Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this investigation was to evaluate the benefits and the potential risks of a very low calorie protein-diet in obese patients with metabolic abnormalities and at increased cardiovascular risk. To this end, the 420 kcal diet (with 50% of energy as protein) was administered for 10 days to 10 grossly obese subjects with glucose intolerance, hyperlipemia, arterial hypertension, ischemic cardiopathy and thrombotic risk related to high levels of fibrinogen factor VIII and reduced fibrinolytic activity. Weights loss averaged 360 g/day with a mean protein loss of 17 g/day occurring essentially during the very early phase of the diet. There was a rapid normalisation of blood pressure, plasma lipids and glycaemia. With the exception of a slightly negative potassium balance other ion remained in balance. There was no change in electrocardiogram, in parameters of blood coagulation or in hepatic and renal function. There was only a moderate increase in ketonaemia and plasma urate. It appears therefore, that an 8 to 10 day very low calorie protein-diet is well tolerated even in obese patients with increased cardiovascular risk, and that it corrects of several metabolic abnormalities without alteration in cardiac, hepatic or renal function.
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PMID:[Evaluation of tolerance of a modified protein diet in obese subjects]. 665 61

Alteration of coagulation status and certain clinical chemistry laboratory determinations of 75 adult patients undergoing cardiopulmonary bypass procedures for acquired heart disease was studied during and after surgery. None of the patients was given transfusions of blood or blood components. With hemodilution, the mean hematocrit value dropped from 38% to 28% during the procedure. Fibrin degradation products and euglobulin lysis time were transiently abnormal. Factor V diminished somewhat during the procedure, whereas factors VIII and IX increased after surgery. Clottable fibrinogen values decreased slightly, but increased to an abnormally high value at 24 and 48 hours. Mean value of platelet counts decreased from 194,000 to 144,000/microliter immediately after surgery. Knowledge of expected deviation of coagulation factors and certain clinical chemistry tests following open heart surgery is helpful in evaluating the status of the postoperative patient.
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PMID:Alteration of coagulation and selected clinical chemistry parameters in patients undergoing open heart surgery without transfusions. 727 Apr 96

An epidemiological study was performed in a group of secondary school students selected according to their family history to assess whether changes exist in blood viscosity and intraerythrocytic calcium levels in young healthy subjects with positive family histories of arterial hypertension or cerebral and cardiac ischemic vasculopathies, compared to a control group with a negative family history of these disorders. A population of 130 secondary school students without any pathologies were subdivided into 4 groups: 1) with a positive family history of ischemic cardiopathy (ICP); with a positive family history of cerebral ictus; 3) with a family history of arterial hypertension; 4) a negative family history of these diseases. Total blood viscosity, hematocrit, plasma fibrinogen and intraerythrocytic calcium was evaluated in all groups. The results show that these parameters were within the normal range, as was to be expected in healthy subjects. Blood viscosity was also normal in all groups; intraerythrocytic calcium levels were slightly higher in groups with histories of cardiovascular disease and in particular there was an increased percentage of cases with values above the threshold level. Higher fibrinogen levels were also recorded, but always within the normal range, in the group with a positive history of ICP. The epidemiological study is important to assess whether a family pattern of cardiovascular disease can also influence such independent risk parameters as blood viscosity and intraerythrocyte calcium, owing to the possible greater frequency of development of cardiovascular disease.
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PMID:[An epidemiological study on blood viscosity and intraerythrocytic calcium in a group of high-school students selected according to their family histories]. 756 49

Although coronary heart disease (CHD) is currently the leading cause of death among American Indians, information on the prevalence of CHD and its association with known cardiovascular risk factors is limited. The Strong Heart Study was initiated in 1988 to quantify cardiovascular disease and its risk factors among three geographically diverse groups of American Indians. Members of 13 Indian communities in Arizona, Oklahoma, and South and North Dakota between 45 and 74 years of age underwent a physical examination that included medical history; an electrocardiogram; anthropometric and blood pressure measurements; an oral glucose tolerance test; and measurements of fasting plasma lipoproteins, fibrinogen, insulin, hemoglobin A1c, and urinary albumin. Prevalence rates of definite myocardial infarction and definite CHD were higher in men than in women at all three centers (p < 0.0001) and higher in those with diabetes mellitus (p = 0.002 in men and p = 0.0003 in women). Diabetes was associated with relatively higher prevalence rates of myocardial infarction (diabetic:nondiabetic prevalence ratio = 3.8 vs. 1.9) and CHD (prevalence ratio = 4.6 vs. 1.8) in women than in men. Prevalence rates of heart disease were lowest in the communities in Arizona; prevalence rates were similar in Oklahoma and South Dakota/North Dakota and were two- to threefold higher than those in Arizona. By logistic regression, prevalent CHD among American Indians was significantly and independently related to age, diabetes, hypertension, albuminuria, percentage of body fat, smoking, high concentrations of plasma insulin, and low concentrations of high density lipoprotein cholesterol. In contrast to reports from other non-Indian populations, diabetes was the strongest risk factor. The lower prevalence of CHD among Indians in Arizona is distinctive in view of their higher rates of diabetes, obesity, hypertension, and albuminuria, but it may be partly related to their low frequency of smoking and their low concentrations of total and low density lipoprotein cholesterol. These findings from the initial Strong Heart Study examination emphasize the importance of diabetes and its associated variables as risk factors for CHD in Native American populations.
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PMID:Coronary heart disease prevalence and its relation to risk factors in American Indians. The Strong Heart Study. 763 30

We measured fibrinogen levels as well as the fibrinolytic parameters tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor 1 (PAI-1) in plasma samples obtained at basal conditions and after stimulating the fibrinolytic system by venous occlusion (VO). Samples were taken from patients with primary pulmonary hypertension (PPH), with secondary thromboembolic pulmonary hypertension (SPHTH), with secondary pulmonary hypertension due to congenital heart disease with Eisenmenger's reaction (SPHCD), and from healthy control individuals (CON). Fibrinogen levels were not significantly different between the groups with PPH and SPHTH or between SPHCD and CON. The latter groups, however, exhibited significantly lower fibrinogen plasma levels compared with PPH or SPHTH (p < 0.01). Basal plasma levels of t-PA antigen, t-PA activity, and PAI-1 activity, respectively, did not differ significantly between the study groups. After VO, mean t-PA activity levels increased to a higher extent in control subjects compared with patients with PPH, or SPHTH, or SPHCD, with significant differences only between CON and SPHTH or CON and PPH (p < 0.03). Patients with PPH and SPHTH exhibit both increased fibrinogen plasma levels and a diminished fibrinolytic response compared with healthy subjects. Moreover, the fibrinogen plasma levels in patients with SPHCD are in normal range, and the fibrinolytic response is similar to CON compared with PPH and SPHTH, thus indicating the existence of a comparable prothrombotic situation in patients with PPH and SPHTH.
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PMID:Fibrinogen, t-PA, and PAI-1 plasma levels in patients with pulmonary hypertension. 792 65

Children with cyanotic congenital heart disease who undergo operation with cardiopulmonary bypass are at increased risk of thromboembolic or hemorrhagic complications, or both. Regulation of thrombin, a key enzyme in coagulation, is essential in preventing these complications. We therefore examined the in vitro capacity of plasma from 15 children with cyanotic congenital heart disease to generate thrombin and to inhibit 125I-thrombin before and after cardiopulmonary bypass. We also assessed whether thrombin had been generated in vivo by assaying levels of fibrinogen, thrombin-antithrombin III complexes, and D-dimer. Plasma levels of the thrombin inhibitors, antithrombin III, alpha-2-macroglobulin, and heparin cofactor II were also measured. Thrombin regulation was normal before operation. After cardiopulmonary bypass, the in vitro capacity to generate thrombin decreased by 50%, and this was primarily a result of hemodilution (31%). Similar postoperative decreases were noted in the levels of antithrombin III, heparin cofactor II, and alpha-2-macroglobulin (26% to 45%). However, the total in vitro plasma thrombin inhibitory capacity decreased by only 13%. Levels of thrombin-antithrombin III and D-dimer increased after operation, indicating that thrombin had been generated and inhibited in vivo. Clinically, there were no thromboembolic complications although six patients required replacement therapy for excessive small-vessel bleeding. In conclusion, thrombin regulation is significantly altered after cardiopulmonary bypass. Although thrombin is generated in vivo, the total residual capacity to do so is impaired because of hemodilution. Despite a concomitant decrease in thrombin inhibitor levels, the total residual in vitro capacity of plasma to inhibit thrombin is relatively spared. This suggests that after cardiopulmonary bypass the risk of hemorrhagic complications after an additional hemostatic challenge is relatively greater than the risk of thrombotic complications. This might be reflected in the predominance of hemorrhagic complications in our patients.
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PMID:Thrombin regulation in congenital heart disease after cardiopulmonary bypass operations. 830 75

The Oslo Diet and Exercise Study (ODES) is an unmasked randomized 2 x 2 factorial trial of 1-year duration for each participant. During 1990-1991 219 participants (198 males and 21 females) aged 41-50 were randomized into one of four treatment groups; no treatment (control), dietary changes alone, exercise alone, or a combination of the two treatments. At inclusion, the participants had no overt heart disease, but they had increased body weight; slightly increased blood pressure, serum triglycerides, and total cholesterol, and they had decreased HDL cholesterol. Further, they were all inactive at leisure time. The primary aim of the trial is to compare the isolated and combined effects of the four treatments on the variables fibrinogen, fibrinolytic capacity, coagulation factor VII, and platelet volume. A series of secondary hypotheses will also be tested, such as the effects on other coagulation and fibrinolytic components and activities; lipids and lipoproteins; fatty acids; glucose and insulin response to a glucose load; clinical, physiological, and anthropometric variables; and quality of life. The dietary treatments are adapted according to each participant's risk profile (level of total cholesterol, HDL cholesterol, triglycerides, blood pressure, and body weight). Fish and fish products are recommended. Special emphasis is put on caloric restriction in those who are overweight and those with elevated blood pressure. Exercise sessions take place three times a week under the guidance of highly qualified instructors. The aim is to increase peak oxygen uptake through aerobic endurance training. Adherence to the exercise program is monitored closely.
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PMID:The Oslo Diet and Exercise Study (ODES): design and objectives. 833 52

Six hundred fifty seven patients with angina pectoris underwent coronary angiography after measurement of plasma fibrinogen levels. Coronary artery disease (CAD) was angiographically confirmed in 75% of the patients. Other cardiac disease, either alone or in combination with CAD, was diagnosed in 8% and 11% of cases, respectively; 17% of the patients had no evidence of overt heart disease. Fibrinogen concentrations showed a graded increase according to the severity of coronary stenosis (p = 0.02) but were not significantly associated with any other cardiac heart disease. However, patients with valvular heart diseases had on average a 5.9% elevation of fibrinogen levels as compared to patients without proven cardiac disease (p = 0.08), similar to the observed 6.9% increase for CAD (p = 0.005). On average, patients with cardiomyopathies or pulmonary hypertension had only a 1.6% or 1.2% increase, respectively. The increase in fibrinogen levels associated with CAD was similar in patients with and without coexisting heart diseases. The results demonstrate a significant positive relation of fibrinogen to the presence and severity of CAD irrespective of a possible confounding influence from other cardiac diseases. The results therefore lend support to the hypothesis of a pathogenetic role for fibrinogen as a cardiovascular risk factor.
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PMID:Relation of fibrinogen to presence and severity of coronary artery disease is independent of other coexisting heart disease. The ECAT Angina Pectoris Study Group. 849

Hypercholesterolemia is often the cause for the primary heart disease ultimately necessitating heart transplantation (HTx). After transplantation, persisting hypercholesterolemia results in an increased peroxidation of LDL retained by extracellular matrix of the intima. Oxidized LDL accumulates in monocyte derived macrophages, it leads to immobilization of tissue macrophages and provokes the expression of vascular adhesion molecules, growth factors and cytokines. In a prospective open controlled study, the impact of long-term cholesterol reduction by diet in combination with the HMG-CoA-reductase inhibitor Simvastatin on graft vessel disease (GVD) was evaluated. Patients of the control group received only a low fat diet. Simvastatin treatment decreased total and LDL-cholesterol significantly and was not associated with adverse effects. The one year angiographies revealed GVD in 24.1% of the control and 12.1% of the Simvastatin group (Study I). In high risk patients with LDL-cholesterol concentrations above 135 mg/dl, in spite of maximal Simvastatin treatment or plasma fibrinogen concentrations above 400 mg/dl, the heparin mediated extracorporeal low density lipoprotein precipitation (H.E.L.P.)-system was applied. H.E.L.P. was used either for prevention of GVD soon after HTx or for treatment of GVD after development of coronary lesions. Study II proved that the H.E.L.P.-system could significantly lower LDL-cholesterol, Lp(a) and fibrinogen in most high risk patients after HTx, resulting in successful prevention or even treatment of GVD.
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PMID:What is the role of lipid lowering therapy in heart-allograft failure? 858 84

The fact that the cardiovascular risk of ex-smokers approximates that of non-smokers after two years of abstinence, implies that accelerated atherogenesis is not the chief mechanism of smoking-related heart disease. Indeed, smoking or nicotine have adverse effects on blood rheology, thrombotic risk, coronary blood flow, and risk for arrhythmias. Omega-3-rich fish oils can be expected to correct or compensate for a remarkable number of the adverse impacts of smoking/nicotine: increased plasma fibrinogen, decreased erythrocyte distensibility, increased plasma and blood viscosity, increased platelet aggregability, increased plasminogen activator inhibitor levels, vasoconstriction of the coronary bed, reduced fibrillation threshold, increased triglycerides, reduced high-density lipoprotein cholesterol, and increased production of superoxide by phagocytes. Smokers who cannot overcome their addiction should be encouraged to substitute nicotine aerosols/gum for tobacco and advised to use supplementary fish oil and other cardioprotective nutrients.
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PMID:Fish oil may be an antidote for the cardiovascular risk of smoking. 873 61


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