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)

The common underlying heart diseases were ischemic heart disease (39%), valvular heart disease (27%), hypertensive heart disease (10%) in 104 patients (mean age 79 yrs) with congestive heart failure (CHF). Cardiomyopathy (5%) and congenital heart disease (2%) such as atrial septal defect were less common. In addition, many extracardiac diseases including anemia, hypothyroidism, renal failure and pulmonary disease contributed to the etiology of CHF in the elderly. Cardiac amyloidosis should be considered as an uncommon cause of refractory CHF. While the precipitating factor was not found in half of the 104 patients with CHF, the most common factors were respiratory infection, myocardial ischemia and arrhythmia. In addition, inappropriate drug usage including poor drug compliance, the use of beta-blockers and excessive intake of sodium and fluid precipitated or exacerbated heart failure. Renal failure was a most important complication and predisposed to refractory CHF. Aged patients with mild CHF (NYHA class II) showed an insufficient production of cyclic AMP and GMP in proportion to the increases of norepinephrine and atrial natriuretic peptide in comparison with health aged subjects after the submaximal treadmill exercise test. This finding may suggest that an inadequate compensation of neurohumoral factors is prone to cause CHF in the elderly. Appropriate management of acute CHF in the elderly begins with recognition of the underlying heart disease, complications and the severity of cardiac function. In addition to medical management including loop diuretics, vasodilator, beta-receptor agonist and phosphodiesterase inhibitor, cases associated with respiratory and renal failure require mechanical ventilation and continuous hemofiltration.
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PMID:[The etiology and management of congestive heart failure in the elderly]. 820 67

Heart rate variability (HRV) is considered to indicate cardiac autonomic reflex activity. The reproducibility of HRV determinations from repeated Holter recordings has not been vigorously evaluated. This represents, however, an important question since HRV determinations are increasingly used to examine disease-related changes in the autonomic tone or the effects of therapeutic interventions. Thus, the present study examined the reproducibility of 4 commonly used time-domain parameters (SDNN, SDANN, rMSSD, pNN50) and the spectral components of HRV in 17 healthy volunteers and in patients with coronary artery disease (n = 9) or hypertensive heart disease (n = 9). In all subjects, 2 Holter recordings were obtained 7 days apart. In both, healthy volunteers and in patients, overall reproducibility of HRV parameters was good exhibiting correlation coefficients between 0.60 and 0.98. However, in individual subjects particularly in those without heart disease a higher degree of variability of HRV measurements was observed. In those patients with markedly reduced HRV, reproducibility was best. It is concluded that repeated HRV determinations may be utilized to examine the effects of underlying disease progress or of therapeutic interventions on cardiac autonomic tone.
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PMID:[Reproducibility of heart rate variability measurements in repeated 24-hour long-term ECG registration]. 832 80

AV nodal tachycardia may present at any age, but onset in late adulthood is considered uncommon. To evaluate whether onset of AV nodal tachycardias at older age is related to organic heart disease (possibly setting the stage for re-entry due to degenerative structural changes) 32 consecutive patients with symptomatic AV nodal tachycardia were studied. The age at onset of attacks showed a bimodal pattern, with 2 peaks: one between 15 and 35 years (22 patients) and one around 55 years (10 patients). Significantly more older patients had an underlying heart disease (60% versus 14%, P < 0.01), with coronary artery disease in 4 and hypertensive heart disease in 3. Frequent supraventricular ectopic activity was seen during baseline 24-h ambulatory monitoring in all the older patients, versus in only half of the younger patients (P = 0.005). These results indicate that late onset AV nodal tachycardia (i.e. > age 45 years) is not infrequent (33%). The frequent supraventricular arrhythmias on one hand and age-related structural AV nodal changes, potentially enhanced by underlying heart disease on the other, both may contribute to the development of late onset re-entrant AV nodal tachycardia.
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PMID:Late onset atrioventricular nodal tachycardia. 846 10

The pathophysiological role of myocardial catecholamines in cardiomyopathies is still not completely understood. We there-fore assessed myocardial catecholamine concentrations (MCC) in 34 patients with hypertrophic cardiomyopathy (HCM) (76.5% males; mean age 46.7 +/- 11.6 years; left ventricular ejection fraction [LVEF] 75.3 +/- 9.8%) and in 32 patients with dilated cardiomyopathy (DCM) (87.5% males, mean age 43.1 +/- 12.5 years, LVEF 34.9 +/- 8.3%). Initial assessment included clinical work up, cardiac catheterization and endomyocardial biopsy. Myocardial norepinephrine (MNEC), epinephrine (MEC), and dopamine (MDC) concentrations in endomyocardial biopsy samples were measured using the catechol-O- methyl transferase radioenzymatic method. Significantly higher MNEC and MEC were demonstrated in HCM than in DCM patients (MNEC: 781.9 +/- 125.8 ng.g-1 fresh myocardial tissue (ft) HCM vs 262.6 +/- 68.9 ng.g-1 ft DCM, p < 0.01; and MEC: 91.6 +/- 13.9 ng.g-1 ft HCM vs 35.8 +/- 6.2 ng.g-1 ft DCM, P < 0.01). The difference in MDC did not reach statistical significance (76.1 +/- 8.3 ng.g-1 ft HCM vs 70.1 +/- 11.8 ng.g ft DCM; P > 0.05). In addition, we compared the MCC levels in 24 patients, clinically presented as dilated cardiomyopathy categorized according to the various aetiologies: 12/24 with primary DCM (75.0% males, mean age 49.6 +/- 9.5 years; LVEF 25.8 +/- 63%), 7/24 with alcohol-induced heart disease (85.7% males, mean age 46.8 +/- 7.1 years; LVEF 26.4 +/- 4.6%), and 5/24 with hypertensive heart disease (100% males, 45.1 +/- 10.6 years; LVEF 25.6 +/- 9.1%), but no significant difference was found among them (P > 0.05). There was no significant difference in tissue dopamine concentrations.
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PMID:Myocardial catecholamines in primary heart muscle disease: fact or fancy? 868 78

Ventricular ectopic activity is commonly encountered in clinical practice. Usually it is not associated with life-threatening consequences in the absence of significant structural heart disease. However, frequent ventricular ectopic beats can be highly symptomatic and even incapacitating in some patients. Currently, reassurance and pharmacological therapy are the mainstays of treatment. This study assesses the useful role of catheter ablation in eliminating drug refractory monomorphic ventricular ectopic beats in severely symptomatic patients. Eight patients were included, five patients had no heart disease and in three patients a structural heart disease was present (coronary artery disease in 1, hypertensive heart disease in 1, mitral valve prolaps in 1). The ejection fraction was higher than 40% in all patients (mean EF 56 +/- 14%). Mean number of ventricular ectopic activity was 29,295 +/- 10,650 VPB/24 h (1209 +/- 457 VPB/h) before ablation. No other spontaneous or induced arrhythmias were documented. The site of origin of ventricular ectopic activity was accurately mapped by using earliest endocardial activation time during ectopic activity or pace mapping, or both. The ectopic focus was located in the right ventricular outflow tract in five patients and in the left ventricle in three patients (posteroseptal 2, anterolateral 1). Frequent ventricular ectopic beats were successfully eliminated by catheter ablation in all patients. Early recurrence occurred in one patient after 10 min and 30 min after the procedure. In another patient a recurrence occurred 6 days after the procedure. In a second session he was successfully ablated and remained free of recurrence since 2 months. After ablation the mean number of ventricular premature beats was 211 +/- 159 VPB/24 h (9 +/- 7 VPB/h). The mean number of radiofrequency applications was 8 +/- 7 (range 2-22). Mean radiation time was 12 +/- 8 min. No complications were observed. During a mean follow-up of 6 months there were no further recurrences in the remaining six patients. Radiofrequency catheter ablation can be successfully used to eliminate monomorphic ventricular ectopic activity. It may therefore be a reasonable alternative for the treatment of severely symptomatic, drug resistant monomorphic ventricular ectopic activity.
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PMID:[High frequency catheter ablation as therapy of symptomatic ventricular extrasystole]. 917 12

The spontaneously hypertensive rat (SHR) is a well studied animal model of genetic hypertension and heart disease of unknown cause. With the use of differential display, a transcript was found in SHR myocardium that on sequence analysis was identified as an endogenous retrovirus (ERV). ERV gene expression was greater than an order of magnitude increased in adult SHR hearts relative to age-matched normotensive Wistar-Kyoto rats and was further increased in hearts from SHR with heart failure. In situ hybridization studies demonstrated that increased ERV gene expression was localized to myocardial cells. Increases in ERV transcripts in SHR suggest a possible link between inherited proviral elements and genetic hypertensive heart disease.
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PMID:Endogenous retroviral transcripts in myocytes from spontaneously hypertensive rats. 923 26

Abnormalities in left ventricular (LV) diastolic function may be the earliest indications of hypertensive heart disease. Because the two ventricles influence each other's performance this study was designed to investigate the impact of chronic LV pressure overload in essential hypertension (HT) on diastolic function of right ventricle (RV). RV and LV diastolic function was evaluated in 74 patients with mild-to-moderate essential HT using pulsed wave Doppler echocardiography. Fifty-five normotensive patients without heart disease acted as control subjects. In studied group, 17 patients (23%) had normal mitral (MV) and tricuspid (TV) flow parameters, 28 (38%) had impaired LV filling parameters [MV early (E) to late (A) peak flow velocity ratio (MV E/A) 0.81 +/- 0.12 vs control 1.19 +/- 0.18, p < 0.001] while 29 patients (39%) had abnormal both mitral [MV E/A) 0.72 +/- 0.15 vs control 1.19 +/- 0.18, p < 0.001] and tricuspid flow parameters (TV E/A) 0.8 +/- 0.19 vs control 1.23 +/- 0.1, p < 0.001). In group with impaired diastolic filling of both ventricles indices of mitral flow were significantly more abnormal compared to group with normal TV flow parameters (MV E/A 0.72 +/- 0.15 vs control 0.81 +/- 0.12, p < 0.05). RV filling parameters correlated with filling parameters. There was good correlation between TV A and MV E (r = -0.56, p < 0.01), the time velocity integral of early mitral inflow (MV E-VTI) (r = -0.64, p < 0.001) and positive correlation with MV A (r = 0.78, p < 0.0001). Also there was good correlation between LV mass and TV E (r = -0.56, p < 0.01) and the time velocity integral of early tricuspid inflow (r = -0.72, p < 0.001). Data indicate that RV diastolic function is abnormal in essential hypertension and these abnormalities are closely related to those of LV diastolic function and LV mass.
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PMID:[Right ventricular diastolic disfunction and its relation to left ventricular performance in patients with hypertension]. 941 9

Analysis of the data from 7188 cases seen in the 1980s two general hospitals in Shanghai and comparison of the data with those in the 1950s, 1960s and 1970s revealed that the percentage of heart diseases among the inpatients in medical wards increased in each decades, from 9.89%, 15.69% 20.91% to 23.54% respectively. The constituent ratios of different etiologic types of heart diseases changed. Coronary heart disease constituted the largest proportion, next in number was rheumatic heart disease and congenital heart disease was in the third place. The incidence of congenital heart diseases, myocarditis, cardiac dysrhythmias without organic heart diseases, cardiomyopathy and endocarditis increased and that of rheumatic heart disease, pulmonary heart disease and hypertensive heart disease apparently decreased, syphilitic heart disease was rarely encountered.
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PMID:[The trend of changes in etiologic types of heart diseases in Shanghai from 1948 to 1989]. 959 15

A specific treatment for Chagas' disease has not yet been discovered, even though the condition is endemic in large parts of the Region of the Americas. Earlier studies have addressed the possibility that the sulfatide galactocerebroside in Trypanosoma cruzi behaves as an immunogen involved in the production of the high antisulfatide antibody levels found in patients with chronic infestation with the parasite. This may be an important factor in the pathogenesis of the cardiac symptoms and peripheral neuropathy seen in Chagas' disease, which is the most important cause of myocarditis in Central and South America and the second most important cause of heart failure in several of the countries located in these subregions. The present study was conducted in order to ascertain whether patients with Chagas' disease and other patients not afflicted with the ailment differ insofar as the presence of antibodies against sulfatide is concerned, and it describes antisulfatide antibody levels in 124 hospital patients (74 men and 50 women) between the ages of 15 and 94 who were in the cardiology unit of Vargas Hospital in Caracas from 1 July to 30 June 1995. Antisulfatide antibody titers were determined by means of enzyme-linked immunosorbent assays (ELISA), and the antigen employed was sulfatide cerebroside obtained from bovine brain tissue. Of the 124 patients under study, 39 (31.5%) suffered from Chagas' disease and had antisulfatide antibody levels higher than those detected in patients without Chagas (P = 0.0298) and in 28 seemingly healthy controls (P = 0.0035). Serum levels of antisulfatide antibodies in patients with other forms of heart disease were also compared with those seen in the control group, and significantly higher levels were found in patients with acute ischemic heart disease (P = 0.0049), rheumatic valvular heart disease (P = 0.0075), chronic ischemic heart disease (P = 0.0464) and bradiarrythmias (P = 0.0157), and significantly lower ones in subjects with hypertensive heart disease (P = 0.0367). These antibody levels showed no correlation with clinical or paraclinical variables indicative of the degree of cardiac compromise. Our results support the notion that antibodies against sulfatide may play a role in the pathogenesis of Chagas' cardiomyopathy and other forms of heart disease and should be further studied in an effort to determine their potential role in these processes.
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PMID:[Anti-sulfatide antibody titers in patients with chronic Chagas disease and other forms of cardiopathy]. 960 14

The aim of this study was to determine whether measurement of plasma levels of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) is an efficacious method to predict patients with heart disease irrespective of left ventricular function in a multiphasic health screening program. We have examined whether patients with various heart disease selected by physical examination, ECG, and chest X-rays can be identified by plasma levels of ANP and BNP. We examined 481 consecutive subjects who visited our checkup clinic for a multiphasic health screening test. By routine methods, among the 481 subjects, 13 were found to have some form of heart disease (old myocardial infarction, 2; cardiomyopathy, 2; valvular heart disease, 2; hypertensive heart disease, 5, and lone atrial fibrillation, 2). Sensitivity, specificity, and quintile analysis for identification of the patients with heart disease were determined by various cutoff levels of plasma ANP and BNP. Receiver operating characteristic (ROC) curves were constructed for the identification of these patients. A plasma BNP level of 40 pg/ml had a sensitivity of 85% and a specificity of 92% for heart disease detection. The area under the ROC curve for BNP was significantly greater than that for ANP (0.94 vs. 0.81; p < 0.001). A plasma BNP level of 13 pg/ml or less gave a 100% negative prediction value for heart disease. Plasma BNP concentration is a useful biochemical marker for the screening of asymptomatic patients with heart disease due to various etiologies from large population samples.
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PMID:Plasma B-type natriuretic peptide measurement in a multiphasic health screening program. 977 44


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