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

In a prospective study of neurological complications of coronary bypass surgery, detailed pre- and post-operative bedside ophthalmological evaluation was undertaken in 312 patients. Post-operative neuro-ophthalmological complications developed in 80/312 (25.6%) patients and included: areas of retinal infarction (17.3%); retinal emboli (2.6%); visual field defects (2.6%); reduction of visual acuity (4.5%) and Horner's syndrome (1.3%). Neuro-ophthalmological complications were not observed in a control group of 50 patients undergoing major peripheral vascular surgery. Ten of 75 patients reviewed at 6 months still had detectable neuro-ophthalmological abnormalities, but functional disability occurred only in those with persistent visual field defects. Multivariate analysis revealed that extra-coronary vascular disease, severe and prolonged duration of heart disease prior to operation, and large drop in haemoglobin level during surgery may predispose to neuro-ophthalmological complications.
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PMID:Neuro-ophthalmological complications of coronary artery bypass graft surgery. 349 86

A 4-year follow-up study was carried out on the prognosis of 54 patients (36 men and 18 women) who survived their first ischaemic brain infarction which had occurred under the age of 65. Twenty patients (15 men and 5 women) already had documented atherosclerotic vascular disease other than ischaemic brain infarction at the time of the hospital admission (atherosclerotic group). When both sexes were considered together, mortality during the 4-year follow-up was significantly higher in the atherosclerotic group than in the non-atherosclerotic group (6/20 versus 3/34; p less than 0.05) and this was due to an excess of cerebrovascular mortality (4/20 versus 0/34; p less than 0.05). The incidence of recurrent fatal or non-fatal ischaemic brain infarction was significantly higher in the atherosclerotic group than in the non-atherosclerotic group (8/20 versus 3/34; p less than 0.01). Among those patients who survived the 4-year follow-up period the incidence of new non-fatal atherosclerotic vascular events (cerebrovascular accident, myocardial infarction, other heart disease or intermittent claudication) was significantly higher in the atherosclerotic group than in the non-atherosclerotic group (8/14 versus 8/31; p less than 0.05). It is concluded, that the presence of atherosclerotic vascular disease at the time of first ischaemic brain infarction in patients under the age of 65 is associated with a significantly increased risk for recurrent ischaemic brain infarction or other new atherosclerotic vascular events.
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PMID:Four-year prognosis of patients under the age of 65 surviving their first ischaemic brain infarction. 371 78

The goal of banding the pulmonary artery (PA) in children with complex heart disease is to reduce PA pressure and blood flow, relieve symptoms of circulatory congestion, and insure low pulmonary vascular resistance for future repair. To assess the hypothesis that two-dimensional echocardiography (E) measurements could be used to predict noninvasively the tightness of the PA band by measuring its diameter, we examined 15 patients with PA band. Of the 12 patients who underwent cardiac catheterization, nine with no symptoms of circulatory congestion had distal systolic PA pressure less than 0.5 systemic, and three symptomatic patients had distal PA pressure of more than 0.5 systemic. None had left ventricular outflow tract obstruction or pulmonary vascular disease. The E measurements were the internal diameter of the PA band (d), and PA annulus (D) in diastole. The d/D ratios correlated significantly with the ratios of measured distal to proximal PA systolic pressure (r = 0.98, P less than 0.001). Of the three patients not catheterized, one had a d/D ratio of less than or equal to 0.4 and two greater than 0.4. The former one had an excellent clinical improvement after banding, while the latter two remained in circulatory congestion. Doppler echocardiographic evaluation in five patients did not improve upon the data from the d/D ratios.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Two-dimensional echocardiographic assessment of adequacy of pulmonary artery banding. 372 27

This review of atherosclerotic risk factors in cardiovascular disease concentrates on those aspects of lipid and carbohydrate metabolism that may be associated with atherogenesis and that may be altered by ingestion of oral contraceptive (OC) agents. Atherogenesis is facilitated by 1 or more of at least 3 conditions: elevated low-density lipoprotein (LDL) levels, elevated intermediate-density lipoprotein (IDL) levels (which are remnants of very-low-density lipoprotein level catabolism), and increased quantities of the breakdown products of chylomicron metabolism (chylomicron remnants) and decreased high-density lipoprotein (HDL) levels. Over the year, considerable evidence has linked atherosclerosis, particularly that occurring in the coronary vessels, to elevated levels of both dietary and blood cholesterol. Since LDL is the major carrier of cholesterol in the plasma, it comes as no surprise that there is a strong relationship between elevated plasma LDL levels and coronary vascular disease. Low levels of HDL also are predictive of coronary vascular disease. Moreover, low HDL levels are increasingly associated with atherosclerosis in the cerebral and peripheral blood vessels, while total and LDL cholesterol levels are not as predictive of such disease. It has been reasonably well established that lipid abnormalities are associated with atherogenesis in the laboratory and with clinical vascular disease in patients. It has been more difficult to demonstrate that atherosclerosis can be prevented or reversed by treatment of such disorders. Yet, considerable evidence supports that point of view. Many questions remain concerning the relationship of atherogenesis and abnormalities of lipoprotein metabolism. The relationship between diabetes and atherosclerosis is even less well understood. There is little question that diabetics are at increased risk of developing atherosclerosis. In fact, atherosclerosis may be more prominent in diabetic women. Regarding OCs, several general points need to be made before discussing the effects of OCs on atherosclerotic risk factors: OCs may have effects on other metabolic parameters that have not been identified as prominent risk facts in atherogenesis; in some cases OCs appear to enhance the effects of other risk factors in ways that are not totally understood; and OCs may profoundly affect the metabolism of lipoproteins and glucose in ways that enhance atherogenesis. Women who use OCs must be carefully counseled about the interplay of such agents and other atherosclerotic risk factors. The decision to place a woman with 1 or more prominent atherosclerotic risk factors on OCs should be a careful one. Risk factors, particularly levels of total and HDL cholesterol, blood glucose, blood pressure, and smoking status, should be ascertained before prescribing OCs, particularly in women with family histories of heart disease.
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PMID:Atherosclerotic risk factors in cardiovascular disease. 377 10

Lung biopsy specimens from 10 consecutive cases of congenital heart disease and pulmonary hypertension (2 months-6.5 years) were examined by light and electron microscopy. By light microscopy, 8 cases showed a reduction in number of patent alveolar wall arteries associated with the structural features of early pulmonary vascular disease-extension of muscle, a significant increase in pulmonary arterial medial thickness (P less than 0.001) and little if any intimal proliferation (Heath & Edwards Grade I or II). In one additional child with Grade IV disease, arterial number could not be determined accurately. For all 10 cases, all blocks of tissue examined by light and electronmicroscopy showed absence of any lumen in structures identified as alveolar wall arteries by their position, shape and the presence of an external (or single) elastic lamina. In 3 additional similar cases, endothelial cells of narrowed and occluded arteries were marked by labelling with the lectin Ulex europaeus. Occluded arteries were identified consisting of mature smooth muscle cells and remnants of degenerating endothelial cells. Occlusion of alveolar wall arteries appears to be an early event in the development of pulmonary vascular disease, is associated with differentiation of smooth muscle cells in normally thin walled precapillary arteries and precedes significant obliterative intimal changes in more proximal vessels.
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PMID:Occlusion of intra-acinar pulmonary arteries in pulmonary hypertensive congenital heart disease. 379 78

Pulmonary wedge angiograms have been shown to reflect the severity of pulmonary vascular disease in congenital heart disease. Thirteen pulmonary wedge angiograms with a balloon occlusion catheter were performed in 11 adult patients (five normals and six with primary pulmonary hypertension [PPH]) and their features related to the resting pulmonary artery pressure (PAP). Individual cine frames from each study were selected and digitized with a computer-assisted operator-interactive program. By fitting densitometric profiles from the vessel segments, serial arterial cross-sectional diameters were calculated from mathematically derived points. There was a strong correlation between arterial taper (T, change in vessel caliber per unit axial length) and a power function of mean PAP with T = 0.304 X PAP-0.59, R = .91, P less than .001. These results demonstrate a correlation between an angiographically derived morphologic characteristic of the pulmonary vasculature (taper) and a hemodynamic parameter (PAP) in PPH. This offers a method to follow the course of the disease and the effects of drug therapy by assessing anatomic changes in the vessels.
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PMID:Automated morphologic evaluation of pulmonary arteries in primary pulmonary hypertension. 380 57

For evaluation of pulmonary vascular disease 140 open lung biopsies were performed in 137 patients with congenital heart disease in order to decide whether the state of the lung vessels would allow corrective surgery. As far as possible follow-up was obtained in patients who underwent a cardiac repair. From the study of these biopsy specimens it appeared that medial hypertrophy of pulmonary arteries and changes in pulmonary veins should not be considered an impediment for a corrective operation as long as more advanced changes are absent. The same is true for intimal thickening due to longitudinal smooth muscle, post-thrombotic changes or cellular proliferation. Concentric-laminar intimal fibrosis forms no contra-indication as long as it is mild but, if severe, it is likely that hypertensive pulmonary vascular disease will progress in spite of cardiac repair. In the presence of fibrinoid necrosis or plexiform lesions correction of a cardiac anomaly should not be attempted. The presence of dilatation lesions is more disputable but probably, as long as they are scarce and not accompanied by fibrinoid necrosis or plexiform lesions, corrective surgery may be attempted. This becomes very dubious when they are more numerous.
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PMID:Open lung biopsies in congenital heart disease for evaluation of pulmonary vascular disease. Predictive value with regard to corrective operability. 400 87

We have developed real-time two-dimensional Doppler echocardiography, which can display color flow mapping on a two-dimensional echocardiogram. Intraoperative two-dimensional Doppler echocardiography was performed during cardiovascular operations before and after the definitive procedure in 33 patients, 14 with valvular disease, eight with congenital heart disease, and 11 with vascular disease. Its clinical usefulness was evaluated. In patients with valvular heart disease, 13 valve replacements, 10 valvuloplasties, and four untouched lesions were assessed. No paravalvular leakage and three instances of minimal physiological transvalvular leakage from St. Jude Medical valves in the mitral position were noticed. Regurgitation after valvuloplasty was graded by extent of the regurgitant flow. This grading, comparable to postoperative grading, indicated no need for an additional procedure. In congenital heart disease, preoperative diagnoses were confirmed. The effect of the corrective operation was evaluated and no significant leakage or stenosis was found. Interatrial shunt flow was shown to increase after operative balloon atrial septostomy in a patient with dextro-transposition of the great arteries. In 11 patients with dissecting aortic aneurysm, the aneurysm was totally visualized in the operative field, including the structure and flow dynamics. In two patients, the preoperative cineangiographic diagnosis regarding involvement of dissection was corrected. After the vascular procedure, sufficient flow in the major aortic branches was confirmed in all patients and minimal leakage at the suture line was noticed in four patients. In conclusion, intraoperative color flow mapping by two-dimensional Doppler echocardiography has enabled the precise diagnosis and the necessary operation to be determined before cardiopulmonary bypass. It has also allowed the effects of the operation to be assessed before chest closure.
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PMID:Intraoperative color flow mapping by real-time two-dimensional Doppler echocardiography for evaluation of valvular and congenital heart disease and vascular disease. 406 30

Relative rates of proportionate mortality from cancer of six sites based on total cancer deaths and the proportions expected in all towns, and from four types of cardiovascular disease based on total deaths from all causes, have been related in the 80 county boroughs of England and Wales to the sources of water supply and to the average hardness of water in the towns. The sources of water, from upland surfaces, artesian wells and rivers, were classified in eight groups, and significant associations were found for cancers of the stomach, oesophagus, prostate, male bladder and female breast, and for hypertensive and chronic rheumatic heart disease. No associations were apparent with intestinal cancer, vascular disease of the nervous system or arteriosclerotic heart disease. Hardness or softness of the water was classified in seven groups and significant associations were found for the same diseases as for source of water, none being evident for coronary disease.
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PMID:Mortality from cancer and cardiovascular diseases in the county boroughs of England and Wales classified according to the sources and hardness of their water supplies, 1958-1967. 451 76

Mortality data for cerebral vascular disease in Canada and its provinces were analysed as an initial approach to the understanding of the epidemiology of this disease. Since 1950, there has been a decline in mortality attributed to vascular lesions of the central nervous system. This decline has been more pronounced in females. Five-year average age-sex-specific rates (1960-64) showed an almost constant proportional increase with age. The highest mortality rates tended to occur in the Eastern Provinces.From 1950 to 1964 there was a 21% decline in mortality due to intracranial hemorrhage and a concomitant 53% decline in mortality attributed to hypertensive disease. Over the same period there was a 24% increase in mortality attributed to cerebral embolism and thrombosis, and an 8% increase in mortality due to arteriosclerotic heart disease. Areal correlations offered only inconsistent support for the hypothesis that these associated trends are due to common etiologic determinants.Evidence presently available does little to clarify to what extent these trends and differences can be attributed to coding, certification and diagnostic practices, and to what extent to changing and differing incidence and prognosis.
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PMID:The epidemiology of cerebral vascular disease in Canada: an analysis of mortality data. 592 46


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