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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To investigate cardiovascular adaptation to chronic anemia we studied eight ovine fetuses made anemic by serial isovolemic hemorrhage and seven nonanemic controls. After 1 wk carotid arterial oxygen content was reduced to 1.6 +/- 0.2 ml/dl and hematocrit to 13.3 +/- 1.6% in anemic fetuses compared with 6.9 +/- 1.2 ml/dl and 32.4 +/- 3.9% in controls. Cardiac output was higher in the anemic group (753 +/- 102 vs. 490 +/- 66 ml.min-1.kg fetus-1) as stroke volume and heart rate both increased. Blood flow to the carcass, skin, kidneys, intestines, brain, and heart was increased. Vascular resistance fell in all tissues except the placenta. Central venous pressure, arterial pH, plasma total protein, and blood volume were not different although extravascular fluid accumulated in six of the anemic fetuses. The estimated capillary hydrostatic pressure was greater in anemic (7.6 +/- 1.8 mmHg) than control fetuses (5.0 +/- 1.5 mmHg) and the ratio of precapillary to postcapillary resistance was less. We conclude that reduction in the ratio of precapillary to postcapillary resistance in chronic fetal anemia increases blood flow, oxygen delivery, and capillary hydrostatic pressure.
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PMID:Hemodynamics and organ blood flow in fetal sheep subjected to chronic anemia. 175 May 77

Left ventricle (LV) performance was assessed by echocardiography (2-D and M-mode) in 30 patients with chronic severe anaemia and an equal number of age and sex matched healthy controls. Patients with anaemia were divided into two groups: those with tachycardia (pulse rate more than 100 per min) and those without. LV performance indices computed were LV ejection fraction (LVEF), % fractional shortening (FS), cardiac index (CI) and stroke volume index (SVI). In patients of anaemia with tachycardia, LVEF was 48.6 +/- 8.41 (mean +/- SEM) vs 71.6 +/- 4.96 among controls. Percentage FS was 19.93 +/- 4.21 vs 36.0 +/- 4.5, CI 5.46 +/- 1.2 vs 3.1 +/- 0.78 l/min/m2, and stroke index 48.6 +/- 12.2 vs 41.5 +/- 10.7 ml/beat/m2. In patients without tachycardia, LVEF was 55.1 +/- 8.86, percentage FS 23.6 +/- 5.42, CI 2.87 +/- 0.526 and stroke index 41.34 +/- 12.1. These findings suggest that LV performance was depressed in both groups of patients with anaemia but LV function was better in patients without tachycardia.
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PMID:Assessment of left ventricular function in chronic severe anaemia. An echocardiographic study. 181 98

The aim of the study was to evaluate, before and after hemodialysis (HD), the effects of partial correction of anemia with erythropoietin on: cardiac index (CI), stroke index (SI), heart rate (HR), ventricular ejection index (EVI), mean arterial pressure (PAM) and systemic vascular resistance index (SVRI). Cardiac parameters were gathered by means of transthoracic bioimpedance (BoMed). Twelve patients (6 M, 6 F) aged 50.6 +/- 5 years, on HD for 92.8 +/- 15.9 months, were studied twice (basal, end of follow-up). Before rHuEPO therapy, 6 patients had a "pathologic" cardiac response to HD (defined as an increase of CI despite the reduction of pre-load). After rHuEPO, 5 out of 6 patients with a "pathologic" response reverted to a "normal" response, and 1 hypertensive patient from a "normal" to a "pathologic" response. The EVI, CI and SI of patients with "pathological" response significantly improved after rHuEPO as compared with pre rHuEPO values (EVI 1.36 +/- 0.14 vs 1.07 +/- 0.08, p = 0.023; CI 3.18 +/- 0.24 vs 1.78 +/- 0.27, p less than 0.01; SI 43 +/- 3.7 vs 24 +/- 3.8, p less than 0.01). In conclusion, partial correction of anemia with rHuEPO induces an improvement of myocardial performance, without significant hemodynamic adverse effects. Our results suggest also that anemia could play a significant role in the pathogenesis of myocardial disfunction in HD patients.
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PMID:[Effects of erythropoietin on the cardiovascular system and the intradialytic hemodynamic behavior]. 181 33

Evolution of cardiac index in 12 patients with severe renal anemia on regular hemodialysis (hematocrit 19.9 +/- 2.8%) was studied during the first 4 months of treatment with recombinant human erythropoietin (rhEPO). At the end of the study period, hematocrit rose to 31.1 +/- 3.5% (p less than 0.001) and cardiac index significantly decreased (5.34 +/- 1.25 vs. 3.81 +/- 0.84 liters/min/m2, p less than 0.001). Cardiac index fell mainly because of reduction of stroke volume (108 +/- 27 vs. 81 +/- 25 ml, p less than 0.001), while heart rate did not change during the study period. Before starting rhEPO cardiac index was elevated in 11 out of the 12 patients, whereas after 4 months of treatment this was only maintained in 4 of them. We conclude that substitution with rhEPO in hemodialysis patients significantly decreases cardiac index, confirming anemia as the main factor for hyperdynamic circulatory state in these patients. Whether this reduction in cardiac index will ameliorate cardiac morbidity or not and hematocrit levels for achieving the major benefits require further studies.
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PMID:Hemodynamic changes in hemodialyzed patients during treatment with recombinant human erythropoietin. 186 67

A rare case of ischemic stroke related to Herpes zoster infection of the eye and documented arteritis in an HIV-positive patient is analyzed. The woman, aged 32, who was born in Angola and lived in Zaire, was diagnoses at the Hospital Universitario de Santa Maria, Lisbon. She presented with a 5-month history of sudden hemiplegia, 4 months after onset of herpes zoster ophthalmicus. Among extensive diagnosis tests, she was positive for HIV by ELISA and Western blot, hepatomegaly, and generalized lymphadenopathy. She has left Herpes zoster ophthalmicus with ptosis bulbi and mottled discoloration of the skin over the distribution of the 1st division of the left trigeminal nerve, and right spastic hemiparesis. Her helper T-cell count was 952/cubic mm, and her T-cell ratio was 0.9. She had anemia, hypoalbuminemia, positive serology for cytomegalovirus, Herpes simplex, Epstein Barr virus, and hepatitis B. She had no bacterial infections, but her stool contained Trichuris trichiura eggs and giardia lamblia cysts. Her cardiovascular system and cerebrovascular fluid were negative. Computed tomography of the head showed an old left capsular infarct. Cerebral angiography showed arteritis of the left choroidal artery with occlusion. She was treated with metronidazole and mebendazole, and had surgery for removal of the left eye with a prosthetic replacement. Strokes are common in AIDS patients, resulting from fungal infections, endocarditis, infectious or non-infectious emboli, or arteritis from herpes zoster infections. This is the 1st published case of hemiplegia and Herpes zoster in a European or African patient with HIV-1.
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PMID:Herpes zoster and controlateral hemiplegia in an African patient infected with HIV-1. 186 23

Identification of the beta s-gene-cluster haplotype and alpha-gene status provide a useful tool to improve the possibility for early detection in high-risk SS patients. The DNA polymorphisms of the beta s-gene-cluster modify the clinical course in sickle cell anemia especially as it involves the risk of end-stage organ failure of the kidney, lung, and brain. In both Africa and America, the CAR beta s haplotype increases the risk of developing irreversible complications at an early age. The degree of anemia, the Hb F concentration, and the preservation (or lack thereof) of G gamma Hb F is haplotype dependent and correlates with the overall clinical course of the patient. Further modulation of the clinical course by the coinheritance of alpha-thalassemia-2 tends to decrease the risk of soft tissue organ failure but increases the risk of osteonecrosis. A single individual can be expected to fit into the overall pattern. Some sickle related illness will eventually occur in all patients. In the presence of a Senegal haplotype, the patient's health is better, with the CAR haplotype it is always worse; severity is intermediate in the Benin. These genetic markers can be used to identify the endangered patient before the onset of irreversible major organ failure. The high risk SS patient with a CAR chromosome or one who is homozygous Ben without alpha-thalassemia-2 should be monitored closely for evidence of vasculopathy-induced microinfarction of the brain, kidneys, or lungs. Such a patient needs preventive therapy before suffering a major hemisphere stroke, losing kidney function, or developing cor pulmonale secondary to restrictive lung disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sickle cell anemia: beta s-gene-cluster haplotypes as prognostic indicators of vital organ failure. 188 45

In two patients with carotid artery stenosis and anemia, neurological deficits appeared whenever the hemoglobin level fell below a critical level of 5-6 g/dl and resolved with correction of the anemia. Profound anemia should be considered as a cause of focal neurological deficit, especially if there is evidence of cerebral atherosclerosis.
Stroke 1991 Sep
PMID:Severe anemia associated with transient neurological deficits. 192 64

We performed a prospective study in 106 patients with acute stroke. The main purpose was to evaluate the associated diseases and to determine their prevalence and incidence in two different types of cerebrovascular disease: the intracerebral hemorrhage (HI) and ischaemic events (AI). The studied population included 54 men and 52 women with a mean age of 66.8 +/- 10.3 years. A clinical examination was performed in all patients by different specialists and all were submitted to diverse complementary tests, including a computed tomography scan of the brain (TAC) and an echocardiogram (ECO). We found 24 (23%) HI and 82 (77%) AI. In the past history, previous stroke were more prevalent in AI (p less than 0.01). Heart disease was present in 87 (82%) patients but, among them, only atrial fibrillation which was found in 19 (18%) patients, was significantly more frequent in AI (p less than 0.02). Hypertension (HTA) existed in 79 (75%) patients, respiratory complications and periferic vascular disease in 9 (8%), diabetes in 44 (42%) and dyslipidemia in 31 (29%) patients. No significant difference was found between the two groups of stroke regarding these diseases; however, there was a tendency for HTA and diabetes to be more prevalent in HI and for periferic vascular disease in AI. In the blood tests, high haematocrit was found in 35 (33%) patients, anemia in 21 (20%), hypercholesterolemia in 17 (16%), hypertrigliceridemia in 18 (17%) and uremia or creatinemia or ionic alteration in 32 (30%) patients, without any difference in their prevalence and incidence in the two groups of stroke. In conclusion, in this prospective study of patients with an acute stroke, there was 23% of HI and 77% of AI, a high prevalence of previous stroke, heart disease and HTA, but only the previous stroke and, within heart disease, the atrial fibrillation were significantly more frequent in the AI group. Also, periferic vascular disease had a tendency to be more frequent in AI, as well as diabetes and HTA had in HI.
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PMID:[The patient with acute cerebrovascular disorders: assessment of associated diseases]. 208 57

To clarify the hemodynamics of anemia, 28 patients with iron deficiency anemia were investigated in respect to their parameters of left ventricular (LV) systolic and diastolic function. The subjects were categorized in three groups: 1) patients (pts) with severe anemia, whose hemoglobin (Hb) concentration was less than 7 g/dl (N = 7); 2) pts with moderate anemia, whose Hb concentration was between 7 and 10 g/dl (N = 13): and 3) pts with mild anemia whose Hb concentration was between 10 and 12 g/dl (N = 8). Changes in hemodynamic parameters were observed before and after treatment in 14 subjects. These results were compared with those of normal subjects (N = 11). In the anemic patients, LV stroke volume (SV), and heart rate both increased. An increase in SV was accompanied by an increase in LV preload (LV diastolic diameter = LVDd by M-mode echocardiography) and an increase in the Doppler parameters of early diastolic filling (peak velocity in the rapid filling phase, acceleration rate, and deceleration rate). SV correlated roughly with LVDd (r = 0.44, p less than 0.05). In addition, the indices of LV contractility as measured by the pulsed Doppler method (ET/PEP) and by M-mode echocardiography (mVcf) also increased. These factors which contributed to hyperkinetic circulation were restored as the anemia improved. It was concluded that an increase in SV is an important determinant of high cardiac output in chronic anemia, because it parallels the severity of anemia. The change in SV is preload-dependent, and is suspected of being LV contractility-dependent.
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PMID:[Studies of hyperkinetic circulatory state in chronic anemia]. 210 8

In nine anesthetized mongrel dogs anemia was produced by exchanging blood with plasma substitute thus reducing hemoglobin gradually in three steps. Aortic, atrial and ventricular blood pressures, cardiac output, electrocardiogram, phonocardiogram and the first derivative of the left ventricular pressure were continuously monitored. Blood samples were taken to determine hemoglobin, blood gases and whole blood viscosity. Progressive hemodilution resulted in a significant increase in cardiac output and left ventricular stroke work, while total peripheral resistance, oxygen content and whole blood viscosity decreased significantly. There were no significant changes in cardiac pressures, myocardial contractility, diastolic pressure time index and blood gases. The oxygen supply/demand ratio had gradually declined, while electrocardiogram showed no significant changes. These results suggest that moderate isovolemic hemodilution in animals with normal coronary vessels does not impair left ventricular function as this was manifested by the unchanged hemodynamic and electrocardiographic findings.
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PMID:The influence of hemodilution on left ventricular function. 221 99


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