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)

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

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

The incidence of angina pectoris was investigated and the treadmill test was carried out to assess the presence of myocardial ischemia and heart pump function in 238 patients suffering from mitral and aortal heart disease. Comparison with the coronarography readings has demonstrated that the diagnostic value of the painful syndrome in the health status and anamnesis does not exceed 24%. The appearance of an angina pectoris attack in combination with ischemic alterations on the ECG raised the diagnostic value up to 50%. The authors have distinguished a symptom-complex including the development of angina pectoris, appearance of the ischemic signs on the ECG with the integrity of heart pump function, increasing the diagnostic value of the test up to 83-100%. The integrity or insufficiency of heart pump function were shown to allow differentiation between atherosclerotic and relative coronary insufficiency. The conclusion is drawn about the necessity of carrying out the treadmill test according to the program in patients suffering from heart disease with suspected coronary insufficiency.
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PMID:[The diagnosis of coronary failure in patients with aortic and mitral valve defects]. 175 2

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

To investigate the predictive value of nonsustained ventricular tachycardia (NSVT) for sudden cardiac death (SCD), 104 patients (37 cases with myocardial disease, 17 with ischemic heart disease, 10 with hypertension, 5 with valvular heart disease, 5 with miscellaneous heart disease and 31 without heart disease) who had NSVT on 24-hour ambulatory electrocardiograms (DCG) were clinically followed. The first survey was performed when mean follow-up period reached to 26 months from the discovery of NSVT and the second one was done 60 months after the first survey. Seven SCD were found during 1st period and 4 additional SCD occurred during 2nd period. The patients with polymorphic NSVT showed more frequent SCD (6 in 11 cases with polymorphic NSVT) than with monomorphic NSVT (5 in 93 cases with monomorphic NSVT), however, the rate of VT, duration and number of episodes recorded on DCG were independent to SCD. Moreover, none of the patients without structural cardiac disease have died suddenly. In this follow-up study, SCD was occurred most frequently in the cases with cardiomyopathy, especially dilated type.
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PMID:[A predictive value of ventricular tachycardia detected by long-term electrocardiography for sudden cardiac death]. 178 50

In 1985, the cardiovascular Section of the Society of Surgery decided to start a registry of cardiac surgery procedures. Since then, basic data on surgical treatment of patients with heart disease have been collected each year. The following conclusions have been drawn from the data available: 1. The situation in cardiac surgery in Czechoslovakia is catastrophic. Czechoslovakia ranks among nations with the lowest numbers of operations per population in Europe. The most critical situation exists in IHD. 2. The standard of care provided to patients in individual areas of Czechoslovakia is about the same. 3. The critical lack of funds led to a decrease in the number of operations performed in 1990. 4. Organization of health care is poor, as indicated by length of hospital stay longer than that in the industrialized nations. 5. It is crucial to allocate more money to departments of cardiac surgery.
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PMID:[Heart surgery in Czechoslovakia]. 179 42

The authors used programmed ventricular stimulation in 38 patients who had during Holter monitoring severe ventricular arrhythmias (greater than or equal to Lown 4a). The group comprised patients with IHD (22x), hypertrophic (11x) and dilatating cardiomyopathy (2x). Three patients had no organic heart disease. Nine patients were treated at the time of examination with antiarrhythmic drugs. In a total of 16 patients it proved possible to provoke ventricular tachycardia (VT)--four times permanent ventricular tachycardia, 12x transient ventricular tachycardia (NSVT). In the group of treated patients SVT was provoked twice and NSVT also twice, always in patients who took amiodarone. Using programmed ventricular stimulation the following antiarrhythmic drugs were tested: mexiletine, cordarone, ajmaline. The capacity of all tested antiarrhythmics in the prevention of VT was comparable. A total of two patients died during the investigation, in both cases a sudden death. One suffered from hypertrophic cardiomyopathy, one from IHD. In both on Holter monitoring NSVT episodes were revealed. Programmed stimulation provoked in both SVT, both were treated at the time of death with tested antiarrhythmics. The authors conclude that programmed ventricular stimulation is a suitable method for rationalization of antiarrhythmic treatment, the clinical results, however, do not correspond to laboratory results. They recommend therefore to use also Holter monitoring of patients at risk.
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PMID:[Determination of anti-arrhythmia therapy of ventricular arrhythmias based on programmed ventricular stimulation]. 179 55

To assess if the presence of false tendons (FT) in the left ventricle can be an independent factor increasing the risk of ventricular arrhythmias in apparently healthy subjects, we examined 38 persons aged 18-60 years in whom during echocardiographic examination we accidently found FT in the left ventricle. No other echocardiographic disorders were present. Physical examination, ECG and stress ECG showed no symptoms of heart disease. The only ischaemic heart disease risk factor was smoking in 20 persons (in 6--more then 20 cigarettes daily). 24-hours Holter monitoring revealed single supraventricular complexes in 9 persons (34.7%). We found ventricular arrhythmias in 6 persons (15.8%): 4 (10.5%) had single, unifocal ventricular complexes, 1 (2.6%) had more (up to 6 in one minute) ventricular complexes, and 1 (2.6%) had some ventricular couplets. We observed no ventricular arrhythmias in stress ECG. We conclude, that in apparently healthy subjects with FT the frequency of ventricular arrhythmias is not higher, then in the normal healthy population.
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PMID:[False tendons in the left ventricle--an independent arrhythmogenic factor?]. 180 Aug 25

Research of the relevant international literature on HLA studies in patients with hypertrophic cardiomyopathy yielded controversial results. There are no studies, conducted in sufficiently large groups of patients, that would consider the different functional and morphological forms of the disease. Therefore, the authors carried out detailed typing of 60 Class I and II antigens in 117 patients known to suffer from hypertrophic cardiomyopathy. Values of the relative risk and chi-square test showed a number of possible associations. However, after correction for the number of antigens tested, only HLA-B21 was shown to have a significantly high frequency (in patients with the obstructive form and in those with advanced myocardial hypertrophy, defined as a wall thickness greater than 30 mm). An association with this antigen has previously been demonstrated in a number of cases of ischaemic heart disease, myocardial infarction of young people, and in hypertensive subjects. HLA typing may be helpful in recognizing forms which are not fully typical. In Czechoslovakia, HLA-B21 carriers are at increased risk of developing a serious heart disease manifesting already in young age.
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PMID:An immunogenetic study in hypertrophic cardiomyopathy. 181 Jul 2

Beat-to-beat fluctuations of the spatial QRS-T angle, which are reported to be greater in patients with ischemic heart disease than in healthy subjects, are thought to be a helpful factor in diagnosing ischemic heart disease. In this study, we assessed the usefulness of the standard deviation of the spatial QRS-T angle per beat as an index of magnitude of the fluctuations. The subjects consisted of 27 patients with effort angina, 14 with vasospastic angina, 18 with the "chest pain syndrome" and 36 normal controls. The standard deviations of the spatial QRS-T angle were obtained for 10 consecutive stable beats at rest using Frank's orthogonal X, Y, Z scalar electrocardiogram. The results were compared with those of coronary angiography and exercise tolerance tests. Treadmill exercise tests were performed in all patients using Bruce's protocol to observe decreased ST levels and delta ST/HR indices. QRS-T angle deviation values were 8.10 +/- 8.64 degrees (mean +/- SD) in the effort angina group, 3.63 +/- 1.26 degrees in the vasospastic angina group, 4.13 +/- 1.70 degrees in the "chest pain syndrome" group, and 2.35 +/- 0.85 degrees in the normal control group; the groups of patients with heart disease showed significantly higher values (all p < 0.01) than did the control group. The effort angina group showed a significantly higher value than did the vasospastic angina group and the "chest pain syndrome" group (all p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Ischemic heart disease detected by the standard deviation of the spatial QRS-T angle and by treadmill exercise test]. 184 6


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