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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A previously healthy girl, without heart disease, who ingested 2400 mg of verapamil developed hypotension, trifasicular block pattern, mental confusion, mild metabolic acidosis, and hyperglycemia. She recovered with symptomatic and supportive therapy. A discussion is presented about the action mechanism of the drug.
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PMID:Verapamil acute self-poisoning. 46 77

Moderately alcohol-discordant male twin pairs, aged 45-65 years, have been examined with respect to ischemic heart disease (IHD) and associated factors. No conclusion can yet be drawn with regard to manifest or subclinical IHD, while significant disparities were found with regard to systolic and diastolic blood pressures, high cigarette consumption, hyperglycemia, and serum cholesterol; the greater number of findings of pathological values were found in the high alcohol-consumption as compared to the low alcohol-consumption cotwins. These findings offer a possible explanation for the increased number of reports showing a connection between high consumption of alcohol and occurrence heart disease.
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PMID:Alcohol consumption in relation to factors associated with ischemic heart disease: a cotwin control study. 103 29

Patients in the coronary care unit with acute pulmonary edema, heart failure, and other organic heart disease were studied. Blood and urine samples were taken on admission prior to any treatment and later at prescribed intervals. All the patients with APE were found to have elevated plasma osmolalities and hyperglycemia on admission which decreased with treatment. This was in contrast to the other two groups excluding those factors such as ethyl alcohol and diabetes which can raise plasma osmolality or blood glucose. A discussion of this mild hyperosmolal state in APE follows including possible causes as well as cellular effects of hyperosmolality on humans.
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PMID:Acute pulmonary edema and hyperosmolality: a clinical study. 106 77

We report here the 14-year sex-specific effect of non-insulin-dependent diabetes mellitus on the risk of fatal ischemic heart disease in a geographically defined population of men and women aged 40 through 79 years. There were 207 men and 127 women who had diabetes at baseline based on medical history or fasting hyperglycemia. They were compared with 2137 adults who had fasting euglycemia and a negative personal and family history of diabetes. The relative hazard of ischemic heart disease death in diabetics vs nondiabetics was 1.8 in men and 3.3 in women, after adjusting for age, and 1.9 and 3.3, respectively, after adjusting for age, systolic blood pressure, cholesterol, body mass index, and cigarette smoking using the Cox regression model. The sex difference in the independent contribution of diabetes to fatal heart disease was largely explained by the persistently more favorable survival rate of women (than men) without diabetes.
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PMID:Why is diabetes mellitus a stronger risk factor for fatal ischemic heart disease in women than in men? The Rancho Bernardo Study. 198 13

Twenty-eight children with Down syndrome (DS) and acute lymphocytic leukemia (ALL) were compared to non-DS control leukemics matched by age, white blood cell (WBC) count, and treatment protocol to evaluate presenting manifestations, toxicity, and outcome. The DS children with ALL did not have unique clinical or biologic characteristics to distinguish their disease from that of non-DS patients. Eleven of the DS patients had successfully banded cytogenetic studies of their leukemic cells with the distribution of model chromosome number of 46 (n = 1), 47 (2), 48 (5), and greater than 50 (3). The abnormal leukemic line involved an isochromosome of the long arm of chromosome 9[i(9q)] in 3 cases. Multiagent chemotherapies induced complete remissions in 25 patients (85%), yet overall 5 year event-free survival was only 23 +/- 8% when compared to 64 +/- 9% for control children receiving similar therapies (P less than 0.01). A significant cause of treatment failure was late marrow recurrence in the DS children. Host toxicity was striking in these children. Severe congenital heart disease present in one-third contributed to 2 deaths during antileukemia therapy. Hyperglycemia secondary to diabetogenic agents and repeated bronchitis were common toxicities. Intolerance to the antifolate methotrexate with severe gastrointestinal and skin toxicities was universal. We conclude that the poor prognosis for the child with DS and ALL stems in part from their increased risk of complications and toxicity from intensive modern leukemia therapies, specifically antifolates.
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PMID:Clinical and biological characteristics of acute lymphocytic leukemia in children with Down syndrome. 214 60

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

In a study of low-dose oral contraceptives, it was found that the low dosage caused insignificant effects on glucose and lipid metabolism. 57 women of good health were studied and divided into 3 groups determined by the preparation given: monophasic desogestrel, monophasic cyproterone acetate, and triphasic gestodene. There was no family history of diabetes mellitus nor was there hyperlipoproteinemia in any of the women. Among the 3 groups, there were negligible differences concerning glucose and insulin levels and lipid profiles. This held true at both the beginning and concluding stages of the study. In all of the women, the insulin area/glucose area ratio was unaffected. Lipid metabolism and hyperglycemia have been linked to heart disease, and other reports have shown glucose and lipid abnormalities produced in women taking the 2 most popular progestins, norgestrel and norethindrone. Thus, the minor effects on carbohydrate and lipid metabolism found in these tests are significant.
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PMID:Metabolic effects of three new low-dose pills: a six-month experience. 252 17

One of the leading causes of mortality in diabetics is myocardial disease. In the past few years this subject has generated a significant amount of interest with the result that myocardial problems associated with diabetes are far better understood. Though originally thought to occur as a result of atherosclerosis, various studies have shown that heart disease can occur in the absence of atherosclerosis, suggesting a diabetic cardiomyopathy. Using diabetic animals, it has been possible to characterize diabetes-induced myocardial abnormalities. Diabetic rat hearts do not respond to conditions of high stress as well as controls. The functional depression is accompanied by altered cardiac enzyme systems. A decrease in myosin ATPase activity which appears to be a result of diabetes-induced hypothyroidism is seen. Also, a depression of sarcoplasmic reticular calcium ATPase, along with a depression of calcium uptake by the SR, is seen in diabetic rat hearts. Na+, K+ ATPase activity has also been shown to be depressed and the depression appears to correlate with depressed atrial contractility. High levels of circulating fats in diabetics may alter the integrity of membranes leading to altered enzyme activities. Insulin treatment has been relatively successful at reversing or preventing myocardial changes in the diabetic rat. Other treatments that have been studied include thyroid hormone treatment, since the depression of myosin ATPase can be corrected by such treatment; and carnitine treatment, as the elevation of long chain acyl carnitines (LCAC) and the resulting depression of calcium uptake in the SR can be so normalized. These treatments have not been successful at normalizing cardiac function. A combination of the two treatments normalized function only partially, suggesting that factors besides myosin ATPase and SR calcium uptake are involved. Other treatments that have been tried include vanadate, methyl palmoxirate, and choline and methionine. Vanadate treatment has proved to be encouraging in that it normalizes both function and hyperglycemia. Methyl palmoxirate, a fatty acid analog, normalized only the elevation of LCAC but did not affect function. Methionine and choline were only partially successful in preventing the functional alterations of diabetic rat hearts. The purpose of the present article is to review our understanding of diabetes-induced myocardial problems and their possible causes. Findings from our laboratory and others are described in which attempts have been made to normalize cardiac function.
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PMID:Diabetes-induced abnormalities in the myocardium. 293 41

The rate of birth abnormalities is 4-10 times higher in diabetic mothers than in the normal population. Mice embryos exposed to hyperglycemia increased developmental abnormalities (mostly before the 7th week of pregnancy) in linear fashion, while insulin treatment lowered them. The high level of glycosylated hemoglobin (HbAlC) during this period is associated with frequent abnormalities. In 116 diabetic women abnormal embryos were found in 22% of cases when HbAlC was 8.5%, while only 3% of the embryos were abnormal when HbAlC was 8.5%. Pregnant women whose diabetes was balanced from the 8th week of pregnancy had a 5.5% rate of abnormality compared to only .8% in those treated 3 months before pregnancy, and they also had fewer complications during pregnancy. The diabetic woman planning a pregnancy should have it earlier in life, get examined for nephropathy, retinopathy (treated by photocoagulation), hypertension, and ischemic heart disease. If these diseases are severe pregnancy is not advised. Before and during pregnancy sugar level must be checked 6-7 times a day and imbalance treated by insulin injections, or subdermal insulin pump in severe cases. Pregnancy is recommended only if the daily sugar balance is satisfactory, and the HbAlC value is less than 8%.
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PMID:[Pregnancy counseling in diabetic women]. 306 26

In order to determine whether low levels of high-density lipoprotein cholesterol (HDL-C), which are predictive of ischemic heart disease in the general population, can also predict death from ischemic heart disease among diabetic men, we contrasted lipoprotein and other heart disease risk factors in 62 men with non-insulin-dependent diabetes mellitus, 14 of whom died of ischemic heart disease during a 12-year follow-up period. Compared to all other diabetic men, those who died of ischemic heart disease were older, had higher levels of fasting plasma glucose (FPG) total plasma cholesterol, and triglycerides, lower HDL-C levels, and higher low-density lipoprotein cholesterol (LDL-C) levels and were more likely to have been cigarette smokers; only total cholesterol, LDL-C, and the LDL/HDL ratio were statistically significant. Age, FPG, total plasma cholesterol, and LDL-C were all independently predictive of fatal heart disease by multivariate analysis. Neither HDL-C nor the LDL/HDL ratio predicted ischemic heart disease death better than the total plasma cholesterol or LDL-C. The use of HDL-C, LDL-C, or total plasma cholesterol level in the model did not eliminate the significant association with FPG, which suggests that the noxious effect of hyperglycemia is independent of the changes in blood lipids.
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PMID:Lipoproteins as predictors of ischemic heart disease in non-insulin-dependent diabetic men. 345 58


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