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)

Signal-averaged electrocardiogram (ECG) variables were analyzed in 81 patients with ventricular tachyarrhythmia and nonischemic heart disease using the ART LVP 101 EPX system (Austin, TX): 15 ventricular tachycardia patients with arrhythmogenic right ventricular dysplasia (ARVD), 7 ventricular tachycardia patients with dilated cardiomyopathy, 25 patients with "idiopathic" verapamil-sensitive left ventricular tachycardia, 24 patients with "idiopathic" right ventricular tachycardia, and 10 "idiopathic" ventricular fibrillation (IVF) patients with rbbb pattern and ST-segment elevation in the precordial leads. Data from 52 normal control subjects were also analyzed. The first study was to test the hypothesis of any difference in signal-averaged ECG indices between patients with ARVD and patients with dilated cardiomyopathy. Longer filtered QRS duration and T40 and higher amplitude of the terminal filtered QRS complex outside the end of the standard QRS complex (log V-outside) were noted in patients with ARVD (filtered QRS duration, 172 vs 144 ms, P < .05; T40, 94 vs 62 ms, P < .05; log V-outside, 1.48 vs 0.56, P < .01). Endocardial mapping showed noticeable extension of fractionated electrograms in the right ventricle and longer duration of fractionated intracardiac electrograms in patients with ARVD, which might explain the difference in signal-averaged ECG indices between these two diseases. The second study was to test the hypothesis of and the variables that can suggest the arrhythmogenic substrate in patients with idiopathic ventricular tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Time-domain and frequency-domain analyses of the signal-averaged ECG in patients with sustained ventricular tachyarrhythmia and nonischemic heart diseases. 788 60

We describe three children with Noonan syndrome with cardiopathy. One female child had cardiopathy and ocular abnormalities. The other two male children had congenital heart disease of which one had uncommon association of tricuspid valve dysplasia with regurgitation associated with endocardial cushion defect. Karyotypes of the female and one of the male children were normal. The growth hormone and thyroid hormone studies in the first and second male children were normal. All the three children were managed conservatively and followed-up.
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PMID:Cardiopathy and ocular abnormalities in Noonan syndrome. 789 1

Renal artery stenotic disease is the most common form of surgically correctable hypertension. Occlusive lesions of the renal artery are categorized as: arteriosclerotic, fibrodysplastic (intimal fibroplasia, medial fibrodysplasia, perimedial dysplasia) and developmental. The incidence of stroke, heart disease and renal failure has been reduced with contemporary drug management of hypertensive vascular disease, but similar salutary outcomes have not accompanied the medical treatment of renin-mediated renovascular hypertension. Selection of patients for operation implies documentation that a renal artery stenosis is of functional importance. Advances in the surgical management of renovascular hypertension have evolved over the past 50 years, such that carefully performed reconstructions benefit 85-95% of properly selected patients.
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PMID:The evolution of surgery for renovascular occlusive disease. 804 46

Respiratory syncytial virus (RSV) is the only viral respiratory pathogen that produces an annual epidemic of respiratory illness. Infants with cardiac disease or infants born prematurely with or without bronchopulmonary dysplasia are at increased risk of severe RSV disease. A recently developed RSV immunoglobulin (RSVIG) was studied to determine safety and efficacy in prevention of severe RSV disease in such children who are high risk for severe RSV illness. Results from this prospective, blinded trial involving 249 children (102 with broncho-pulmonary dysplasia, 87 with congenital heart disease and 60 who were born prematurely) indicate that high dose RSVIG reduced the incidence and severity of RSV lower respiratory tract infection. It is a safe and effective means of RSV prophylaxis in selected high risk children.
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PMID:Role of antibody and the use of respiratory syncytial virus immunoglobulin in the prevention of respiratory syncytial virus disease in preterm infants with and without bronchopulmonary dysplasia. 807 36

Between January 1979 and December 1991, 174 of a total of 2304 carotid reconstructions (7.5%) were performed in 166 patients for stenotic coiling or kinking of the internal carotid artery. There was a 1.4 male predominance and the mean age of the patients was 66.3 +/- 9.6 years (range 38 to 91 years). Seventeen patients (9.8%) were asymptomatic, 54 (31%) were symptomatic because of a previous stroke, and 103 (59.2%) had had transient ischemic attacks. The symptoms were hemispheric in 108 (62.1%) cases, ocular in 19 (10.9%), and vertebrobasilar in 30 (17.2%). The stenotic coiling or kinking was isolated in 35 (20.1%) cases and associated with other lesions of the internal carotid artery in 139 (79.9%). These included 119 atherosclerotic stenoses, 14 aneurysms, and six stenotic lesions due to fibromuscular dysplasia. Angioplasty of the carotid bifurcation was performed in 102 (58.6%) patients, associated with endarterectomy in 84 (48.3%) cases and with dilatation of dysplastic lesions in six (3.5%) cases. A bypass graft and resection and anastomosis of the carotid artery were performed in 36 (20.7%) patients each. There were four postoperative deaths (2.3%): two were due to neurologic causes, one to heart disease, and one to complications of an associated surgical procedure. Five patients (2.9%) had postoperative strokes and eight (4.6%) had transient ischemic attacks. At postoperative follow-up investigations four (2.3%) patients had carotid occlusions and 10 (5.7%) had morphologic abnormalities. At 5 years, actuarial survival was 80.97 +/- 8.8%, patency was 96.12 +/- 2.95%, and the ipsilateral stroke-free rate was 93.12 +/- 4.49%. Treatment of stenotic coiling or kinking of the internal carotid artery yields satisfactory results, comparable to those of endarterectomy, for isolated atherosclerotic carotid stenoses and is effective in the prevention of ipsilateral ischemic stroke.
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PMID:Stenotic coiling and kinking of the internal carotid artery. 812 55

We reviewed the data of 42 consecutive patients (mean age 55 +/- 12 years) who underwent surgery for control of recurrent drug-refractory ventricular arrhythmia. A history of myocardial infarction was present in 38 patients, 4 patients had congenital heart disease (2 aneurysms, 1 right ventricular dysplasia, 1 hamartoma). The mean LV ejection fraction was 40 +/- 14%. At preoperative electrophysiologic study, ventricular tachycardia was inducible in 32 of 33 patients. The mean heart rate was 188/min. A mean of 3.3 +/- 2.1 antiarrhythmic drug trials were ineffective. The most frequently performed surgical procedure (n = 36) was visually guided subendocardial resection, alone or in combination with cryothermal ablation. In 30 patients additional aneurysmectomy was performed. A mean of 1.9 +/- 1.4 coronary arteries in 32 patients were bypassed. The overall in-hospital mortality (30 days) was 9.5% (1 arrhythmic death, 1 pump failure, 1 sepsis, 1 hemorrhagic shock). We found 2 significant (p < 0.05) predictors of perioperative mortality: recent myocardial infarction and patient's age. During a mean follow-up of 33 months (range 1 to 90), there were 3 sudden cardiac deaths and 6 nonfatal recurrences of ventricular tachycardia which were subsequently prevented with antiarrhythmic drug therapy. Thus, the overall success in control of arrhythmia was 92%, in 59% by surgery alone. Survival was 79% at 2 years after surgery and 63% at 5 years. We conclude that patients who have successful subendocardial resection and aneurysmectomy for control of ventricular arrhythmia have an excellent chance of arrhythmia-free survival and a relatively good prognosis.
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PMID:[Surgery for arrhythmia in patients with therapy-resistant ventricular tachycardia]. 821 Oct 13

In sustained ventricular tachycardia (VT) unrelated to coronary artery disease, the incidence of reentry with an excitable gap was examined, and rapid pacing was performed to entrain VT in 48 episodes in 42 consecutive patients. Coronary artery disease was excluded by coronary arteriography. The underlying heart diseases were postoperative congenital heart diseases (n = 5), dilated (n = 7) or hypertrophic (n = 4) cardiomyopathy, arrhythmogenic right ventricular dysplasia (n = 6) and miscellaneous heart diseases (n = 5), as well as no demonstrable heart disease (n = 15) in which 8 patients had verapamil-responsive VT. Except for 1 patient with hypertrophic cardiomyopathy, 48 morphologically distinct monomorphic sustained VTs were induced. Twenty-five VTs showed right bundle branch block morphology and 23 left bundle branch block morphology, and VT was entrained in 84 and 96%, respectively. The overall incidence of the entrainment was 89.6% (43 of 48 monomorphic VTs), and the frequency of the ability to entrain VT ranged between 33.3 and 100% in the subgroups. The lowest frequency was found in hypertrophic cardiomyopathy. In conclusion, most inducible monomorphic sustained VT unassociated with coronary artery disease was presumed to be reentry with an excitable gap.
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PMID:Frequency of presumed reentry with an excitable gap in sustained ventricular tachycardia unassociated with coronary artery disease. 821 49

A time-domain signal-averaged ECG was performed in 52 patients with arrhythmogenic right ventricular dysplasia (ARVD) proven by angiography, in 45 control subjects with normal hearts, and in 132 patients with various types of ventricular arrhythmias and no evidence of cardiac disease during routine cardiac examination. Based on the results of control subjects, patients with at least 2/3 abnormal parameters (QRS > or = 113 ms, LAS > or = 38 ms, RMS 40 < or = 16 microV) were considered as having late potentials (LP). Prevalence of LP was 75% (39/52) in patients with ARVD, 19% (25/132) in patients with apparently idiopathic ventricular arrhythmias, and 4% (4/45) in controls (P < 0.01). In ARVD, no relationship was found between LP and age, type of ventricular arrhythmia (sustained or not), or extent of the disease on angiography. A significant correlation was found between the values of two parameters (QRS and LAS length) and the delay between the first ventricular arrhythmia and the examination (r = 0.39 and 0.42 respectively, P < 0.01). Further examinations (echo and/or angiography) revealed underlying heart disease in 26/132 patients with apparently normal hearts, including 13 with ARVD. LP were present in 21/26 patients (81%) with diseased heart vs 4/106 (4%) in those with normal hearts after complete examination, giving a sensitivity of 86%, and a specificity of 96% for detecting underlying heart disease. During a follow-up of 3.1 +/- 1.2 years after signal-averaged ECG, only one patient died from heart failure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Late potentials in arrhythmogenic right ventricular dysplasia. Prevalence, diagnostic and prognostic values. 822 60

Although heart, heart-lung, or lung transplantation is performed in more than 200 children annually, the number of patients referred for such procedures is considerably greater, and little is known about the outcome of those referrals. To determine the outcome of pediatric transplant referrals we reviewed the follow-up of 31 patients evaluated at our institution for heart (24), heart-lung (three), or lung (four) transplantations between January 1991 and September 1992. Indications included hypoplastic left heart syndrome (seven patients), cardiomyopathy or myocarditis (seven patients), and postoperative congenital heart disease (10 patients) for heart transplantation; Eisenmenger's syndrome (three patients) for heart-lung transplantation; and primary pulmonary hypertension (two patients), broncho pulmonary dysplasia, and cystic fibrosis for lung transplantation. Only 14 of 31 referred patients were listed for transplantation; the remaining 17 patients either improved when medical therapy was maximized (nine patients), died within days of referral (three patients), refused (two patients), chose alternate surgery (one patient), were medically unacceptable (one patient), or are currently undecided (one patient). To date 7 of 14 patients listed have undergone successful heart transplantation; the remaining seven patients either improved and did not require transplantation (two patients), refused (one patient), died waiting (one patient), are currently awaiting a donor (one patient), or underwent Norwood procedure because of donor unavailability (two patients). Thus including patients who died before listing, only 14 of 31 referrals (45%) were deemed in need of a transplant.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Outcome after referral for pediatric transplantation. 824 Dec 13

Two patients with recurrent episodes of symptomatic, sustained monomorphic ventricular tachycardia (VT) resistant to medical therapy underwent catheter ablation for the relief of VT. One patient had arrhythmogenic right ventricular dysplasia while the other had no structural heart disease. The VT had left bundle branch block morphology with normal axis in both the patients. The cycle length during VT was 260 msec and 270 msec respectively. Site for ablation was guided by pacemapping and the target site was identified in the right ventricular outflow tract in both the patients. Two cathodal shocks of 200 J in the first patient and one shock of 200 J in the second patient resulted in abolition of the arrhythmia. At repeat electrophysiologic testing at 7 days in the first patient and at 8 months in the second, VT was not inducible despite three extrastimuli from two right ventricular sites. Over a follow up of 24 and 26 months respectively, there has been no recurrence without any antiarrhythmic therapy. There were no acute or long term complications. In conclusion, catheter ablation offers a cure in patients with right ventricular tachycardia resistant to antiarrhythmic drugs.
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PMID:Transcatheter ablation of ventricular tachycardia arising from right ventricular outflow tract. 836 34


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