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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred nineteen patients admitted to the coronary care unit with pulmonary edema were retrospectively reviewed to identify the demographic characteristics and underlying cardiac disorders of this population. The patients with pulmonary edema were compared with 119 patients admitted to the coronary care unit with chest pain. Cardiac catheterization in 71 patients with pulmonary edema and 93 with chest pain showed left main and 3-vessel coronary artery diseases to be equally common in both groups, although anginal pain was infrequent in patients with pulmonary edema (n = 28, 24%). Left ventricular function was reduced in the patients with pulmonary edema compared with those with chest pain (mean ejection fraction 42 vs 59%; p less than 0.001). More patients with pulmonary edema were black, and had diabetes and preexisting hypertension than those with chest pain. The results of cardiac catheterization were the same for black and white patients with pulmonary edema. In conclusion, patients with pulmonary edema have a high incidence of cardiac disease, and pulmonary edema may be 1 manifestation of silent myocardial ischemia. Important demographic differences exist between patients admitted with pulmonary edema and those who present with chest pain.
Am J Cardiol 1991 Dec 15
PMID:Comparison of angiographic findings and demographic variables in patients with coronary artery disease presenting with acute pulmonary edema versus those presenting with chest pain. 174 62

In a totally nonselected group of patients with acute myocardial infarction (AMI) (n = 921) admitted from the emergency department to the coronary care unit or other hospital ward, the occurrence of non-Q-wave AMI and the prognosis in these patients was determined and compared with those in whom Q waves were developed. Fifty-two percent had AMI without new Q waves. Patients with a non-Q-wave AMI differed from patients with Q-wave AMI, more frequently having a previous history of AMI (p less than 0.001), angina pectoris (p less than 0.01), diabetes mellitus (p less than 0.05), congestive heart failure (p less than 0.001), and a higher mean age (p less than 0.001), whereas smoking was more common in Q-wave AMI. Patients with non-Q-wave AMI had a 1-year mortality of 31% compared with 26% in Q-wave AMI (p greater than 0.2) and a reinfarction rate of 20% compared with 12% for Q-wave AMI (p less than 0.01). Among patients aged less than 75 years without a previous history of AMI, congestive heart failure, and diabetes mellitus, the 1-year mortality rate was 16% for patients with Q waves versus 15% for those without Q waves (NS). Appearance of Q waves was not independently associated with death. We conclude that in a nonselected group of patients with AMI the occurrence of a non-Q-wave AMI is much higher than previously reported. The prognosis in AMI during one year of follow-up is not associated with development of Q waves.
Clin Cardiol 1991 Nov
PMID:Prognosis in acute myocardial infarction in relation to development of Q waves. 176 23

Ultrasonic tissue characterization has shown the potential to yield information about structural and functional properties of cardiovascular tissue. The development of real-time two-dimensional integrated backscatter imaging has made feasible clinical investigations of ultrasonic tissue characterization, including detection of stunned myocardium in patients with acute ischemia, recognition of remote infarction, detection of cardiac allograft rejection, and study of diffuse myocardial involvement with systemic diseases such as diabetes mellitus. Technical improvements and scientific advances in the understanding of the interaction between ultrasound and tissue may open an even wider range of clinical applications. Even in its present, relatively preliminary form, tissue characterization appears to have the potential for clinical application. Additional clinical experience will stimulate refinements and increases in the diagnostic power of this promising approach.
Clin Cardiol 1991 Nov
PMID:Ultrasonic backscatter tissue characterization in cardiac diagnosis. 176 39

We study 71 type I diabetics and 25 controls, trying to analyze the anatomical and functional changes due to diabetes. The diabetics, with a mean age of 18.4 +/- 8.2 years, were strictly selected excluding any disease and treatment besides insulin. In 66, and echocardiographic M mode and 2D study was done to calculate wall thickness, cavity dimensions and systolic function indexes; in all, Eco-Doppler analyzing 9 diastolic function indexes. The results showed an increase in septal thickness in diabetics (p less than 0.01 in diastole and less than 0.001 in systole). There was no difference in systolic function or posterior wall thickness, having the diabetics a significant increase of the T 1/2 (p less than 0.001), a decrease of the deceleration of E and the ratio E/A (p less than 0.001). As a group, 12.5% of the diabetics had anatomical abnormalities, and 18.3% diastolic abnormalities at least in two indexes. The only significant correlation was established between the evolution time and the T 1/2 (p less than 0.01). We conclude that in this group of selected diabetics, the anatomical and functional abnormalities found were only imputable to the diabetic abnormality.
Rev Esp Cardiol 1991 Oct
PMID:[The cardiac anatomical and functional changes in a group of young type-1 diabetics without microangiopathy]. 176 6

This review highlights the contributions of recent pericyte research towards our understanding of normal and pathological functioning of microvessels. Pericytes are implicated in a variety of microvascular alterations, including wound healing, diabetes, inflammation, hypertension and neoplasia. They are capable of changing into other mesodermally derived cell types, including smooth muscle cells, osteoblasts and chondrocytes. The contractile properties of pericytes are being systematically examined in vitro; in addition to their tendency to contract spontaneously, pericytes can contract further in response to mediators of inflammation. In vivo studies indicate pericytes are concentrated near endothelial cell junctions along venules where they likely participate in inflammatory events. As agents are identified which modify pericyte responses to disease states, better therapeutic approaches will become possible.
Can J Cardiol 1991 Dec
PMID:Recent advances in pericyte biology--implications for health and disease. 176 82

We have studied 130 patients with diabetes mellitus and 455 patients without. All the patients were consecutively admitted to our Coronary Care Unit with their first myocardial infarction. We have observed a higher incidence of heart failure, in-hospital mortality, atrial fibrillation, conduction abnormalities, and post-infarction angina among diabetics. Nevertheless, diabetic patients do not show evidence of larger infarcts than those without diabetes. In our patients the higher mortality among diabetics is related to an increased occurrence of left ventricular failure. Moreover, post-infarction ischemic episodes are more common compared with non diabetics. Since infarcts in diabetics do not seem to be more extensive than in non diabetics, we suggest, in accordance with others, that the poorer outcome among diabetic patients with AMI could be related to an underlying cardiac dysfunction of diabetics in addition to coronary artery diseases.
Acta Cardiol 1991
PMID:Clinical correlation between diabetic and non diabetic patients with myocardial infarction. 178 49

The segmental distribution of stenoses within the coronary arteries was analysed in a population of 258 patients with a first myocardial infarction undergoing coronary angiography to evaluate the effect of thrombolytic therapy, and in a population of 466 patients undergoing elective coronary angiography for stable angina. Mean ages were 53.7 and 56.7 years respectively (P = NS). As judged angiographically, coronary arterial disease was more extensive in the group suffering angina, with a greater proportion of patients with two- or three-vessel disease (odds ratio 2.56, 95% confidence interval 1.87 to 3.52) and more patients having stenoses in two or more coronary arterial segments (odds ratio 1.52, 95% confidence interval 1.12 to 2.08). For each coronary vessel, the probability of finding a stenosis greater than 50% in an individual segment was greater in the group presenting with angina. There was a relative deficiency of stenoses within the main stem of the left coronary artery or its proximal left anterior descending branch among the patients suffering myocardial infarction. Within those having angina, subgroups were identified with "isolated" and "diffuse" coronary arterial disease: the latter patients tended to have a lower concentration of total cholesterol in the serum, but an increased prevalence of diabetes mellitus. Patients presenting clinically with a first myocardial infarction, and patients with severe angina, constitute distinct populations selected by different mechanisms from the overall pool of patients with atheromatous coronary arterial disease.
Int J Cardiol 1991 Sep
PMID:Segmental analysis of coronary arterial stenoses in patients presenting with angina or first myocardial infarction. 179 Oct 84

In order to evaluate the possible role played by snoring as a risk factor for cardiovascular disease, we studied 400 patients aged 30-80 years, divided into 4 groups matched for age, sex and body mass index. The first group consisted of 100 patients who snored, having risk factors (hypertension, diabetes, obesity, smoking, high serum cholesterol level) for cardiovascular disease. The second group consisted of 100 non-snoring patients with risk factors. The third and fourth groups were formed by 100 snoring and 100 non-snoring patients without risk factors. We investigated the morbidity and the mortality from cardiovascular disease over a period of five years (1982-1987). An increase in morbidity and mortality was found for snorers with risk factors (36 and 17 respectively) compared to non-snorers with risk factors (10 and 4, P less than 0.001), and also to both snorers and non-snorers without risk factors (7 and 3, P less than 0.001; 3 and 1, P less than 0.001 respectively). No difference was noted between snorers and non-snorers without risk factors. A higher morbidity and mortality for cardiovascular disease was found in snorers with risk factors as compared with non-snorers having risk factors. Furthermore, the morbidity and mortality in patients without risk factors was found to be lower compared with that found in snorers with risk factors. In conclusion, snoring worsened the prognosis of patients with risk factors for cardiovascular disease, but did not represent an independent or predictive risk factor in itself.
Int J Cardiol 1991 Sep
PMID:Snoring and risk of cardiovascular disease. 179 Oct 87

Consecutive patients admitted to our hospital with suspected acute myocardial infarction during 21 months were prospectively evaluated. One-year mortality after discharge from hospital was related to whether or not an infarction developed (infarct versus non-infarct patients). Of patients discharged alive after developing an infarct, there was a mortality of 17% (n = 777) versus 12% (n = 1830) (P less than 0.001) for all patients not developing infarction. In a high risk group (any of the following: age greater than or equal to 75 years, previous history of myocardial infarction, diabetes mellitus or congestive heart failure) patients developing infarction had a mortality of 24% (n = 457) versus 17% (n = 1221) for those who did not (P less than 0.001). In a low risk group (none of the high risk criteria), the corresponding mortality was 8% (n = 316) for patients suffering infarction and 3% (n = 603) for those not having infarction (P less than 0.001). The difference in mortality between patients with and without infarction was most marked in women (21% vs 11%; P less than 0.01) and in hypertensives (25% vs 12%; P less than 0.001), but less marked in men (16% vs 13%; NS) and in patients without hypertension (13% vs 12%; NS). Among patients not suffering infarction, mortality was particularly high in those with previous congestive heart failure (23%) and diabetes mellitus (21%).
Int J Cardiol 1991 Sep
PMID:One-year mortality rate after discharge from hospital in relation to whether or not a confirmed myocardial infarction was developed. 179 Oct 91

The purpose of this study was to evaluate the clinical characteristics and the factors related to early mortality in the acute myocardial infarction of the geriatric population. We studied 814 consecutive patients with their first acute myocardial infarction admitted to the coronary care unit at tha Hospital General de Galicia. 401 patients were older than 65 years (Group A) and 413 were younger (Group B). Group A was found a significantly lower percentage of males (64.7% versus 88.4%; p less than 0.001) and smokers (46.7% versus 72.7%; p less than 0.001; and older patients showed a greater incidence of diabetes mellitus (28.1% versus 15.2%; p less than 0.001) and arterial hypertension (45.6% versus 31.7%; p less than 0.01). In the geriatric population, the clinical course of the acute myocardial infarction is characterized by a greater incidence of heart failure (35.3% versus 11.1%; p less than 0.001), cardiogenic shock (18% versus 5.7%; p less than 0.001) and post-acute myocardial infarction angina pectoris (18.3% versus 12.2%; p less than 0.05). Early mortality (first month) was significantly higher in elderly patients (22.7% versus 6.3%; p less than 0.001). The multivariate analysis by stepwise logistic regression identified cardiogenic shock, age and heart failure as the only independent predictive variables for early mortality. We conclude that early mortality in the acute myocardial infarction is high and related to severe degrees of pump failure and age.
Arch Inst Cardiol Mex
PMID:[Clinical and prognostic implications of age in acute myocardial infarct]. 179 10


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