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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diabetes, and possibly the hypothyroidism that attends diabetes, impairs mechanical relaxation of ventricular muscle, in part by depressing the rate of Ca2+ uptake by sarcoplasmic reticulum. Left ventricular hypertrophy exacerbates the adverse effects of diabetes on cardiac performance, but its effects on relaxation variables have not been well characterized. We examined the impact of streptozotocin-induced diabetes (8 weeks) on ventricular pressure load-dependent relaxation and sarcoplasmic reticular calcium uptake of hearts from spontaneously hypertensive rats and Wistar-Kyoto rats. Subsets of diabetic hypertensive rats were treated with either insulin (10 units/kg/day) or triiodothyronine (8-10 micrograms/kg/day). Diabetes impaired load-dependent relaxation and depressed sarcoplasmic reticular calcium uptake only in spontaneously hypertensive rat hearts. Either insulin or triiodothyronine treatment prevented the diabetes-induced depressions of both mechanical and biochemical indexes of relaxation. The results suggest that 1) hypertrophic ventricles of spontaneously hypertensive rats are more susceptible to the detrimental effects of diabetes on relaxation indexes than are the nonhypertrophic Wistar-Kyoto rat ventricles, and 2) the hypothyroidism that attends diabetes may contribute to the impaired relaxation of diabetic spontaneously hypertensive rat left ventricle.
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PMID:Ventricular relaxation of diabetic spontaneously hypertensive rat. 214 Aug 16

Clinical, electrocardiographic and echocardiographic findings of 69 subjects aged 80 years or over were analyzed in order to assess the prevalence of left ventricular mass, hyperlipidemia, hypertension and cigarette smoking. Of the 69 subjects studied, 41 had no symptoms or sign of cardiovascular disease, 28 had one or more cardiac symptoms (NYHA stage 2-4). 25 had electrocardiographic evidence of left ventricular hypertrophy and there were no differences between the asymptomatic and symptomatic groups. Echocardiographically, the left ventricular mass index ranged between 103 to 247 g/m2 in men and 170 to 251 g/m2 in women. In 36 subjects with high left ventricular mass index, the ventricular septal thicknesses ranged from 12 mm to 15 mm in 19 subjects, and posterior wall thicknesses ranged from 12 mm to 16 mm in 17 subjects. Of the 58 patients with an adequate echocardiogram, 47 had clinically diagnosed hypertension (81%). In our study population, a prevalence of left ventricular hypertrophy (62%), isolated systolic hypertension (26%), definite hypertension (33.3%), high LDL-cholesterol (63%), low HDL-cholesterol (26%), abnormal Q wave (16%), cigarette smoking (47.8%) and diabetes mellitus (1.4%) were found.
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PMID:Left ventricular mass index and prevalence of heart disease in the population aged 80 years and over. 214 63

Systolic or diastolic hypertension, cigarette smoking, diabetes mellitus, left ventricular hypertrophy, age, prior stroke, transient cerebral ischemic attack, extracranial arterial disease, and coronary heart disease are risk factors for the most common type of geriatric stroke, atherothrombotic brain infarction (ABI). Also, by contributing to hypertension and diabetes mellitus, obesity predisposes to ABI. The relationship of abnormal serum lipids and of physical inactivity to ABI is unclear. Antihypertensive treatment decreases the incidence of fatal and nonfatal stroke in patients with systolic and diastolic hypertension. Cessation of smoking also decreases risk.
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PMID:Risk factors for geriatric stroke: identification and follow-up. 220 86

Based on postmortem records at the Wayne County Medical Examiners' Office from 1982 to 1986, autopsy results indicated that the deaths of 129 persons aged 20-34 resulted from heart disease: 51 of these deaths were attributed to atherosclerotic cardiovascular disease (ASCVD), 29 to hypertensive cardiovascular disease, 28 to cardiomyopathy, and 21 to other cardiac causes. The majority of the deaths due to ASCVD occurred among men, both black and white, followed by black women, and the incidence increased with age. All of these deaths due to ASCVD were sudden and accounted for all deaths due to ischemic heart disease in this age group among Wayne County residents. Diabetes mellitus, left ventricular hypertrophy, a history of seizures, and the recent ingestion of alcohol were all found to be associated with sudden death from ASCVD in this group. Obesity did not seem to be a significant factor. These data suggest that ASCVD is not rare as a cause of death in young adults and some of the risk factors identified in older subjects also operate in this age group.
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PMID:Atherosclerotic cardiovascular disease and sudden deaths among young adults in Wayne County. 222 Jul 3

To determine the prevalence of cardiac disorders as risk factors for stroke, we conducted a survey in 1986 in a stratified random sample of the population of Rochester, Minnesota, 35 years of age or older. The medical records of the 2,122 subjects in the sample were retrieved with use of the Rochester Epidemiology Project medical records linkage system. The data were used to estimate (1) the reliability of self-reported information about cardiac and cerebrovascular disorders and (2) the age- and sex-specific prevalence of diabetes mellitus and various cardiac and cerebrovascular conditions. The estimated prevalence for selected risk factors in the population 35 years of age or older was 5.8% for diabetes mellitus, 3.3% for myocardial infarction, 1.2% for mitral valve disease, 4.2% for left ventricular hypertrophy, and 2.8% for atrial fibrillation or flutter. These data can be used to estimate resources required for evaluation and management of the disorders. When the prevalence and the relative risk for stroke are known for a particular cardiac disorder, the proportion of stroke attributable to that disorder can be estimated.
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PMID:Prevalence of cardiovascular disease and diabetes mellitus in residents of Rochester, Minnesota. 224 50

Despite significant advances in the technology of percutaneous transluminal coronary angioplasty (PTCA) and the ability to perform the procedure in more complex cases, there are still problems of acute closure and resultant acute myocardial infarction. Approximately two thirds of patients who undergo acute closure will require bypass surgery. Independent factors that can be predictive of patients who will undergo acute closure include stenosis length exceeding a two-lumen diameter, female gender, stenosis at a bend of 45 degrees or more, stenosis at a branching point, stenosis-associated thrombus or filling defect, other stenoses in the vessel undergoing dilatation, and multivessel disease. Factors that can be identified only at the time of the procedure are post-PTCA percentage of stenosis, an intimal tear or dissection, and a post-PTCA gradient of 20 mm Hg or more. The outcome of abrupt closure depends on several factors. The features that have been found to be predictive of fatal outcome are female gender, collateral channels originating from the dilated vessel, a large amount of jeopardized myocardium, left ventricular hypertrophy, hypertension before PTCA, diabetes, and multivessel disease. When abrupt closure occurs, attempts should be made to reopen the artery even if a decision has been made to proceed to bypass surgery. Techniques that can help when the artery cannot be kept open include prolonged inflation (3-5 minutes), use of a bailout or perfusion catheter, and infusion of an oxygenated perfluorochemical (Fluosol, Alpha Therapeutic Corp., Los Angeles, California). Intracoronary stenting and laser balloon angioplasty are new techniques that might prove useful in the management of the dissection that commonly leads to abrupt closure.
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PMID:Prediction of acute closure in percutaneous transluminal coronary angioplasty. 230 49

Joint studies of the ALIMDA and Society of Actuaries, notably those of 1935, 1959 and 1979, established that there is a progressive rise in cardiovascular mortality with successive increments in blood pressure. This has provided the basis of underwriting. The converse is not true, or at least has not been true until very recently. Drugs that effectively reduce blood pressure have been available for several decades, but reduction and maintenance of blood pressure is still accomplished in only a minority of hypertensives. Long-term trials employing a combination of drugs, i.e., diuretics, vasodilators and reserpine and subsequently beta-blockers, almost without fail have not shown that treatment with these agents significantly reduces heart disease mortality and sudden death. This has been attributed, perhaps without basis, to an unfavorable countering effect of increased lipid levels, aggravating this risk factor, and other undesirable metabolic effect of diuretics, such as hypokalemia and depletion of body magnesium, increasing the propensity to ventricular arrhythmias, hyperglycemia, worsening diabetes, and hyperuricemia. A survey of 674 persons with hypertension seen personally during the period 1985-89, who were under the care of approximately that many physicians, reveals striking changes in drug prescription and use during this brief period that portend a major change in the outlook of hypertension. Two classes of drugs have increased rapidly in popularity: these are the angiotensin-converting enzyme inhibitors (ACE inhibitors) and the calcium blockers. Both classes of drugs effectively lower blood pressure and have minimal side effects with good compliance. They act not only to reduce peripheral vascular resistance, but also locally in the heart muscle to directly cause left ventricular hypertrophy to regress, an effect of great consequence. The drugs used in former trials such as the vasodilators and diuretics have no effect on left ventricular hypertrophy, unlike the ACE inhibitors and calcium antagonists. Left ventricular hypertrophy is the key lesion in hypertension and is only in part due to increased work load imposed by elevated pressure. It is associated with elevated blood pressure, but not closely and occurs independently; ventricular myocytes as well as myocytes of the vasculature being stimulated to growth by angiotensin and calcium, potentiating the effect of norepinephrine. Left ventricular hypertrophy greatly increases the propensity to ventricular arrhythmias and sudden death, and is a prime cause of cardiac mortality and sudden death not only in hypertension, but also in obesity, aging and diabetes, in which conditions left ventricular hypertrophy also is very common.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Major new developments affecting treatment and prognosis in hypertension. 235 5

We examined the prognostic significance of left ventricular hypertrophy determined by echocardiography in a cohort beginning renal replacement therapy. No patient had hemodynamically significant valvular disease or echocardiographic signs of obstructive cardiomyopathy. Using the Cox proportional hazards model, left ventricular hypertrophy was significantly associated with survival. The relative risk, based on comparison of upper and lower quintiles of left ventricular mass index, was 3.7 (95% confidence intervals, 1.6 to 8.3) for all-cause mortality and 3.7 (95% confidence intervals, 1.2 to 11.1) for cardiac mortality. The independent risk, adjusted for age, known coronary artery disease, diabetes, level of systolic blood pressure, and treatment (dialysis or transplantation), was 2.9 (95% confidence intervals, 1.3 to 6.9) for all-cause mortality and 2.7 (95% confidence intervals, 0.9 to 8.2) for cardiac mortality. Therefore, left ventricular hypertrophy appears to be an important, independent, determinant of survival in patients receiving therapy for end-stage renal failure.
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PMID:Impact of left ventricular hypertrophy on survival in end-stage renal disease. 252 54

A 38-year-old female was admitted to our hospital because of dyspnea. The diagnosis of total lipodystrophy was made by following findings: (1) gaunt appearance; (2) insulin-resistant diabetes mellitus; (3) hyperlipidemia; (4) fatty liver. Chest X-ray demonstrated cardiomegaly, pulmonary edema and pleural effusion. Echocardiogram was characterized by left ventricular hypertrophy with asymmetrical septal hypertrophy and left ventricular dysfunction. Renal biopsy revealed focal glomerulosclerosis. We reported a patient with total lipodystrophy combined with heart failure and renal failure, which have been rarely associated with the disease.
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PMID:Total lipodystrophy with heart failure and renal failure: report of a case. 253 Mar 77

Cardiac function was evaluated in 40 Type 1 diabetic patients aged less than 30 years and compared with 20 age- and sex-matched control subjects using resting and exercise electrocardiography, and echocardiography. The duration of diabetes was from 0.25 to 25 years (mean 10 years), and few patients had microvascular complications. Left ventricular end-diastolic and end-systolic diameters were similar in both groups, with no significant differences between the groups in mean thickness of the intraventricular septum and the posterior wall of the left ventricle. Fractional shortening and mean velocity of circumferential fibre shortening as indices of ventricular function were similar in both groups. Left ventricular hypertrophy (Minnesota Code 3,1) was observed in the resting electrocardiogram of 22 patients and 12 control subjects (NS), but no other significant abnormalities were observed. One diabetic patient developed asymptomatic ST segment depression during exercise electrocardiography. In conclusion, the chamber size, wall thickness, and systolic function of the left ventricle are normal in most young Type 1 diabetic patients who have few microvascular complications.
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PMID:Non-invasive evaluation of cardiac function in young patients with type 1 diabetes. 253


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