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)

Implantable cardioverter defibrillators (ICD's) are effective for reducing mortality in refractory malignant ventricular arrhythmias (MVA). Second generation ICD's (Telectronics Guardian 4202/4203) were implanted in 7 patients (all male, mean age 58.1 years) with ventricular fibrillation (VF) in 2, ventricular tachycardia (VT) in 1, and both VF and VT in 4. Underlying heart disease was coronary artery disease in 4 patients, and valvular heart disease, dilated cardiomyopathy and no obvious cause (documented primary VF, reproducible at electrophysiologic study) in 1 patient each. Mean ejection fraction was 40 +/- 14%. Mean defibrillation threshold of the two epicardial patches at implantation by means of median sternotomy was 18 +/- 9 joule, and patch impedance 35 +/- 7 ohms. Post defibrillation bradypacing via epicardial electrode was programmed in 5 patients (70%). Mean follow-up was 10.1 months (1-25 months). Successful defibrillation of 28 spontaneous VT/VF episodes was noted in 2 patients, while the other 5 have had no further episodes of MVA so far. One device was explanted following tissue necrosis at the battery site after a MVA-recurrence-free interval of 15 months. The reconfirmation algorithm prevented false shock delivery in 2 patients.
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PMID:[Clinical experience with a second-generation cardioverter-defibrillator]. 195 43

This study examined the differences in mortality rate among the three ethnic groups aged 35 to 69: 1) Japanese living in Kawasaki city, 2) Koreans living in Kawasaki city, 3) Koreans living in Korea. Three different measures were used for analysis: 1) mortality rate by sex and age, 2) Mantel-Haenszel Rate Ratio (MHRR), 3) Standardized Proportional Mortality Ratio (SPMR). Major findings were as follows: 1) In terms of mortality rate by sex and age, Koreans in both Kawasaki and Korea showed higher mortality rates than Japanese in Kawasaki for both sexes and for all of the age categories. Koreans living in Kawasaki and Koreans living in Korea showed nearly identical levels of mortality rate for both sexes and for all of the age categories. 2) Calculation of MHRR utilizing a mortality rate for Japanese living in Kawasaki as 1 yielded the following: For all causes of death, MHRR of Korean males living in Kawasaki aged 35 to 59 was 2.59, and 2.37 for ages 60 to 69. For females MHRR for those age groups were 1.91 and 2.06 respectively. All of these MHRRs were statistically significantly high (p less than 0.05). 3) Among the causes for the high MHRR for Korean males living in Kawasaki aged 35 to 59 compared in Japanese living in Kawasaki were the following: all Malignant neoplasms (ICD 9, 140-208), Malignant neoplasm of liver (155), Hypertensive disease (401-405), Ischemic heart disease (410-414), Pneumonia (480-486), Liver Cirrhosis (571). For males aged 60 to 69, causes were Tuberculosis (010-018), all Malignant neoplasms, Malignant neoplasm of liver, Ischemic heart disease, Disease of the pulmonary circulation and other forms of heart disease (415-429), Cerebrovascular disease (430-438), and Liver Cirrhosis. In the case of females, Tuberculosis, Disease of the pulmonary circulation and other forms of heart disease, Malignant neoplasm of trachea, bronchus and lung were causes for high MHRR for Koreans in Kawasaki aged 35 to 59. All Malignant neoplasms, Malignant neoplasm of liver, Malignant neoplasm of trachea, bronchus and lung, Accidental causes of death except motor vehicle accidents (E800-807, E826-848, E850-949) were causes for females aged 60 to 69. 4) The mortality rates for ages 35 to 69 for both sexes are similar for both Koreans living in Kawasaki and in Korea.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A mortality study of middle-aged and elderly Koreans in Kawasaki City in comparison with Koreans in Korea and Japanese in Kawasaki City]. 213 81

In preparation for the 10th revision of the International Classification of Diseases (ICD-10), a two-part study was undertaken to assess the international comparability of the coding, by the 9th revision (ICD-9), of death certificates mentioning cancer, to see whether there had been improvement since the 8th revision (ICD-8). Part I repeated a 1978 study in which nine countries coded the same 1,234 United States death certificates mentioning cancer by ICD-9. The proportion of disagreements in coding the underlying cause of death fell about 35% between 1978 and the present study. This reduction was probably due to the new more detailed rules for coding cancer death certificates given in ICD-9. To combat the criticism of the possible bias associated with using United States death certificates only, in Part II of the study, each of seven countries submitted about 100 certificates translated into English which had posed problems in coding cancer. Discrepancies in assigning the underlying cause of death were found for 54% of these problem certificates. The major types of problems identified were coding when multiple cancer sites were mentioned on the death certificate, whether to select heart disease or cancer as the underlying cause of death, and the interpretation of the coding rules. Better rules for ICD-10 must be provided for both physicians and coders if international comparability of cancer mortality data is to be achieved.
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PMID:The international comparability of cancer mortality data. Results of an international death certificate study. 270 35

The association between an a priori measure of social connections and five-year mortality from all causes, cardiovascular diseases (International Classification of Diseases, Eighth Revision (ICD-8) codes 390-458), and ischemic heart disease (ICD-8 codes 410-414) was studied in 13,301 men and women from eastern Finland who were first interviewed in 1972 or 1977. For men, there was a graded association between extent of social connections and mortality. In multivariate models with adjustment for age, smoking, serum cholesterol, mean weighted blood pressure, measures of prevalent illness, and other possible confounders, men who were in the two lowest quintiles of the social connections scale were at increased risk compared with those in the highest quintile (odds ratio (OR)all cause = 1.54, 95% confidence interval (CI) = 1.21-1.95; ORcardiovascular disease = 1.54, 95% CI = 1.11-2.13; ORischemic heart disease = 1.34, 95% CI = 0.94-1.90). No strong or consistent association was found for women. The association for men was modified by levels of blood pressure with the effect of low social connections greater at higher levels of blood pressure. In three separate analyses, there was no evidence for confounding or effect modification due to prevalent illness at baseline.
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PMID:Social connections and mortality from all causes and from cardiovascular disease: prospective evidence from eastern Finland. 339 3

A proportionate mortality study of police and firefighters in New Jersey was conducted using the records of a comprehensive retirement system. Three reference populations were used: U.S. general population, New Jersey general population, and police as a reference group for the firefighters. Overall neither group differed from the New Jersey male population in the cause of death. Analyses by latency showed an increase in skin cancer and cirrhosis in firefighters and cirrhosis in police. With increased time from first employment, an inverse association was found between heart disease and time of first exposure. This was reflected in statistically significant increased proportionate mortality rates (PMR) for arteriosclerotic heart disease (ASHD) (ICD 410-414) for both working police (PMR = 1.15) and firefighters (PMR = 1.2). Retired police and firefighters had PMRs of 0.96 and 0.98, respectively. Firefighters had a significant increase in nonmalignant respiratory disease (PMR = 1.98) and leukemia (PMR = 2.76) when the police were used as a reference group. Potential causes of the above findings are discussed.
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PMID:Mortality in police and firefighters in New Jersey. 348 81

We dual coded 2,268 deaths due to heart disease occurring in Maryland, using the 8th and 9th revisions of the International Classification of Diseases (ICDA-8, Adapted for Use in the United States, and ICD-9). Certifier preference was for generalized cardiovascular terms rather than terms specific to the heart, resulting in an artifactual change in chronic ischemic heart disease death (IHD) rates in Maryland between 1978 and 1979 because the 8th and 9th ICD revisions classified these terms differently. Medical examiners were more likely to use these generalized cardiovascular terms as were physicians who went to certain medical schools in the state. The physician's terminology preference was associated with the sex and race of the decedent and was related to aspects of the patient's medical care. The ICD should be modified in the 10th revision to allow for the separate classification of generalized cardiovascular terminology within the ischemic heart disease category.
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PMID:The effect of physician terminology preference on coronary heart disease mortality: an artifact uncovered by the 9th revision ICD. 379 55

A study of vital statistics data from five Minneapolis-St. Paul winters indicates cardiovascular mortality is influenced by winter temperatures and snow. Although air temperature was not statistically implicated in triggering cardiovascular mortality in four of the five study winters, during the winter of 1976-77, about 15 per cent of the variance in daily cardiovascular mortality could be attributed to fluctuations in the daily minimum air temperature. Snow influenced mortality on the day of occurrence as well as the two days following a snowfall. There appear to be some differences in the ability of winter weather to influence mortality from acute myocardial infarction (ICD 410) and old myocardial infarction (ICD 412). The variance in daily ICD 410 mortality attributable to the influence of snow is somewhat less than that in daily ICD 412 mortality. The greatest variance in daily ICD 412 mortality that could be ascribed to snow occurred during the winter of 1974-75, and was 13 per cent. It is likely that rain intermixed with snow may also trigger increased mortality from cardiovascular disease. A combination of rain and snow can produce dramatic increased in mortality from ICD 410. Study of mortality data from five winters indicates that snow is somewhat more important in triggering deaths from heart disease than is air temperature.
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PMID:Winter weather and cardiovascular mortality in Minneapolis-St. Paul. 705 66

In published series of nonthoractomy ICDs, there has invariably been a need for combining transvenous lead(s) with a subcutaneous patch to obtain adequate DFTs. Since the newer generation transvenous lead ICD systems became available for clinical investigation, we have tested and implanted 38 such systems in patients with drug-refractory malignant ventricular arrhythmias who were first seen with aborted sudden death (n = 10), syncope (n = 3), or sustained ventricular tachycardia (n = 25). These patients (mean age 60 +/- 15 years) had coronary artery disease (n = 25), congenital heart disease (n = 1), or cardiomyopathy (n = 12) as the underlying heart disease and a mean left ventricular ejection fraction of 34% +/- 16%. Seventeen (45%) patients had previous cardiac surgery (coronary bypass and/or valve replacement). The transvenous lead system included the Endotak C (single) lead of CPI (n = 27) or the EnGuard double-lead system of Telectronics (n = 11). The integrated pace/sense/defibrillation lead(s) were usually introduced via the left cephalic vein; after endocardiac positioning and testing, the leads were tunneled to the abdominal pocket in which the ICD device was implanted. DFTs were adequate for all patients (100%) and averaged 13.5 +/- 5.4 J (range 2.4 to 25 J). A subcutaneous patch or array was needed in only three patients. Because of protocol requirements, a subcutaneous patch or electrode array was intraoperatively tested in another three patients but was finally not implanted because better DFTs were achieved with the transvenous lead-alone configuration. The leads were combined with second-generation devices in 12 patients and third-generation ICDs in 26 (68%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fully transvenous cardioverter defibrillators: rare need for subcutaneous patch with two newer-generation systems. 794 52

To assess the frequency of hospital encoded diagnoses of acute rheumatic fever (ARF) and Kawasaki disease (KD), the two leading causes of acquired heart disease in children in the United States, we performed a survey of the medical record departments of United States children's hospitals and of general hospitals that have at least 400 beds and a pediatric ward. With a simple questionnaire, data were gathered for the years 1984 through 1990 by ICD.9CM codes, with a 58% response rate. About 8000 diagnoses of KD and 6000 diagnoses of ARF were encoded during the study period. Encoded diagnoses of both KD and ARF showed yearly fluctuations in the earlier years (1984 through 1987). For KD there was a general trend toward increasing numbers after 1986. These data are consistent with increased physician awareness and diagnosis of KD. For ARF a gradual decline was observed between 1986 and 1990. About 80% of ARF diagnoses were reported from general hospitals. The much smaller pool of encoded diagnoses of ARF at the children's hospitals showed a 56% increase from 1985 to 1986. These data suggest that the highly publicized increase in cases of acute rheumatic fever in the United States during the mid-1980s may reflect focal rather than nationwide increased activity and that nationally the number of diagnoses of ARF actually may have continued to decline gradually from 1984 through 1990.
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PMID:Seven-year national survey of Kawasaki disease and acute rheumatic fever. 855 45

Despite recent therapeutic advances, SCD remains the leading cause of mortality in industralized nations. The most frequent cause of SCD is ventricular tachyarrhythmias in the setting of advanced structural heart disease due to chronic coronary heart disease or idiopathic dilated cardiomyopathy. Although high-risk groups can be prospectively identified, attempts at primary prevention have been largely unsuccessful. Effective treatment strategies for SCD survivors include antiarrhythmic drug therapy guided by programmed stimulation, endocardial resection, and ICDs. Device therapy has proven extremely effective in preventing recurrent sudden death from ventricular tachyarrhythmias. Widespread application of ICD therapy, perhaps even to include members of high-risk populations that have not experienced cardiac arrest, will depend on many factors including the demonstration that device therapy improves total mortality, not just arrhythmia-related mortality, reduction in cost, and improvements in the devices themselves. Some of the important characteristics of the optimal ICD of the future are nonthoracotomy lead placement; subpectoral generator placement; multiprogrammable, tiered therapy; improved diagnostic specificity, whether based on electrogram or hemodynamic-sensing algorithms; improved integration of brady- and tachy-sensing systems; and enhanced electrogram storage capability with trans-telephonic retrieval of electrogram recordings. The creation of this ideal ICD will obviously require continued technological advances; however, given the tremendous improvements realized over the first three generations of ICD systems, optimism for the future seems warranted.
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PMID:Future developments in implantable cardioverter defibrillators: the optimal device. 823 76


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