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

In 103 out of 220 alcoholics (46.8%) with no heart disease electrocardiographic abnormalities were found, sinus tachycardia, T-wave irregularities and intraventricular conduction disturbances being the most common features. Comparing 138 chronic alcoholics with those of 134 healthy abstainers for the systolic time-intervals, the following abnormalities were found in the former group: prolonged PEP and ICT, shortened LVET, increased PEP/LVET and heart rate. Correction of the time intervals for heart-rate left the direction of the changes unaffected. Nor was the age of the subjects found to affect the intervals to any significant degree either in the alcoholics or in the control group. It is therefore assumed that the effect of alcohol on the time-intervals operates through at least two mechanisms, an increase in heart-rate, and a depression of myocardial contractility.
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PMID:Changes in cardiac function in the "preclinical" stage of alcoholic heart disease. 745 29

Despite the increasing use of Doppler echocardiographic (DE) techniques to determine pulmonary arterial pressure in the neonate undergoing intensive care, there have been no studies comparing their repeatability in this population. Our objective was to compare the repeatability of four such techniques in neonates. The study was conducted in two regional neonatal units serving the North East of England. Group A (repeatability between observers): Two experienced observers performed detailed DE examinations, one directly after the other. Group B (within observer repeatability/temporal variability): One observer performed two examinations 1 hour apart. Group A comprised 15 preterm babies (26-36 weeks' gestation, 975-2915 g), most with mild respiratory failure; 4 healthy term babies; and 7 with congenital heart disease, in whom tricuspid regurgitation (TR) only was measured. Their ages were 18 hours to 12 days. Group B comprised 11 babies aged 12-64 hours with moderate to severe respiratory failure; 10 were preterm (26-36 weeks, 785-2800 g). We recorded four measurements: (1) Peak velocity of TR in m/s; (2) peak left-to-right ductal flow velocity (PDAmax in m/s); (3) TPV/RVET ratio; and (4) PEP/RVET ratio, where TPV = time to peak velocity at the pulmonary valve, PEP = right ventricular preejection period, and RVET = right ventricular ejection time. The Bland-Altman analysis was used to produce the coefficient of repeatability (CR: 95% confidence limits of repeatability), also expressed as a repeatability index (CR/mean value) and as a number of "confidence steps"-a measure of sensitivity of the technique to hemodynamic change (range of values within the population/CR). Between-observer and within-observer repeatabilities were similar. Within-observer CR and index (%) results were for TR +/- 0.26 m/s (9%); for PDAmax, +/- 0.48 m/s (39%); TPV/RVET 0.1:1.0 (34%), PEP/RVET 0.12:1.00 (36%). TR and PDAmax had the largest number of confidence steps in the expected range of values (TR 8.5; PDA max 6.5; TPV/RVET 3.2; PEP/RVET 3.2). The most repeatable technique was TR, but PDAmax would also be useful for a serial study owing to the potential for large change. Systolic time interval ratios were less repeatable and likely to be less sensitive indicators of hemodynamic change.
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PMID:Estimation of pulmonary arterial pressure in the newborn: study of the repeatability of four Doppler echocardiographic techniques. 878 Oct 85

This year, several studies performed were justified by the increasing importance of diastolic dysfunction, while the systolic dysfunction remains stable. Its prognosis, previously considered as benign, is similar to heart failure due to systolic dysfunction. Studies are difficult in this field and we are often satisfied by imperfect results: PEP CHF, limited by the enrollment issue, showed only a trend for a beneficial effect of ACE-inhibitors. However the study can be considered as significant if only limited to the first year of follow-up, which can be justified. The second major field of research is resynchronization therapy: echocardiographic studies keep on providing asynchrony criteria. The benefit is greater in case of less extended fibrosis, and if the heart disease is non-ischemic, and if the paced zone does not contain fibrosis. Finally, a promising study on the interest of left ventricular discharge by a long-term circulatory assistance in case of severe systolic dysfunction should be cited.
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PMID:[The best of cardiac failure in 2006]. 1740 68


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