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)

Cardiac disorders associated with cerebral embolism including cardiac surgery, myocardial infarction, endocarditis and non-valvular atrial fibrillation (NVAF) are reviewed along with methods to detect cardioembolic sources. Warfarin and aspirin are effective in the primary prevention of stroke in NVAF but the relative efficacy remains to be determined.
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PMID:The cardiac factor in stroke. 162 36

Xamoterol, a new beta 1 partial agonist, has the potential to modulate cardiac response to variations in sympathetic tone in patients with heart failure. Its properties should result in beta-receptor stimulatory effects at low levels of sympathetic tone and beta-receptor protective effects at higher levels of sympathetic tone. The acute effects of intravenous (i.v.) xamoterol on hemodynamics at rest and during exercise were studied in 30 patients with mild to moderate heart failure (13 patients in New York Heart Association class II; 17 in class III) due to ischemic (n = 24) or cardiomyopathic (n = 6) heart disease. Cardiac index, stroke volume and stroke work index at rest were significantly improved after i.v. administration of xamoterol and consistent with net agonist effects. During exercise, heart rate and double product were significantly reduced (net antagonist effects), but with preservation of the expected increases in cardiac index and systolic blood pressure. These hemodynamic findings confirm the ability of xamoterol to modulate cardiac response to variations in sympathetic tone. Tachyphylaxis and arrhythmogenicity limit the chronic use of drugs with full beta-agonist properties as positive inotropes in heart failure. The patients were therefore entered into a 6-month double-blind, placebo-controlled, crossover study of chronic oral xamoterol therapy, 200 mg twice daily, and the hemodynamic responses to i.v. xamoterol were repeated at the end of the trial. No impairment in either resting or exercise effects was observed, indicative of a maintained response and absence of tachyphylaxis after chronic therapy. Furthermore, 24-hour ambulatory electrocardiographic monitoring showed no change in ventricular arrhythmias during oral treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Acute and chronic hemodynamic effects of xamoterol in mild to moderate congestive heart failure. 167 87

1. The cardiovascular effects of the proprietary cold remedies, Mu-cron and Boots Cold Relief tablets were compared with 'placebo' Boots Pain Relief tablets in a double-blind study involving 16 healthy volunteers. Measurements (impedance cardiography, forearm plethysmography) were made over 4 h after oral drug administration. 2. Two Mu-cron tablets (containing phenylpropanolamine [(1R,2S)- plus (1S,2R)-norephedrine] 50 mg) increased blood pressure (maximal effect 18 +/- 1/8 +/- 1 mm Hg (mean +/- s.e. mean), P less than 0.001), stroke volume (4.9 +/- 0.8 ml m-2, P less than 0.05), total peripheral resistance (243 +/- 27 dyn s cm-5 m2, P less than 0.001) and forearm vascular resistance (1.3 +/- 0.3 mm Hg ml-1 min, P less than 0.01) and reduced the ratio of pre-ejection period to ventricular ejection time (-0.031 +/- 0.003, P less than 0.05) and forearm blood flow (-2.6 +/- 0.5 ml min-1, P less than 0.05) but did not affect heart rate or cardiac index. 3. Two Boots Cold Relief tablets (containing phenylephrine 10 mg and caffeine 60 mg) caused a small and short-lived increase in total peripheral resistance but did not have consistent effects on other measurements. Two Boots Pain Relief tablets (containing caffeine 60 mg) did not have important cardiovascular effects. 4. The cardiovascular effects of phenylpropanolamine, including vasoconstriction and an increase in cardiac performance, are consistent with its alpha- and beta 1-adrenoceptor agonist action. While it may help the symptoms of rhinitis, its use in patients with heart disease or hypertension is hazardous.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A comparison of the cardiovascular effects of phenylpropanolamine and phenylephrine containing proprietary cold remedies. 172 92

During 1989, 2,150,466 deaths were registered in the United States--17,533 fewer deaths than the record-high number recorded in 1988. In 1989, as for at least the past 20 years, nearly three fourths of deaths were attributable to the first four leading causes of death--heart disease, cancer, stroke, and unintentional injury. This report summarizes mortality data compiled by CDC's National Center for Health Statistics (NCHS) for 1989 (1) and compares patterns with 1988.
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PMID:Mortality patterns--United States, 1989. 173 89

Patients with heart disease may have myocardial ischemia or left ventricular (LV) dysfunction without symptoms. The exercise responses of 14 asymptomatic patients with valvular aortic stenosis (AS) were studied using treadmill testing, thallium-201 scintigraphy and radionuclide angiography. Compared with age- and gender-matched control subjects, patients with AS demonstrated reduced exercise tolerance (10.7 +/- 2.5 vs 13.3 +/- 4.2 min; p = 0.06) and maximal oxygen consumption (26.7 +/- 6.3 vs 36.3 +/- 9.5 ml O2/min/kg; p = 0.004) associated with decreased peak systolic blood pressure response to exercise (177 +/- 18 vs 214 +/- 42 mm Hg; p less than 0.004). Ten of 14 patients developed ST-segment depression during exercise, only 3 of whom had reversible thallium defects. Patients with AS tended to have greater LV ejection fractions at rest (65 +/- 11 vs 58 +/- 7; p = 0.08) and significantly decreased early peak filling rates (4.8 +/- 1.3 vs 6.1 +/- 0.6 stroke volume/s; p = 0.003) compared with those of control subjects. During maximal supine exercise, patients with AS had less of an increase in ejection fraction (2 +/- 9 vs 15 +/- 7%; p less than 0.001) associated with a decrease in end-diastolic (-7 +/- 15 vs +5 +/- 16%; p = 0.06) and stroke (-6 +/- 17 vs +30 +/- 13%; p less than 0.001) volumes from baseline measurements.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Systemic and left ventricular responses to exercise stress in asymptomatic patients with valvular aortic stenosis. 174 29

Thrombus formation in the left atrium and left ventricle is primarily due to stasis of blood which causes activation of the coagulation system. Migration of thrombotic material into the circulation depends on the dynamic forces of the circulation. Atrial fibrillation is the commonest underlying cardiac disorder predisposing to thromboembolism. Rheumatic mitral stenosis, left atrial enlargement, prior myocardial infarction, hypertension, and echocardiographic left ventricular hypertrophy are risk factors for thromboembolic stroke in elderly patients with chronic atrial fibrillation. Non-valvular atrial fibrillation accounts for 45% of cardiac sources of thromboembolic stroke and includes patients with ischemic heart disease, hypertension, thyrotoxic heart disease, hypertrophic cardiomyopathy, chronic sinoatrial disorder, and idiopathic atrial fibrillation. 15% of cardiac sources of thromboembolic stroke are associated with acute myocardial infarction, 10% with left ventricular aneurysm and mural thrombi remote from an acute myocardial infarction, 10% with rheumatic valvular heart disease, and 10% with prosthetic cardiac valves. Mitral valve prolapse, mitral annular calcium, nonischemic cardiomyopathies, infective endocarditis, nonbacterial thrombotic endocarditis, left atrial myxoma, paradoxical embolism associated with congenital heart disease, calcific aortic stenosis, and complex atherosclerotic plaque within the proximal aorta also contribute to thromboembolism.
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PMID:Etiology and pathogenesis of thromboembolism. 176 43

Between March 1982 and March 1991, 225 heart transplantations (HTx) have been performed in 220 patients suffering end stage cardiac disease. Thirteen percent were females and 87% were males. Age range was from 5 to 68 years. The underlying cardiac disease was ischemic cardiopathy in 51.5%, congestive dilated cardiomyopathy in 42%, valvular cardiomyopathy in 3.5%, toxic myocarditis (post-adriamycin) in 1.5% and chronic rejection in 2.5% (retransplantation). Selection of the recipients was done following the currently well established criteria also taking into account the absolute major contraindications for HTx. Due to the still increasing demand of donor organs, currently donor age has been extended up to 50 years for male and 55 years for female donors. One quarter of the grafts were harvested on site in our institution, two other quarters were harvested somewhere else in Belgium and the last quarter provided by other countries cooperating with Eurotransplant. All patients have undergone orthotopic cardiac transplantation using the standard Lower and Shumway technique. Immunosuppression protocols have changed four times throughout the years. Nevertheless all were based on the use of Ciclosporine variously combined with other current immunosuppressive drugs. Rejection monitoring relied on routine endocardiac biopsy and was diagnosed according to the Billingham criteria. The in-hospital mortality is currently 11%. Infection, early right heart graft failure and acute rejection were the leading causes of death. The major causes of early morbidity were several curable infections, reversible rejection episodes, transient acute renal failure and controllable arterial hypertension. Among the survivors followed for at least one month up to nine years, half of late mortality was caused by chronic rejection followed by infection, sudden death, metabolic disorders, stroke and malignancy. Late morbidity involves cases of mild coronary graft diseases, biological renal insufficiency, some degree of arterial hypertension, dislipidemia. Current actuarial survival rate is 87% at one year, 76% at 5 years up to 9 years. Our experience confirms that HTx represents today and effective therapy for selected patients suffering end stage cardiac disease.
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PMID:A survey of nine years heart transplantation at Erasme Hospital, University of Brussels. 178 50

A retrospective study of 194 patients is carried out. Patients were divided into two groups: 154 patients with acute cerebrovascular accident (ACA) and 40 patients without vascular pathology, hospitalized for other causes. A descriptive analysis of these patients is made with respect to age, sex, type of ACA, previous ACA and potential relationship between the type of this first ACA and the one motivating current hospitalization. In addition, ACA is related to risk factors (hypertension, dyslipemia, diabetes, cardiopathy). In our series, variables that can be considered as risk factors, with significant differences between both groups, are: HTA, tobacco consumption, cardiopathy, dyslipemia (hypercholesterolemia and hypertriglycemia, hyperuricemia and diabetes. Alcoholism, anticoagulation, antiaggregation or polyglobulia were not risk factors. In 33.2% of patients with current ACAs, there were antecedent of clinically documented cerebrovascular pathology; one thing of them were transitory cerebral ischemias and more than half of them, cerebral infarcts. In conclusion, we stressed the role of primary and secondary prevention acting against risk factors, given the recurrence of this pathology and the irreversibility of the injuries once happened.
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PMID:[Cerebrovascular accident: study of risk factors and development in 154 cases]. 179 Feb 78

The study concerned 206 diabetic patients, aged 35-54 years, from the urban Kragujevac area. Of this number 40.3 per cent had macrovascular disease, including vascular heart disease (34.9%), diseased leg blood vessels (12.1%) and cerebral stroke (2.4%). According to the results of discriminative analysis of potential risk factors (age, sex, body weight index, cigarette smoking, systolic and diastolic blood pressure, glycemia, triglycerides, lipoproteins, total cholesterol, HDL and LDL cholesterol, onset and duration of diabetes, family history) diabetic patients with macrovascular disease and patients with vascular heart disease predominated in female population with early onset of diabetes and high level of diastolic blood pressure.
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PMID:[Microvascular disease in diabetics--discrimination analysis of risk factors]. 179 79

58% of currently married women in Japan were current users of contraception in 1990. The condom was the most popular method, with a use rate of 43%, followed by natural family planning methods (9%). The unusual popularity of the condom is, in part, explained by the nonavailability of oral contraceptives (OCs); the pill is illegal in Japan because of government concerns about its side effects. However, the Ministry of Health has given Japanese pharmaceutical companies permission to develop a low-dose OC assumed to lower the risks of hypertension, stroke, and heart disease that should become available soon. In anticipation of this move, the 1986 and 1990 National Surveys on Family Planning asked respondents their views on OC legalization and whether they would become acceptors. 10% of women in both surveys indicated they intended to use the pill and another third were uncertain. Intention to use the pill was related to recognition of its high effectiveness and a desire to reduce the need for abortion. 29% of respondents in the 1990 survey reported a least 1 abortion, and 25% had been using contraception at the time their last pregnancy occurred. Logit regression revealed that intent to seek abortion in the event of another pregnancy and joint family type were the only factors, after adjustment, significantly associated with planned OC use; age, educational level, and employment status were not significant. The surveys further revealed a need to reassure Japanese women about the pill's safety if acceptance rated exceeding 10% are to be achieved. 13% of 1986 respondents and 21% of those interviewed in 1990 stated opposition to legalization of the pill and 48% in both surveys were uncertain. 77% of women in the 1986 survey and 70% of those in 1990 cited concerns about pill safety as a reason for their opposition.
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PMID:Prospects for increased contraceptive pill use in Japan. 179 77


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