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

The risk of suddenly presenting ventricular tachyarrhythmias or death was analyzed in a prospective way in 71 patients with acute myocardial infarction and in 21 patients without any apparent cardiopathy. The average surface signal was measured when the patient was admitted in the hospital and on the following days of the acute phase of the infarction. Holter 24 hours monitoring and determination of the ejection fraction with radionuclide angiocardiography were also performed. Patients were divided into 4 groups, depending on the existence of arrhythmias and if late electric activity was recorded or not. Fifty-five patients (group I), presented an abnormal signal analysis (voltage in the 40 msec of the QRS period higher than 20 microvolts), and ventricular arrhythmias. Group II was formed by 8 patients who presented arrhythmogenic activity but did not present late electric activity. Group III was formed by 6 patients who did not present arrhythmias but presented late electric activity. Twenty-three patients who did not present late electric activity or ventricular arrhythmias formed group IV. Late electric activity that was registered at 41 +/- 1 msec with a QRS complex lasting 115 +/- 4 msec and with a voltage lower than 20 microvolts in group I showed meaningful differences with the other groups: Group II: (24 +/- 5 msec, QRS 111 +/- 4 msec, P less than 0.001); Group III: (41 +/- 2 msec, QRS 109 +/- 5 msec, P less than 0.01); Group IV: (26 +/- 5 msec, QRS 80 +/- 7 msec, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Simplified method for the early detection of post potentials in patients with acute myocardial infarct]. 237 33

The authors compare the psychologic reactions to acute stress situations due to acute myocardial infarction and in patients operated on for acquired heart disease. To evaluate the emotional experience of the patients psychodiagnostic methods were used. Some of them were specially developed by the authors. New data were obtained on the specific psychosocial adaptation and psychosocial defense of these categories of patients.
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PMID:[The characteristics of the psychological reactions to stress situations caused by acute myocardial infarct and surgery for acquired heart defect]. 239 88

We investigated 303 (men: women = 2:1) cases who suffered sudden heart arrest in Yamagata city since 1984 to 1987. The incidence rate was 41.0/100,000/year, and increased markedly with increasing age. There was a tendency for sudden death to occur in the winter season, evening and early morning. Two major causes were cardiac disease (especially ischemic heart disease) (46.4%) and intracranial hemorrhages (18.6%). 20% of all the heart-arrest cases were able to be saved, but, depending on the kind of heart disease the survival rate varied greatly (18.8% in acute myocardial infarction and 71.4% in vasospastic angina), (40.0% in ventricular fibrillation and 13.3% in the bradycardic arrhythmias). Survival rate was also effected by the time interval from the onset till the beginning of cardio-pulmonary resuscitation. About one half of the cases had histories of cardiac disease. Premonitory symptoms were observed in at least one third of the cases.
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PMID:[Sudden cardiac death in the emergency hospital]. 240 68

Currently, there are three prognostic indicators of ventricular electrical instability: long-term ambulatory ECG recording, programmed electrical stimulation and the signal-averaged electrocardiogram. Several clinical studies have suggested that frequent and complex ventricular premature contractions in patients with organic heart disease may identify future cardiac events, including sudden cardiac death although, with respect to prognosis, it is not likely that any grading system based on the ambulatory ECG will be without meaningful limitations. No study has adequately tested the hypothesis that decreasing ventricular arrhythmias after acute myocardial infarction reduces mortality. The inducibility of ventricular tachycardia during programmed electrical stimulation is regarded as an independent risk factor for sudden death. Predominantly due to the lack of standardized protocol and definitions, the actual relevance of current literature remains somewhat compromised. The indication for antiarrhythmic treatment in those patients in whom ventricular tachycardia can be induced has not been established with certainty since the effects of therapy on the prognosis are unknown. For patients with complex ventricular arrhythmias in whom sustained ventricular tachycardia cannot be induced, antiarrhythmic drug treatment does not appear indicated. Based on a number of studies, the presence of late potentials in the signal-averaged ECG has also been shown to be a meaningful prognostic indicator. The signal-averaged ECG, however, is not only subject to various technical problems but is also encumbered by limitations arising from electrophysiologic considerations. While no relationship could be established between late potentials and complex ventricular arrhythmias in the ambulatory ECG within the first two months after acute myocardial infarction, there was, however, a correlation between late potentials and the inducibility of ventricular tachycardia during programmed electrical stimulation. Consequently, the signal-averaged ECG may serve as a screening test to identify patients who should subsequently undergo programmed electrical stimulation for arrhythmia assessment or guided institution of treatment provided this proves to be effective in reducing the risk of future major arrhythmic events.
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PMID:Risk stratification of patients with complex ventricular arrhythmias. Value of ambulatory electrocardiographic recording, programmed electrical stimulation and the signal-averaged electrocardiogram. 245 72

The effect selenium in the form of sodium selenite on central hemodynamic conditions and coronary artery flow was studied in pig hearts infarcted by a ligature of the ramus interventricularis anterior. Infusions of sodium selenite solutions at levels of 1-3 mg/kg body wt improved the survival of infarcted pigs. Both short-term and long-term protective effects of selenite could be demonstrated. It is of potential therapeutic importance that sodium selenite administration suppresses the electrical vulnerability of the cell membrane, notably the occurrence of ventricular late potentials in the ischemic border zone. Coronary blood circulation, as evidenced by an increase of heart rate and coronary artery dilatation and peripheral vasodilation was also improved. The pulsatile coronary blood flow thus is altered, increasing total perfusion of the infarcted heart. Initial observations with human subjects suggest that selenium deficiency is a factor in the pathogenesis of ischemic and arteriosclerotic heart disease. In 54 hospitalized patients with clinical diagnosis of acute myocardial infarction, serum selenium levels were 670 +/- 266 nmol/L, as compared to 981 +/- 209 nmol/L in 93 healthy controls. In 32 patients with general arteriosclerosis, the serum Se level was 375 +/- 85 nmol/L, in 64 patients with arteriosclerotic occlusional disease in the leg region, 366 +/- 85 nmol/L, respectively. Serum selenium levels of healthy subjects were found to be age- and sex dependent. In men, the selenium concentrations reached maximum levels of 1083 nmol/L in the 41-50 y age group. In women in the same age group, the serum Se level was 1385 nmol/L. Evidence is presented to suggest that selenium is preventing oxidative damage of heart cell membranes by lipid peroxidation.
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PMID:Selenium in cardiology and angiology. 248 14

A sensitive and highly specific ELISA assay was developed to determine the anti-myosin humoral immune response (AMA) in various heart diseases: acute viral myocarditis, infective endocarditis, acute myocardial infarction, and valve and coronary bypass surgery. The mean study entry AMA titer of each patient group was already significantly increased compared with age matched controls. During further follow-up (90 d) all the groups except for endocarditis showed a significant increase of AMA titer compared with their entry titer. Anti-myosin antibody titer were higher after cardiac surgery than after myocardial infarction or inflammatory heart disease. These results suggest that anti-myosin immune response is not limited to infectious processes in which the pathogen induces antibodies which cross-react with heart constituents but is merely caused by direct cardiac injury. Myosin as a major compound of heart cellular proteins turned out to be a good candidate to trigger immune response after cardiac injury.
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PMID:Anti-myosin humoral immune response following cardiac injury. 249 42

The aim of this paper was to study atrial natriuretic factor, plasma renin activity and antidiuretic hormone values during paroxysmal atrial arrhythmias with different ventricular rates before and after pharmacological cardioversion and during chronic atrial flutter-fibrillation. The study was carried out: 1) during acute arrhythmias (atrial flutter-fibrillation or supraventricular tachycardia) and after restoration of normal sinus rhythm in 2 patients without heart disease, in 13 with chronic heart disease and in 6 with acute myocardial infarction; 2) during chronic atrial flutter-fibrillation in 5 patients with chronic ischemic heart disease, without congestive heart failure. Atrial natriuretic factor, aldosterone, plasma renin activity and antidiuretic hormone values were measured by radio-immunoassay. During paroxysmal atrial arrhythmias atrial natriuretic factor levels were higher than normal in all patients, particularly in those with supraventricular tachycardia. Most of the aldosterone measurements were above the normal range. As far as plasma renin activity and antidiuretic hormone values are concerned, levels higher than the normal range were found in the patients with severe hemodynamic impairment. Central venous pressure was above normal in all patients except in the 2 without heart disease, and there was a positive correlation between atrial natriuretic factor and central venous pressure values. After restoration of normal sinus rhythm atrial natriuretic factor values returned to normal except in acute myocardial infarction patients, in 1 chronic ischemic heart disease patient with congestive heart failure and in 3 patients with mitral valve disease. In all patients with chronic atrial flutter-fibrillation and in 5 patients with acute atrial flutter-fibrillation and low rate, above normal atrial natriuretic factor values were found with normal central venous pressure values. Atrial distension due to high central venous pressure values, lack of atrial contraction and rhythmic detension of the atrial stretch receptors, may be considered the major stimuli responsible for atrial natriuretic factor release during acute paroxysmal atrial arrhythmias and atrial flutter-fibrillation with low ventricular rate, respectively.
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PMID:[Atrial natriuretic factor in acute atrial hyperkinetic arrhythmia and chronic atrial fibrillo-flutter]. 252 75

Comparison between subjects who were identified from a register of cases of myocardial infarction and a random sample of the same community showed that in the Lower Hunter region of New South Wales men who currently are not married are at higher risk of acute myocardial infarction or of sudden coronary death than are married men of the same age. While there are indications that unmarried men have a life-style that is different from that of currently married men, their increased risk of ischaemic heart disease is greater than can be accounted for by differences in factors such as age, the previous history of heart disease, their alcohol and tobacco consumption and various socioeconomic factors.
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PMID:Marriage is associated with a lower risk of ischaemic heart disease in men. 259 28

An implantable left ventricular assist system (LVAS) utilizing an electromechanically driven dual pusher-plate blood pump has been employed in a multiinstitutional trial as a bridge to cardiac transplantation. Under development for permanent circulatory support in patients with end-stage heart disease, the LVAS, in this application, derives power and control from an external console via a percutaneous lead. The LVAS was implanted in 20 patients (16 men, 4 women) who were hemodynamically unstable or in refractory cardiogenic shock. The mean age was 44.9 years (range, 25 to 63 years). Preoperative diagnosis was evenly divided between end-stage ischemic disease, cardiomyopathy, and acute myocardial infarction. Implanted in the left upper quadrant within the anterior abdominal wall, the blood pump was connected between the left ventricular apex and ascending aorta. Total support of the systemic circulation and substantial left ventricular unloading were achieved with synchronous counterpulsation for periods up to 90 days (mean, 22.7 days). All patients were stabilized hemodynamically. The mean preoperative cardiac index of 1.5 L/min/m2 increased by a factor of 2. Pulmonary arterial pressures decreased substantially. Serious complications occurred in 16 patients, precluding cardiac transplantation in 10. Most complications (greater than 70%) were in patients who did not receive transplants; the most common complication was bleeding. Twelve of 13 patients with LVAS implants for more than seven days were mobilized, and 4 were fully ambulatory and completely rehabilitated. Orthotopic cardiac transplantation was performed in 10 patients after implants ranging from two to 90 days (mean, 30.3 days).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Implantable electrical left ventricular assist system: bridge to transplantation and the future. 264 1

Cardiopathy caused by cisplatin has been reported in Japan, but acute myocardial infarction (AMI) has not. We report a case of AMI that occurred during therapy with cisplatin.
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PMID:[A case of acute myocardial infarction after treatment with cisplatin]. 273 71


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