Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The left ventricular systolic ejection phase was cineangiographically analyzed in an attempt to evaluate left ventricular performance. Forty-eight patients were classified into five groups: (1) 9 controls; (2) 5 patients with PMD (congestive type) (COCM); (3) 9 patients with PMD hypertrophic type) (HCM), (4) 9 patients with ischemic heart disease (IHD); and (5) 16 patients with mitral stenosis (MS). The rate of volume change (deltaV/deltat) and the volume change as a percentage of stroke volume (deltaV/SV) in patients with COCM and IHD were lower in the early systole and higher in the mid-systole as compared with the control group. Normalized systolic ejection rate (NSER) and velocity of circumferential fiber shortening (Vcf) for the early and late systole were significantly lower in patients with COCM and IHD than in the control group. In two patients with IHD in whom normal indices of left ventricular performance and no asynergy were observed, NSER and Vcf were normal in the late systole but were significantly lower in the early systole. In all 48 patients, deltaV/deltat, deltaV/SV, NSER and Vcf were compared statistically with conventional ejection phase indices and isometric phase indices. delthV/SV for the midstystole showed a negative correlation with EF, MNSER and mVcf. NSER and Vcf for all three phases showed a good correlation with Vmax, max dp/dt and R-max dp/dt but a better correlation with EF, MNSER and mVcf. It was concluded that NSER and Vcf for the early systole were sensitive indices of left ventricular performance and may be utilized to detect subtle depression of left ventricular performance.
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PMID:Quantitative analysis of left ventricular ejection phase by means of left ventricular cineangiography. 59 71

In 135 patients with mitral stenosis of the III and IV stages oxidative phosphorylation in the mitochondria of the left cardiac auricle was studied by the polarographic method. A uniform lowering of the mitochondrial respiration at different metabolic states with IV stage of the affection and in patiens of a more advanced age (36-52 years) was demonstrable. In some instances the conjugation of oxidation and phosphorylation was on a decline too. A nitrous oxide anesthesia (by comparison with the ether-oxygen one) produced a substantial depression of the mitochondrial respiration, especially when alpha-ketoglutarate was used. The sensitivity to the inhibitory effect of nitrous oxide in the elderly was higher. Respiration with succinate as a substrate in the young (20-35 years) patients proved little sensitive to the suppressing action of this type of anesthesia.
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PMID:[Oxidative phosphorylation in the myocardium of patients with mitral valve stenosis during surgery]. 101 35

The incidence of positive submaximal treadmill exercise tests was evaluated in patients with mitral stenosis and aortic stenosis, no electrocardiographic evidence of left ventricular hypertrophy, and normal coronary arteries on angiography. Seven of 19 patients (37 percent) with aortic stenosis (53 to 80 mm Hg gradient across the aortic valve) had greater than or equal to 1.0 mm of ischemic S-T segment depression during or after a submaximal treadmill test. Three of 15 patients (20 percent) with mitral stenosis (11 to 22 mm Hg mean gradient across the mitral valve) had greater than or equal to 1.0 mm of ischemic S-T segment depression during or after a submaximal treadmill exercise test. Patients with significant valvular disease, no electrocardiographic evidence of left ventricular hypertrophy, and normal coronary arteries may have a positive submaximal treadmill exercise test due to an unfavorable balance between myocardial oxygen supply and myocardial oxygen demand.
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PMID:Treadmill exercise test in aortic stenosis and mitral stenosis. 117 8

Echocardiographic tracings of posterior left atrial wall motion were examined in 30 normal subjects, 17 patients of mitral stenosis with sinus rhythm and 31 coronary patients with elevated left ventricular end-diastolic pressure. Because of the plane of the posterior left atrial wall motion and the angle of the sound beam, usually the postero-inferior portion of the left atrial wall was recorded. In normal subjects, there were 3 positive waves (A,C,V waves) and 2 negative waves (X and Y waves). The A wave during atrial contraction period occurred in the closing motion of the mitral valve and was initiated by a slight negative wave. The fourth heart sound was consistent with the ascending limb of the A wave. The C wave coincided with the first heart sound followed by the pronounced negative depression (X wave). The X trough coincided with the beginning of the mitral valve opening in early diastole and was the deepest point in the motion curve. The V wave was a peaked anterior motion during rapid filling period and followed by the third heart sound. The Y wave was a slight negative depression following the V wave, and its trough occurred when the both leaflets of the mitral valve assumed a semiclosed position. In both mitral stenosis and coronary artery disease, significant increase (p less than 0.01) of the A wave excursion and significant decrease (p less than 0.01) of the V wave excursion were observed, resulting in marked increase (p less than 0.01) of the A/V ratio. The slope of the ascending limb of the V wave was also decreased apparently in both conditions. These findings might reflect increased resistance to left atrial emptying in mitral stenosis and decreased left ventricular filling rate in coronary artery disease. This study shows that echocardiographic examination of the posterior left atrial wall motion is feasible and useful in estimating the presence of either mitral stenosis or decreased left ventricular filling rate.
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PMID:Study of posterior left atrial wall motion by echocardiography and its clinical application. 118 90

Between 1978 and 1987, 1270 patients who survived single aortic or mitral valve replacement at the Rehabilitation Center in Bad Krozingen, Germany, underwent a comprehensive rehabilitation program. The preoperative diagnosis was isolated aortic stenosis in 425, isolated aortic regurgitation in 159, mixed aortic lesion in 211, isolated mitral stenosis in 208, isolated mitral insufficiency in 137 and mixed mitral lesion in 130 cases. Follow up examinations were carried out one and six months after surgery, and at yearly intervals thereafter. Exercise testing was performed with an electrically braked bicycle ergometer in the supine position, and the load was increased by 25 or 50 watts every two minutes until fatigue, severe angina, more than 0.3 mV ST-segment depression, or 80% of the age predicted maximum heart rate was achieved. Patients after aortic valve replacement had a better exercise performance one month after operation than did those after mitral valve replacement. Those with mitral stenosis showed more severe impairment of exercise tolerance than did the mitral insufficiency group. There was a steady increase in exercise tolerance between one and six months postoperatively, both in patients with aortic and those with mitral valve replacement, but the difference in performance between the two groups was still present (72% versus 57% of normal). The results of univariate and multivariate analyses showed that the preoperative employment status was the most important factor for postoperative return to work, followed by gender (male > female), exercise tolerance and valualar lesion (aortic > mitral).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Exercise tolerance and working capacity after valve replacement. 134 26

We present the case of a parturient with severe mitral stenosis and pulmonary hypertension who received general anaesthesia using alfentanil for urgent Caesarean section. Alfentanil promoted haemodynamic stability and allowed immediate postoperative extubation. Epidural morphine provided postoperative analgesia. This combination permitted early ambulation and prevention of thromboembolism. A disadvantage of this technique, neonatal respiratory depression, was promptly reversed with a single dose of naloxone. The anaesthetic management of mitral stenosis in pregnancy is discussed and the neonatal pharmacokinetics of maternally administered alfentanil are presented.
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PMID:Alfentanil for urgent caesarean section in a patient with severe mitral stenosis and pulmonary hypertension. 211 2

A case was reported of bilateral coronary artery-pulmonary artery fistulas associated with mitral valve stenosis. A thirty seven year old female was admitted with the complaint of exertional dyspnea and palpitation, which had lasted for the 3 years previous to her admission to our hospital. Electrocardiogram showed sinus bradycardia and no ST-T changes, but exercise ECG showed significant ST depression after 6 min of exercise. The DDR (9 mm/sec) and mitral valve area (0.61 cm2) were shown by UCG examination to have decreased, and the pressure at half time (360 msec) was shown by Doppler UCG to be prolonged. On cardiac catheterization, coronary arteriography showed fistula from RCA to PA, and fistula from LCA to PA, but no occlusive lesions were demonstrated. P/S blood flow ratio was 1.09, and O2 saturation was stepped up 3% in PA. She was operated on and given open mitral commissurotomy and closure of the fistula opening, via the PA. After surgical repair, no abnormality was found by exercise ECG, and no fistulas were shown on coronary arteriography.
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PMID:[A case of bilateral coronary artery--pulmonary artery fistulas associated with mitral valve stenosis]. 230 31

The influence of left ventricular (LV) function on surgical risk was assessed in 98 patients with mitral stenosis (MS) using echocardiographic studies including a dobutamine test in 42 cases. Intraoperative LV myocardial biopsy was also performed in 24 cases. Preoperatively, depressed LV function [% fractional shortening (%FS) less than or equal to 27%] was observed in 21 patients (21%). Seven patients had postoperative LV failure, five of whom had preoperative depression of LV function. Among these five patients, three had low cardiac output; and in the other two preoperative %FS was severely depressed. In cases of poor responses to preoperative dobutamine, postoperative improvement in %FS and the cardiac index were not as marked in the good-response group, and some of these patients had LV failure postoperatively. Percent fibrosis of the LV myocardium, which was demonstrated by intraoperative biopsy, correlated negatively with preoperative %FS, and %fibrosis was greater in the group responding poorly to dobutamine administration, especially in patients with postoperative LV failure. These results suggest that some patients with MS were developing LV failure postoperatively due to impaired myocardium. Myocardial fibrosis seemed to be an important causative factor in these patients. Preoperative evaluation utilizing dobutamine administration is useful in screening for high-risk patients.
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PMID:[The influence of left ventricular function on surgical risk in mitral stenosis]. 264 79

Left ventricular systolic stress was studied in nineteen patients with mitral stenosis, twelve in sinus rhythm and seven in atrial fibrillation. Left ventricular dimensions and volumes and septal and posterior wall thickness were measured by means of M and two bidimensional echocardiography at rest and during isometric exercise. Expulsive indices: fractional shortening, ejection fraction and mean circumferential shortening rate were calculated. Ventricular mass, meridional stress and several end-systolic stress or pressure/volume relationships were estimated. Patients with atrial fibrillation were older and had systolic dysfunction: greater end-systolic volumes and depression of both expulsive fractions and some of the end-systolic indices. Preload and wall thickness were normal. Patients with atrial fibrillation showed higher ventricular stress as a consequence of greater ventricular dimensions. Ejection fraction correlates directly with mitral valve area and inversely with inotropic state and heart rate. It is concluded that systolic dysfunction in mitral stenosis is multifactorial. The most important determinants of the abnormality are heart rate and inotropic state. The study did not show any primary abnormality of afterload or hypotrophy of the left ventricle.
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PMID:[Systolic stress in mitral stenosis]. 278 85

The authors present a case of a 62-year-old woman who was hospitalized with severe medical problems that included congestive heart failure secondary to mitral stenosis and atrial fibrillation, coronary artery disease, chronic renal failure, and a recent history of a right cerebral lacunar infarction. She also had a 2-year history of anxiety and depression, manifested in the hospital by frequent crying spells, sleeplessness, and ruminating about her illnesses. The patient received buspirone 5 mg three times a day for her anxiety and depression. Approximately 12 hours after her first dose, she developed dramatic myoclonus, dystonias, and akathisia. She was given 25 mg of intramuscular diphenhydramine and 1 mg of intramuscular benztropine mesylate, which resulted in little relief; however, 1 mg clonazepam caused both the myoclonic jerks and dystonias to resolve completely.
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PMID:Acute generalized myoclonus following buspirone administration. 337 31


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