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. 1979 Oct;42(4):402–409. doi: 10.1136/hrt.42.4.402

Haemodynamic and electrocardiographic accompaniments of resting postprandial angina.

J Figueras, B N Singh, W Ganz, H J Swan
PMCID: PMC482174  PMID: 508470

Abstract

The early postprandial changes in 10 patients with angiographically proven coronary artery disease and history of postprandial angina were studied by the continuous recording on magnetic tape of the electrocardiogram and haemodynamic variables. The significant changes 20 minutes after a meal not followed by angina included increases in cardiac index and stroke index, with a decrease in systemic vascular resistance. When angina developed after a meal, there were significant increases in mean systemic arterial blood pressure, heart rate, pulmonary capillary wedge pressure, and systemic vascular resistance with decreases in stroke index at the onset of pain rather than at the onset of ischaemic electrocardiographic abnormalities. The first haemodynamic variable to change was pulmonary capillery wedge pressure which tended to increase coincident in time with the electrocardiographic abnormalities. In all cases, postprandial angina occurred within 25 minutes after a meal. In every instance, there was little or no change in the product of heart rate and systolic arterial blood pressure at the onset of the ischaemic electrocardiographic abnormalities at a time when the pulmonary capillary wedge pressure had begun to rise. Postprandial angina, like many cases of rest angina, may rise on the basis of a primary decrease in myocardial perfusion, the nature of which is unclear but merits further investigation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BRANDT J. L., CASTLEMAN L., RUSKIN H. D., GREENWALD J., KELLY J. J., Jr The effect of oral protein and glucose feeding of splanchnic blood flow and oxygen utilization in normal and cirrhotic subjects. J Clin Invest. 1955 Jul;34(7 Pt 1):1017–1025. doi: 10.1172/JCI103151. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Braunwald E. Control of myocardial oxygen consumption: physiologic and clinical considerations. Am J Cardiol. 1971 Apr;27(4):416–432. doi: 10.1016/0002-9149(71)90439-5. [DOI] [PubMed] [Google Scholar]
  3. Cohen L. S., Elliott W. C., Klein M. D., Gorlin R. Coronary heart disease. Clinical, cinearteriographic and metabolic correlations. Am J Cardiol. 1966 Feb;17(2):153–168. doi: 10.1016/0002-9149(66)90347-x. [DOI] [PubMed] [Google Scholar]
  4. Dagenais G. R., Oriol A., McGregor M. Hemodynamic effects of carbohydrate and protein meals in man: rest and exercise. J Appl Physiol. 1966 Jul;21(4):1157–1162. doi: 10.1152/jappl.1966.21.4.1157. [DOI] [PubMed] [Google Scholar]
  5. FRIEDMAN M., ROSENMAN R. H., BYERS S. SERUM LIPIDS AND CONJUNCTIVAL CIRCULATION AFTER FAT INGESTION IN MEN EXHIBITING TYPE-A BEHAVIOR PATTERN. Circulation. 1964 Jun;29:874–886. doi: 10.1161/01.cir.29.6.874. [DOI] [PubMed] [Google Scholar]
  6. Fronek K., Stahlgren L. H. Systemic and regional hemodynamic changes during food intake and digestion in nonanesthetized dogs. Circ Res. 1968 Dec;23(6):687–692. doi: 10.1161/01.res.23.6.687. [DOI] [PubMed] [Google Scholar]
  7. GORLIN R. PATHOPHYSIOLOGY OF CARDIAC PAIN. Circulation. 1965 Jul;32:138–148. doi: 10.1161/01.cir.32.1.138. [DOI] [PubMed] [Google Scholar]
  8. Ganz W., Swan H. J. Measurement of blood flow by thermodilution. Am J Cardiol. 1972 Feb;29(2):241–246. doi: 10.1016/0002-9149(72)90635-2. [DOI] [PubMed] [Google Scholar]
  9. Goldstein R. E., Redwood D. R., Rosing D. R., Beiser G. D., Epstein S. E. Alterations in the circulatory response to exercise following a meal and their relationship to postprandial angina pectoris. Circulation. 1971 Jul;44(1):90–100. doi: 10.1161/01.cir.44.1.90. [DOI] [PubMed] [Google Scholar]
  10. Guazzi M., Polese A., Fiorentini C., Magrini F., Bartorelli C. Left ventricular performance and related haemodynamic changes in Prinzmetal's variant angina pectoris. Br Heart J. 1971 Jan;33(1):84–94. doi: 10.1136/hrt.33.1.84. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Guazzi M., Polese A., Fiorentini C., Magrini F., Olivari M. T., Bartorelli C. Left and right heart haemodynamics during spontaneous angina pectoris. Comparison between angina with ST segment depression and angina with ST segment elevation. Br Heart J. 1975 Apr;37(4):401–413. doi: 10.1136/hrt.37.4.401. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. JONES W. B., THOMAS H. D., REEVES T. J. CIRCULATORY AND VENTILATORY RESPONSES TO POSTPRANDIAL EXERCISE. Am Heart J. 1965 May;69:668–676. doi: 10.1016/0002-8703(65)90249-8. [DOI] [PubMed] [Google Scholar]
  13. KLAKEG C. H., PRUITT R. D., BURCHELL H. B. A study of electrocardiograms recorded during exercise tests on subjects in the fasting state and after the ingestion of a heavy meal. Am Heart J. 1955 Apr;49(4):614–625. doi: 10.1016/0002-8703(55)90080-6. [DOI] [PubMed] [Google Scholar]
  14. KUO P. T., JOYNER C. R., Jr Angina pectoris induced by fat ingestion in patients with coronary artery disease; ballistocardiographic and electrocardiographic findings. J Am Med Assoc. 1955 Jul 23;158(12):1008–1013. doi: 10.1001/jama.1955.02960120008004. [DOI] [PubMed] [Google Scholar]
  15. Kattus A. A., Alvaro A. B., Coulson A. Effectiveness of isosorbide dinitrate and nitroglycerin in relieving angina pectoris during uninterrupted exercise. Chest. 1975 Jun;67(6):640–646. doi: 10.1378/chest.67.6.640. [DOI] [PubMed] [Google Scholar]
  16. Lecerof H. Central haemodynamics during spontaneous angina pectoris. Br Heart J. 1974 Nov;36(11):1087–1091. doi: 10.1136/hrt.36.11.1087. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. MULLER O., RORVIK K. Haemodynamic consequences of coronary heart disease with observations during anginal pain and on the effect of nitroglycerine. Br Heart J. 1958 Jul;20(3):302–310. doi: 10.1136/hrt.20.3.302. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Norryd C., Denker H., Lunderquist A., Olin T., Tylén U. Superior mesenteric blood flow during digestion in man. Acta Chir Scand. 1975;141(3):197–202. [PubMed] [Google Scholar]
  19. O'Brien K. P., Higgs L. M., Glancy D. L., Epstein S. E. Hemodynamic accompaniments of angina: a comparison during angina induced by exercise and by atrial pacing. Circulation. 1969 Jun;39(6):735–743. doi: 10.1161/01.cir.39.6.735. [DOI] [PubMed] [Google Scholar]
  20. REGAN T. J., BINAK K., GORDON S., DEFAZIO V., HELLEMS H. K. Myocardial blood flow and oxygen consumption during postprandial lipemia and heparin-induced lipolysis. Circulation. 1961 Jan;23:55–63. doi: 10.1161/01.cir.23.1.55. [DOI] [PubMed] [Google Scholar]
  21. REININGER E. J., SAPIRSTEIN L. A. Effect of digestion on distribution of blood flow in the rat. Science. 1957 Dec 6;126(3284):1176–1176. doi: 10.1126/science.126.3284.1176. [DOI] [PubMed] [Google Scholar]
  22. Vatner S. F., Franklin D., Van Citters R. L. Coronary and visceral vasoactivity associated with eating and digestion in the conscious dog. Am J Physiol. 1970 Nov;219(5):1380–1385. doi: 10.1152/ajplegacy.1970.219.5.1380. [DOI] [PubMed] [Google Scholar]

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