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

To assess the validity of the quantitative 201Tl scintimetry in various diseases of the heart (coronary heart disease with and without myocardial infarction, non-coronary cardiomyopathy, scleroderma heart disease and asymmetric septal hypertrophy with IHSS), the 201Tl myocardial uptake values for five standardized projections (a) were correlated with the grade of LAD stenosis, (b) the pattern of myocardial wall motion and (c) were compared with the 201Tl uptake values derived from normal patients. Significant reduction (c) of 201Tl myocardial uptake could in individual cases be evaluated in acute myocardial infarction (95%), in dys- and akinesia (90%), in hypokinesia (71%), in scleroderma heart disease (50%), in non-coronary cardiomyopathy (50%) as well as in normokinesia (28%) when associated with LAD stenosis. The mean values (b) of 201Tl uptake in normo- and hypokinesia significantly differed between these two groups and from those evaluated in dys- and akinesia. The latter group showed the lowest 201Tl uptake values computed which in some cases were very close to the mean mediastinal 201Tl uptake. The correlation (a) of individual 201Tl values demonstrated that 201Tl distribution in the myocardium is not only equivalent to myocardial ""perfusion'' but is corresponding with the myocardial function. In non-coronary cardiomyopathy reduced 201Tl values sometimes could not be separated from values in coronary heart disease (and myocardial infarction). A regional increase of myocardial mass as in septal hypertrophy correlated well with an augmented 201Tl uptake when referred to the 201Tl storage in the mediastinum.
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PMID:Evaluation of myocardial function with the 201thallium scintimetry in various diseases of the heart. A correlative study based on 100 patients. 14 51

Nine atrial pacing (SP) runs and 8 ventricular pacing (VP) runs were carried out in patients without heart disease, and 10 AP runs in patients with coronary artery disease (CAD). For evaluation of myocardial contractility, the time derivative of left ventricular pressure (dpdt) was used. Comparing rest and AP at 155/min, AP in normal patients revealed a significant increase in dP/dtmax and a significant decrease in left ventricular end-diastolic pressure (LVEDP). This represents frequency potentiation. When comparing rest and VP values at 155/min in normal patients, no changes in dP/dtmax and LVEDP were seen. AP in patients with CAD demonstrated no change in dP/dtmax, but a decrease in LVEDP when compared to the rest values. dP/dtmin and left ventricular systolic pressure did not change in the 3 groups. VP, and even AP, in 2 additional patients with isolated left bundle branch block (LBBB) AND WITHOUt associated heart disease, revealed the same constellation of parameters as VP in normal patients. Our results show a lack of frequency potentiation in normal patients during VP and in patients with isolated LBBB during both AP and VP. It is concluded that the lack of frequency potentiation during AP in CAD is produced primarily by mechanical asynchrony of contraction, angiographically demonstrated as akinesia and dyskinesia. The lack of frequency potentiation in normal patients during VP and in patients with isolated LBBB due to asynchrony of activation resulting in asynchrony of contraction.
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PMID:Mechanical and electrical causes for lack of frequency potentiation in normal patients, in coronary artery disease and in left bundle branch block. 108 Jan 9

Left ventricular volumes and contractile patterns were evaluated during the first sinus beat after a compensatory pause resulting from ventricular arrhythmia and were compared to the second sinus beat (control beat) in order to evaluate the effect of postextrasystolic potentiation. Twelve patients had no evidence of heart disease (group I). Fifty patients had coronary artery disease and included 14 patients (group IIa) with no prior myocardial infarction and a normal left ventricular contractile pattern and 19 pateints (group IIb) with an abnormal contractile pattern. Seventeen pateints (group IIc) had a documented transmural myocardial infarction as well as an abnormal left ventricular contractile pattern. In all patients the first postextrasystolic sinus beat, when compared to the second sinus beat, demonstrated increases in stroke volume and ejection fraction and decrease in end-systolic volume. There were no qualitative changes in the contractile pattern in the immediate postextrasystolic beat in the patients with normal left ventricular function. In both group IIb and group IIc the changes in end-systolic volume, stroke volume and ejection fraction were significantly greater than observed in groups I and IIa. Abnormal wall segments present in the control beat in groups IIb and IIc demonstrated after postextrasystolic potentiation a normal contractile pattern, improved pattern or no change when compared to the control beat. Abnormal wall segments were more likely to revert to normal as a result of postextrasystolic potentiation in group IIb than group IIc. Akinesia was less likely to revert completely to normal than hyposinesia. In 20 of 24 patients the changes in contractile pattern after aortocoronary bypass surgery corresponded to those observed as a result of postextrasystolic potentiation.
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PMID:Response of the left ventricle in coronary artery disease to postextrasystolic potentiation. 113 55

Quantifiable 201Tl scanning of the myocardium was performed in 23 patients with coronary heart disease and 10 without heart disease. Taking into consideration normal relative minimal storage of 201Tl in different regions of the myocardium (five projections), decreased 201Tl uptake in underperfused myocardium (acute myocardial infarction, coronary artery stenoses with hypo-, dys-, and akinesia) was recognizable according to extent and localisation (iso-impulse rate scan). The lowest relative 201Tl storage was found in dyskinesia or akinesia (37.6-54.1%) in the region of the anterior wall, as well as in acute myocardial infarction (50%). In the period after myocardial infarction persistence and normalisation of underperfusion could both be demonstrated. 201Tl scan as a non-invasive test is an appropriate means for demonstrating relative regional perfusion in the myocardium, with myocardial capacity for active uptake of potassium-like thallium being determined at the same time.
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PMID:[Results of 201thallium myocardial scanning in coronary heart disease (author's transl)]. 127 50

Thirty-one patients, mean age 54 years, had been on chronic ambulatory peritoneal dialysis (CAPD) for an average of 38 months. Mean values (mg/dl) for triglycerides (567), total-C (267), LDL-C (133), and Apo-B (154) were elevated, and HDL-C (30) were low. The low values for total-C/Apo-B and LDL-C/Apo-B suggest an increase in the number of low density lipoprotein (LDL) particles, rather than in the amount of cholesterol per LDL particle. Without knowledge of lipids, ischemic heart disease for the 31 patients was categorized into five grades in the following manner. All patients were graded based on history (angina, myocardial infarction, and bypass surgery), electrocardiogram (EKG), and echocardiography. In addition, five patients underwent coronary angiography, the results of which were considered in their grading. The five grades were assigned as follows: Grade I, no evidence (n = 15); Grade II, angina with EKG ischemia (n = 4); Grade III, myocardial infarction (MI) (n = 1); Grade IV, MI with dyskinesia-akinesia on echo (n = 4); Grade V, severe three vessel disease on angiography, or multiple infarcts, or Grade IV with heart failure (n = 7). Only Apo-B (r = 0.56) and total-C/HDL-C (r = 0.57) correlated with severity of grade, with p less than 0.001. When patients with and without detectable ischemic heart disease were compared by stepwise logistic regression, Apo-B was the only variable that independently predicted heart disease (p = 0.001). However, contribution of the lipid changes induced by CAPD has not been established.
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PMID:Ischemic heart disease, serum cholesterol, and apolipoproteins in CAPD. 175 Dec 58

A 37 year old man without coronary risk factors or known heart disease showed progression of Hodgkin's disease after radiation and multiple chemotherapy. One day after the first cycle of chemotherapy with methotrexate, Ifosfamide and etoposide, he had an acute myocardial ischemia. The creatinin-kinase was elevated up to 325 U/l. Coronary angiography showed a thrombus in the left anterior descending coronary artery (LAD), while the other coronary arteries were normal. Ventriculography showed an apical akinesia. After 7 days of treatment with heparin coronary angiogram was normalized, without any stenosis in the LAD. To our knowledge this is the first documented case of a coronary artery thrombosis and myocardial ischemia after chemotherapy in a patient without coronary heart disease. We conclude that chemotherapy can cause myocardial ischemia by coronary artery thrombosis in patients without prior heart disease.
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PMID:[Acute coronary thrombosis and myocardial ischemia following chemotherapy of Hodgkin's disease]. 220 11

To investigate and determine the local wall motion of normal right ventricles, biplane angiograms from 14 normal subjects were analyzed. In all patients, organic heart disease was excluded by angiography and right heart catheterization under exercise. Using a radial model, segmental systolic area shortening was determined for the anterior, anteroapical and inferior segment in the RAO-projection and the inferior, anteroapical and anterior (free wall) segment in the LAO-projection. The highest segmental shortening was found for the anterior wall in the RAO-projection (45.6 +/- 7.8%) and for the free wall in the LAO-projection with 42.7 +/- 11.3% (RAO: anteroapical 28.1 +/- 6.3%; inferior: 26.5 +/- 7.8%. LAO: anteroapical: 34.7 +/- 18.8%; inferior: 30.6 +/- 21.6%). Corresponding to these different segment shortenings, right ventricular contraction seems to have a disharmonic pattern in comparison to the left ventricle. Normal local wall motion of segmental area shortening was predicted by the means-2SD (95.5%) confidence interval. The confidence interval of the inferior (-12.6%) and anteroapical (-2.9%) segment in the LAO-projection was poor compared to the other segments (RAO: anterior 30.0%; anteroapical 15.5%; inferior: 10.9%; LAO: free wall: 20.1%). For the LAO-inferior and LAO-anteroapical segment, even akinesia was within the 95.5% confidence interval. In conclusion, quantification of local wall motion seems possible with reasonable confidence for RAO segments and the free wall in the LAO-projection only.
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PMID:[Quantitative segmental analysis of wall function of the right ventricle in probands with healthy hearts]. 336 87

Left cardiac catheterisation, selective coronarography and ventriculography were employed in a study of 89 patients with left bundle-branch block. Three subjects presented normal haemodynamic and cineangiographic data, 16 displayed valve defects, usually of the aorta, 34 had ischaemic heart disease, and 36 cardiomyopathy mostly of a congestive type. Deviation of the axis in excess of--30 degrees on the frontal plane appeared to be more frequently accompanied by ischaemia, though this finding was not prognostic from the haemodynamic standpoint. A prolonged QRS (over 0.15") was more frequent in valvular heart disease and accompanied by more evident left valve dysfunction. Comparison between the 34 ischaemic patients and 317 coronary patients without left bundle-branch block showed that the former has a higher frequency of leftness in the distribution of their coronary circulation, and more extensive impairment of the coronary arteries, especially the ramus interventricularis anterior. Changes in left ventricle kinetics and serious hypokinesia and/or akinesia appear to be due to the heart disease responsible of the block. The series examined did not make it clear whether this intraventricular conduction defect can cause albeit slight alterations in left ventricle wall motility.
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PMID:[Cineangiographic and hemodynamic evaluation of left bundle branch block]. 726 12

The determinations of stroke volume (SV) were used with the aid of different formulae in patients with the ischaemic heart disease with areas of akinesia of the left ventricle, and those with the acquired mitral and aortal valve disease, congestive cardiopathy and in healthy individuals. Tetrapolar rheography was used as control. The calculation of SV with echocardiogram of the left ventricle in patients with areas of akinesia of the left ventricle and valvular regurgitation gives unduly high figures. The same data have been obtained in determining the SV with echocardiogram of the mitral valve with relative insufficiency. The figures of SV calculated with the echocardiogram of the aortal valve in patients with the disease of the aortal valve are lower as compared to the rheographic data.
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PMID:[Various methods of determining left ventricular stroke volume by using echocardiography]. 731 Dec 98

Mitral regurgitation in patients with chronic ischemic cardiopathy may occur following dysfunction of the papillary muscles and left ventricular impairment. A total of 291 patients with significant coronary lesions and absence of associated cardiopathies are reviewed. Patients were divided into three groups: Group A, formed by 241 cases without mitral regurgitation; group B, including 42 patients with slight mitral regurgitation, and group C, formed by eight patients with moderate or severe mitral regurgitation. Significant differences between groups A and B in relation to the number of affected coronary arteries, inferior or anterolateral akinesia-dyskinesia, and left ventricular enlargement were observed. There were no significant differences between groups B and C, though all patients of the last group had two or three affected coronary arteries. Angiographic mitral regurgitation following chronic ischemic cardiopathy is uncommon, especially moderate or severe degrees of regurgitation. Mitral regurgitation is related to the number of affected coronary arteries, presence of inferior or anterolateral akinesia-dyskinesia, and enlargement of the left ventricle. Clinical signs of significant mitral regurgitation may suggest the existence of coronary lesions, at least in two vessels.
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PMID:[Angiographic mitral regurgitation in patients with chronic ischemic cardiopathy. Coronarioangiographic and ventriculographic correlations (author's transl)]. 739 6


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