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[Silent myocardial ischemia in outpatients being treated for hyperlipoproteinemia]
M Tomecková1, V Danzig, J Bultas
1II. interní klinika 1. LF UK a VFN, Praha.
Insights
Hyperlipoproteinaemia, a condition linked to high cholesterol, significantly increases the risk of silent myocardial ischaemia. Load testing and ECG monitoring are effective screening methods for this asymptomatic heart condition.
Area of Science:
- Cardiology
- Metabolic Disorders
- Preventive Medicine
Context:
- Hyperlipoproteinaemias, particularly hypercholesterolaemia, are established risk factors for atherogenesis.
- Silent myocardial ischaemia, an asymptomatic form of coronary heart disease, poses a significant health concern.
Purpose:
- To determine the prevalence of silent myocardial ischaemia in individuals with hyperlipoproteinaemia.
- To evaluate the optimal diagnostic procedures for detecting silent myocardial ischaemia in this high-risk group.
Summary:
- A study of 57 patients with hyperlipoproteinaemia revealed a prevalence of 13% in men and 11.8% in women for silent myocardial ischaemia.
- Diagnostic procedures included ergometric loading tests, 24-hour ambulatory ECG monitoring, and load scintigraphy.
Impact:
- Silent myocardial ischaemia is significantly more prevalent in individuals with hyperlipoproteinaemia compared to the general population.
- Ergometric testing and ambulatory ECG monitoring, supported by scintigraphy, are recommended as effective screening tools.
Background:
Hyperlipoproteinaemias, in particular those associated with hypercholesterolaemia, are in a causal relationship with the development and acceleration of atherogenesis. One of the serious forms of coronary heart disease is silent myocardial ischaemia--an asymptomatic objectively confirmed ischaemic episode. The objective of the present study was to 1. assess the prevalence of this disease in subjects with hyperlipoproteinaemia and 2. to assess the optimal diagnostic procedure to detect it.
Methods And Results:
The group comprises 57 subjects selected at random (23 men and 34 women) from the out-patient department for genetics and treatment of hyperlipoproteinaemias. In all subjects an ergometric loading test was made and 24-hour ambulatory ECG monitoring. Suspected silent myocardial ischaemia (i.e. positive results of the two examinations) was confirmed by load scintigraphy of the heart muscle. Silent myocardial ischaemia was proved in 3 of 23 examined men (13%) and in 4 of 34 women (11.8%).
Conclusions:
Prevalence of silent myocardial ischaemia is significantly higher in high risk subjects--with hyperlipoproteinaemia than in the general asymptomatic population. The best screening test for its detection is a loading test and ambulatory ECG monitoring, supplemented by loading scintigraphy of the heart muscle.