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)

To evaluate the pulmonary extravascular space in patients with congenital heart disease, lung uptake of thallium-201 (T1-201) was quantitatively studied. A total of 50 T1-201 imagings were performed in 33 patients with total anomalous pulmonary venous connection (TAPVC); 4 preoperatively, 22 postoperatively in the early stage (within 6 months), and 24 in the late stage (7 months or later). The images consisted of 17 supracardiac TAPVC (type-I), 13 paracardiac (type-II) and 3 infracardiac (type-III). In patients with tetralogy of Fallot (T/F), T1-201 imaging was performed 15 times preoperatively, 12 in the early stage and 15 in the late stage, postoperatively. Furthermore, 29 patients with ventricular septal defect (VSD) or patent ductus arteriosus (PDA) were also studied preoperatively, and 21 in the late postoperative stage. Twenty-five patients with arrhythmias or a history of Kawasaki disease without perfusion defects were studied on T1-201 myocardial imaging. Lung uptake of T1-201 was analyzed with a computer using the anterior image of the chest, and the average count ratio of the right lung (P) to the left ventricular wall (LV) was calculated. P/LV values were compared between the patients before and after surgery, and differences in anatomical types in TAPVC were also evaluated. In TAPVC, P/LV values decreased gradually in the postoperative state, but were significantly higher than those of controls even in the late stage. In the late postoperative stage, type-I TAPVC had significantly higher P/LV values than those of type-II.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pulmonary uptake of thallium-201 in patients with congenital heart disease: comparison between total anomalous pulmonary venous connection and tetralogy of Fallot]. 133 7

This study describes the immunologic abnormalities during the acute phase of juvenile polyarteritis syndrome (JPS), a multisystem necrotizing vasculitis of young dogs with a predilection for the coronary arteries. JPS has striking clinical, laboratory, and pathologic similarities to Kawasaki disease (KD), the most common cause of acquired heart disease in children in the United States. The immunologic abnormalities include an increase in serum IgA, an increase in the percentage of peripheral B cells and a decrease in the percentage of total peripheral T cells, a marked suppression of the blastogenic response to mitogenic stimulation, an inability to generate immunoglobulin-secreting plasma cells following polyclonal activation, the presence of antineutrophil cytoplasmic antibodies, and evidence of monocyte/macrophage activation. These immunoregulatory abnormalities are similar to those observed in children during the acute phase of KD. This unique, naturally occurring animal model of necrotizing vasculitis may prove useful for investigating novel therapeutic interventions in the treatment of necrotizing vasculitis and may yield insight into the immunopathology and etiology of KD.
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PMID:Immunologic abnormalities in canine juvenile polyarteritis syndrome: a naturally occurring animal model of Kawasaki disease. 139 27

A great variety of problems referable to the cardiovascular system can prompt a visit to the pediatric emergency room. From the initial presentation of congenital heart disease, to the subsequent life-long management of these patients, to miscellaneous problems like Kawasaki disease and chest pain, the front-line pediatrician must be skilled in the recognition and early management of myriad complaints. This article focuses on information that can assist the emergency pediatrician in the evaluation and treatment of the cardiac patient from arrival in the emergency room until transfer of care to the pediatric cardiologist or inpatient staff.
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PMID:Cardiac issues in the pediatric emergency room. 152 24

Cardiomyopathy (Cm), a rare form of cardiac disease in infancy, is receiving increasing attention stimulated by the availability of endocardial biopsy and new forms of therapy. Population-based information on frequency of occurrence, types, and maternal and infant characteristics of this diverse group of heart muscle disorders has been obtained in the course of an etiologic study on cardiovascular disease in infancy. The Baltimore-Washington Infant Study (BWIS) enrolled 2659 infants with heart disease and 2801 control infants between January 1, 1981 and March 31, 1987, a 6-year prevalence of 4.46/1000 live births. Fifty-six infants had cardiomyopathy, in the absence of a structural defect (prevalence 1/10,000). The cases were classified clinicopathologically as follows: dilated Cm (n = 17), hypertrophic Cm (n = 26), tumor (n = 5), endocardial fibroelastosis (n = 5), glycogen storage (n = 1), mucocutaneous lymph node syndrome (n = 1), and infarction (n = 1). Eleven syndromic associations and six metabolic disturbances indicate genetic risk factors. Some of the same syndromes occurred in other infants who had structural cardiac abnormalities. This overlap suggests that embryonic myocardial disease might sometimes be responsible for altered cardiac structures, possibly secondary to hemodynamic changes. Familial myocardial disease occurred in two infants with hypertrophic Cm. The Cm group did not differ by race and sex from controls, but the mothers were of lower educational and occupational status with less private care and with later registration for pregnancy care. The descriptive epidemiology of this population-based case group provides evidence of greater etiologic heterogeneity than has been shown in clinical reports.
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PMID:Cardiomyopathy in infancy: observations in an epidemiologic study. 161 21

Endothelin (ET) is a potent vasoconstrictor peptide with an as yet uncertain physiological role in cardiovascular disease. We measured blood plasma ET concentrations using a recently developed radioimmunoassay and analysed the relations between ET concentration, systemic arterial pressure and systemic vascular resistance. In addition, ET levels before and after percutaneous balloon valvuloplasty and angioplasty were measured. Fifty-one patients were studied: (1) 13 patients with small left-to-right shunting or Kawasaki heart disease (age ranged from 4 to 144 months); (2) 10 patients who had undergone balloon valvuloplasty or angioplasty (age ranged from 1 to 233 months) and (3) 28 healthy infants and children (age ranged from 3 to 152 months). Systemic vascular resistance was calculated by the formula (mean aortic pressure--mean right atrial pressure) X 80/cardiac output (dyne.sec.cm-5). Plasma ET concentrations in healthy children less than 2 years were significantly higher than those over 2 years (2.48 +/- 0.62 vs 1.31 +/- 0.53 pg/ml). In eight patients in groups 1 and 2, plasma ET concentration in the pulmonary artery (2.00 +/- 0.43 pg/ml) was significantly lower than that in the femoral vein (2.39 +/- 0.69 pg/ml) and aorta (2.23 +/- 0.59 pg/ml), suggesting ET secretion derived from endothelial cells in peripheral pulmonary vessels. There was a significant positive correlation between ET concentrations in the femoral vein and systemic vascular resistance (r = 0.55, p less than 0.05). After balloon dilatation ET concentration rose from 2.15 +/- 0.82 pg/ml to 2.61 +/- 1.38 pg/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Plasma endothelin concentration: relation with vascular resistance and comparison before and after balloon dilatation procedures. 162 68

Kawasaki disease is now the most common cause of acquired heart disease in America's children. It is an acute febrile illness that may cause coronary artery aneurysm formation in infected children. The results of a multicenter, randomized trial on the effect of intravenous administration of gamma globulin (IVGG) plus aspirin versus aspirin alone upon coronary aneurysm formation show a decrease in coronary aneurysm formation from the usual 20%-30% to 3%. Administration of IVGG presents some unique challenges for nurses. Also, the pediatric nurse must educate parents and children about this disease to prepare them for discharge and long-term follow-up care.
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PMID:New hope for children with Kawasaki disease. 171 Jun 60

The coronary artery lesions in Kawasaki disease (KD) are thought to be a possible risk factor for atherosclerosis in the long term from the pathological point of view. Here we report results of a comparative control study to investigate the distensibility of the coronary artery in KD. A total of 146 patients were divided into 5 groups as follows. (I) Normal group (N); consisting of 44 patients with a known history of KD but with no coronary artery lesion. Among this group of patients those who each showed a regression in their coronary artery aneurysms were divided into 2 subgroups according to the time since onset of KD. (II) A group in the early stage after regression (ER); consisting of 18 patients with a known history of KD followed for 1.8 +/- 0.6 years. (III) A group in the later stage after regression (LR); consisting of 22 patients with a known history of KD followed for 9.4 +/- 2.8 years. (IV) an abnormal group (A); consisting of 21 patients followed for 7.9 +/- 4.0 years with a persistent aneurysm and/or stenosis in a coronary artery at the time of this study. And (V) a control group (C); consisting of 41 patients with a congenital heart disease such as a small ventricular septal defect or mild pulmonary stenosis or patent ductus arteriosus and no history of KD. In each case, the coronary artery diameter was measured by angiography before and after intracoronary infusion of isosorbide dinitrate (ISDN).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Coronary artery distensibility in Kawasaki disease--evaluation by intracoronary infusion of isosorbide dinitrate in long-term follow-up. 184 Nov 75

We review the major advances that have occurred in the diagnosis and treatment of cardiac diseases in children during the last four decades. During this period, most forms of congenital heart disease have become treatable by operation, and diagnosis has become possible through echocardiography alone. Operative mortality has dropped, and long-term follow-up shows excellent results in most patients. The incidence of rheumatic fever has declined, although it has increased recently in several areas of the United States. The occurrence of infective endocarditis and of myopericarditis has remained stable, while the recently described Kawasaki disease can affect the coronary arteries in children and appears to represent a new condition.
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PMID:Forty years of cardiac disease in children. Progress and problems--first of three parts. 194 32

In adult patients with atherosclerotic coronary artery disease and in pediatric patients with Kawasaki heart disease, characteristics of internal thoracic artery grafts (ITA grafts) used for coronary artery bypass grafting (CABG) were quantitatively assessed by postoperative angiography. In 142 adult patients with a ITA graft for the left anterior descending artery (LAD), the diameter ratio between ITA graft and recipient LAD at the point close to the anastomotic site (ITA/LAD diameter ratio) was determined by postoperative angiography. This ratio for the adult patients as a whole was 1.04 +/- 0.34. The multivariate analysis (Quantification I) was performed to assess the effects of the following 12 factors on the ITA/LAD diameter ratio: (1) age at the time of operation, (2) sex, (3) time-duration from the operation to angiography, (4) laterality of the ITA used, (5) presence of an undivided major side branch of the ITA graft, (6) presence of blood flow competition between the ITA graft and other grafts, (7) presence of distal stenosis of the recipient LAD, (8) severity of LAD stenosis after the operation, and (9-12) presence of hyperlipidemia, diabetes mellitus, hypertension, or smoking history. The standardized category scores of 25% LAD stenosis, 50% LAD stenosis, and blood flow competition between the ITA and other grafts were -0.815, -0.359, and -0.306, respectively. Insignificant stenosis of the recipient coronary artery was associated with reduction of the ITA/LAD diameter ratio, and this ratio strongly correlated with the severity of LAD stenosis (partial correlation coefficient: 0.627). However, no other factors significantly influenced on the ITA/LAD diameter ratio. In 15 pediatric patients, the length and diameter of 19 ITA grafts and 5 saphenous vein grafts (SVGs) which remained patent in the early (about one month) and late (14 +/- 4 months) postoperative period were determined. Only in the ITA graft, increases in graft length and diameter associated with patient growth were recognized. In the present study, the physiological characteristics of the ITA graft were demonstrated as a viable conduit with flow adaptability and growth potential.
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PMID:[A quantitative angiographic study of characteristics of internal thoracic artery grafts in coronary artery bypass surgery]. 205 Nov 1

We evaluated the validity of body surface mapping (MAP) in assessing noninvasively the degree of myocardial ischemia in patients with significant coronary arterial stenosis following Kawasaki disease. Delay of ventricular depolarization was examined by a departure map (DM) using mean QRS map, and the sensitivity of this method in detecting myocardial ischemia was evaluated based on the findings of coronary arteriography (CAG). The other noninvasive measures were also evaluated. MAP was obtained in 29 patients with significant coronary arterial stenotic lesions, including coronary occlusion, segmental stenosis and localized stenosis of 75% or greater. Mean QRS map was obtained based on MAPs in 41 children without organic heart disease and in 22 patients with significant stenotic lesions. The departure index (DIi) was calculated by subtracting potentials at each lead from those of the mean QRS maps and divided by the standard deviation. Departure area (Da) was defined as an area with DIi of -2 or less. Each MAP was subdivided into nine sections, and Da greater than or equal to one-eighth of the anterior wall section, Da greater than or equal to one-third of the posterior and inferior wall sections or Da greater than or equal to half of the other sections were regarded as ischemic areas. Sensitivity in detecting ischemia by MAP was assessed by the CAG findings, which was also compared to the sensitivity of the electrocardiograms (ECG), ECG with dipyridamole administration (Dp-ECG), vectorcardiograms (VCG), Holter ECG (Holter), treadmill test (TM), Master's double step test (MD), two-dimensional echocardiography (2DE) and thallium myocardial imaging (TMI).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diagnosis of myocardial ischemia in patients with a significant coronary arterial stenosis following Kawasaki disease]. 213 52


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