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)

In order to determine the cause of syncopes or disorders of conduction, 584 programmed stimulations using 2 ventricular extrastimuli delivered during an imposed rhythm were performed, between 1981 and 1985, in patients without ventricular tachycardia (VT) proven by Holter recordings. Eighty-seven non-sustained VT (NSVT) (15%), 8 ventricular fibrillations (VF) (1%), 16 ventricular flutters (VF1) (3%) and 23 sustained VT (SVT) (4%) were induced. To appraise the significance of these responses the patients were followed up for a mean period of 2 +/- 1 years. Among the NSVT patients the first 47 were followed up until 1984 and the others, less numerous, until 1985. Patients who responded to stimulation with NSVT had (4.4%) or did not have an underlying cardiopathy; their mean left ventricular ejection fraction (LVEF) was 53.5 +/- 17% (n = 10); 17% died of heart disease, but the disease was related to VT in only one case; 36% of these patients had cardiac symptoms, but only one presented with episodes of NSVT. Patients who responded with VF had a normal (50%) or abnormal heart; their mean LVEF was 52 +/- 19%; one died of heart failure, the others were asymptomatic. All but one of the patients who responded with VF1 had an underlying cardiopathy and a mean LVEF of 38 +/- 19%; 3 died, 2 of heart failure and 1 of sudden death; 13 were asymptomatic. All patients who responded with SVT had an underlying cardiopathy and a mean LVEF of 37 +/- 13%; 7 (30%) died, including 2 sudden deaths; 2 had episodes of VT and 12 were asymptomatic. In summary, an underlying cardiopathy was present in one-half of the patients who responded with NSVT or VF and in all patients who responded with VF1 or SVT. The risk of VT was low (5%) in patients who responded with NSVT, VF or VF1 and was higher (17%) in those who responded with SVT.
Arch Mal Coeur Vaiss 1987 Aug
PMID:[Prognostic value of ventricular tachycardia induced by stimulation in patients without documented tachycardia]. 312 85

The purpose of this study was to search for factors correlated with the absence of reinduction of a clinical ventricular tachycardia (VT) by stimulation in patients under anti-arrhythmic treatment. Repeated stimulations were performed in 41 patients with spontaneous VT and sustained, monomorphous ventricular arrhythmia induced by stimulation. The stimulation included 1 or 2 extrastimuli delivered into the right ventricle in sinus rhythm, then in imposed ventricular rhythm (600-400 ms). At least 4 anti-arrhythmic drugs were tested. In 16 patients (group I) of mean age 51 +/- 11 years VT was no longer reinducible under anti-arrhythmic treatment. In 25 patients (group II) of mean age 57 +/- 12 years no anti-arrhythmic drug was able to prevent VT induction. The characteristics of spontaneous and induced VT and of isotopic left ventricular ejection fraction (LVEF) were compared in both groups. The absence of reinduction of VT was obtained more easily in patients with: spontaneous, frequently unsustained VT; VT requiring 2 ventricular extrastimuli delivered in imposed rhythm to be induced; rapid initial induced VT (cycle 233 +/- ms vs 297 +/- 63 ms); less advanced underlying heart disease (LVEF 38 +/- 18 vs 27 +/- 13%). The subsequent history of the patients showed that the absence of reinduction of VT was correlated with a low risk of recurrence of VT (12.5 vs 48%) and with a lower risk of mortality (6% vs 32%) than in patients whose VT was always inducible under anti-arrhythmic treatment.
Arch Mal Coeur Vaiss 1987 Sep
PMID:[Factors predicting the response to an antiarrhythmic during an electrophysiologic study for ventricular tachycardia]. 312 9

Propafenone (P), a class IC antiarrhythmic drug, was tested intravenously and orally in the curative and preventive treatment of sustained (VTS) and non-sustained (VTNS) ventricular tachycardia. The 16 patients involved included 11 men and 5 women of mean age 49 years. They all had heart disease: ischaemia in 3, right ventricular arrhythmogenic dysplasia in 6, dilated myocardiopathy in 5 and left ventricular aneurysm in 2. Intravenous P in doses of 1.5 mg/kg controlled VT within 2 or 3 minutes on average in 9 out of 12 patients. Following the injection VT could not be reinduced in 2 out of 10 patients; other inductions were harder to obtain or resulted in VTNS instead of VTS (n = 3), or remained unchanged (n = 5). When P was administered orally (mean dose 900 mg) to 14 patients reinduction of VT was no longer possible in 2 cases, more difficult in 1 case, remained unchanged in 7 cases and was easier in 4 cases. Long-term oral therapy at the same dosage level prevented recurrences of VT in 7 out of 14 patients; the drug was discontinued in 2 patients owing to its arrhythmogenic effect on induced VT. The patients were followed up for 5 to 36 months (mean: 16.4 +/- 11.7 months). In this trial the results of long-term treatment could not be predicted from Holter recordings or measurements of plasma levels.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1987 Sep
PMID:[Treatment of ventricular tachycardia with propafenone. Parallel study of ventricular provocation tests]. 312 12

Ninety patients admitted to a neurology unit for cerebral ischaemic accident without evidence of embolism from the heart were examined by ambulatory electrocardiographic monitoring (AEM) and by echocardiography assessable in 76 cases. On the basis of a standard cardiac evaluation (SCE) including physical examination, chest radiography and electrocardiography, the patients were divided into 3 groups: 42 with normal SCE (group I), 19 with isolated arterial hypertension (group II) and 36 with patent cardiac disease (group III). Significant abnormalities were detected by AEM in 10.5% of group I patients, 18.5% of group II patients and 33% of group III patients. A structural cardiopathy was discovered at echocardiography in 33%, 62% and 91% respectively of patients in these 3 groups. The greatest number of mitral valve prolapses (7/9 cases) was found in group I. The main echocardiographic abnormality detected in group II was dilatation of the left cardiac cavities: atrium more than 38 mm in 8 cases, ventricle more than 50 mm in 3 cases. Comparisons between the two explorations showed that arrhythmias were often associated with dilatation of the left cardiac cavities (39%) and much less frequently with mitral valve prolapse (11%) and myocardial hypertrophy (16%). Our results suggest that when examinations cannot be routinely performed in hospital patients with a cerebral ischaemic accident echocardiography should be reserved to patients with heart disease or hypertension, and AEM to those with heart disease or hypertension and with dilatation of the left cardiac cavities.
Arch Mal Coeur Vaiss 1987 Oct
PMID:[Indications for the long-term electrocardiogram and echocardiogram after a cerebral ischemia complication]. 312 7

Between January, 1979 and December, 1985, 193 Saint Jude medical valves (SJM) were implanted in 165 patients (74 male, 91 female) aged from 14 to 78 years (mean age: 49 years). 101 patients underwent aortic valve replacement, 36 had mitral valve replacement and 21 had multiple valve replacement. Fitting with an SJM prosthesis was a primary emergency operation for 15 patients (9%) and a reoperation for 49 patients (31%). A concomitant surgical procedure was carried out in 39 patients (24%). The overall peri-operative mortality rate was 9% (15 patients), this figure falling to 5% (6/112 patients) when emergency surgery and reoperations are excluded. No patient was lost sight of. Mean follow-up was 37 +/- 3 months (range: 4 to 84 months), for a total duration of 413 years/patient. Five patients died of heart disease during the follow-up period, representing a mortality rate of 1.2% per year/patient. The actual survival rate was calculated as 90% at 1 year and 83% at 7 years. During that period 7 thromboembolic accidents occurred among 5 patients (actual rate: 1.7 accident per 100 years/patient). Two mechanical valve desinsertions requiring reoperation were recorded. Altogether, the actuarial rate of patients without any post-operative complication was 88% at 1 year and 65% at 7 years. Functional improvement was dramatic since 94% of survivors are now in class I or II, whilst 67% of patients were in class III or IV prior to surgery. It may be concluded that the mid-term
Arch Mal Coeur Vaiss 1987 Nov
PMID:[Clinical experience with the Saint Jude prosthesis. Results over a period of 7 years]. 312 17

We report a case of vagal hypertonia syndrome in a newborn infant, developed after surgical repair of an aortic coarctation combined with banding of the pulmonary artery trunk. The parasympathetic activity had adverse repercussions on haemodynamics. The diagnosis was confirmed by prolonged asystole on the oculocardiac reflex and by concomitant arrhythmia and disorders of conduction demonstrated by Holter recordings. To our knowledge, no other case of vagal hypertonia associated with a congenital cardiopathy has yet been reported. Infants with this syndrome are at a high risk of sudden death. Treatment with vagolytic drugs is of questionable value, and prolonged supervision of the patient is mandatory.
Arch Mal Coeur Vaiss 1987 Nov
PMID:[Syndrome of vagal hypertonia in a newborn infant manifested during the surgical repair of aortic coarctation associated with banding of the pulmonary artery]. 312 27

A new case of right coronary artery abnormally issued from the pulmonary trunk is reported. The patient was an asymptomatic young man in whom a continuous cardiac murmur was discovered by chance and an angiographic examination disclosed the coronary abnormality. A review of the literature yielded 37 cases of this anomalous origin which was either isolated, as in the case reported here, or associated with another congenital or acquired cardiopathy. The diagnosis may be suspected on the presence of a continuous murmur in an usually asymptomatic subject and is confirmed by angiography. The abnormality is generally well tolerated owing to an inter-coronary collateral circulation resulting in retrograde perfusion of the right coronary artery from the left coronary artery. This good tolerance explains why an isolated abnormality of that type is often discovered belatedly, in contrast with the anomalous origin of the left coronary artery from the pulmonary trunk, which is usually revealed at birth by clinical signs of acute coronary insufficiency. However, the likelihood of either cardiac failure due to the left-to-right shunt in elderly people or, chiefly, acute myocardial ischaemia by coronary steal with a risk of sudden death in young people makes it imperative in such cases to perform reimplantation surgery.
Arch Mal Coeur Vaiss 1988 Jan
PMID:[Right coronary artery issuing from the pulmonary artery: review of the literature apropos of a case]. 313 15

Twenty-seven patients (15 men, 12 women; mean age 48.9 years) suffering from ventricular tachycardia (VT) (n = 30) were studied by radionuclide angiocardiography with Fourier phase analysis, both in sinus rhythm and during tachycardia. VT was spontaneous, electrically inducible, sustained, haemodynamically stable and monomorphous, with a mean rate of 174 beats/min (range: 115-260 beats). Heart diseases responsible for VT were: non-obstructive cardiomyopathy (n = 7), hypertrophic cardiomyopathy (n = 1), ischaemic heart disease (n = 5), probable right ventricular arrhythmogenic dysplasia (n = 4), congenital left ventricular aneurysm (n = 2), sequela of myocarditis (n = 2) and aortic valve regurgitation (n = 1); no heart disease was detectable in 5 patients. On surface electrocardiogram there was good concordance between the initial radionuclide site of VT activation and the configuration and electrical axis of QRS. At Fourier phase analysis all 17 VT of the right lag type originated in the left ventricle, arising from the apical septum (n = 7) or lateral segment (n = 2) in case of left axis, from the basal segment (n = 6) or the lateral segment (n = 1) in case of vertical or right axis, and from the middle left septum (n = 1) in case of normal axis. Nine VT of the left lag type originated in the right ventricle, arising from the basal septum or the latero-basal region in case of vertical or right axis (n = 6), from the apical septum or the inferior-apical region in case of left axis (n = 2) and from the middle septum in case of normal axis (n = 1). Four of our patients (3 with coronary disease and 1 with congenital left ventricular aneurysm) had VT of the left lag type and an initial radionuclide site of activation in the middle part of the left septum in case of left axis (n = 2) and in the basal part of that septum in case of right axis (n = 2). Seven patients were operated upon for recurrent VT: 4 had intra-operative mapping which in every case confirmed the results of radionuclide angiocardiography, a method which in the other 3 patients was the only surgeon's guide. Correlations between the site of origin of VT at radionuclide mapping and kinetic abnormalities visualized at radiological angiography and gamma-ray angiocardiography were common in our study. In one of our patients the same lesion gave birth to 2 VT of different morphologies.(ABSTRACT TRUNCATED AT 400 WORDS)
Arch Mal Coeur Vaiss 1988 Apr
PMID:[Isotope angiocardiographic study of 30 cases of ventricular tachycardia with Fourier phase analysis]. 313 7

In spite of the prominent position reached by echocardiography in the anatomical and functional diagnosis of congenital heart disease, angiography remains the reference method for preoperative assessment of most cardiovascular malformations. Digitalization of angiographic images, recently applied to cardiology, is of particular interest in paediatrics: the versatility of the method, the smaller amount and dilution of the contrast medium, the diminution of catheter size and the shorter exposure to X-rays are factors that reduce the risk of this invasive investigation. The experience acquired by the exploration of 500 congenital heart disease shows that there is no technical obstacle to using this method in paediatric cardiology, especially since the images obtained clearly are of better quality. Digital angiocardiography already has superseded the conventional analogical exploration in paediatric patients.
Arch Mal Coeur Vaiss 1988 May
PMID:[Digital subtraction angiography in pediatrics]. 313 21

Interrupted aortic arch is a duct-dependent heart disease, and this is why the use of prostaglandins E, which keep the ductus arteriosus open to feed the descending aorta, has transformed its formerly sombre prognosis. The authors report the cases of 9 neonates and infants presenting with interrupted aortic arch associated with ventricular septal defect who underwent total repair of the malformations under extracorporeal circulation. Five children were less than 10 years' old. The aortic lesions were of type A in 2 cases (interruption distal to the left subclavian artery) and of type B in 7 cases (interruption between the left carotid and subclavian arteries). In the second group the lesions were of type B1 in 5 cases (without retro-oesophageal right subclavian artery) and of type B2 in 2 cases (right retro-oesophageal artery distal to the interruption). There was one death (11 p. 100). So far, no child has been reoperated upon for residual aortic obstruction or reopened ventricular septal defect. This technique of total repair in one stage, with closure of the ventricular septal defect, seems to be preferable to the two-stage technique in which stage one includes, in addition to aortic arch repair, cerclage of the pulmonary artery, a procedure with numerous disadvantages and a higher overall mortality rate.
Arch Mal Coeur Vaiss 1988 May
PMID:[Complete repair of the interrupted aortic arch by an anterior approach. Apropos of 9 cases]. 313 22


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