D, Wu H. Source: Chinese Medical Sciences Journal = Chung-Kuo I Hsueh K'o Hsueh Tsa Chih / Chinese Academy of Medical Sciences. 2000 December; 15(4): 205-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12906138

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Shoshin beriberi with vasospastic angina pectoris possible mechanism of midventricular obstruction: possible mechanism of mid-ventricular obstruction. Author(s): Ito M, Tanabe Y, Suzuki K, Kumakura M, Aizawa Y. Source: Circulation Journal : Official Journal of the Japanese Circulation Society. 2002 November; 66(11): 1070-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12419944

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Spinal cord stimulation for angina pectoris and peripheral vascular disease. Author(s): Erdek MA, Staats PS. Source: Anesthesiology Clinics of North America. 2003 December; 21(4): 797-804. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14719720

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Spinal cord stimulation in peripheral vascular disease and angina pectoris. Author(s): Augustinsson LE. Source: Journal of Neurosurgical Sciences. 2003 March; 47(1 Suppl 1): 37-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14631672

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Suboptimal inhibition of platelet aggregation following tirofiban bolus in patients undergoing percutaneous coronary intervention for unstable angina pectoris. Author(s): Soffer D, Moussa I, Karatepe M, Harjai KJ, Boura J, Dixon SR, Grines CL, O'Neill WW, Roubin GS, Moses JW. Source: The American Journal of Cardiology. 2003 April 1; 91(7): 872-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12667576

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Superoxide generation in directional coronary atherectomy specimens of patients with angina pectoris: important role of NAD(P)H oxidase. Author(s): Azumi H, Inoue N, Ohashi Y, Terashima M, Mori T, Fujita H, Awano K, Kobayashi K, Maeda K, Hata K, Shinke T, Kobayashi S, Hirata K, Kawashima S, Itabe H, Hayashi Y, Imajoh-Ohmi S, Itoh H, Yokoyama M. Source: Arteriosclerosis, Thrombosis, and Vascular Biology. 2002 November 1; 22(11): 1838-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12426213

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Systemic T-cell activation in stable angina pectoris. Author(s): Jonasson L, Linderfalk C, Olsson J, Wikby A, Olsson AG. Source: The American Journal of Cardiology. 2002 March 15; 89(6): 754-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11897219

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Temporary cessation of spinal cord stimulation in angina pectoris-effects on symptoms and evaluation of long-term effect determinants. Author(s): Ekre O, Norrsell H, Wahrborg P, Eliasson T, Mannheimer C. Source: Coronary Artery Disease. 2003 June; 14(4): 323-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12826932

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The current cost of angina pectoris to the National Health Service in the UK. Author(s): Stewart S, Murphy N, Walker A, McGuire A, McMurray JJ. Source: Heart (British Cardiac Society). 2003 August; 89(8): 848-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12860855

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The effect of a neuropeptide Y Y1 receptor antagonist in patients with angina pectoris. Author(s): Gullestad L, Bjuro T, Aaberge L, Apelland T, Skardal R, Kjekshus E, Nordlander M, Ablad B, Pernow J. Source: European Heart Journal. 2003 June; 24(12): 1120-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12804926

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The use of partial fatty acid oxidation inhibitors for metabolic therapy of angina pectoris and heart failure. Author(s): Rupp H, Zarain-Herzberg A, Maisch B. Source: Herz. 2002 November; 27(7): 621-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12439634

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Therapeutic options for patients with chronic refractory angina pectoris. Author(s): DeJongste MJ, Hautvast RW, Tio RA. Source: Journal of the American College of Cardiology. 2002 October 16; 40(8): 1541; Author Reply 1541-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12392847

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Time for contrast material to traverse the epicardial artery and the myocardium in STsegment elevation acute myocardial infarction versus unstable angina pectoris/nonST-elevation acute myocardial infarction. Author(s): Wong GC, Frisch D, Murphy SA, Sabatine MS, Pai R, James D, Kraimer N, Katsiyiannis PT, Marble SJ, DiBattiste PM, Demopoulos LA, Gourlay SG, Barron HV, Cannon CP, Gibson CM; LIMIT AMI and TACTICS-TIMI 18 Study Groups. Source: The American Journal of Cardiology. 2003 May 15; 91(10): 1163-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12745096

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Transmyocardial laser revascularisation and other treatment modalities for angina pectoris. Author(s): Huikeshoven M, van der Sloot JA, Tukkie R, Beek JF. Source: Lasers in Medical Science. 2003; 18(1): 2-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12627266

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Treatment of unstable angina pectoris/non-ST-segment elevation myocardial infarction in elderly patients. Author(s): Aronow WS. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2003 October; 58(10): M927-33. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14570861

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Treatment options for angina pectoris and the future role of enhanced external counterpulsation. Author(s): Holmes DR Jr. Source: Clin Cardiol. 2002 December; 25(12 Suppl 2): Ii22-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12489600

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Trimetazidine in geriatric patients with stable angina pectoris: the tiger study. Author(s): Kolbel F, Bada V. Source: Int J Clin Pract. 2003 December; 57(10): 867-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14712887

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Unstable angina pectoris and non-Q-wave myocardial infarction. Author(s): Cavusoglu E, Sharma SK, Frishman W. Source: Heart Disease. 2001 March-April; 3(2): 116-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11975780

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Unusual case of a large midoesophageal diverticulum mimicking unstable angina pectoris. Author(s): Hoffmann JC, Pistorius G, Muller P, Zeitz M. Source: Journal of Internal Medicine. 2002 April; 251(4): 355-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11952887

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Usefulness and safety of percutaneous myocardial laser revascularization for refractory angina pectoris. Author(s): Salem M, Rotevatn S, Stavnes S, Brekke M, Vollset SE, Nordrehaug JE. Source: The American Journal of Cardiology. 2004 May 1; 93(9): 1086-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15110197

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Usefulness of dynamic multislice computed tomography of left ventricular function in unstable angina pectoris and comparison with echocardiography. Author(s): Dirksen MS, Bax JJ, de Roos A, Jukema JW, van der Geest RJ, Geleijns K, Boersma E, van der Wall EE, Lamb HJ. Source: The American Journal of Cardiology. 2002 November 15; 90(10): 1157-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12423725

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Usefulness of elevated levels of soluble vascular cell adhesion molecule-1 in predicting in-hospital prognosis in patients with unstable angina pectoris. Author(s): Rallidis LS, Gika HI, Zolindaki MG, Xydas TA, Paravolidakis KE, Velissaridou AH. Source: The American Journal of Cardiology. 2003 November 15; 92(10): 1195-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14609595

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Usefulness of endothelin(A) receptor antagonists for the prevention of in-stent restenosis in patients with stable angina pectoris or silent myocardial ischemia. Author(s): Kyriakides ZS, Psychari SN, Kolettis TM, Georgiadis M, Antoniadis A, Kremastinos DT. Source: The American Journal of Cardiology. 2003 February 15; 91(4): 476-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12586272

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Usefulness of high-sensitivity C-reactive protein in predicting long-term risk of death or acute myocardial infarction in patients with unstable or stable angina pectoris or acute myocardial infarction. Author(s): Zebrack JS, Anderson JL, Maycock CA, Horne BD, Bair TL, Muhlestein JB; Intermountain Heart Collaborative (IHC) Study Group. Source: The American Journal of Cardiology. 2002 January 15; 89(2): 145-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11792332

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Usefulness of implantable cardioverter-defibrillators in refractory variant angina pectoris complicated by ventricular fibrillation in patients with angiographically normal coronary arteries. Author(s): Meisel SR, Mazur A, Chetboun I, Epshtein M, Canetti M, Gallimidi J, Katz A, Strasberg B, Peled B. Source: The American Journal of Cardiology. 2002 May 1; 89(9): 1114-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11988204

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Usefulness of plasma N-terminal proatrial natriuretic peptide (proANP) as an early predictor of outcome in unstable angina pectoris or non-ST-elevation acute myocardial infarction. Author(s): Jernberg T, Stridsberg M, Lindahl B. Source: The American Journal of Cardiology. 2002 January 1; 89(1): 64-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11779526

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Usefulness of prodromal unstable angina pectoris in predicting better survival and smaller infarct size in acute myocardial infarction (The InTIME-II Prodromal Symptoms Substudy). Author(s): Christenson RH, Leino EV, Giugliano RP, Bahr RD. Source: The American Journal of Cardiology. 2003 September 1; 92(5): 598-600. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12943885

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Validation of the thrombolysis in myocardial infarction (TIMI) risk score for unstable angina pectoris and non-ST-elevation myocardial infarction in the TIMI III registry. Author(s): Scirica BM, Cannon CP, Antman EM, Murphy SA, Morrow DA, Sabatine MS, McCabe CH, Gibson CM, Braunwald E. Source: The American Journal of Cardiology. 2002 August 1; 90(3): 303-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12127617

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Value of C-reactive protein in patients with stable angina pectoris, coronary narrowing (30% to 70%), and normal fractional flow reserve. Author(s): Meuwissen M, de Winter RJ, Chamuleau SA, Heijne M, Koch KT, van den Berg A, van Straalen JP, Bax M, Schorborgh CE, Kearney D, Sanders GT, Tijssen JG, Piek JJ. Source: The American Journal of Cardiology. 2003 September 15; 92(6): 702-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12972111

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Value of intracoronary ultrasound and Doppler in the differentiation of angiographically normal coronary arteries: a prospective study in patients with angina pectoris. Author(s): Erbel R, Ge J, Bockisch A, Kearney P, Gorge G, Haude M, Schumann D, Zamorano J, Rupprecht HJ, Meyer J. Source: European Heart Journal. 1996 June; 17(6): 880-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8781827

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Value of the addition of amlodipine to atenolol in patients with angina pectoris despite adequate beta blockade. Author(s): Dunselman PH, van Kempen LH, Bouwens LH, Holwerda KJ, Herweijer AH, Bernink PJ. Source: The American Journal of Cardiology. 1998 January 15; 81(2): 128-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9591892

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Variability of changes in Doppler transmitral filling pattern during stress echocardiography in patients with stable angina pectoris. Author(s): Meluzin J, Toman J, Soucek M, Rihacek I, Novak M, Koukalova H, Groch L. Source: International Journal of Cardiology. 1994 July; 45(3): 209-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7960266

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Variability over time of haemostatic and other cardiovascular risk factors in patients suffering from angina pectoris. ECAT Angina Pectoris Study Group. Author(s): Pyke SD, Thompson SG, Buchwalsky R, Kienast J. Source: Thrombosis and Haemostasis. 1993 November 15; 70(5): 743-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8128428

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Variant angina pectoris associated with moyamoya disease. Author(s): Ikeda U, Fujikawa H, Shimada K. Source: Lancet. 1998 January 17; 351(9097): 183-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9449876

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Vasoconstrictor peptides and cold intolerance in patients with stable angina pectoris. Author(s): Dodds PA, Bellamy CM, Muirhead RA, Perry RA. Source: British Heart Journal. 1995 January; 73(1): 25-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7888256

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Vasomotor responses of coronary stenoses to acetylcholine and their relation to serum lipid levels in stable angina pectoris. Author(s): Tousoulis D, Gorog D, Crake T, Homaei H, Ahmed N, Davies GJ. Source: The American Journal of Cardiology. 1999 June 15; 83(12): 1606-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10392862

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Which drug to choose for stable angina pectoris: a comparative study between bisoprolol and nitrates. Author(s): van de Ven LL, Vermeulen A, Tans JG, Tans AC, Liem KL, Lageweg NC, Lie KI. Source: International Journal of Cardiology. 1995 January 6; 47(3): 217-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7721498

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Why angina pectoris in aortic stenosis. Author(s): Gould KL. Source: Circulation. 1997 February 18; 95(4): 790-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9054730

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Wide-complex tachycardia with mild angina pectoris. Author(s): Hancock EW. Source: Hosp Pract (Off Ed). 1993 February 15; 28(2): 27, 30. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7679392

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William Heberden and Myron Prinzmetal: angina pectoris. Author(s): Sternbach G. Source: The Journal of Emergency Medicine. 1991 January-April; 9(1-2): 81-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2045655

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William Heberden, Edward Jenner, John Hunter and angina pectoris. Author(s): Hart FD. Source: J Med Biogr. 1995 February; 3(1): 56-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11640008

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Willingness to pay for reductions in angina pectoris attacks. Author(s): Kartman B, Andersson F, Johannesson M. Source: Medical Decision Making : an International Journal of the Society for Medical Decision Making. 1996 July-September; 16(3): 248-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8818123

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Withdrawal phenomenon after abrupt cessation of nifedipine in stable angina pectoris. Author(s): Martsevich SY, Koutishenko N, Metelitsa VI. Source: International Journal of Cardiology. 1993 December 31; 42(3): 298-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8138342

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Women react with more myocardial ischemia and angina pectoris during elective percutaneous transluminal coronary angioplasty. Author(s): Jensen J, Eriksson SV, Lindvall B, Lundin P, Sylven C. Source: Coronary Artery Disease. 2000 October; 11(7): 527-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11023240

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Women with angina pectoris receive less antiplatelet treatment than men. Author(s): Bouvy ML, Heerdink ER, Klungel OH, de Boer A, Stuurman-Bieze AG, Leufkens HG. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 1999 April; 49(441): 299-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10736910

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CHAPTER 2. NUTRITION AND ANGINA PECTORIS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and angina pectoris.

Finding Nutrition Studies on Angina Pectoris The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “angina pectoris” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “angina pectoris” (or a synonym): •

A case of successful coronary artery bypass grafting in a patient with angina pectoris and hypothyroidism. Author(s): Department of Thoracic Surgery, Osaka Medical College, Takatsuki, Japan. Source: Koike, R Suma, H Oku, T Satoh, H Sawada, Y Matsuyama, N Takeuchi, A Funauchi, T Ishimura, T Wakabayashi, A Jpn-Circ-J. 1989 April; 53(4): 336-40 0047-1828

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Clinical observation on 300 cases of angina pectoris treated by the spleen-stomach regulating method. Author(s): Guang'anmen Hospital Affiliated to China Academy of Traditional Chinese Medicine, Beijing. Source: Gao, R Li, L Lu, Z J-Tradit-Chin-Med. 1998 June; 18(2): 87-90 0254-6272

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Effect of L-arginine administration on myocardial thallium-201 perfusion during exercise in patients with angina pectoris and normal coronary angiograms. Author(s): First Department of Internal Medicine, Kobe University School of Medicine, Japan. [email protected] Source: Fujita, H Yamabe, H Yokoyama, M J-Nucl-Cardiol. 2000 Mar-April; 7(2): 97-102 1071-3581

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Plasma selenium and glutathione peroxidase in relation to cancer, angina pectoris and short-term mortality in 68-year-old men. Author(s): Department of Clinical Chemistry, University Hospital, Lund, Sweden. Source: Akesson, B Steen, B Compr-Gerontol-[A]. 1987 June; 1(2): 61-4 0902-0071

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Treatment of angina pectoris with medicinal plaster fixed at acupoints--a report of 54 cases. Author(s): Institute of Acupuncture and Moxibustion, China Academy of Traditional Chinese Medicine, Beijing. Source: Liu, Y Wang, T Zhang, J J-Tradit-Chin-Med. 1998 March; 18(1): 12-4 0254-6272

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to angina pectoris; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Vitamin E Source: Prima Communications, Inc.www.personalhealthzone.com

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Minerals Carnitine Source: Prima Communications, Inc.www.personalhealthzone.com HMG-CoA Reductase Inhibitors (Statins) Source: Integrative Medicine Communications; www.drkoop.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND ANGINA PECTORIS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to angina pectoris. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to angina pectoris and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “angina pectoris” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to angina pectoris: •

116 cases of coronary angina pectoris treated with powder composed of radix ginseng, radix notoginseng and succinum. Author(s): Yuan J, Guo W, Yang B, Liu P, Wang Q, Yuan H. Source: J Tradit Chin Med. 1997 March; 17(1): 14-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10437237

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A clinical investigation on garlicin injectio for treatment of unstable angina pectoris and its actions on plasma endothelin and blood sugar levels. Author(s): Li G, Shi Z, Jia H, Ju J, Wang X, Xia Z, Qin L, Ge C, Xu Y, Cheng L, Chen P, Yuan G. Source: J Tradit Chin Med. 2000 December; 20(4): 243-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11263272

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A placebo-controlled, double-blind study of eicosapentaenoic acid-rich fish oil in patients with stable angina pectoris. Author(s): Solomon SA, Cartwright I, Pockley G, Greaves M, Preston FE, Ramsay LE, Waller PC. Source: Current Medical Research and Opinion. 1990; 12(1): 1-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2188794

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Acupuncture in angina pectoris. Author(s): Kraemer ES, Cardoso Mde F, Yamamura Y. Source: Journal of Internal Medicine. 1991 April; 229(4): 383. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2026994

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Acupuncture in angina pectoris: do psycho-social and neurophysiological factors relate to the effect? Author(s): Ballegaard S, Karpatschoff B, Holck JA, Meyer CN, Trojaborg W. Source: Acupuncture & Electro-Therapeutics Research. 1995 April-July; 20(2): 101-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7491848

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Acupuncture in angina pectoris: does acupuncture have a specific effect? Author(s): Ballegaard S, Meyer CN, Trojaborg W. Source: Journal of Internal Medicine. 1991 April; 229(4): 357-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2026989

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Acupuncture in severe, stable angina pectoris: a randomized trial. Author(s): Ballegaard S, Jensen G, Pedersen F, Nissen VH. Source: Acta Med Scand. 1986; 220(4): 307-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3541499

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Acupuncture treatment of angina pectoris. Author(s): Li Y. Source: J Tradit Chin Med. 1999 December; 19(4): 279-82. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10921132

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Addition of acupuncture and self-care education in the treatment of patients with severe angina pectoris may be cost beneficial: an open, prospective study. Author(s): Ballegaard S, Johannessen A, Karpatschof B, Nyboe J. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 1999 October; 5(5): 405-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10537240

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Alternative approaches to the medical management of angina pectoris: acupuncture, electrical nerve stimulation, and spinal cord stimulation. Author(s): Bueno EA, Mamtani R, Frishman WH.

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Source: Heart Disease. 2001 July-August; 3(4): 236-41. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11975800 •

Angina pectoris and therapy with cisplatin, vincristine, and bleomycin. Author(s): Dixon A, Nakamura JM, Oishi N, Wachi DH, Fukuyama O. Source: Annals of Internal Medicine. 1989 August 15; 111(4): 342-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2474263

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Angina pectoris associated with infusions of 5-FU and vindesine. Author(s): Blijham GH, Fiolet HH, van Deijk WA, Hupperets PS, Janssen JH. Source: Cancer Treat Rep. 1986 February; 70(2): 314-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3948198

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Angina pectoris following cisplatin, etoposide, and bleomycin in a patient with advanced testicular cancer. Author(s): Rodriguez J, Collazos J, Gallardo M, Hernando G. Source: The Annals of Pharmacotherapy. 1995 February; 29(2): 138-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7538830

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Angina pectoris refractory for conventional therapy--is neurostimulation a possible alternative treatment? Author(s): Hautvast RW, DeJongste MJ, ter Horst GJ, Blanksma PK, Lie KI. Source: Clin Cardiol. 1996 July; 19(7): 531-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8818432

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Angina pectoris with special reference to its mechanical causes. 1938. Author(s): Appleyard EC. Source: J Am Osteopath Assoc. 2001 August; 101(8): 464-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11534527

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Antithrombin III and protein C in stable angina pectoris--influence of dietary supplementation with polyunsaturated fatty acids. Author(s): Schmidt EB, Kristensen SD, Sorensen PJ, Dyerberg J. Source: Scandinavian Journal of Clinical and Laboratory Investigation. 1988 September; 48(5): 469-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3060987

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Beneficial effect of Inula racemosa (pushkarmoola) in angina pectoris: a preliminary report. Author(s): Tripathi SN, Upadhyaya BN, Gupta VK.

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Source: Indian J Physiol Pharmacol. 1984 January-March; 28(1): 73-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6436179 •

Catecholamine metabolism during pacing-induced angina pectoris and the effect of transcutaneous electrical nerve stimulation. Author(s): Emanuelsson H, Mannheimer C, Waagstein F, Wilhelmsson C. Source: American Heart Journal. 1987 December; 114(6): 1360-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3500628

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Circadian variation of basal total vascular tone and chronotherapy in patients with vasospastic angina pectoris. Author(s): Mori H, Nakamura N, Tamura N, Sawai M, Tanno T, Narita T, Singh RB, Otsuka K. Source: Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 2002; 56 Suppl 2: 339S-344S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12653190

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Clinical observation in 46 cases of angina pectoris treated by the catgut-embedding therapy. Author(s): Li Z. Source: J Tradit Chin Med. 2003 September; 23(3): 199-200. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14535187

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Clinical observation on 300 cases of angina pectoris treated by the spleen-stomach regulating method. Author(s): Gao R, Li L, Lu Z. Source: J Tradit Chin Med. 1998 June; 18(2): 87-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10437220

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Comparative efficacy of high-dose versus low-dose nicorandil therapy for chronic stable angina pectoris. Author(s): Kinoshita M, Nishikawa S, Sawamura M, Yamaguchi S, Mitsunami K, Itoh M, Motomura M, Bito K, Mashiro I, Kawakita S. Source: The American Journal of Cardiology. 1986 October 1; 58(9): 733-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2945420

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Comparison of combination nifedipine-propranolol and diltiazem-propranolol with high dose diltiazem monotherapy for stable angina pectoris. Author(s): Morse JR. Source: The American Journal of Cardiology. 1988 November 15; 62(16): 1028-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3055924

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Comparison of oral propranolol and verapamil for combined systemic hypertension and angina pectoris. A placebo-controlled double-blind randomized crossover trial. Author(s): Frishman WH, Klein NA, Klein P, Strom JA, Tawil R, Strair R, Wong B, Roth S, LeJemtel TH, Pollack S, Sonnenblick EH. Source: The American Journal of Cardiology. 1982 November; 50(5): 1164-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6127946

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Coronary blood flow dynamics during transcutaneous electrical nerve stimulation for stable angina pectoris associated with severe narrowing of one major coronary artery. Author(s): Jessurun GA, Tio RA, De Jongste MJ, Hautvast RW, Den Heijer P, Crijns HJ. Source: The American Journal of Cardiology. 1998 October 15; 82(8): 921-6. Erratum In: Am J Cardiol 1999 February 15; 83(4): 642. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9794345

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Cost-benefit of combined use of acupuncture, Shiatsu and lifestyle adjustment for treatment of patients with severe angina pectoris. Author(s): Ballegaard S, Norrelund S, Smith DF. Source: Acupuncture & Electro-Therapeutics Research. 1996 July-December; 21(3-4): 18797. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9051166

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DATA: a decision aid for management of the patient with stable angina pectoris. Author(s): Hopkins CB, Maysuria H. Source: Critical Reviews in Biomedical Engineering. 2000; 28(1-2): 41-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10999363

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Effect of acupuncture in patients with angina pectoris. Author(s): Richter A, Herlitz J, Hjalmarson A. Source: European Heart Journal. 1991 February; 12(2): 175-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2044550

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Effects of acupuncture in moderate, stable angina pectoris: a controlled study. Author(s): Ballegaard S, Pedersen F, Pietersen A, Nissen VH, Olsen NV. Source: Journal of Internal Medicine. 1990 January; 227(1): 25-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2105371

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Effects of L-arginine supplementation on endothelium-dependent coronary vasodilation in patients with angina pectoris and normal coronary arteriograms. Author(s): Egashira K, Hirooka Y, Kuga T, Mohri M, Takeshita A. Source: Circulation. 1996 July 15; 94(2): 130-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8674170

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Effects of oral L-arginine supplementation on exercise-induced QT dispersion and exercise tolerance in stable angina pectoris. Author(s): Bednarz B, Wolk R, Chamiec T, Herbaczynska-Cedro K, Winek D, Ceremuzynski L. Source: International Journal of Cardiology. 2000 September 15; 75(2-3): 205-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11077135

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Electrical neuromodulation improves myocardial perfusion and ameliorates refractory angina pectoris in patients with syndrome X: fad or future? Author(s): Jessurun GA, Hautvast RW, Tio RA, DeJongste MJ. Source: European Journal of Pain (London, England). 2003; 7(6): 507-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14575663

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Electrical neurostimulation for angina pectoris. Acupuncture and TENS--where east meets west. Author(s): Colquhoun DM. Source: The Medical Journal of Australia. 1993 April 5; 158(7): 440-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8469188

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Fish oil in angina pectoris. Author(s): Kristensen SD, Schmidt EB, Andersen HR, Dyerberg J. Source: Atherosclerosis. 1987 March; 64(1): 13-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3109445

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Increased thromboxane A2 generation and altered membrane fatty acid composition in platelets from patients with active angina pectoris. Author(s): Prisco D, Rogasi PG, Matucci M, Abbate R, Gensini GF, Serneri GG. Source: Thrombosis Research. 1986 October 1; 44(1): 101-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3024352

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Indigenous free radical scavenger MAK 4 and 5 in angina pectoris. Is it only a placebo? Author(s): Dogra J, Grover N, Kumar P, Aneja N. Source: J Assoc Physicians India. 1994 June; 42(6): 466-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7852231

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Influence of naloxone on the effects of high frequency transcutaneous electrical nerve stimulation in angina pectoris induced by atrial pacing. Author(s): Mannheimer C, Emanuelsson H, Waagstein F, Wilhelmsson C. Source: British Heart Journal. 1989 July; 62(1): 36-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2788001

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Long-term home treatment with epidural analgesia does not affect later spinal cord stimulation in patients with otherwise intractable angina pectoris. Author(s): Andersen C, Hole P. Source: The Clinical Journal of Pain. 1998 December; 14(4): 315-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9874010

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Neurostimulation treatment for angina pectoris. Author(s): Murray S, Collins PD, James MA. Source: Heart (British Cardiac Society). 2000 February; 83(2): 217-20. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10648501

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Noninvasive assessment of the autonomic nervous tone in angina pectoris: an application of digital plethysmography with auditory stimuli. Author(s): Matoba T, Ohkita Y, Chiba M, Toshima H. Source: Angiology. 1983 February; 34(2): 127-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6401953

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Occupation, type A behavior and self-reported angina pectoris. Author(s): Byrne DG, Reinhart MI. Source: Journal of Psychosomatic Research. 1989; 33(5): 609-19. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2795533

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Refractory angina pectoris in end-stage coronary artery disease: evolving therapeutic concepts. Author(s): Schoebel FC, Frazier OH, Jessurun GA, De Jongste MJ, Kadipasaoglu KA, Jax TW, Heintzen MP, Cooley DA, Strauer BE, Leschke M. Source: American Heart Journal. 1997 October; 134(4): 587-602. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9351724

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Refractory angina pectoris: mechanism and therapeutic options. Author(s): Kim MC, Kini A, Sharma SK. Source: Journal of the American College of Cardiology. 2002 March 20; 39(6): 923-34. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11897431

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Respiratory compromise: a rare complication of transcutaneous electrical nerve stimulation for angina pectoris. Author(s): Mann CJ. Source: Journal of Accident & Emergency Medicine. 1996 January; 13(1): 68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8821235

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Safety and efficacy of Hartone in stable angina pectoris--an open comparative trial. Author(s): Kumar PU, Adhikari P, Pereira P, Bhat P.

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Source: J Assoc Physicians India. 1999 July; 47(7): 685-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10778587 •

Spinal cord stimulation in severe angina pectoris--presentation of current studies, indications and clinical experience. Author(s): Eliasson T, Augustinsson LE, Mannheimer C. Source: Pain. 1996 May-June; 65(2-3): 169-79. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8826504

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TCM differential treatment of angina pectoris--an illustrative case report. Author(s): Zhang D, Yu Y, Tu X. Source: J Tradit Chin Med. 1999 September; 19(3): 234-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10921158

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TENS in refractory angina pectoris. Three case reports. Author(s): West PD, Colquhoun DM. Source: The Medical Journal of Australia. 1993 April 5; 158(7): 488-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8469202

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The effect of fish oil on lipids, coagulation and fibrinolysis in patients with angina pectoris. Author(s): Schmidt EB, Kristensen SD, Dyerberg J. Source: Artery. 1988; 15(6): 316-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3178506

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The effect of transcutaneous electrical nerve stimulation (TENS) on catecholamine metabolism during pacing-induced angina pectoris and the influence of naloxone. Author(s): Mannheimer C, Emanuelsson H, Waagstein F. Source: Pain. 1990 April; 41(1): 27-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2352762

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The effects of transcutaneous electrical nerve stimulation in patients with severe angina pectoris. Author(s): Mannheimer C, Carlsson CA, Emanuelsson H, Vedin A, Waagstein F, Wilhelmsson C. Source: Circulation. 1985 February; 71(2): 308-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3871177

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The successful use of spinal cord stimulation to alleviate intractable angina pectoris. Author(s): McCleane GJ.

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Source: Ulster Med J. 1998 May; 67(1): 59-60. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9652202 •

Therapeutic effect of Crataegus pinnatifida on 46 cases of angina pectoris--a double blind study. Author(s): Weng WL, Zhang WQ, Liu FZ, Yu XC, Zhang PW, Liu YN, Chi HC, Yin GX, Huang MB. Source: J Tradit Chin Med. 1984 December; 4(4): 293-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6397664

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Total occlusion of left main coronary artery without angina pectoris. Author(s): DePace NL, Kimbiris D, Iskandrian AS, Bemis CE, Segal BL. Source: Archives of Internal Medicine. 1983 May; 143(5): 1064-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6679220

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Transcutaneous electrical nerve stimulation (TENS) for treatment of severe angina pectoris refractory to maximal medical and surgical management--a case report. Author(s): Magarian GJ, Leikam B, Palac R. Source: Angiology. 1990 May; 41(5): 408-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1972613

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Transcutaneous electrical nerve stimulation (TENS) in angina pectoris. Author(s): Mannheimer C, Carlsson CA, Vedin A, Wilhelmsson C. Source: Pain. 1986 September; 26(3): 291-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3534690

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Transcutaneous electrical nerve stimulation (TENS) in angina pectoris. Author(s): Mannheimer C, Carlsson CA, Vedin A, Wilhelmsson C. Source: International Journal of Cardiology. 1985 January; 7(1): 91-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3877003

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Transcutaneous electrical nerve stimulation in severe angina pectoris. Author(s): Mannheimer C, Carlsson CA, Ericson K, Vedin A, Wilhelmsson C. Source: European Heart Journal. 1982 August; 3(4): 297-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6982163

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Transcutaneous electrical nerve stimulation in unstable angina pectoris. Author(s): Borjesson M, Eriksson P, Dellborg M, Eliasson T, Mannheimer C. Source: Coronary Artery Disease. 1997 August-September; 8(8-9): 543-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9431483

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Treatment of angina pectoris with medicinal plaster fixed at acupoints--a report of 54 cases. Author(s): Liu Y, Wang T, Zhang J. Source: J Tradit Chin Med. 1998 March; 18(1): 12-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10437254

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Treatment of unstable angina pectoris based on disease- and syndromedifferentiation. Author(s): Zhong J, Shi D. Source: J Tradit Chin Med. 2000 June; 20(2): 141-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11039008

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Unstable angina pectoris--changes in the ST-T segment during daily activities such as bathing, eating, defecating and urinating. Author(s): Tanabe T, Goto Y. Source: Japanese Circulation Journal. 1983 April; 47(4): 451-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6834649

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Vasodilator therapy for angina pectoris: the intersection of homeopathy and scientific medicine. Author(s): Fye WB. Source: Journal of the History of Medicine and Allied Sciences. 1990 July; 45(3): 317-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1976673

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Visceral chest pain in unstable angina pectoris and effects of transcutaneous electrical nerve stimulation. (TENS). A review. Author(s): Borjesson M. Source: Herz. 1999 April; 24(2): 114-25. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10372297

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to angina pectoris; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Angina Source: Healthnotes, Inc.; www.healthnotes.com Angina Source: Integrative Medicine Communications; www.drkoop.com Atherosclerosis and Heart Disease Prevention Source: Prima Communications, Inc.www.personalhealthzone.com Congestive Heart Failure Source: Healthnotes, Inc.; www.healthnotes.com Heart Attack Source: Healthnotes, Inc.; www.healthnotes.com

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Chinese Medicine Bawei Chenxiang San Alternative names: Bawei Chenxiang Powder Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Danshen Alternative names: Danshen Root; Radix Salviae Miltiorrhizae Source: Chinese Materia Medica Fufang Danshen Pian Alternative names: Compound Saivia Tablets Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China

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Gualou Alternative names: Snakegourd Fruit; Fructus Trichosanthis Source: Chinese Materia Medica Guanxin Suhe Alternative names: Guanxin Suhe Pills; Guanxin Suhe Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Jiangxiang Alternative names: Rosewood; Lignum Dalbergiae Odoriferae Source: Chinese Materia Medica Shexiang Baoxin Wan Alternative names: hexiang Baoxin Pills; Shexiang Baoxin Wan (She Xiang Bao Xin Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Tanxiang Alternative names: Sandalwood; Lignum Santaii Albi Source: Chinese Materia Medica Xiebai Alternative names: ongstamen Onion Bulb; Xiebai (Xie Bai); Bulbus Aiiii Macrostem Source: Chinese Materia Medica •

Herbs and Supplements Alpha2-Adrenergic Agonists Source: Integrative Medicine Communications; www.drkoop.com Beta-Blockers Source: Integrative Medicine Communications; www.drkoop.com Beta-Carotene Source: Prima Communications, Inc.www.personalhealthzone.com Bromelain Source: Healthnotes, Inc.; www.healthnotes.com Coenzyme Q10 Source: Healthnotes, Inc.; www.healthnotes.com Crataegus Alternative names: Hawthorn; Crataegus oxyacantha L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Cysteine Source: Integrative Medicine Communications; www.drkoop.com

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Diltiazem Source: Healthnotes, Inc.; www.healthnotes.com Fibric Acid Derivatives Source: Integrative Medicine Communications; www.drkoop.com Fo-Ti Alternative names: Polygonum multiflorum Source: Healthnotes, Inc.; www.healthnotes.com Glutamic Acid Source: Healthnotes, Inc.; www.healthnotes.com Hawthorn Alternative names: Crataegus laevigata, Crataegus oxyacantha, Crataegus monogyna Source: Healthnotes, Inc.; www.healthnotes.com Hawthorn Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Isosorbide Dinitrate Source: Healthnotes, Inc.; www.healthnotes.com Isosorbide Mononitrate Source: Healthnotes, Inc.; www.healthnotes.com Kudzu Alternative names: Pueraria lobata Source: Healthnotes, Inc.; www.healthnotes.com Metoprolol Source: Healthnotes, Inc.; www.healthnotes.com N-Acetyl Cysteine (NAC) Source: Prima Communications, Inc.www.personalhealthzone.com Nadolol Source: Healthnotes, Inc.; www.healthnotes.com Nitroglycerin Source: Healthnotes, Inc.; www.healthnotes.com Nitroglycerin Alternative names: Deponit, Minitran, Nitrek, Nitro-Bid, Nitro-Derm, Nitro-Dur, Nitro-Time, Nitrocine, Nitrodisc, Nitrogard, Nitroglyn, Nitrol, Nitrolingual, Nitrong, NitroQuick, Nitrostat, Transderm-Nitro Source: Prima Communications, Inc.www.personalhealthzone.com

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Panax Alternative names: Ginseng; Panax ginseng Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Phenothiazine Derivatives Source: Integrative Medicine Communications; www.drkoop.com Propranolol Source: Healthnotes, Inc.; www.healthnotes.com Royal Jelly Source: Healthnotes, Inc.; www.healthnotes.com Sulfonylureas Source: Integrative Medicine Communications; www.drkoop.com Thiazide Diuretics Source: Integrative Medicine Communications; www.drkoop.com Thioxanthene Derivatives Source: Integrative Medicine Communications; www.drkoop.com Tribulus Puncture Alternative names: Puncture Vine, Goathead; Tribulus terrestris L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Tricyclic Antidepressants (TCAs) Source: Integrative Medicine Communications; www.drkoop.com Vasodilators Source: Integrative Medicine Communications; www.drkoop.com Verapamil Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. PATENTS ON ANGINA PECTORIS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “angina pectoris” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on angina pectoris, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Angina Pectoris By performing a patent search focusing on angina pectoris, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 8Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on angina pectoris: •

Composition and method for reducing blood pressure, alleviating or eliminating angina pectoris and headaches, and enhancing skin and hair Inventor(s): Pak; Kyoungsik (371 Sweetbriar Rd., King of Prussia, PA 19406) Assignee(s): none reported Patent Number: 6,726,939 Date filed: March 22, 2000 Abstract: A composition for reducing or stabilizing blood pressure and relieving headaches comprises (a) a first component comprising (i) tea, or (ii) tea and vitamin B6, or (iii) a combination of vitamin C and vitamin B6, or (iv) a combination of tea, vitamin C, and vitamin B6, and (b) a sulfur-containing amino acid. Preferably, the composition is provided in tablet or capsule form. Excerpt(s): This invention relates to the field of blood pressure and angina pectoris, and specifically is concerned with a composition for stabilizing or reducing blood pressure and alleviating or preventing angina pectoris. Teas, especially green tea, oolong tea, and black tea, have come to be recognized for their advantageous properties for enhancing health and longevity. Green tea, for example, contains antioxidants, including antioxidant polyphenols that have been linked with providing antiviral, antibacterial, and anticarcinogenic properties, as well as stimulating the immune system. Further, it is thought that green tea may assist in the fight against aging, with the antioxidants in green tea preventing or blocking the formation of free radicals in the human body. Additionally, it is thought that green tea may help relieve headaches, including migraine headaches, eliminate or relieve angina pectoris, lower overall cholesterol levels, reduce the risk of heart attacks, lessen the likelihood of death from heart attack, decrease the risk of stroke, enhance immune functions, and aid digestion. Web site: http://www.delphion.com/details?pn=US06726939__

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Compositions for treatment of hyperlipidemia and angina pectoris Inventor(s): No; Yong Il (1414-608 Maehwa Apt., Sanbon-Dong 1015, Gunpo-City, Kyonggi-Do, KR) Assignee(s): none reported Patent Number: 6,413,554 Date filed: January 10, 2001 Abstract: The present invention relates to a galenic composition effective for prevention and treatment of hyperlipidemia and ischemia, and angina pectoris due to reperfusion. More specifically, the present invention relates to a composition effective for prevention and treatment of hyperlipidemia and cardiovascular disorders, particularly, angina pectoris due to myocardial ischemia, which contains eight (8) kinds of medicinal herbs consisting of Allium thumbergii, trichosanthis semen, angelicae gigantis radix, salviae radix, cinnamomi ramulus, curcumae tuber, paeoniae rubrae radix and pinelliae rhizoma as the major ingredients.

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Excerpt(s): The present invention relates to a gelenic composition effective for prevention and treatment of hyperlipidemia, and angina pectoris due to ischemia and reperfusion. More specifically, the present invention relates to a galenic composition effective for prevention and treatment of hyperlipidemia and cardiovascular disorders, particularly, angina pectoris due to myocardial ischemia, which contains eight (8) kinds of medicinal herbs consisting of Allium thumbergii, trichosanthis semen, angelicae gigantis radix, salviae radix, cinnamomi ramulus, curcumae tuber, paeoniae rubrae radix and pinelliae rhizoma as the major ingredients. In many countries, including Korea, which are under gradual Westernization of dietary life and cultural activities, diseases of adult peoples have been raised as one of serious social problems. Among them, particularly, hyperlipidemia which attacks preferentially the middle forties and has been known as a typical type of diseases developed predominantly in advanced countries has also been raised as one of most common diseases of adult peoples. Hyperlipidemia, which has been known as the main cause of arteriosclerosis and as having a deep correlation with angina pectoris, myocardial infarction and cerebral apoplexy, generally means the blood cholesterol level of 240 mg/dl or more, and it has been proposed that blood cholesterol level should be lowered to the normal value below 200 mg/dl. The major constituents of lipid present in blood are generally classified into total cholesterol, which is commonly called cholesterol, neutral fat (triglyceride), low density lipoprotein, very low density lipoprotein and high density lipoprotein. It has been disclosed that the cause of hyperlipidemia includes heredity, alcohol intake, high fat and high calorie diet, obesity, diabetes, liver functional disorders, thyroid functional disorders and nephritic syndrome. In general, if hyperlipidemic state is continued, arteriosclerosis may be caused through the pathway that fat plaque is deposited and attached to vascular wall to induce fibrosis and then calcium is deposited thereon. Ultimately, due to such pathway the inside of artery becomes narrower. Web site: http://www.delphion.com/details?pn=US06413554__

Patent Applications on Angina Pectoris As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to angina pectoris: •

Composition for the treatment of heart failure Inventor(s): Aass, Halfdan; (Oslo, NO), Andreassen, Arne; (Oslo, NO), Aukrust, Pal; (Oslo, NO), Fjeld, Jan; (Oslo, NO), Froland, Stig; (Oslo, NO), Gullestad, Lars; (N-Baerum Post-Terminal, NO), Ihlen, Halfdan; (Oslo, NO), Kjekshus, John; (Oslo, NO), Lien, Egil; (Trondheim, NO), Nitter-Hauge, Sigurd; (Oslo, NO), Simonsen, Svein; (Oslo, NO), Ueland, Thor; (Oslo, NO) Correspondence: Burns Doane Swecker & Mathis L L P; Post Office Box 1404; Alexandria; VA; 22313-1404; US Patent Application Number: 20030170241 Date filed: February 20, 2003

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This has been a common practice outside the United States prior to December 2000.

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Abstract: The present invention relates to the use of an immunomodulating agent, in particular intravenous immunoglobulin (IVIG), in the manufacture of a medicament for use in the treatment of non-viral or non-autoimmune induced heart disorders or nonviral or non-autoimmune associated phases of heart disorders or the symptoms associated therewith. Particular heart disorders to be treated are selected from the group comprising chronic CHF, chronic (stable) angina pectoris and acute coronary syndromes. Pharmaceutical compositions for use in the treatment of such disorders comprising immunomodulating agents are also provided. Excerpt(s): The present invention relates to heart disorders and in particular the use of immunomodulating agents for the treatment of heart disorders and the symptoms associated therewith. Heart disorders or diseases, which are generally characterised by impaired cardiac function, e.g. heart failure affect a large number of people worldwide and in particular in the Western world. Heart disorders or diseases are responsible for a reduced quality of life and premature death in a significant proportion of sufferers. Heart disorders occur in men, women, and children of both sexes, but are particularly prevalent in men and in elderly or middle aged people. Heart failure is characterized by impaired cardiac function either due to reduced pump function (systolic dysfunction) or reduced filling (diastolic dysfunction). There are a number of different causes of heart failure of which the most common in the western world is coronary artery disease. Other common causes are cardiomyopathy (primary or secondary), hypertension, valvular diseases, and congenital defects. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Herbal composition for angina pectoris, method to prepare same and uses thereof Inventor(s): Guo, Zhixin; (Tianjin, CN), Liu, Yan; (Tianjin, CN), Wu, Naifeng; (Tianjin, CN), Yan, Xijun; (Tianjin, CN), Ye, Zhengliang; (Tianjin, CN) Correspondence: Albert Wai-Kit Chan; Law Offices OF Albert Wai-Kit Chan, Llc; World Plaza, Suite 604; 141-07 20th Avenue; Whitestone; NY; 11357; US Patent Application Number: 20030152651 Date filed: July 31, 2002 Abstract: This invention provides compositions comprising extracts of Radix Salviae Miltiorrhizae, Radix Notoginseng and Borneol. Said compositions comprise notoginsenoside R.sub.1 and ginsenoside R.sub.g1 which are active components for therapeutic applications. This invention also provides a method of preparation of the said compositions and a method of identification and determination of the amount of individual effective components of said compositions. Finally, this invention provides various uses of the compositions. Excerpt(s): This application is a continuation-in-part of International Patent Application No. PCT/US01/49396, filed Dec. 18, 2001 which claims benefit of U.S. Serial No. 60/258,057, filed Dec. 22, 2000, the content of which are incorporated here into this application. Throughout this application, various publications are referenced and the disclosures of these publications are hereby incorporated by reference into this application in order to more fully describe the state of the art as known to the skilled therein as of the date of the invention described and claimed herein. Chronic stable angina pectoris is due to transit myocardial ischemia. Aspirin, nitrates, betaadrenoceptor blocking drugs, and calcium channel blocking drugs used alone or in combination with one another are the commonly used drugs for angina pectoris.

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Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Metal stent for insertion in coronary artery Inventor(s): Yoon, Jung-Han; (Wonju, KR) Correspondence: Fleshner & Kim; P O Box 221200; Chantilly; VA; 20153-1200; US Patent Application Number: 20030114921 Date filed: November 15, 2002 Abstract: The object of this invention is to provide a metal stent used for insertion into a coronary artery to treat a patient suffering from angina pectoris or myocardial infarction due to a coronary artery disease. This stent consists of a plurality of primary stent units (1), each having a zigzag shape rounded at its bent portions and being expandable in a circumferential direction. The primary stent units (1) are assembled into a single cylindrical structure of the stent such that each two primary stent units (1) are integrated into one secondary stent unit by a first strut (2') or (2") connecting each projected bent portion of each of the two primary stent units (1) to an associated bent portion of the other. Each two secondary stent units are integrated into a desired stent by a plurality of hook-shaped second struts (3) connecting the projected bent portions of the two secondary stent units to each other. Excerpt(s): The present invention relates, in general, to medical care instruments, or socalled "stents" for insertion in blood vessels and, more particularly, to a coronary care stent made of a metal inserted in the coronary artery to treat a patient suffering from angina pectoris or myocardial infarction due to a coronary artery disease. Coronary artery disease is typically causes ischemia of the heart muscle by involving the coronary artery that is supplying the blood and nutrient to the heart muscle. The most typical etiological factor of such coronary artery diseases is arteriosclerosis. When plaque, formed by the mixing of cholesterol, other lipids, and a variety of components in the coronary artery and deposited on the inner lining of arterial walls, is excessively built up inside of the arterial lumen, the plaque undesirably causes an artery stenosis and ischemia of the heart muscle, thus making the heart muscle suffer lack of oxygen and nutritive substances. In the case of lack of oxygen and nutritive substance to the heart muscle due to ischemia of the heart muscle, a patient suffers angina pectoris or myocardial infarction, which may be fatal. In the prior art, the non-surgical treatments of patients suffering from such coronary artery diseases use the two types of devices: an expandable balloon catheter or an expandable stent to enlarge the lumen and improve the angina, both being used for non-surgical insertion into a troubled coronary artery. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method for reducing coronary artery reactivity Inventor(s): Hermsmeyer, R. Kent; (Portland, OR) Correspondence: Howard Eisenberg, ESQ.; Suite 1600; 601 SW Second Avenue; Portland; OR; 97204-3157; US Patent Application Number: 20030119799 Date filed: October 7, 2002

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Abstract: A method for treating myocardial ischemia and angina pectoris comprising administering to a subject in need thereof an effective amount of progesterone with or without estrogen. Excerpt(s): This application is a continuation of pending U.S. patent application Ser. No. 09/548,476, filed on Apr. 13, 2000, which in turn is a continuation-in-part of U.S. patent application Ser. No. 08/806,358, filed Feb. 26, 1997 and entitled "Method for Reducing Coronary Artery Reactivity`. The entire disclosure of the above applications is incorporated herein by reference. The invention relates to the use of progesterone to reduce coronary artery reactivity, as well as kits relating thereto. The invention also involves screening methods and animal models for testing the ability of a compound to reduce coronary artery reactivity. Cardiovascular disease, including coronary heart disease, stroke and other vascular diseases, is the leading cause of death of men and women in economically-developed countries. The most common and lethal form of cardiovascular disease is ischemic heart disease. It has generally been regarded that ischemic heart disease is caused, primarily, by atherosclerosis of the coronary arteries. This is a condition where plaques form in the inner lining of the arteries, causing narrowing of the channel and thereby impairing blood flow to the heart. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method for treating unstable angina pectoris Inventor(s): Lerch, Peter; (Bern, CH), Luscher, Thomas; (Zumikon, CH), Noll, Georg; (Erlenbach, CH) Correspondence: Millen, White, Zelano & Branigan, P.C.; 2200 Clarendon BLVD.; Suite 1400; Arlington; VA; 22201; US Patent Application Number: 20040014654 Date filed: August 18, 2003 Abstract: The invention relates to the use of reconstituted HDL for improving the endothelial function in patients suffering from hypercholesterolaemia and for treating or preventing acute coronary diseases such as unstable angina pectoris. Excerpt(s): The invention relates to the use of reconstituted HDL for improving endothelial function in hyper-cholesterolemia and for the therapy or prophylaxis of acute coronary disorders such as unstable angina pectoris or myocardial infarction. The endothelium on the one hand separates the blood from extravascular tissue, and on the other hand regulates important functions of the vessel wall. An important prerequisite for the endothelial monolayer to function fully is its functional and structural integrity. Some of the important functions of the endothelium are control of the adhesion of cells (monocytes, platelets), the invasion of immunocompetent cells and the proliferation of smooth muscle cells. In addition, bioactive substances such as prostaglandins, nitric oxide (NO) or endothelin-1 are produced in the endothelial cells. These substances have effects on the structure, the metabolism and the permeability of vessels, modulate vascular tone and control coagulation, fibrinolysis and inflammatory reactions. Injury to the endothelium or inflammations, for example caused by unfavorable lipid profiles, lead to dysfunction, a critical factor in the development of atherosclerosis. This process may take place over years or decades and does not in the early stage lead to any clinical symptoms. However, with suitable methods, it is possible to find structural changes in the vessel wall in this stage. High cholesterol levels, especially high LDL cholesterol, or low HDL cholesterol favors rapid buildup of atherosclerosis, which normally starts with

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deposits in the form of fatty streaks which may later develop into plaques. Such plaques may lead to local reductions in blood flow or, if there is increased mechanical stress, also rupture, form thrombi and lead to acute coronary syndromes such as unstable angina pectoris or myocardial infarction. Unstable angina pectoris is also described as an inflammatory reaction which leads to a systematic dysfunction of endothelial cells. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Smooth muscle growth inhibitory arteriosclerosis, and kit therefor

composition,

diagnostic

method

for

Inventor(s): Matsuzawa, Yuji; (Takarazuka-shi, JP), Ohmoto, Yasukazu; (Itano-gun, JP) Correspondence: Sughrue Mion, Pllc; 2100 Pennsylvania Avenue, NW; Washington; DC; 20037-3213; US Patent Application Number: 20030166551 Date filed: July 8, 2002 Abstract: The invention provides not only a smooth muscle growth inhibitory composition and a composition for inhibiting expression of adhesion molecules in vascular endothelial cells, each comprising the adipose tissue-specific secretory factor apM1 as an active ingredient, but also a method for diagnosis of arteriosclerosis which comprises assaying apM1 in a sample, an antibody against apM1, and a diagnostic kit for arteriosclerosis which comprises the antibody as an active component, all of which contribute to the elucidation of obesity-related genes and corresponding expression products which are useful for the etiologic exploration and establishment of therapeutic modalities for various obesity-related diseases, particularly arteriosclerosis inclusive of angina pectoris and myocardial infarction. By utilizing the information thus obtained, therapeutic and diagnostic methods for various diseases can be established. Excerpt(s): This invention relates to a smooth muscle growth inhibitory composition comprising apM1 (adipose most abundant gene transcript 1) as an active ingredient, a method for diagnosis of arteriosclerosis (atherosclerosis) which comprises assaying said apM1 in a sample, and a diagnostic kit for arteriosclerosis which comprises an antibody against said apM1 as an active component. It is well known that, in modern society, obesity or an excessive accumulation of body fat is involved in the development of diabetes mellitus, hyperlipidemia, hypertension, and atherosclerotic diseases inclusive of angina pectoris and myocardial infarction. With obesity, not only genetic factors but also environmental factors are associated. Recently, leptin and many other obesityrelated genes have been isolated from animal models. While the group of these genes thus isolated is suspected to be involved in the establishment of obesity in man, various environmental factors such as the excessive food intake and insufficient physical exercise by contemporary man are also considered to be playing a crucial role in the development of diabetes mellitus and atherosclerosis via fat storage. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with angina pectoris, you can access the U.S. Patent Office archive via the Internet at the following Web

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address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “angina pectoris” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on angina pectoris. You can also use this procedure to view pending patent applications concerning angina pectoris. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON ANGINA PECTORIS Overview This chapter provides bibliographic book references relating to angina pectoris. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on angina pectoris include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “angina pectoris” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on angina pectoris: •

Medical Emergencies in the Dental Office. 5th ed Source: St. Louis, MO: Mosby, Inc. 2000. 540 p. Contact: Available from Mosby, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 426-4545. E-mail: [email protected]. Website: www.mosby.com. PRICE: $52.95 plus shipping and handling. ISBN: 1556644205. Summary: Maintaining a high level of skill in the prevention, recognition, and management of medical emergencies is important in the field of dentistry. This textbook covers the management of medical emergencies in the dental office. Thirty chapters are offered in eight sections: prevention, unconsciousness, respiratory distress, altered consciousness, seizures, drug related emergencies, chest pain, and cardiac arrest. Specific topics include medicolegal considerations, vasodepressor syncope (fainting), postural hypotension (low blood pressure and feeling faint upon getting up from a

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prone or semi prone position), acute adrenal insufficiency, differential diagnosis, airway obstruction, hyperventilation, asthma, heart failure, acute pulmonary edema (fluid in the lungs), diabetes mellitus, thyroid gland dysfunction, cerebrovascular accident (stroke), drug overdose reactions, allergy, angina pectoris, acute myocardial infarction, and cardiac arrest and cardiopulmonary resuscitation. The text concludes with a quick reference section to life threatening situations (offered in algorithm format) and a subject index. Each chapter includes black and white photographs and extensive references. •

Coronary artery disease in women: What all physicians need to know Source: Philadelphia, PA: American College of Physicians: American Society of Internal Medicine. 1999. 615 pp. Contact: Available from American College of Physicians-American Society of Internal Medicine, 190 North Independence Mall West, Philadelphia, PA 19106. Telephone: (215) 351-2400 or (800) 523-1546 / fax: (215) 351- 2799 / e-mail: [email protected] / Web site: http://www.acponline.org. $43 for nonmembers, $32 for members; plus shipping and handling. Summary: This book for health care practitioners reviews all important aspects of coronary artery disease, with an emphasis on gender differences, age, and race. It contains five parts: the introduction, prevention, diagnosis, management, and conclusion. The section on prevention discusses smoking; diabetes and insulin resistance; the history and pharmacologic management of lipids/cholesterol; nutrition; hypertension; obesity; exercise as prevention; aspirin, antioxidants, and alcohol; and issues in hormone replacement therapy. The diagnosis section provides information on the differential diagnosis of chest pain, noninvasive testing techniques, and influence of gender in coronary angiography. Topics in the the section on management include angina pectoris, acute coronary syndromes, bypass grafting risks, angioplasty, congestive heart failure, psychosocial issues, and pharmacologic secondary prevention. The concluding section discusses future trends in treatment and research. Each chapter contains a summary and list of references. Numerous charts and graphs present statistical information. The book concludes with an index.

•

Women's concise guide to a healthier heart Source: Cambridge, MA: Harvard University Press. 1997. 136 pp. Contact: Available from Harvard University Press, 79 Garden Street, Cambridge, MA 02138. Telephone: (800) 448-2242 or (617) 495-2600 / fax: (800) 962-4983. $12.95. Summary: This book for the general public focuses on recognizing and preventing heart diseases in women. It is divided into three parts. Part one defines the most common heart diseases such as angina pectoris, arrhythmia, coronary artery disease, heart failure, and heart valve disorders. The second part elaborates on other conditions that impact the heart's function. Topics include diabetes, high blood pressure, high cholesterol, obesity, and stroke. Part three discusses various ways of preventing or controlling heart disease, such as alcohol use, diet, estrogen replacement therapy, exercise, quitting smoking, stress reduction, and weight control. The book concludes with a resource listing and an index.

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Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “angina pectoris” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “angina pectoris” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “angina pectoris” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Nitroglycerin 6: Unstable Angina Pectoris and Extracardial Indications by H. Roskamm; ISBN: 0899255809; http://www.amazon.com/exec/obidos/ASIN/0899255809/icongroupinterna

•

The Coronary Vascular System in Angina Pectoris (International Congress and Symposium Series (ICSS)) by P.A. Zwieten, K.I. Lie; ISBN: 1853151742; http://www.amazon.com/exec/obidos/ASIN/1853151742/icongroupinterna

Chapters on Angina Pectoris In order to find chapters that specifically relate to angina pectoris, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and angina pectoris using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “angina pectoris” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on angina pectoris: •

Ischemic Heart Disease Source: in Little, J.W., et al. Dental Management of the Medically Compromised Patient. 5th ed. St. Louis, MO: Mosby, Inc. 1997. p. 192-205. Contact: Available from Harcourt Health Sciences. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 325-4177. Fax (800) 874-6418. Website: www.harcourthealth.com. PRICE: $48.00 plus shipping and handling. ISBN: 0815156340. Summary: A working knowledge of the multitude of compromised health states is essential for dental professionals, as the majority of medically compromised patients need or want oral health care. This chapter on ischemic heart disease is from a text that provides the dental practitioner with an up to date reference work describing the dental management of patients with selected medical problems. Ischemic heart disease is coronary atherosclerosis that is symptomatic; the symptoms are the result of oxygen deprivation consequent to reduced vascular flow to the heart. Other conditions such as embolism, coronary ostial stenosis, coronary artery spasm, and congenital abnormalities also may cause ischemic heart disease. The authors discuss incidence and prevalence of the condition, its etiology (including lifestyle factors), pathophysiology and complications, specific congenital heart defects, signs and symptoms (clinical presentation and laboratory findings), the medical management of patients with angina

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pectoris or myocardial infarction (heart attack), and the dental management of this population. 4 figures. 5 tables. 37 references. •

Pain and Neurological Disorders Source: in Wray, D., et al. Textbook of General and Oral Medicine. Edinburgh, Scotland: Churchill Livingstone. 1999. p. 293-306. Contact: Available from Harcourt Health Sciences. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 325-4177. Fax (800) 874-6418. Website: www.harcourthealth.com. PRICE: $50.00 plus shipping and handling. ISBN: 0443051895. Summary: Orofacial and dental pain are common problems in dental practice. Indeed, the majority of presenting symptoms are pain related, and many patients will only visit their dentist when in pain. This chapter on pain and neurological disorders is from an undergraduate dentistry textbook that covers both general medicine and surgery, and oral medicine, emphasizing the overlap between them. Topics include odontological pain (toothache), which can be caused by acute necrotizing gingivitis, cracked tooth, dentinal pain, food impaction, lateral periodontal abscess, mucosal pain, periapical periodontitis, pericoronitis, periodontal pain, and pulpal pain; non odontological pain, including functional pain syndromes, temporomandibular disorders, atypical facial pain, oral dysaethesia (burning mouth or tongue), psychotropic treatment of functional facial pain syndromes; organic facial pain syndromes, including trigeminal neuralgia, giant cell arteritis, periodic migrainous neuralgia (cluster headache), angina pectoris, tension headache, migraine, and sinusitus; and neurological disorders, including facial palsy, Bell's palsy, Ramsay Hunt syndrome, bilateral facial palsy, abnormal facial movements, facial sensory loss, extracranial causes of sensory loss, intracranial causes of facial sensory loss, benign trigeminal neuropathy, psychogenic causes, and management of patients with facial sensory loss. Clinical points to remember are highlighted in text boxes. 1 figure. 8 tables.

•

Cardiovascular Complications of Rheumatic Diseases Source: in Maddison, P.J.; et al., Eds. Oxford Textbook of Rheumatology. Volume 1. New York, NY: Oxford University Press, Inc. 1993. p. 116-125. Contact: Available from Oxford University Press, Inc., New York, NY. Summary: This chapter for health professionals examines the cardiovascular complications of rheumatic diseases. Cardiac disorders that present as chest pain are described, including angina pectoris, acute myocardial infarction, pericarditis, and acute aortic dissection. Dyspnoea, dizzy spells, and syncope are discussed. Specific cardiovascular syndromes associated with rheumatic disorders are described, including coronary artery disease, pericardial disease, myocardial disease, conduction system disease, aortic insufficiency, and mitral valve insufficiency. Treatment strategies in unstable angina and acute myocardial infarction are identified. The evaluation of patients with suspected coronary disease is briefly explained. The difference between rheumatic pericarditis and other causes of pericarditis is discussed. 50 references and 5 tables.

•

Medical Emergencies Source: in Terezhalmy, G.; Batizy, L.G., eds. Urgent Care in the Dental Office: An Essential Handbook. Carol Stream, IL: Quintessence Publishing Company, Inc. 1998. p. 7-49.

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Contact: Available from Quintessence Publishing Company, Inc. 551 North Kimberly Drive, Carol Stream, IL 60188-1881. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $68.00 plus shipping and handling. ISBN: 0867153237. Summary: This chapter on emergencies is from a manual on urgent care in the dental office. The authors note that, with advances in medicine and the prevalence of dental disease in the geriatric patient population, the clinician may now be called on more often to provide dental care to medically or pharmologically compromised patients. Oral health care providers must be able to recognize high risk patients and initiate immediate correction of life-threatening problems. The chapter covers basic emergency procedures, emergency steps, cardiopulmonary resuscitation, vasovagal syncope (fainting), angina pectoris, myocardial infarction (heart attack), cardiogenic shock, cerebrovascular accident (stroke), respiratory alkalosis (hyperventilation), acute respiratory failure (respiratory depression), respiratory obstruction (foreign body), asthma, anaphylaxis (immediate hypersensitivity reaction), Type IV allergic reaction (delayed hypersensitivity reaction), status epilepticus (seizure), and hypoglycemia. For each emergency, the authors provide a brief overview and outline the signs and symptoms, diagnosis, and recommended emergency treatment. 18 figures. 1 table. 3 references.

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CHAPTER 6. PERIODICALS AND NEWS ON ANGINA PECTORIS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover angina pectoris.

News Services and Press Releases One of the simplest ways of tracking press releases on angina pectoris is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “angina pectoris” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to angina pectoris. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “angina pectoris” (or synonyms). The following was recently listed in this archive for angina pectoris: •

Molecular Changes During Angina Pectoris May Lead To New Treatments Source: Reuters Medical News Date: April 26, 1996

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “angina pectoris” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “angina pectoris” (or synonyms). If you know the name of a company that is relevant to angina pectoris, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “angina pectoris” (or synonyms).

Academic Periodicals covering Angina Pectoris Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to angina pectoris. In addition

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to these sources, you can search for articles covering angina pectoris that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for angina pectoris. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with angina pectoris. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to angina pectoris: Anticoagulants •

Systemic - U.S. Brands: Coumadin; Miradon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202050.html

Calcium Channel Blocking Agents •

Systemic - U.S. Brands: Adalat; Adalat CC; Calan; Calan SR; Cardene; Cardizem; Cardizem CD; Cardizem SR; Dilacor-XR; DynaCirc; Isoptin; Isoptin SR; Nimotop; Norvasc; Plendil; Procardia; Procardia XL; Vascor; Verelan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202107.html

Clopidogrel •

Systemic - U.S. Brands: Plavix http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203403.html

Enoxaparin •

Systemic - U.S. Brands: Lovenox http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202686.html

Heparin •

Systemic - U.S. Brands: Calciparine; Liquaemin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202280.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html.

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Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute10: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

10

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.11 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:12 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

11 Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 12 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway13 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “angina pectoris” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 35693 491 630 56 73 36943

HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.17 Simply search by “angina pectoris” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

13

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

14

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 15 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 16 17

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists18 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.19 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.20 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

18 Adapted 19

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 20 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on angina pectoris can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to angina pectoris. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to angina pectoris. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “angina pectoris”:

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Angina http://www.nlm.nih.gov/medlineplus/angina.html Coronary Disease http://www.nlm.nih.gov/medlineplus/coronarydisease.html Heart Diseases http://www.nlm.nih.gov/medlineplus/heartdiseases.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on angina pectoris. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

ABCs of PXE, The Source: Sharon, MA: PXE International. 2001. 8 p. Contact: Available from PXE International. 23 Mountain Street, Sharon, MA 02067. (781) 784-3817. Fax (781) 784-6672. E-mail: [email protected]. Website: www.pxe.org. PRICE: Single copy free. Summary: This fact sheet provides people who have pseudoxanthoma elasticum (PXE) with definitions of terms associated with this condition. Terms are ABCC6, acquired PXE, allele, angioid streaks, angina pectoris, arteries, arteriosclerosis, autosomal, axilla, biopsy, blood and tissue bank, Bruch's membrane, calcium, central vision, chelation therapy, choroidal neovascularization, collagen, consanguinity, dermis, dominant, drusen, elastic fibers, electron microscope, expressivity, fibroblasts, flexural creases, fluorescein angiography, and fovea. Other terms are gastrointestinal bleeding, genes, genetic counseling, genome, genotype, Gronblad-Strandberg, heterozygote, homozygotes, hypertension, intermittent claudication, laser therapy, legal blindness, mutation, myocardial infarction, oral lesions, peau d'orange, penetrance, phenocopy, phenotype, pseudoxanthoma, recessive, retina, Trental, visual aids, and x-ray.

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The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to angina pectoris. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to angina pectoris. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with angina pectoris. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about angina pectoris. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at

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http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “angina pectoris” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “angina pectoris”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “angina pectoris” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “angina pectoris” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.21

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

21

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)22: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

22

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on angina pectoris: •

Basic Guidelines for Angina Pectoris Angina Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001107.htm Hypertension Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000468.htm

•

Signs & Symptoms for Angina Pectoris Chest pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Diaphoresis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003218.htm Dysphagia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003115.htm

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Shortness of breath Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm •

Diagnostics and Tests for Angina Pectoris Angiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003327.htm Angioplasty Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002953.htm Cardiac catheterization Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003419.htm Coronary angiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003875.htm Coronary angiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003876.htm Differential Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm ECG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003868.htm Echocardiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003869.htm Factor I Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003650.htm

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Nutrition for Angina Pectoris Folate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002408.htm

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Surgery and Procedures for Angina Pectoris Angioplasty Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002953.htm Balloon angioplasty Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002953.htm CABG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002946.htm Coronary angioplasty Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002953.htm

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Minimally invasive direct coronary artery bypass (MIDCAB) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/007012.htm Percutaneous transluminal coronary angioplasty Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002953.htm PTCA Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002953.htm •

Background Topics for Angina Pectoris Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Calcium antagonists Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002580.htm Smoking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002032.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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ANGINA PECTORIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 1-phosphate: A drug that halts cell suicide in human white blood cells. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abscess: A localized, circumscribed collection of pus. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Actin: Essential component of the cell skeleton. [NIH] Acute leukemia: A rapidly progressing cancer of the blood-forming tissue (bone marrow). [NIH]

Acute-Phase Reaction: An early local inflammatory reaction to insult or injury that consists of fever, an increase in inflammatory humoral factors, and an increased synthesis by hepatocytes of a number of proteins or glycoproteins usually found in the plasma. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenovirus: A group of viruses that cause respiratory tract and eye infections. Adenoviruses used in gene therapy are altered to carry a specific tumor-fighting gene. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH]

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Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal insufficiency: The reduced secretion of adrenal glands. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Afterload: The tension produced by the heart muscle after contraction. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Airway Obstruction: Any hindrance to the passage of air into and out of the lungs. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alkalosis: A pathological condition that removes acid or adds base to the body fluids. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH]

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Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alprenolol: 1-((1-Methylethyl)amino)-3-(2-(2-propenyl)phenoxy)-2-propanol. Adrenergic beta-blocker used as an antihypertensive, anti-anginal, and anti-arrhythmic agent. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. [NIH]

Amenorrhea: Absence of menstruation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amlodipine: 2-((2-Aminoethoxy)methyl)-4-(2-chlorophenyl)-1,4-dihydro-6-methyl-3,5pyridinedicarboxylic acid 3-ethyl 5-methyl ester. A long-acting dihydropyridine calcium channel blocker. It is effective in the treatment of angina pectoris and hypertension. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH]

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Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Anginal: Pertaining to or characteristic of angina. [EU] Angiography: Radiography of blood vessels after injection of a contrast medium. [NIH] Angioid Streaks: Small breaks in the elastin-filled tissue of the retina. [NIH] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Anovulation: Suspension or cessation of ovulation in animals and humans. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antecedent: Existing or occurring before in time or order often with consequential effects. [EU]

Antianginal: Counteracting angina or anginal conditions. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticarcinogenic: Pertaining to something that prevents or delays the development of cancer. [NIH] Anticoagulants: Agents that prevent blood clotting. Naturally occurring agents in the blood are included only when they are used as drugs. [NIH]

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Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antithrombotic: Preventing or interfering with the formation of thrombi; an agent that so acts. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU]

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Arteries: The vessels carrying blood away from the heart. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteriovenous Fistula: An abnormal communication between an artery and a vein. [NIH] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atenolol: A cardioselective beta-adrenergic blocker possessing properties and potency similar to propranolol, but without a negative inotropic effect. [NIH] Atherectomy: Endovascular procedure in which atheromatous plaque is excised by a cutting or rotating catheter. It differs from balloon and laser angioplasty procedures which enlarge vessels by dilation but frequently do not remove much plaque. If the plaque is removed by surgical excision under general anesthesia rather than by an endovascular procedure through a catheter, it is called endarterectomy. [NIH] Atrial: Pertaining to an atrium. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Attenuated: Strain with weakened or reduced virulence. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU]

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Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Axilla: The underarm or armpit. [NIH] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]

Axillary Artery: The continuation of the subclavian artery; it distributes over the upper limb, axilla, chest and shoulder. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Baroreflex: A negative feedback system which buffers short-term changes in blood pressure. Increased pressure stretches blood vessels which activates pressoreceptors (baroreceptors) in the vessel walls. The net response of the central nervous system is a reduction of central sympathetic outflow. This reduces blood pressure both by decreasing peripheral vascular resistance and by lowering cardiac output. Because the baroreceptors are tonically active, the baroreflex can compensate rapidly for both increases and decreases in blood pressure. [NIH]

Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Beta blocker: A drug used to slow the heart rate and reduce pressure inside blood vessels. It also can regulate heart rhythm. [NIH] Beta-Thromboglobulin: A platelet-specific protein which is released when platelets aggregate. Elevated plasma levels have been reported after deep venous thrombosis, preeclampsia, myocardial infarction with mural thrombosis, and myeloproliferative disorders. Measurement of beta-thromboglobulin in biological fluids by radioimmunoassay is used for the diagnosis and assessment of progress of thromboembolic disorders. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving

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chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bisoprolol: A cardioselective beta-1-adrenergic blocker. It is effective in the management of hypertension and angina pectoris. [NIH] Bladder: The organ that stores urine. [NIH] Bleomycin: A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and

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is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Artery: The continuation of the axillary artery; it branches into the radial and ulnar arteries. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]

Bupivacaine: A widely used local anesthetic agent. [NIH] Bupropion: A unicyclic, aminoketone antidepressant. The mechanism of its therapeutic actions is not well understood, but it does appear to block dopamine uptake. The hydrochloride is available as an aid to smoking cessation treatment. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcitonin: A peptide hormone that lowers calcium concentration in the blood. In humans, it is released by thyroid cells and acts to decrease the formation and absorptive activity of osteoclasts. Its role in regulating plasma calcium is much greater in children and in certain diseases than in normal adults. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH]

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Cardiac arrest: A sudden stop of heart function. [NIH] Cardiac catheterization: A procedure in which a thin, hollow tube is inserted into a blood vessel. The tube is then advanced through the vessel into the heart, enabling a physician to study the heart and its pumping activity. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiogenic: Originating in the heart; caused by abnormal function of the heart. [EU] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH] Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage. [NIH] Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage. [NIH] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH]

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Catgut: Sterile collagen strands obtained from healthy mammals. They are used as absorbable surgical ligatures and are frequently impregnated with chromium or silver for increased strength. They tend to cause tissue reaction. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Celiprolol: A cardioselective beta-1-adrenergic antagonist that may act as a partial agonist at some adrenergic sites. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Adhesion Molecules: Surface ligands, usually glycoproteins, that mediate cell-to-cell adhesion. Their functions include the assembly and interconnection of various vertebrate systems, as well as maintenance of tissue integration, wound healing, morphogenic movements, cellular migrations, and metastasis. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU]

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Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chaos: Complex behavior that seems random but actually has some hidden order. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chelation: Combination with a metal in complexes in which the metal is part of a ring. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chondrocytes: Polymorphic cells that form cartilage. [NIH] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Choroidal Neovascularization: A pathological process consisting of the formation of new blood vessels in the choroid. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chromosomal: Pertaining to chromosomes. [EU]

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Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chronotherapy: The adaptation of the administration of drugs to circadian rhythms. The concept is based on the response of biological functions to time-related events, such as the low point in epinephrine levels between 10 p.m. and 4 a.m. or the elevated histamine levels between midnight and 4 a.m. The treatment is aimed at supporting normal rhythms or modifying therapy based on known variations in body rhythms. While chronotherapy is commonly used in cancer chemotherapy, it is not restricted to cancer therapy or to chemotherapy. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Claudication: Limping or lameness. [EU] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clomiphene: A stilbene derivative that functions both as a partial estrogen agonist and complete estrogen antagonist depending on the target tissue. It antagonizes the estrogen receptor thereby initiating or augmenting ovulation in anovulatory women. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and

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photocoagulation. [EU] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU]

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Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cones: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide sharp central vision and color vision. [NIH] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted

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beyond normal dimensions. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues, allows radiographic visualization of the structure. [EU] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium. [NIH] Coronary Arteriosclerosis: Thickening and loss of elasticity of the coronary arteries. [NIH] Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. [NIH] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]

Coronary Disease: Disorder of cardiac function due to an imbalance between myocardial function and the capacity of the coronary vessels to supply sufficient flow for normal function. It is a form of myocardial ischemia (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels. [NIH] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Coronary Vasospasm: Spasm of the large- or medium-sized coronary arteries. [NIH] Coronary Vessels: The veins and arteries of the heart. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH]

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Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cotinine: 1-Methyl-5-(3-pyridyl)-2-pyrrolidinone antidepressant. Synonym: Scotine. [NIH]

fumarate.

Stimulant

proposed

as

Counterpulsation: A technique for assisting the circulation by decreasing the afterload of the left ventricle and augmenting the diastolic pressure. It may be achieved by intra-aortic balloon, or by implanting a special pumping device in the chest, or externally by applying a negative pressure to the lower extremities during cardiac systole. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]

Creatine Kinase: A transferase that catalyzes formation of phosphocreatine from ATP + creatine. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic isoenzymes have been identified in human tissues: MM from skeletal muscle, MB from myocardial tissue, and BB from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins. EC 2.7.3.2. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH]

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Death Certificates: Official records of individual deaths including the cause of death certified by a physician, and any other required identifying information. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic Errors: Incorrect diagnoses after clinical examination or technical diagnostic procedures. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilator: A device used to stretch or enlarge an opening. [NIH] Diltiazem: A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of the calcium ion in membrane functions. It is also teratogenic. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Dipyridamole: A drug that prevents blood cell clumping and enhances the effectiveness of fluorouracil and other chemotherapeutic agents. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention

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of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Discriminant Analysis: A statistical analytic technique used with discrete dependent variables, concerned with separating sets of observed values and allocating new values. It is sometimes used instead of regression analysis. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disposition: A tendency either physical or mental toward certain diseases. [EU] Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dobutamine: A beta-2 agonist catecholamine that has cardiac stimulant action without evoking vasoconstriction or tachycardia. It is proposed as a cardiotonic after myocardial infarction or open heart surgery. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Drusen: Tiny yellow or white deposits in the retina or optic nerve head. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyslipidemia: Disorders in the lipoprotein metabolism; classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high-density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated levels of low-density lipoprotein (LDL) cholesterol and low levels of HDL cholesterol predispose to premature atherosclerosis. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH]

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Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrocardiography: Recording of the moment-to-moment electromotive forces of the heart as projected onto various sites on the body's surface, delineated as a scalar function of time. [NIH]

Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electron microscope: A microscope (device used to magnify small objects) that uses electrons (instead of light) to produce an enlarged image. An electron microscopes shows tiny details better than any other type of microscope. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH]

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Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]

Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endorphin: Opioid peptides derived from beta-lipotropin. Endorphin is the most potent naturally occurring analgesic agent. It is present in pituitary, brain, and peripheral tissues. [NIH]

Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Energy Intake: Total number of calories taken in daily whether ingested or by parenteral routes. [NIH] Enoxaparin: A drug used to prevent blood clots. It belongs to the family of drugs called

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anticoagulants. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epilepticus: Repeated and prolonged epileptic seizures without recovery of consciousness between attacks. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Ergonovine: An ergot alkaloid with uterine and vascular smooth muscle contractile properties. [NIH] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]

Estrogen Replacement Therapy: The use of hormonal agents with estrogen-like activity in postmenopausal or other estrogen-deficient women to alleviate effects of hormone deficiency, such as vasomotor symptoms, dyspareunia, and progressive development of osteoporosis. This may also include the use of progestational agents in combination therapy. [NIH]

Etoposide: A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle. [NIH] Excimer laser: An ultraviolet laser used in refractive surgery to remove corneal tissue. [NIH] Excipients: Usually inert substances added to a prescription in order to provide suitable

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consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exercise Tolerance: The exercise capacity of an individual as measured by endurance (maximal exercise duration and/or maximal attained work load) during an exercise test. [NIH]

Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extravascular: Situated or occurring outside a vessel or the vessels. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Facial: Of or pertaining to the face. [EU] Facial Pain: Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as facial pain syndromes. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH]

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Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] Fibrinolytic Agents: Fibrinolysin or agents that convert plasminogen to fibrinolysin (plasmin). [NIH] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescein Angiography: Visualization of a vascular system after intravenous injection of a fluorescein solution. The images may be photographed or televised. It is used especially in

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studying the retinal and uveal vasculature. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Fractals: Patterns (real or mathematical) which look similar at different scales, for example the network of airways in the lung which shows similar branching patterns at progressively higher magnifications. Natural fractals are self-similar across a finite range of scales while mathematical fractals are the same across an infinite range. Many natural, including biological, structures are fractal (or fractal-like). Fractals are related to "chaos" (see nonlinear dynamics) in that chaotic processes can produce fractal structures in nature, and appropriate representations of chaotic processes usually reveal self-similarity over time. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma-interferon: Interferon produced by T-lymphocytes in response to various mitogens and antigens. Gamma interferon appears to have potent antineoplastic, immunoregulatory and antiviral activity. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gangrene: Death and putrefaction of tissue usually due to a loss of blood supply. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body

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through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Ginseng: An araliaceous genus of plants that contains a number of pharmacologically active agents used as stimulants, sedatives, and tonics, especially in traditional medicine. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH]

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Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycerophospholipids: Derivatives of phosphatidic acid in which the hydrophobic regions are composed of two fatty acids and a polar alcohol is joined to the C-3 position of glycerol through a phosphodiester bond. They are named according to their polar head groups, such as phosphatidylcholine and phosphatidylethanolamine. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors

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influencing life style are socioeconomic, educational, and cultural. [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart Arrest: Sudden and usually momentary cessation of the heart beat. This sudden cessation may, but not usually, lead to death, sudden, cardiac. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one

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generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Heterozygote: An individual having different alleles at one or more loci in homologous chromosome segments. [NIH] Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Hirudin: The active principle in the buccal gland secretion of leeches. It acts as an antithrombin and as an antithrombotic agent. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homozygotes: An individual having a homozygous gene pair. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Hospital Mortality: A vital statistic measuring or recording the rate of death from any cause in hospitalized populations. [NIH] Hospital Records: Compilations of data on hospital activities and programs; excludes patient medical records. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH]

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Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophic cardiomyopathy: Heart muscle disease that leads to thickening of the heart walls, interfering with the heart's ability to fill with and pump blood. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Hypolipidemic: A drug that lowers abnormally high plasma concentrations of cholesterol or triglycerides or both. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU] Illusion: A false interpretation of a genuine percept. [NIH] Imaging procedures: Methods of producing pictures of areas inside the body. [NIH] Immune response: The activity of the immune system against foreign substances (antigens).

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[NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inoperable: Not suitable to be operated upon. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH]

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Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intercellular Adhesion Molecule-1: A cell-surface ligand with a role in leukocyte adhesion and inflammation. Its production is induced by gamma-interferon and it is required for neutrophil migration into inflamed tissue. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [NIH] Interleukin-8: A cytokine that activates neutrophils and attracts neutrophils and Tlymphocytes. It is released by several cell types including monocytes, macrophages, Tlymphocytes, fibroblasts, endothelial cells, and keratinocytes by an inflammatory stimulus. IL-8 is a member of the beta-thromboglobulin superfamily and structurally related to platelet factor 4. [NIH] Interleukins: Soluble factors which stimulate growth-related activities of leukocytes as well as other cell types. They enhance cell proliferation and differentiation, DNA synthesis, secretion of other biologically active molecules and responses to immune and inflammatory stimuli. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intermittent Claudication: A symptom complex characterized by leg pain and weakness brought on by walking, with the disappearance of the symptoms following a brief rest. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the

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brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Laser therapy: The use of an intensely powerful beam of light to kill cancer cells. [NIH] Least-Squares Analysis: A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model. [NIH] Legal blindness: In the U.S., (1) visual acuity of 20/200 or worse in the better eye with corrective lenses (20/200 means that a person must be at 20 feet from an eye chart to see what a person with normal vision can see at 200 feet) or (2) visual field restricted to 20 d [NIH]

Lenses: Pieces of glass or other transparent materials used for magnification or increased

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visual acuity. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Likelihood Functions: Functions constructed from a statistical model and a set of observed data which give the probability of that data for various values of the unknown model parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters. [NIH] Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. [NIH] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Local therapy: Treatment that affects cells in the tumor and the area close to it. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in

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epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lovastatin: A fungal metabolite isolated from cultures of Aspergillus terreus. The compound is a potent anticholesteremic agent. It inhibits 3-hydroxy-3-methylglutaryl coenzyme A reductase (hydroxymethylglutaryl CoA reductases), which is the rate-limiting enzyme in cholesterol biosynthesis. It also stimulates the production of low-density lipoprotein receptors in the liver. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mammogram: An x-ray of the breast. [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH]

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Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Errors: Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (diagnostic errors), errors in the administration of drugs and other medications (medication errors), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from malpractice in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medicament: A medicinal substance or agent. [EU] Medication Errors: Errors in prescribing, dispensing, or administering medication with the result that the patient fails to receive the correct drug or the indicated proper drug dosage. [NIH]

MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Lipids: Lipids, predominantly phospholipids, cholesterol and small amounts of glycolipids found in membranes including cellular and intracellular membranes. These lipids may be arranged in bilayers in the membranes with integral proteins between the layers and peripheral proteins attached to the outside. Membrane lipids are required for active transport, several enzymatic activities and membrane formation. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolic therapy: Treatment to correct changes in metabolism that can be caused by

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disease. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metoprolol: Adrenergic beta-1-blocking agent with no stimulatory action. It is less bound to plasma albumin than alprenolol and may be useful in angina pectoris, hypertension, or cardiac arrhythmias. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microclimate: The climate of a very small area. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microspheres: Small uniformly-sized spherical particles frequently radioisotopes or various reagents acting as tags or markers. [NIH]

labeled

with

Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Mitral Valve Insufficiency: Backflow of blood from the left ventricle into the left atrium, owing to imperfect functioning of the mitral valve. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH]

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Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocyte: A type of white blood cell. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myelosuppression: A condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets. Myelosuppression is a side effect of some cancer treatments. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardial Reperfusion: Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing myocardial reperfusion injury. [NIH] Myocardial Reperfusion Injury: Functional, metabolic, or structural changes in ischemic heart muscle thought to result from reperfusion to the ischemic areas. Changes can be fatal to muscle cells and may include edema with explosive cell swelling and disintegration, sarcolemma disruption, fragmentation of mitochondria, contraction band necrosis, enzyme washout, and calcium overload. Other damage may include hemorrhage and ventricular arrhythmias. One possible mechanism of damage is thought to be oxygen free radicals. Treatment currently includes the introduction of scavengers of oxygen free radicals, and

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injury is thought to be prevented by warm blood cardioplegic infusion prior to reperfusion. [NIH]

Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neuropsychological Tests: Tests designed to assess neurological function associated with certain behaviors. They are used in diagnosing brain dysfunction or damage and central nervous system disorders or injury. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine,

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epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrophil: A type of white blood cell. [NIH] Niacinamide: An important compound functioning as a component of the coenzyme NAD. Its primary significance is in the prevention and/or cure of blacktongue and pellagra. Most animals cannot manufacture this compound in amounts sufficient to prevent nutritional deficiency and it therefore must be supplemented through dietary intake. [NIH] Nicorandil: A derivative of the niacinamide that is structurally combined with an organic nitrate. It is a potassium-channel opener that causes vasodilatation of arterioles and large coronary arteries. Its nitrate-like properties produce venous vasodilation through stimulation of guanylate cyclase. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful antianginal agent that also lowers blood pressure. The use of nifedipine as a tocolytic is being investigated. [NIH] Nisoldipine: 1,4-Dihydro-2,6-dimethyl-4 (2-nitrophenyl)-3,5-pyridinedicarboxylic acid methyl 2-methylpropyl ester. Nisoldipine is a dihydropyridine calcium channel antagonist that acts as a potent arterial vasodilator and antihypertensive agent. It is also effective in patients with cardiac failure and angina. [NIH] Nitrates: Inorganic or organic salts and esters of nitric acid. These compounds contain the NO3- radical. [NIH] Nitric acid: A toxic, corrosive, colorless liquid used to make fertilizers, dyes, explosives, and other chemicals. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitroglycerin: A highly volatile organic nitrate that acts as a dilator of arterial and venous smooth muscle and is used in the treatment of angina. It provides relief through improvement of the balance between myocardial oxygen supply and demand. Although total coronary blood flow is not increased, there is redistribution of blood flow in the heart when partial occlusion of coronary circulation is effected. [NIH] Nociceptors: Peripheral receptors for pain. Nociceptors include receptors which are sensitive to painful mechanical stimuli, extreme heat or cold, and chemical stimuli. All nociceptors are free nerve endings. [NIH] Nonlinear Dynamics: The study of systems which respond disproportionately (nonlinearly) to initial conditions or perturbing stimuli. Nonlinear systems may exhibit "chaos" which is classically characterized as sensitive dependence on initial conditions. Chaotic systems, while distinguished from more ordered periodic systems, are not random. When their behavior over time is appropriately displayed (in "phase space"), constraints are evident which are described by "strange attractors". Phase space representations of chaotic systems,

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or strange attractors, usually reveal fractal (fractals) self-similarity across time scales. Natural, including biological, systems often display nonlinear dynamics and chaos. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Oligomenorrhea: Abnormally infrequent menstruation. [NIH] On-line: A sexually-reproducing population derived from a common parentage. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Optic nerve head: The circular area (disc) where the optic nerve connects to the retina. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoclasts: A large multinuclear cell associated with the absorption and removal of bone. An odontoclast, also called cementoclast, is cytomorphologically the same as an osteoclast and is involved in cementum resorption. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH]

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Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation outside the body, as during open heart surgery. [NIH] Pacemaker: An object or substance that influences the rate at which a certain phenomenon occurs; often used alone to indicate the natural cardiac pacemaker or an artificial cardiac pacemaker. In biochemistry, a substance whose rate of reaction sets the pace for a series of interrelated reactions. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paramedic: An emergency medical technician (EMT) who received further training for the delivery of some aspects of advanced life support (ALS) care. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Particle: A tiny mass of material. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH]

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Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Peau d'orange: A dimpled condition of the skin of the breast, resembling the skin of an orange, sometimes found in inflammatory breast cancer. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perhexiline: 2-(2,2-Dicyclohexylethyl)piperidine. Coronary vasodilator used especially for angina of effort. It may cause neuropathy and hepatitis. [NIH] Periapical Granuloma: Chronic nonsuppurative inflammation of periapical tissue resulting from irritation following pulp disease or endodontic treatment. [NIH] Periapical Periodontitis: Inflammation of the periapical tissue. It includes general, unspecified, or acute nonsuppurative inflammation. Chronic nonsuppurative inflammation is periapical granuloma. Suppurative inflammation is periapical abscess. [NIH] Periapical Tissue: Tissue surrounding the apex of a tooth, including the apical portion of the periodontal membrane and alveolar bone. [NIH] Pericarditis: Inflammation of the pericardium. [EU] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Pericoronitis: Inflammation of the gingiva surrounding the crown of a tooth. [NIH] Periodontal Abscess: Localized circumscribed purulent area of inflammation in the periodontal tissue. It is a derivative of marginal periodontitis and commonly associated with suprabony and infrabony pockets and interradicular involvements, in contrast to periapical abscess which is attributable to pulp necrosis. [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral

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sensory receptors. [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peroxidase: A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and peroxide to an oxidized donor and water. EC 1.11.1.7. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmacodynamic: Is concerned with the response of living tissues to chemical stimuli, that is, the action of drugs on the living organism in the absence of disease. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

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Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelet Factor 4: A high-molecular-weight proteoglycan-platelet factor complex which is released from blood platelets by thrombin. It acts as a mediator in the heparin-neutralizing capacity of the blood and plays a role in platelet aggregation. At high ionic strength (I=0.75), the complex dissociates into the active component (molecular weight 29,000) and the proteoglycan carrier (chondroitin 4-sulfate, molecular weight 350,000). The molecule exists in the form of a dimer consisting of 8 moles of platelet factor 4 and 2 moles of proteoglycan. [NIH]

Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Plethysmography: Recording of change in the size of a part as modified by the circulation in it. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may

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have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polycystic Ovary Syndrome: Clinical symptom complex characterized by oligomenorrhea or amenorrhea, anovulation, and regularly associated with bilateral polycystic ovaries. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Population Density: Number of individuals in a population relative to space. [NIH] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Postoperative Period: The period following a surgical operation. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Postural: Pertaining to posture or position. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Pravastatin: An antilipemic fungal metabolite isolated from cultures of Nocardia autotrophica. It acts as a competitive inhibitor of HMG CoA reductase

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(hydroxymethylglutaryl CoA reductases). [NIH] Precordial: Pertaining to the precordium (= region over the heart and lower part of the thorax). [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Pressoreceptors: Receptors in the vascular system, particularly the aorta and carotid sinus, which are sensitive to stretch of the vessel walls. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary endpoint: The main result that is measured at the end of a study to see if a given treatment worked (e.g., the number of deaths or the difference in survival between the treatment group and the control group). What the primary endpoint will be is decided before the study begins. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prone Position: The posture of an individual lying face down. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring

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secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostaglandins D: Physiologically active prostaglandins found in many tissues and organs. They show pressor activity, are mediators of inflammation, and have potential antithrombotic effects. [NIH] Prostaglandins F: (9 alpha,11 alpha,13E,15S)-9,11,15-Trihydroxyprost-13-en-1-oic acid (PGF(1 alpha)); (5Z,9 alpha,11,alpha,13E,15S)-9,11,15-trihydroxyprosta-5,13-dien-1-oic acid (PGF(2 alpha)); (5Z,9 alpha,11 alpha,13E,15S,17Z)-9,11,15-trihydroxyprosta-5,13,17-trien-1oic acid (PGF(3 alpha)). A family of prostaglandins that includes three of the six naturally occurring prostaglandins. All naturally occurring PGF have an alpha configuration at the 9carbon position. They stimulate uterine and bronchial smooth muscle and are often used as oxytocics. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]

Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pseudoxanthoma: A rare disease of the skin characterized by the appearance of elevated yellowish papules or plaques, particularly on the neck, chest an abdomen and infrequently on the eyelids. [NIH] Pseudoxanthoma Elasticum: A rare, progressive inherited disorder resulting from extensive basophilic degeneration of elastic tissue, usually presenting after puberty and involving the

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skin, eye, and cardiovascular system. Characteristic manifestations are small, circumscribed yellowish patches at sites of considerable movement of the skin, angioid streaks in the retina, and a tendency towards hemorrhage and arterial insufficiency. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]

Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Putrefaction: The process of decomposition of animal and vegetable matter by living organisms. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH]

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Radionuclide Ventriculography: Imaging of a ventricle of the heart after the injection of a radioactive contrast medium. The technique is less invasive than cardiac catheterization and is used to assess ventricular function. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refractory: Not readily yielding to treatment. [EU] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see linear models) the relationship is constrained to be a straight line and least-squares analysis is used to determine the best fit. In logistic regression (see logistic models) the dependent variable is qualitative rather than continuously variable and likelihood functions are used to find the best relationship. In multiple regression the dependent variable is considered to depend on more than a single independent variable. [NIH]

Rehabilitation Centers: Facilities which provide programs for rehabilitating the mentally or physically disabled individuals. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

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Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rickettsiae: One of a group of obligate intracellular parasitic microorganisms, once regarded as intermediate in their properties between bacteria and viruses but now classified

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as bacteria in the order Rickettsiales, which includes 17 genera and 3 families: Rickettsiace. [NIH]

Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Rods: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide side vision and the ability to see objects in dim light (night vision). [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saphenous Vein: The vein which drains the foot and leg. [NIH] Sarcolemma: The plasma membrane of a smooth, striated, or cardiac muscle fiber. [NIH] Sarcoplasmic Reticulum: A network of tubules and sacs in the cytoplasm of skeletal muscles that assist with muscle contraction and relaxation by releasing and storing calcium ions. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH]

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Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Simvastatin: A derivative of lovastatin and potent competitive inhibitor of 3-hydroxy-3methylglutaryl coenzyme A reductase (hydroxymethylglutaryl CoA reductases), which is the rate-limiting enzyme in cholesterol biosynthesis. It may also interfere with steroid hormone production. Due to the induction of hepatic LDL receptors, it increases breakdown of LDL-cholesterol (lipoproteins, LDL cholesterol). [NIH] Sinus of Valsalva: The dilatation of the aortic wall behind each of the cusps of the aortic valve. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smoking Cessation: Discontinuation of the habit of smoking, the inhaling and exhaling of

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tobacco smoke. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Problems: Situations affecting a significant number of people, that are believed to be sources of difficulty or threaten the stability of the community, and that require programs of amelioration. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Soybean Oil: Oil from soybean or soybean plant. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists

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mainly of chromatin. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Squamous: Scaly, or platelike. [EU] Stabilization: The creation of a stable state. [EU] Stable disease: Cancer that is neither decreasing nor increasing in extent or severity. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Status Epilepticus: Repeated and prolonged epileptic seizures without recovery of consciousness between attacks. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH]

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Substrate: A substance upon which an enzyme acts. [EU] Sudden cardiac death: Cardiac arrest caused by an irregular heartbeat. [NIH] Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU] Systemic: Affecting the entire body. [NIH] Systole: Period of contraction of the heart, especially of the ventricles. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Technetium: The first artificially produced element and a radioactive fission product of uranium. The stablest isotope has a mass number 99 and is used diagnostically as a

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radioactive imaging agent. Technetium has the atomic symbol Tc, atomic number 43, and atomic weight 98.91. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thoracic: Having to do with the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombolytic Therapy: Use of infusions of fibrinolytic agents to destroy or dissolve thrombi in blood vessels or bypass grafts. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Ticlopidine: Ticlopidine is an effective inhibitor of platelet aggregation. The drug has been found to significantly reduce infarction size in acute myocardial infarcts and is an effective antithrombotic agent in arteriovenous fistulas, aorto-coronary bypass grafts, ischemic heart disease, venous thrombosis, and arteriosclerosis. [NIH] Tidal Volume: The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen

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plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Toothache: Pain in the adjacent areas of the teeth. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcutaneous: Transdermal. [EU] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transient Ischemic Attacks: Focal neurologic abnormalities of sudden onset and brief duration that reflect dysfunction in the distribution of the internal carotid-middle cerebral or the vertebrobasilar arterial system. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat

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tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Trimetazidine: A vasodilator used in angina of effort or ischemic heart disease. [NIH] Tropomyosin: A protein found in the thin filaments of muscle fibers. It inhibits contraction of the muscle unless its position is modified by troponin. [NIH] Troponin: One of the minor protein components of skeletal muscle. Its function is to serve as the calcium-binding component in the troponin-tropomyosin B-actin-myosin complex by conferring calcium sensitivity to the cross-linked actin and myosin filaments. [NIH] Troponin C: One of the three polypeptide chains that make up the troponin complex of skeletal muscle. It is a calcium-binding protein. [NIH] Troponin I: One of the three polypeptide chains that make up the troponin complex. It inhibits F-actin-myosin interactions. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Uranium: A radioactive element of the actinide series of metals. It has an atomic symbol U, atomic number 92, and atomic weight 238.03. U-235 is used as the fissionable fuel in nuclear weapons and as fuel in nuclear power reactors. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagal: Pertaining to the vagus nerve. [EU] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH]

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Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasoactive: Exerting an effect upon the calibre of blood vessels. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilatation: A state of increased calibre of the blood vessels. [EU] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Dysfunction: A condition in which the ventricles of the heart exhibit a decreased functionality. [NIH] Ventricular fibrillation: Rapid, irregular quivering of the heart's ventricles, with no effective heartbeat. [NIH] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]

Ventricular Remodeling: The geometric and structural changes that the ventricle undergoes, usually following myocardial infarction. It comprises expansion of the infarct and dilatation of the healthy ventricle segments. While most prevalent in the left ventricle, it can also occur in the right ventricle. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and

Dictionary 203

treatment of diseases in animals. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Vindesine: Vinblastine derivative with antineoplastic activity against acute leukemia, lung cancer, carcinoma of the breast, squamous cell carcinoma of the esophagus, head, and neck, and Hodgkin's and non-Hodgkin's lymphomas. Major side effects are myelosuppression and neurotoxicity. Vindesine is used extensively in chemotherapy protocols. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is dependent mainly on the sharpness of the retinal focus. [NIH] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Vitreous Body: The transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina. It is contained in a thin hyoid membrane and forms about four fifths of the optic globe. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zoster: A virus infection of the Gasserian ganglion and its nerve branches, characterized by discrete areas of vesiculation of the epithelium of the forehead, the nose, the eyelids, and the cornea together with subepithelial infiltration. [NIH]

204

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205

INDEX 1 1-phosphate, 30, 143 A Abdomen, 143, 176, 190, 197, 201 Abdominal, 23, 143, 160, 175, 184 Abscess, 143, 185, 195 Acceptor, 143, 176, 184 Acetylcholine, 41, 79, 143, 154, 181, 182 Actin, 143, 180, 181, 201 Acute leukemia, 143, 203 Acute-Phase Reaction, 54, 143 Adaptation, 143, 155 Adenine, 143 Adenosine, 26, 39, 73, 143, 186 Adenovirus, 16, 143 Adipocytes, 143, 176 Adipose Tissue, 105, 143 Adjustment, 19, 89, 143 Adrenal Cortex, 144, 159, 189 Adrenal Glands, 144 Adrenal insufficiency, 108, 144 Adrenal Medulla, 144, 152, 164, 183 Adrenergic, 51, 96, 144, 145, 148, 150, 153, 161, 164, 179, 189 Adverse Effect, 23, 144, 195 Aerobic, 144, 165, 179 Afferent, 144, 176 Afterload, 144, 159 Agar, 144, 187 Age of Onset, 144, 201 Agonist, 144, 153, 155, 161, 181, 182 Airway, 108, 144 Airway Obstruction, 108, 144 Albumin, 33, 42, 72, 144, 179, 187 Algorithms, 12, 144, 150 Alkaline, 144, 151 Alkaloid, 144, 164, 182 Alkalosis, 111, 144 Alleles, 47, 144, 171 Allergen, 145, 195 Alprenolol, 145, 179 Alternative medicine, 114, 145 Ambulatory Care, 32, 145 Amenorrhea, 145, 188 Amino Acid Sequence, 145, 146 Amino Acids, 145, 181, 185, 188, 190, 198 Amlodipine, 42, 50, 61, 65, 78, 145 Ampulla, 145, 163

Amputation, 5, 24, 145 Anaesthesia, 56, 145, 173 Anal, 145, 161, 166 Analgesic, 145, 163 Analog, 145, 167 Anaphylatoxins, 145, 156 Anaphylaxis, 111, 145 Anatomical, 145, 148, 154, 157, 160, 194 Anemia, 5, 22, 145 Anesthesia, 20, 23, 49, 144, 146, 148, 163 Aneurysm, 67, 146, 202 Anginal, 24, 49, 145, 146, 182 Angiography, 24, 44, 59, 140, 146 Angioid Streaks, 130, 146, 191 Angioplasty, 6, 7, 11, 18, 20, 48, 56, 59, 62, 67, 68, 69, 70, 72, 80, 108, 140, 141, 146, 148, 180 Animal model, 104, 105, 146 Anions, 144, 146, 175 Ankle, 33, 146 Anovulation, 146, 188 Antagonism, 60, 146, 160 Antecedent, 13, 26, 61, 146 Antianginal, 37, 49, 146 Antibacterial, 100, 146 Antibiotic, 146, 185 Antibodies, 146, 149, 171, 180, 187 Antibody, 38, 105, 146, 147, 156, 171, 173, 178, 180, 195, 196 Anticarcinogenic, 100, 146 Anticoagulants, 118, 146, 164 Antidepressant, 8, 147, 151, 159 Antigen, 17, 37, 145, 146, 147, 156, 171, 172, 173, 178, 195 Antigen-Antibody Complex, 147, 156 Antihypertensive, 145, 147, 182 Anti-inflammatory, 13, 15, 37, 147, 148 Anti-Inflammatory Agents, 147, 148 Antimetabolite, 147, 167 Antineoplastic, 147, 150, 167, 188, 203 Antioxidant, 15, 100, 147, 148, 184 Antithrombotic, 147, 171, 190, 199 Antiviral, 100, 147, 167, 174 Anxiety, 31, 147, 189 Aorta, 147, 152, 158, 189, 202 Aortic Valve, 147, 195 Apolipoproteins, 147, 176 Apoptosis, 6, 17, 147

206

Angina Pectoris

Aqueous, 28, 147, 149, 159, 172 Arachidonic Acid, 147, 189 Arginine, 17, 35, 82, 89, 90, 145, 147, 182 Arterial, 4, 10, 43, 54, 103, 147, 148, 154, 172, 182, 190, 191, 198, 200 Arteries, 36, 63, 65, 72, 77, 78, 104, 130, 147, 148, 150, 151, 158, 177, 180, 182 Arteriolar, 33, 148, 151 Arterioles, 148, 150, 180, 182, 202 Arteriolosclerosis, 148 Arteriosclerosis, 44, 45, 57, 75, 101, 103, 105, 130, 148, 172, 199 Arteriovenous, 148, 199 Arteriovenous Fistula, 148, 199 Arteritis, 110, 148 Ascorbic Acid, 10, 148, 172 Aspirin, 12, 15, 62, 102, 108, 148 Assay, 15, 148 Asymptomatic, 4, 12, 17, 148 Atenolol, 53, 65, 78, 148 Atherectomy, 56, 60, 75, 148, 163 Atrial, 38, 90, 148 Atrium, 148, 152, 179, 202 Attenuated, 4, 148 Atypical, 67, 110, 148 Auditory, 91, 148, 201 Autoantibodies, 24, 149 Autoantigens, 149 Autonomic Nervous System, 4, 149, 185, 196, 198 Autosuggestion, 149, 172 Axilla, 130, 149 Axillary, 149, 151 Axillary Artery, 149, 151 B Bacteria, 146, 147, 149, 162, 163, 165, 179, 187, 192, 193, 200, 201 Baroreflex, 5, 149 Base, 19, 24, 143, 144, 149, 165, 175, 199 Benign, 16, 110, 148, 149, 167, 169 Beta blocker, 12, 55, 149 Beta-Thromboglobulin, 149, 174 Bilateral, 63, 110, 149, 188 Bile, 149, 167, 171, 173, 176, 197 Bile duct, 149, 173 Bilirubin, 144, 149 Biochemical, 20, 46, 144, 147, 149, 166, 195 Biological response modifier, 150, 174 Biological therapy, 150, 169 Biomarkers, 16, 20, 30, 150 Biopsy, 130, 150, 185 Biosynthesis, 147, 150, 177, 195

Biotechnology, 34, 114, 125, 150 Bisoprolol, 40, 54, 55, 79, 150 Bladder, 150, 157, 190, 201 Bleomycin, 87, 150 Blood Coagulation, 150, 151 Blood Glucose, 150, 170, 174 Blood pressure, 4, 18, 33, 100, 107, 108, 147, 149, 150, 152, 172, 180, 182, 183, 186 Body Fluids, 144, 150, 151, 161, 201 Body Mass Index, 33, 150, 184 Bolus, 74, 150 Bolus infusion, 150 Bone Marrow, 143, 150, 168, 173, 177, 180, 196 Bone scan, 151, 194 Brachial, 13, 33, 40, 57, 151 Brachial Artery, 13, 57, 151 Bradykinin, 151, 182, 187 Buccal, 151, 171 Buffers, 149, 151 Bupivacaine, 55, 151 Bupropion, 8, 151 Bypass, 3, 6, 7, 11, 20, 23, 47, 108, 151, 180, 199 C Calcification, 45, 148, 151 Calcitonin, 66, 151 Carbon Dioxide, 151, 166, 168, 172, 187, 193 Carcinogenic, 151, 173, 197 Carcinoma, 151, 203 Cardiac arrest, 107, 152, 198 Cardiac catheterization, 24, 140, 152, 192 Cardiac Output, 149, 152 Cardiogenic, 111, 152 Cardiomyopathy, 6, 102, 152 Cardiopulmonary, 23, 108, 111, 152 Cardiopulmonary Bypass, 23, 152 Cardiopulmonary Resuscitation, 108, 111, 152 Cardioselective, 148, 150, 152, 153, 189 Cardiotonic, 152, 161 Cardiovascular disease, 5, 9, 10, 13, 15, 20, 29, 32, 33, 104, 152 Cardiovascular System, 152, 191 Carotene, 96, 152, 193 Case report, 3, 44, 53, 67, 92, 93, 152, 155 Case series, 152, 155 Catecholamine, 88, 92, 152, 161, 186 Catgut, 88, 153 Catheter, 103, 148, 153, 163, 175 Catheterization, 12, 59, 146, 153, 175, 180

207

Cause of Death, 11, 104, 153, 160 Celiprolol, 55, 153 Cell Adhesion, 15, 38, 77, 153 Cell Adhesion Molecules, 15, 38, 153 Cell Cycle, 153, 155, 164 Cell Death, 147, 153, 164, 181 Cell Division, 149, 153, 164, 169, 179, 187 Cell membrane, 153, 186 Cell proliferation, 148, 153, 174 Cell Respiration, 153, 179, 193 Cell Size, 153, 166 Cell Survival, 153, 169 Central Nervous System, 143, 149, 153, 167, 169, 181, 183, 195 Central Nervous System Infections, 153, 169 Cerebral, 5, 101, 153, 154, 164, 196, 198, 200 Cerebral Palsy, 154, 196 Cerebrovascular, 5, 108, 111, 152, 154 Cerebrum, 153, 154 Cervical, 55, 154 Cervix, 154 Chaos, 154, 167, 182 Character, 146, 154 Chelation, 130, 154 Chemotactic Factors, 154, 156 Chemotherapeutic agent, 154, 160 Chemotherapy, 154, 155, 203 Chest Pain, 17, 21, 24, 30, 36, 94, 107, 108, 110, 154 Chin, 82, 85, 86, 88, 92, 93, 94, 154, 178 Cholesterol Esters, 154, 176 Cholinergic, 154, 182 Chondrocytes, 154, 166 Choroid, 154, 193 Choroidal Neovascularization, 130, 154 Chromatin, 147, 154, 177, 197 Chromium, 153, 154 Chromosomal, 154, 187 Chromosome, 155, 171, 176 Chronic Disease, 4, 10, 155 Chronic renal, 155, 188 Chronotherapy, 88, 155 Chylomicrons, 155, 176 Circadian, 88, 155 Circadian Rhythm, 155 CIS, 155, 193 Cisplatin, 87, 155 Claudication, 155 Clinical study, 9, 155, 158

Clinical trial, 4, 5, 16, 30, 41, 64, 125, 155, 158, 161, 190, 192 Clomiphene, 26, 155 Cloning, 150, 155 Coagulation, 26, 49, 92, 104, 150, 155, 170, 187 Coenzyme, 96, 148, 156, 177, 182, 195 Cofactor, 156, 190 Cohort Studies, 14, 20, 156 Collagen, 130, 153, 156, 166, 187, 189 Collapse, 145, 156 Colloidal, 144, 156 Colon, 156, 173, 175 Combination Therapy, 156, 164 Complement, 7, 8, 145, 156, 157, 187, 195 Complementary and alternative medicine, 85, 98, 157 Complementary medicine, 85, 157 Complete remission, 157, 193 Compliance, 10, 62, 157 Computational Biology, 125, 157 Computed tomography, 23, 42, 43, 72, 73, 77, 157, 194 Computerized axial tomography, 157, 194 Computerized tomography, 157 Conduction, 110, 157 Cones, 157, 193 Congestive heart failure, 9, 17, 24, 33, 108, 157 Conjunctiva, 157, 200 Connective Tissue, 148, 151, 156, 157, 160, 166, 167, 177, 193 Consciousness, 107, 145, 157, 164, 193, 197, 198 Constipation, 157, 167, 175 Constriction, 157, 175, 202 Constriction, Pathologic, 157, 202 Contractility, 9, 158 Contraindications, ii, 158 Contrast medium, 146, 158, 192 Control group, 18, 23, 25, 29, 30, 33, 158, 189, 192 Controlled clinical trial, 30, 32, 158 Controlled study, 16, 35, 73, 89, 158 Conventional treatment, 39, 158 Cornea, 158, 203 Coronary Angiography, 16, 19, 24, 47, 64, 71, 108, 158 Coronary Arteriosclerosis, 158, 180 Coronary Artery Bypass, 22, 44, 63, 65, 66, 68, 73, 82, 141, 158 Coronary Circulation, 146, 158, 182

208

Angina Pectoris

Coronary Disease, 22, 73, 104, 110, 130, 158 Coronary heart disease, 8, 10, 11, 33, 52, 54, 104, 152, 158 Coronary Thrombosis, 158, 180 Coronary Vasospasm, 45, 158 Coronary Vessels, 158 Corpus, 158, 189, 203 Corpus Luteum, 158, 189 Cortical, 159, 194 Cortisol, 144, 159 Cotinine, 33, 159 Counterpulsation, 36, 48, 50, 76, 159 Cranial, 159, 168, 169, 181, 183, 185, 200, 201 Craniocerebral Trauma, 159, 169 Creatine, 62, 159 Creatine Kinase, 62, 159 Creatinine, 5, 15, 33, 159 Curative, 159, 199 Cutaneous, 56, 159 Cyclic, 159, 169, 182 Cysteine, 96, 97, 159, 198 Cytokine, 159, 174 Cytomegalovirus, 74, 159 Cytoplasm, 147, 153, 159, 163, 177, 194 Cytoskeleton, 22, 159 Cytotoxicity, 155, 159 D Data Collection, 24, 29, 159, 167 Death Certificates, 33, 160 Deletion, 47, 147, 160 Delivery of Health Care, 160, 170 Dendrites, 160, 181 Dental Care, 111, 160 Deprivation, 109, 160 Dermis, 130, 160, 198, 200 Developed Countries, 104, 160 Diabetes Mellitus, 23, 46, 56, 57, 105, 108, 160, 168, 170 Diagnostic Errors, 160, 178 Diagnostic procedure, 99, 114, 160 Diaphragm, 160, 171 Diarrhea, 160, 167, 175 Diastole, 160 Diastolic, 6, 102, 159, 160, 172 Dietary Fats, 160, 176 Digestion, 4, 51, 100, 149, 160, 161, 176, 197 Dihydrotestosterone, 160, 192 Dilatation, Pathologic, 160, 202 Dilation, 148, 151, 160, 202

Dilator, 160, 182 Diltiazem, 62, 88, 97, 160 Dimethyl, 160, 182 Dipyridamole, 46, 63, 160 Direct, iii, 59, 117, 141, 160, 161, 192, 198 Discrete, 161, 176, 203 Discriminant Analysis, 25, 161 Disease Progression, 10, 11, 161 Disposition, 19, 161 Dissection, 61, 110, 161 Distal, 26, 158, 161, 162, 190 Diverticulum, 76, 161 Dizziness, 4, 5, 161, 202 Dobutamine, 42, 48, 59, 161 Dopamine, 151, 161, 182 Double-blind, 8, 16, 35, 39, 50, 63, 73, 86, 89, 161 Drug Interactions, 118, 161 Drug Tolerance, 161, 199 Drusen, 130, 161 Duct, 145, 153, 161, 194, 197, 198 Duodenum, 149, 161, 163, 197 Dyslipidemia, 7, 161 Dyspepsia, 70, 161 E Echocardiography, 45, 59, 77, 79, 140, 162 Edema, 162, 180 Effector, 143, 156, 162 Efficacy, 7, 8, 12, 26, 29, 35, 41, 42, 49, 50, 65, 88, 91, 162, 200 Ejaculation, 162, 194 Elastic, 130, 162, 190, 196 Elasticity, 148, 158, 162 Elastin, 146, 156, 162 Elective, 10, 24, 71, 72, 74, 80, 162 Electric shock, 152, 162 Electrocardiogram, 44, 56, 59, 70, 162 Electrocardiography, 30, 33, 68, 162 Electrocoagulation, 155, 162 Electrode, 30, 162 Electron microscope, 130, 162 Electrons, 147, 149, 162, 175, 184, 191 Elementary Particles, 162, 190 Embolism, 109, 162 Embolus, 162, 173 Embryo, 162, 173 Emergency Treatment, 111, 163 Empirical, 31, 163 Encapsulated, 27, 163 Endarterectomy, 146, 148, 163 Endogenous, 66, 149, 161, 163 Endorphin, 39, 163

209

Endoscope, 163 Endoscopic, 62, 163 Endothelial cell, 17, 104, 105, 163, 166, 174 Endothelium, 13, 15, 40, 57, 68, 89, 104, 163, 182 Endothelium, Lymphatic, 163 Endothelium, Vascular, 163 Endothelium-derived, 163, 182 Endotoxic, 163, 176 Endotoxins, 156, 163 End-stage renal, 155, 163, 188 Energy balance, 5, 163, 176 Energy Intake, 4, 163 Enoxaparin, 42, 118, 163 Environmental Health, 14, 124, 126, 164 Enzymatic, 151, 152, 156, 164, 166, 171, 178, 193 Epidemiological, 9, 37, 52, 164 Epidermis, 160, 164, 175 Epidural, 49, 91, 164 Epilepticus, 164 Epinephrine, 25, 144, 155, 161, 164, 182, 183 Epithelium, 163, 164, 203 Ergonovine, 45, 164 Ergot, 164 Erythrocytes, 145, 151, 164, 195 Esophagus, 164, 170, 197, 203 Estrogen, 14, 49, 104, 108, 155, 164 Estrogen receptor, 155, 164 Estrogen Replacement Therapy, 14, 108, 164 Etoposide, 87, 164 Excimer laser, 46, 164 Excipients, 27, 164 Excitation, 165, 166, 181 Exercise Test, 47, 64, 73, 165 Exercise Tolerance, 33, 55, 90, 165 Exhaustion, 24, 146, 165 Exogenous, 27, 163, 165, 201 Extracellular, 17, 157, 165, 166, 179 Extracellular Matrix, 157, 165, 166 Extracellular Space, 165, 179 Extravascular, 104, 165 Extremity, 33, 165 Eye Infections, 143, 165 F Facial, 110, 165, 196 Facial Pain, 110, 165 Family Planning, 125, 165 Fat, 101, 105, 143, 147, 150, 152, 158, 162, 165, 176, 184, 188, 200

Fatigue, 165, 170 Fatty acids, 144, 165, 169, 189 Femoral, 152, 165 Femoral Artery, 152, 165 Fibrillation, 166 Fibrin, 27, 51, 150, 166, 199 Fibrinogen, 24, 26, 33, 166, 187, 199 Fibrinolysis, 7, 38, 49, 51, 92, 104, 166 Fibrinolytic, 51, 166, 199 Fibrinolytic Agents, 166, 199 Fibroblast Growth Factor, 6, 166 Fibroblasts, 130, 166, 174 Fibrosis, 6, 101, 166, 194 Fixation, 166, 195 Flow Cytometry, 25, 27, 166 Fluorescein Angiography, 130, 166 Fluorescence, 22, 166, 167 Fluorescent Dyes, 166, 167 Fluorouracil, 55, 160, 167 Focus Groups, 29, 167 Forearm, 150, 167 Fovea, 130, 166, 167 Fractals, 167, 183 Free Radicals, 100, 147, 167, 180 Functional Disorders, 101, 167 G Gallbladder, 53, 143, 167 Gamma-interferon, 167, 174 Ganglia, 143, 167, 181, 185, 198 Ganglion, 167, 183, 203 Gangrene, 24, 167 Gas, 151, 167, 168, 171, 175, 182, 191, 193, 202 Gas exchange, 168, 193, 202 Gastrin, 168, 171 Gastrointestinal, 130, 151, 164, 168, 195, 196, 197, 201 Gastrointestinal tract, 168, 195, 197, 201 Gene, 6, 7, 16, 17, 20, 37, 59, 66, 105, 143, 144, 150, 168, 171 Gene Expression, 7, 8, 168 Gene Therapy, 17, 59, 66, 143, 168 Genetics, 20, 168 Genotype, 25, 130, 168, 186 Geriatric, 76, 111, 168 Germ Cells, 168, 184, 196, 199 Gingivitis, 110, 168 Ginseng, 85, 98, 168 Gland, 144, 168, 171, 177, 184, 187, 190, 194, 197, 198, 199 Glossopharyngeal Nerve, 165, 168

210

Angina Pectoris

Glucose, 13, 23, 26, 148, 150, 154, 160, 168, 170, 174 Glucose Intolerance, 160, 168 Glucuronic Acid, 169, 170 Glutathione Peroxidase, 82, 169, 194 Glycerol, 169, 186 Glycerophospholipids, 169, 186 Glycoprotein, 25, 26, 166, 169 Gonadotropin, 26, 169 Governing Board, 169, 188 Grade, 69, 169 Graft, 10, 63, 169, 180 Grafting, 22, 44, 65, 66, 68, 73, 82, 108, 158, 169, 173 Growth factors, 28, 169 Guanylate Cyclase, 169, 182 H Habitual, 5, 154, 169 Hair follicles, 160, 169 Headache, 54, 70, 110, 169 Headache Disorders, 169 Health Behavior, 18, 169 Health Care Costs, 8, 170 Health Expenditures, 170 Health Status, 28, 169, 170 Heart Arrest, 152, 170 Heart attack, 21, 100, 110, 111, 152, 170 Heart failure, 5, 6, 9, 12, 28, 75, 101, 102, 108, 170 Heartbeat, 170, 198, 202 Heartburn, 170, 171 Hemoglobin, 5, 33, 145, 164, 170 Hemoglobinopathies, 168, 170 Hemorrhage, 159, 162, 169, 170, 180, 191, 197 Hemostasis, 26, 170, 195 Heparin, 39, 42, 57, 63, 118, 170, 187 Hepatic, 144, 170, 195 Hepatitis, 170, 185 Hepatocytes, 143, 170 Hereditary, 170, 186 Heredity, 101, 168, 171 Hernia, 171 Herpes, 4, 171 Herpes Zoster, 4, 171 Heterozygote, 130, 171 Hiatal Hernia, 53, 171 Hirudin, 57, 171 Histamine, 145, 155, 171 Homologous, 144, 168, 171, 195, 198 Homozygotes, 130, 171 Hormonal, 14, 164, 171

Hormone, 14, 26, 62, 108, 151, 155, 159, 164, 168, 171, 174, 176, 189, 195, 199 Hormone Replacement Therapy, 14, 62, 108, 171 Hospital Mortality, 45, 49, 171 Hospital Records, 33, 171 Humoral, 70, 143, 171 Humour, 171 Hybridomas, 171, 174 Hydrogen, 143, 149, 151, 169, 171, 172, 176, 179, 184, 186, 190 Hydrogen Peroxide, 169, 172, 176 Hydrolysis, 155, 172, 188, 190 Hydrophobic, 169, 172, 176 Hydroxylysine, 156, 172 Hydroxyproline, 156, 172 Hypercholesterolemia, 13, 161, 172 Hyperglycemia, 47, 56, 172 Hyperlipidemia, 100, 101, 105, 161, 172 Hypersensitivity, 111, 145, 172, 195 Hyperthyroidism, 172, 189 Hypertriglyceridemia, 161, 172 Hypertrophic cardiomyopathy, 41, 172 Hypertrophy, 6, 172 Hyperventilation, 64, 108, 111, 172 Hypoglycemia, 57, 111, 172 Hypolipidemic, 15, 172 Hypotension, 4, 107, 172 Hypothalamus, 149, 172, 187 I Iatrogenic, 61, 172 Illusion, 172, 202 Imaging procedures, 172, 200 Immune response, 147, 149, 172, 173, 195, 203 Immune system, 100, 150, 172, 173, 177, 201, 203 Immunization, 173, 195 Immunogenic, 173, 176 Immunosuppressant, 167, 173 Impaction, 110, 173 Implantation, 28, 39, 173 In vitro, 27, 168, 173 In vivo, 6, 24, 27, 57, 168, 170, 173, 179 Incision, 173, 175 Induction, 26, 173, 195 Infection, 17, 74, 150, 154, 159, 165, 173, 177, 181, 185, 197, 201, 203 Infiltration, 173, 203 Infusion, 35, 55, 57, 63, 173, 181 Initiation, 39, 173 Inoperable, 66, 173

211

Inorganic, 155, 173, 182 Inotropic, 148, 161, 173 Insight, 5, 173 Insulin, 5, 7, 26, 33, 108, 174, 201 Insulin-dependent diabetes mellitus, 174 Intercellular Adhesion Molecule-1, 60, 174 Interferon, 43, 167, 174 Interferon-alpha, 174 Interleukin-1, 15, 174 Interleukin-2, 174 Interleukin-6, 15, 38, 174 Interleukin-8, 58, 174 Interleukins, 43, 174 Intermittent, 21, 130, 174 Intermittent Claudication, 130, 174 Interstitial, 21, 165, 174 Intestines, 143, 168, 174 Intracellular, 17, 173, 174, 178, 182, 188, 193, 194 Intrathecal, 55, 174 Intravascular, 43, 66, 175 Intravenous, 35, 57, 62, 73, 102, 166, 173, 175, 184 Intubation, 153, 175 Invasive, 10, 13, 18, 24, 28, 43, 71, 141, 175, 177, 192 Involuntary, 166, 175, 181, 196 Ion Channels, 21, 175, 198 Ions, 149, 151, 171, 175, 190, 194 Irritable Bowel Syndrome, 167, 175 Isoenzyme, 159, 175 K Kb, 124, 175 Keratinocytes, 174, 175 Kinetics, 15, 175 L Labile, 156, 175 Laser therapy, 130, 175 Least-Squares Analysis, 175, 192 Legal blindness, 130, 175 Lenses, 175 Leptin, 105, 176 Lesion, 158, 176 Lethal, 104, 176 Leukemia, 168, 176 Ligaments, 158, 176 Ligands, 27, 153, 176 Likelihood Functions, 176, 192 Linear Models, 176, 192 Linkages, 170, 176 Lipase, 61, 176

Lipid, 9, 15, 25, 33, 40, 47, 79, 101, 104, 147, 148, 169, 174, 176, 184, 200 Lipid A, 47, 176 Lipid Peroxidation, 40, 176, 184 Lipopolysaccharide, 15, 176 Lipoprotein, 47, 61, 101, 161, 176, 177 Liver, 15, 101, 143, 144, 147, 149, 159, 167, 169, 170, 176, 177, 194 Liver scan, 176, 194 Local therapy, 27, 176 Localized, 143, 163, 166, 173, 176, 185, 187, 201 Logistic Models, 176, 192 Loop, 171, 177 Lovastatin, 177, 195 Low-density lipoprotein, 38, 161, 176, 177 Lymph, 149, 154, 163, 171, 177 Lymph node, 149, 154, 177 Lymphatic, 163, 173, 177, 196, 197 Lymphatic system, 177, 196, 197 Lymphocytes, 17, 147, 167, 171, 173, 174, 177, 197, 203 Lymphoid, 146, 177 Lytic, 27, 177 M Macrophage, 174, 177 Macula, 167, 177 Magnetic Resonance Imaging, 177, 194 Malnutrition, 144, 177 Mammary, 158, 177 Mammogram, 151, 177, 179 Mastication, 177, 200 Medial, 15, 148, 177 Mediate, 153, 161, 178 Mediator, 10, 21, 174, 178, 187, 195 Medical Errors, 32, 178 Medical Records, 33, 171, 178 Medicament, 102, 178 Medication Errors, 178 MEDLINE, 125, 178 Membrane, 90, 130, 153, 154, 156, 157, 160, 165, 175, 178, 179, 183, 185, 186, 193, 194, 200, 203 Membrane Lipids, 178, 186 Menopause, 178, 188, 189 Menstrual Cycle, 178, 189 Mental, iv, 4, 28, 64, 124, 126, 154, 161, 165, 178, 191 Mental Health, iv, 4, 124, 126, 178, 191 Mentors, 31, 178 Mercury, 166, 178 Meta-Analysis, 49, 178

212

Angina Pectoris

Metabolic therapy, 75, 178 Metabolite, 160, 177, 179, 188 Metastasis, 153, 179 Metoprolol, 51, 97, 179 Microbiology, 143, 148, 179 Microcalcifications, 151, 179 Microclimate, 28, 179 Microdialysis, 21, 179 Microorganism, 156, 179, 203 Microscopy, 27, 179 Microspheres, 28, 179 Migration, 174, 179 Mitochondria, 22, 179, 180 Mitosis, 147, 179 Mitotic, 164, 179 Mitral Valve, 110, 179 Mitral Valve Insufficiency, 110, 179 Modeling, 25, 41, 179 Modification, 13, 15, 179, 191 Molecular, 6, 21, 26, 27, 39, 63, 113, 125, 127, 150, 157, 166, 170, 179, 187, 198, 200 Molecule, 27, 77, 147, 149, 156, 162, 163, 165, 170, 172, 179, 184, 187, 192 Monitor, 159, 180, 183 Monoclonal, 30, 171, 180 Monoclonal antibodies, 30, 180 Monocyte, 15, 180 Monotherapy, 49, 65, 88, 180 Morphology, 46, 180 Motility, 167, 180, 195 Motion Sickness, 180, 181 Muscle Contraction, 180, 194 Myelin, 180, 195 Myelosuppression, 180, 203 Myocardial Ischemia, 20, 30, 38, 47, 48, 71, 72, 73, 77, 80, 100, 101, 102, 104, 146, 158, 180 Myocardial Reperfusion, 180, 193 Myocardial Reperfusion Injury, 180, 193 Myocardium, 6, 22, 26, 76, 146, 180, 181 Myosin, 180, 181, 201 N Naloxone, 90, 92, 181 Nausea, 3, 181 Necrosis, 147, 173, 180, 181, 185, 193 Nephropathy, 5, 181 Nerve Endings, 181, 182 Nervous System, 144, 149, 153, 178, 181, 185, 198 Neural, 144, 171, 181 Neuralgia, 110, 181 Neurologic, 22, 181, 200

Neuromuscular, 143, 181 Neuromuscular Junction, 143, 181 Neurons, 21, 160, 167, 181, 182, 198 Neuropathy, 110, 181, 185 Neuropeptide, 75, 181 Neuropsychological Tests, 23, 181 Neurotoxicity, 181, 203 Neurotransmitter, 143, 151, 161, 171, 175, 181, 183, 198 Neutrophil, 174, 182 Niacinamide, 182 Nicorandil, 60, 67, 88, 182 Nicotine, 8, 32, 182 Nifedipine, 50, 55, 65, 80, 88, 182 Nisoldipine, 42, 182 Nitrates, 18, 60, 79, 102, 182 Nitric acid, 182 Nitric Oxide, 13, 17, 38, 104, 182 Nitroglycerin, 17, 62, 68, 97, 109, 182 Nociceptors, 20, 182 Nonlinear Dynamics, 72, 167, 182 Norepinephrine, 144, 161, 181, 183 Normotensive, 67, 183 Nuclear, 30, 52, 59, 68, 162, 167, 181, 183, 201 Nuclei, 162, 168, 177, 179, 183, 190 Nucleus, 147, 154, 159, 162, 177, 183, 190, 196 Nursing Care, 72, 183 O Oligomenorrhea, 183, 188 On-line, 29, 139, 183 Opiate, 181, 183 Opsin, 183, 193 Optic Nerve, 161, 183, 193 Optic nerve head, 161, 183 Oral Health, 109, 183 Orofacial, 110, 165, 183 Osmotic, 144, 183 Osteoclasts, 151, 183 Osteoporosis, 164, 183 Outpatient, 9, 10, 19, 24, 63, 183 Ovaries, 183, 188 Ovary, 158, 184 Overdose, 108, 184 Overweight, 49, 82, 184 Ovulation, 26, 146, 155, 184 Ovum, 158, 184, 189 Oxidation, 15, 75, 143, 147, 169, 176, 184 Oxidative Stress, 10, 15, 24, 184 Oxygen Consumption, 165, 184, 193 Oxygenator, 152, 184

213

P Pacemaker, 50, 184 Palliative, 184, 199 Palsy, 110, 184 Pancreas, 143, 150, 174, 176, 184, 201 Paralysis, 184, 196 Paramedic, 30, 184 Parenteral, 163, 184 Paroxysmal, 146, 169, 184 Partial remission, 184, 193 Particle, 9, 14, 33, 184, 196 Patch, 33, 184, 200 Pathologic, 147, 150, 158, 172, 185 Pathologic Processes, 147, 185 Pathophysiology, 26, 30, 109, 185 Patient Education, 64, 130, 134, 136, 141, 185 Peau d'orange, 130, 185 Penicillin, 146, 185 Peptide, 38, 41, 66, 68, 78, 151, 166, 176, 185, 188, 190 Perception, 21, 43, 185 Percutaneous, 12, 42, 59, 68, 69, 70, 73, 74, 77, 80, 141, 185 Perfusion, 11, 27, 42, 46, 59, 68, 82, 90, 185 Perhexiline, 38, 185 Periapical Granuloma, 185 Periapical Periodontitis, 110, 185 Periapical Tissue, 185 Pericarditis, 110, 185 Pericardium, 185 Pericoronitis, 110, 185 Periodontal Abscess, 110, 185 Periodontitis, 168, 185 Perioperative, 10, 185 Peripheral Nervous System, 181, 184, 185 Peripheral Vascular Disease, 33, 74, 186 Peroxidase, 54, 176, 186 Peroxide, 186 PH, 42, 47, 63, 65, 71, 73, 78, 186 Pharmacodynamic, 65, 186 Pharmacokinetic, 65, 186 Pharmacologic, 24, 27, 108, 146, 186, 200 Pharmacotherapy, 8, 55, 61, 68, 69, 87, 88, 186 Phenotype, 130, 186 Phospholipids, 24, 165, 176, 178, 186 Phosphorus, 151, 186 Photocoagulation, 156, 186 Physiologic, 10, 144, 150, 178, 186, 192 Physiology, 4, 25, 41, 143, 186, 202 Pigments, 152, 186, 193

Pilot study, 14, 20, 24, 68, 187 Pituitary Gland, 166, 187 Placenta, 187, 189 Plants, 144, 151, 168, 180, 183, 186, 187, 188, 200 Plaque, 16, 60, 66, 68, 72, 101, 103, 146, 148, 187 Plasma cells, 146, 187 Plasma protein, 144, 163, 187, 190 Plasmid, 66, 187 Platelet Activation, 27, 187 Platelet Aggregation, 17, 25, 27, 74, 145, 182, 187, 199 Platelet Factor 4, 174, 187 Platelets, 26, 34, 67, 90, 104, 149, 180, 182, 187, 195, 199 Plethysmography, 91, 187 Pneumonia, 158, 187 Podophyllotoxin, 164, 187 Poisoning, 164, 178, 181, 188 Polycystic, 26, 188 Polycystic Ovary Syndrome, 26, 188 Polymers, 27, 188, 190 Polymorphism, 25, 37, 188 Polypeptide, 145, 156, 166, 188, 201 Polysaccharide, 147, 188 Polyunsaturated fat, 87, 188 Population Density, 15, 188 Postmenopausal, 14, 26, 49, 164, 183, 188 Postoperative, 10, 188 Postoperative Period, 10, 188 Postprandial, 4, 53, 188 Postural, 107, 188 Potassium, 182, 188 Potentiates, 174, 188 Potentiation, 38, 188 Practicability, 188, 200 Practice Guidelines, 126, 188 Pravastatin, 17, 188 Precordial, 56, 189 Precursor, 147, 161, 162, 164, 183, 189, 190, 201 Premenopausal, 26, 189 Pressoreceptors, 149, 189 Prevalence, 9, 23, 33, 44, 55, 71, 109, 111, 189 Primary endpoint, 7, 12, 189 Probe, 179, 189 Progesterone, 49, 104, 189, 197 Progression, 6, 7, 11, 15, 24, 34, 146, 189 Progressive, 5, 6, 16, 148, 155, 161, 164, 181, 187, 189, 190

214

Angina Pectoris

Proline, 156, 172, 189 Prone, 108, 189 Prone Position, 108, 189 Prophylaxis, 104, 189 Propranolol, 88, 89, 98, 148, 189 Prospective study, 78, 86, 189 Prostaglandins, 21, 104, 147, 189, 190 Prostaglandins A, 21, 189 Prostaglandins D, 21, 190 Prostaglandins F, 190 Prostate, 150, 190, 201 Protein C, 144, 145, 147, 176, 190, 201 Protein S, 28, 150, 190 Proteolytic, 156, 166, 190 Prothrombin, 45, 190, 199 Protocol, 7, 8, 190 Protons, 21, 171, 190, 191 Protozoa, 179, 190 Proximal, 15, 57, 161, 190, 195 Pseudoxanthoma, 130, 190 Pseudoxanthoma Elasticum, 130, 190 Psychic, 178, 191, 194 Psychogenic, 110, 191 Psychotropic, 110, 191 Puberty, 190, 191 Public Health, 14, 32, 34, 74, 126, 191 Public Policy, 125, 191 Publishing, 34, 110, 111, 191 Pulmonary, 108, 150, 165, 172, 191, 202 Pulmonary Artery, 150, 191, 202 Pulmonary Edema, 108, 191 Pulmonary Ventilation, 172, 191 Pulse, 26, 180, 191 Purulent, 185, 191 Putrefaction, 167, 191 Q Quality of Life, 7, 9, 10, 12, 14, 18, 24, 28, 31, 33, 62, 64, 102, 191 R Race, 11, 15, 108, 179, 191 Radiation, 146, 162, 167, 191, 194, 203 Radioactive, 151, 171, 173, 176, 180, 183, 191, 192, 194, 198, 201 Radioisotope, 191, 200 Radiological, 185, 191 Radionuclide Ventriculography, 37, 192 Random Allocation, 192 Randomization, 12, 192 Randomized, 7, 8, 10, 12, 15, 16, 18, 23, 30, 32, 35, 39, 46, 50, 51, 86, 89, 162, 192 Reactive Oxygen Species, 17, 192

Receptor, 25, 26, 57, 73, 75, 77, 143, 147, 161, 192, 195 Recombinant, 57, 192 Recombination, 168, 192 Recurrence, 41, 56, 63, 155, 192 Reductase, 17, 83, 177, 188, 192, 195 Refer, 1, 151, 156, 161, 166, 171, 177, 192, 200 Refractory, 26, 36, 41, 49, 50, 55, 57, 59, 68, 69, 70, 72, 75, 77, 87, 90, 91, 92, 93, 162, 192 Regeneration, 166, 192 Regimen, 162, 186, 192 Regression Analysis, 50, 161, 192 Rehabilitation Centers, 14, 192 Relapse, 9, 192 Reliability, 53, 192 Remission, 70, 192, 193 Reperfusion, 20, 22, 27, 48, 61, 100, 101, 180, 193 Reperfusion Injury, 22, 193 Respiration, 151, 180, 193 Respiratory failure, 111, 193 Resuscitation, 152, 193 Retina, 130, 146, 154, 157, 161, 183, 191, 193, 194, 203 Retinal, 33, 167, 183, 193, 203 Retinol, 193 Retrospective, 15, 32, 193 Retroviral vector, 168, 193 Rheumatic Diseases, 110, 193 Rhodopsin, 183, 193 Ribose, 143, 193 Rickettsiae, 193 Risk factor, 5, 13, 18, 20, 23, 32, 33, 41, 43, 71, 79, 177, 189, 194 Risk patient, 18, 19, 47, 111, 194 Rods, 193, 194 S Salivary, 159, 194 Salivary glands, 159, 194 Saphenous, 158, 194 Saphenous Vein, 158, 194 Sarcolemma, 22, 180, 194 Sarcoplasmic Reticulum, 22, 194 Scans, 12, 30, 194 Sclerosis, 23, 43, 148, 194 Screening, 68, 104, 155, 194 Sebaceous, 160, 194 Sebaceous gland, 160, 194 Secretion, 144, 155, 171, 174, 194 Secretory, 26, 105, 194, 198

215

Sedentary, 4, 194 Seizures, 107, 164, 184, 194, 197 Selenium, 82, 194 Semen, 100, 101, 162, 190, 194 Semisynthetic, 164, 195 Sensibility, 145, 195 Sensitization, 7, 195 Sensory loss, 110, 195 Septal, 36, 195 Serotonin, 182, 186, 195, 201 Serous, 163, 195 Serum, 5, 26, 30, 33, 54, 58, 74, 79, 144, 145, 156, 159, 169, 177, 195 Shock, 22, 111, 145, 195 Side effect, 117, 144, 150, 180, 195, 200, 203 Signs and Symptoms, 32, 109, 111, 192, 193, 195 Simvastatin, 17, 195 Sinus of Valsalva, 37, 195 Skeletal, 5, 66, 159, 194, 195, 196, 201 Skeleton, 143, 195 Skull, 159, 195, 199 Small intestine, 155, 161, 171, 174, 195 Smoking Cessation, 8, 25, 32, 151, 195 Smooth muscle, 17, 104, 105, 145, 164, 171, 182, 190, 196 Social Environment, 191, 196 Social Problems, 101, 196 Social Support, 31, 196 Solid tumor, 150, 196 Solitary Nucleus, 149, 196 Somatic, 168, 171, 179, 185, 196, 201 Sound wave, 157, 196 Soybean Oil, 188, 196 Spasm, 109, 158, 196 Spastic, 52, 56, 175, 196 Spasticity, 196 Spatial disorientation, 161, 196 Specialist, 131, 160, 196 Species, 164, 179, 180, 191, 192, 196, 197, 203 Specificity, 19, 30, 196 Spermatozoa, 194, 196 Spinal cord, 44, 50, 57, 66, 74, 75, 86, 91, 92, 151, 153, 154, 164, 167, 175, 181, 185, 197, 198 Spleen, 82, 88, 159, 177, 197 Squamous, 197, 203 Stabilization, 3, 27, 197 Stable disease, 17, 197 Staging, 194, 197 Status Epilepticus, 111, 197

Stenosis, 6, 37, 53, 57, 69, 70, 79, 103, 109, 197 Stent, 18, 20, 39, 71, 73, 77, 103, 197 Steroid, 159, 195, 197 Stimulant, 159, 161, 171, 197 Stimulus, 158, 162, 165, 174, 175, 197, 199 Stomach, 82, 88, 143, 164, 168, 171, 174, 181, 195, 197 Stool, 156, 173, 175, 197 Stricture, 197 Stroke, 5, 10, 17, 18, 20, 22, 24, 33, 100, 104, 108, 111, 124, 152, 197 Subacute, 11, 173, 197 Subarachnoid, 169, 197 Subclinical, 9, 173, 194, 197 Subcutaneous, 143, 162, 184, 197 Subspecies, 196, 197 Substrate, 17, 198 Sudden cardiac death, 5, 16, 28, 198 Sudden death, 14, 51, 55, 198 Sulfur, 100, 198 Superoxide, 15, 17, 75, 198 Supplementation, 15, 87, 89, 90, 198 Suppression, 22, 198 Sweat, 160, 198 Sweat Glands, 160, 198 Sympathetic Nervous System, 4, 149, 198 Symptomatic, 109, 198 Synapse, 144, 181, 198, 200 Synaptic, 181, 182, 198 Synaptic Transmission, 182, 198 Syncope, 5, 53, 107, 110, 111, 198 Systemic, 10, 42, 75, 89, 118, 145, 147, 150, 164, 173, 198, 202 Systole, 159, 198 Systolic, 102, 172, 198 T Tachycardia, 5, 80, 161, 198 Technetium, 42, 198 Temporal, 6, 169, 199 Teratogenic, 160, 199 Testicular, 87, 199 Testis, 199 Testosterone, 192, 199 Therapeutics, 73, 86, 89, 119, 199 Thoracic, 49, 55, 63, 69, 82, 160, 199, 203 Threshold, 25, 34, 172, 199 Thrombin, 27, 38, 57, 166, 187, 190, 199 Thrombocytes, 187, 199 Thrombolytic, 32, 199 Thrombolytic Therapy, 32, 199

216

Angina Pectoris

Thrombosis, 17, 27, 37, 38, 45, 51, 54, 55, 57, 71, 75, 79, 90, 149, 190, 197, 199 Thyroid, 9, 101, 108, 151, 172, 199 Thyroid Gland, 108, 172, 199 Thyroid Hormones, 199 Thyroxine, 9, 144, 199 Ticlopidine, 62, 199 Tidal Volume, 172, 199 Tolerance, 17, 168, 199 Tomography, 199 Tone, 5, 88, 91, 104, 183, 196, 200 Tonus, 200 Toothache, 110, 200 Torsion, 173, 200 Toxic, iv, 159, 181, 182, 187, 194, 200 Toxicity, 161, 178, 200 Toxicology, 126, 200 Toxin, 33, 163, 199, 200 Tracer, 15, 200 Trachea, 199, 200 Transcutaneous, 88, 89, 90, 91, 92, 93, 94, 200 Transdermal, 33, 68, 200 Transfection, 150, 168, 200 Transient Ischemic Attacks, 24, 33, 200 Translational, 26, 200 Transmitter, 143, 161, 175, 178, 183, 200 Treatment Outcome, 18, 200 Triage, 19, 32, 200 Trigeminal, 110, 165, 200 Triglyceride, 101, 172, 200 Trimetazidine, 37, 76, 201 Tropomyosin, 201 Troponin, 35, 45, 58, 62, 67, 201 Troponin C, 201 Troponin I, 62, 201 Tryptophan, 156, 195, 201 Tumor marker, 150, 201 Type 2 diabetes, 53, 201 U Uranium, 198, 201 Urethra, 190, 201 Urinary, 33, 201 Urine, 15, 24, 33, 150, 159, 201 Urticaria, 145, 201 Uterus, 154, 158, 183, 189, 201 V Vaccine, 190, 201 Vagal, 5, 201 Vagus Nerve, 196, 201 Vascular endothelial growth factor, 59, 74, 201

Vascular Resistance, 149, 202 Vasoactive, 14, 202 Vasoconstriction, 5, 161, 164, 202 Vasodilatation, 182, 202 Vasodilation, 4, 13, 17, 57, 68, 89, 182, 202 Vasodilator, 13, 94, 151, 161, 171, 180, 182, 185, 201, 202 Vasomotor, 43, 48, 79, 164, 202 Vein, 146, 148, 175, 183, 194, 202 Venous, 33, 148, 149, 182, 190, 199, 202 Venous Thrombosis, 149, 199, 202 Ventilation, 152, 202 Ventricle, 147, 159, 172, 179, 191, 192, 198, 202 Ventricular, 9, 36, 37, 48, 74, 77, 180, 192, 202 Ventricular Dysfunction, 37, 202 Ventricular fibrillation, 77, 202 Ventricular Function, 37, 48, 77, 192, 202 Ventricular Remodeling, 9, 36, 202 Venules, 150, 163, 202 Verapamil, 51, 89, 98, 202 Vertebrae, 197, 202 Vertigo, 3, 202 Vesicular, 171, 202 Veterinary Medicine, 125, 202 Vinca Alkaloids, 203 Vincristine, 87, 203 Vindesine, 87, 203 Viral, 16, 102, 203 Virulence, 148, 200, 203 Virus, 153, 174, 187, 193, 203 Visceral, 94, 149, 168, 201, 203 Visceral Afferents, 149, 168, 201, 203 Visual Acuity, 175, 176, 203 Visual field, 175, 203 Vitreous, 193, 203 Vitreous Body, 193, 203 Vitro, 27, 170, 203 Vivo, 6, 15, 28, 203 W White blood cell, 143, 146, 177, 180, 182, 187, 203 Windpipe, 199, 203 Wound Healing, 153, 166, 203 X Xenograft, 146, 203 X-ray, 130, 157, 158, 167, 177, 183, 194, 203 Y Yeasts, 186, 203 Z Zoster, 203

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Angina Pectoris

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Angina Pectoris

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