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

The omnicardiogram is a new technique in which various leads of the standard electrocardiogram are digitized and subjected to a nonlinear mathematical transformation so as to detect subtle degrees of abnormality not apparent in the original electrocardiogram. Its usefulness in the detection of heart disease was studied in 121 male patients with a normal resting 12 lead electrocardiogram who underwent selective coronary cineangiography for a chest pain syndrome. In normotensive patients with a normal resting electrocardiogram, an abnormal omnicardiogram was recorded in 81 percent of those with three vessel disease, 67 percent of those with two vessel disease and 41 percent of those with one vessel disease. Nineteen percent of patients with normal coronary arteries or nonobstructive coronary artery disease had false positive tracings. The omnicardiogram was abnormal in 81 percent of patients with hypertension whether or not cornary artery disease was present. A double Master exercise test was performed by 109 of the 121 patients. In normotensive patients results of the test were positive in 67 percent of those with three vessel disease, 31 percent of those with two vessel disease and 14 percent of those with one vessel disease. There was a 4 percent rate of false positive tracings. Thus in our study, the omnicardiogram appeared to be superior to the Master test and to provide a useful new approach to detection of coronary artery disease in male patients with a normal resting electrocardiogram.
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PMID:The omnicardiogram: new approach to detection of heart disease in patients with a normal resting electrocardiogram. 111 4

To clarify whether the formation of thrombi could be induced by atrial fibrillation itself or by factors predisposing to atrial fibrillation such as mitral stenosis, plasma D-dimer levels (cross-linked fibrin degradation products) were measured in 73 patients without atrial fibrillation (Group 2). In Group 1, 49 of the 73 patients had factors predisposing to atrial fibrillation such as valvular heart disease, and the remaining 24 had lone atrial fibrillation. In Group 2, 16 patients had organic heart disease and the remaining 5 had a chest pain syndrome. The plasma D-dimer level was significantly higher in Group 1 (150 +/- 19 ng/ml) than in Group 2 (61 +/- 3 ng/ml) (p less than 0.01, mean +/- standard error of the mean). In both groups, there were no significant differences in plasma D-dimer level between patients with and without organic heart disease (146 +/- 18 versus 156 +/- 46 ng/ml in Group 1; 61 +/- 4 versus 59 +/- 10 ng/ml in Group 2). These findings indicate that atrial fibrillation itself may be more important than factors predisposing to atrial fibrillation in the development of intracardiovascular clotting.
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PMID:Increased intracardiovascular clotting in patients with chronic atrial fibrillation. 237 15

Increased myocardial blood flow occurs in ventricular hypertrophy, but flow per 100 grams of myocardium remains normal. The increase in flow may be obtained at the expense of the existing coronary vascular reserve or by an increase in the vascular bed. The coronary vascular reserve was studied by analyzing the hyperemic reaction to selective injection of contrast agent into the coronary arteries in 25 patients: a control group (9 patients) with chest pain syndrome, normal coronary arteries and a normal left ventricle (Group I) and 16 patients with aortic stenosis, left ventricular hypertrophy and normal coronary arteries (Group II). The hyperemic response in Groups I and II was 73.3 +/- 2.2 and 65.8 +/- 9.1 percent, respectively (difference not significant). Group II was subdivided into two groups: Group IIA had five patients with a left ventricular mass of less than 200 g (mean 158.8 +/- 25.9); this group had a hyperemic response of 102.3 +/- 9.9 percent. Group IIB had 11 patients with a left ventricular mass of more than 200 g (mean 308.9 +/- 22.5) and a hyperemic response of 49.27 +/- 10.42 percent. The hyperemic response was correlated with the diastolic left ventricular-aortic gradient (r = +0.64, p less than 0.001), left ventricular mass (r = -0.51, p less than 0.01) and aortic diastolic pressure (r = +0.636, p less than 0.001). Group I had a left ventricular mass similar to that of Group IIA (124.9 +/- 9 and 158.8 +/- 26 g, respectively) but a lower hyperemic response (73.3 +/- 2 and 102.3 +/- 10 percent, respectively). These data suggest that severe left ventricular hypertrophy is associated with a reduction in coronary vascular reserve; it is speculated that this decrease in the vascular reserve capacity may be related to the ischemic component of hypertrophic heart disease.
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PMID:Coronary flow studies in patients with left ventricular hypertrophy of the hypertensive type. Evidence for an impaired coronary vascular reserve. 645 Nov 67

Symptoms of myocardial ischemia, such as chest pain (sometimes with anginal features), acute myocardial infarction, and segmental wall motion abnormalities (including left ventricular apical aneurysm), frequently occur in patients with Chagas' heart disease. Because these clinical findings occur in the presence of normal coronary arteries, it is possible that an abnormality of the coronary vascular reactivity could be present in these patients. Therefore the current study was undertaken to determine whether endothelium-dependent coronary vasodilation is abnormal in Chagas' heart disease. Coronary endothelial function was assessed by infusing the endothelium-dependent vasodilator acetylcholine (10(-8) to 10(-6) mol/L) and the endothelium-independent vasodilator adenosine (10(-4) mol/L) into the left anterior descending coronary artery of nine patients (age 43 +/- 4 years) with Chagas' heart disease. Coronary blood flow was measured with a Doppler flow velocity catheter and by quantitative coronary cineangiography. The left ventricular ejection fraction was 39% +/- 5%; eight patients had a left ventricular apical aneurysm; and one had an area of anteroapical hypokinesis. An impairment of the endothelium-dependent coronary vasodilation was demonstrated by a reduction in coronary blood flow of 41.2% +/- 12.8% produced by the infusion of acetylcholine at 10(-6) mol/L and by a blunted but preserved increase in coronary blood flow of 114.6% +/- 65.0% with the infusion of adenosine at 10(-4) mol/L (p = 0.03). In conclusion, patients with Chagas' heart disease have an abnormality of the coronary endothelium-dependent vasodilation, and this abnormality may play a role in their chest pain syndrome and in the development of segmental wall motion abnormalities.
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PMID:Coronary vascular reactivity is abnormal in patients with Chagas' heart disease. 773 90