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 a survey of 3 California communities by the Stanford Heart Disease Prevention Program, we obtained data on blood pressure, medications, age, height and weight, blood for measurement of plasma renin activity (PRA), plasma renin concentration (PRC), plasma renin reactivity (RR), and plasma renin substate concentration (PRS), and urine for measurement of urinary sodium and creatinine. No effect of conjugated estrogens (Premarin) on blood pressure could be discerned when the blood pressure, corrected for age and relative weight, of 575 women on no medication was compared to that of 82 women taking only Premarin. Premarin increased PRA, PRS, and RR, but had no effect on PRC. We also found in both Premarin-treated woman and controls 1) that RR was positively correlated with PRS, and 2) that PRA is dependent on PRC and PRS. These data indicate that the reninrenin substrate reaction of plasma, even at normal substrate concentration, is strongly deprendent on PRS.
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PMID:The effect of conjugated estrogens on the renin-angiotensin system. 19 9

A case is presented of a familial form of apparently primary cardio-myopathy with findings on investigation and histology which were in favour of a generalised subclinical muscular disorder: a raised serum creatinine phosphokinase, persistent carnosinuria on a vegetarian diet, and under the light microscope several features indicative of a myogenic dystrophic condition on deltoid biopsy. From their clinical features, these original cases may be classified somewhere between primary familial heart disease and the cardiac complications of myopathies. The value of the creatinine phosphokinase isoenzymes and of muscle biopsy in situations such as these is discussed.
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PMID:[Familial myopathy with exclusively cardiac clinical expression]. 41 19

The effects of aminophylline on renal function in 10 premature infants with idiopathic apnea are evaluated. The percent increases in creatinine clearance (128 +/- 339%, mean +/- SD) and sodium clearance (196 +/- 304%, mean +/- SD) are variable while the percent increase in fractional sodium excretion (69 +/- 109%, mean +/- SD) is significant. This effect is postulated to be at the proximal tubule and may be modified by the effects of postnatal age and infusion of albumin. Gestational age, birth weight, heart disease, water and sodium intake and ventilatory support did not appear to influence the results. Hyponatremia is a potential consequence of theophylline therapy for apnea.
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PMID:The effects of theophylline on renal function in the premature newborn. 43 87

Steady state serum concentrations of digoxin were determined repeatedly in 34 infants with congenital heart disease. Simultaneous measurements of renal clearances of digoxin, creatinine and urea were obtained in 29 of the subjects. Serum digoxin concentrations were markedly higher in children under the age of 3 months than in those over this age, despite equal weight--adjusted 24 h doses. This finding was explained by a very rapid increase in renal digoxin clearance in the first 3 months--32 +/- 7 ml/min/1.73m2 at 1 week to 65.6 +/- 30 at 3 months. The subsequent increase in digoxin clearance was much slower, e. g. to 87.7 +/- 43 ml/min/1.73m2 at 12 months. Renal clearance of digoxin was equally well correlated with creatinine clearance (r = 0.87) as with urea clearance (r = 0.83), but it exceeded that of creatinine in all age groups. The findings indicate that both glomerular and tubular function is involved in the renal elimination of digoxin in young children, and that development of renal elimination of the drug parallels that of the maturation of renal function in the early months of life. The neonate and infant with congestive heart failure display impaired ability to eliminate digoxin. The impairment lessens rapidly with the development of renal function over the first 3 months of life. Diminished doses of digoxin should be advocated in this age group if therapeutic serum concentrations of the drug are to be maintained and toxicity avoided.
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PMID:Steady state serum concentrations and renal clearance of digoxin in neonates, infants and children. 65 6

The renal clearance of digoxin and creatinine were measured in eleven infants, aged one to five months, with congenital heart disease and heart failure. The renal clearances of digoxin were low at one month of age (50 ml/min/1.73 m2) but increased progressively until the adult range was attained at about five months of age (130-150 ml/min/1.73 m2). At any given age, however, the renal clearance of digoxin was almost twice as great as the simultaneously determined creatinine clearance (mean ratio 1.73). This stands in marked contract to older subjects where creatinine and digoxin clearances are usually similar. These data explain (in part) the larger digoxin dosage requirement of infants.
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PMID:Renal clearance of digoxin in young infants. 84 90

Digoxin serum and urine levels were determined by radioimmunoassay in 6 subjects (4 patients with heart disease and 2 volunteers without heart disease) who had been maintained on oral digoxin (0.25 or 0.5 mg daily). Observations were made during a 3-day control period and then during 8 days of concomitant digoxin and oral furosemide (40 mg daily) therapy. Serum digoxin levels determined 10 and 24 hr after each dose of digoxin averaged 1.2+/-0.1 ng/ml (M+/-SE) during control and 1.3+/-0.1 during the last 3 days on digoxin and furosemide. The daily urinary excretion of digoxine averaged 51+/-6% of the oral dose during control and 52+/-6 during the entire period of furosemide administration. The renal clearance of digoxin and creatinine averaged 94+/-7 and 87+/-11 ml/min, respectively, during control; corresponding values were 88+/-8 and 85+/-9 for urine collections demonstrating a distinct diuretic effect of furosemide and 87+/-8 and 75+/-10 for urine collections not demonstrating such an effect during diuretic therapy. The results suggest that the diuretic effect of furosemide does not significantly affect the excretion of digoxin
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PMID:Effect of furosemide on the renal excretion of digoxin. 97 15

Children with cyanotic congenital heart disease had a decreased glomerular filtration rate (71-8 +/- 18-9 ml/min per 1-73 m2) measured by endogenous creatinine clearances, compared with children who had had complete corrective surgery, children with noncyanotic heart disease, and normal children. There was a significant correlation between low glomerular filtration rate and haematocrit values above 50%. Daily urinary sodium excretion was reduced in the cyanotic patients.
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PMID:Abnormal renal functions in cyanotic congential heart disease. 100 86

Some new predictors of postoperative psychosis in open-heart surgery have been identified in a multifactorial study of somatic and psychological factors: Somatic predictors are lower body weight, higher blood levels of urea nitrogen and creatinine, preoperative use of tranquilizers, especially in patients with double valve replacement or congenital heart disease and preoperative cerebral embolism in mitral valve disease. Bypass-time has not proved to be a valid predictor. Psychological predictors are distress provoked by severity and duration of illness, repeated delay of surgery as well as the manner of psychological coping with the illness.
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PMID:[Some somatic and psychological predictors of psychopathological disorders after cardiac surgery (author's transl)]. 108 27

During 76 extracorporeal circulations (CEC) carried out for open heart operations using an identical protocol, the authors carried out renal function tests from the time of administration of the anesthetic to the post-operative period. Various periods may be distinguished: pre-operative, anesthesia induction (CEC 1, CEC 2) post induction (CEC 1, post CEC 2) finally, the post-operative period (post-operative 1 to 4). As far as renal hemodynamics are concerned, the authors made the following observations: constant reduction in thiosulphate clearance and endogenous creatinine clearance, which reflect glomerular filtration. Reduction in PAH clearance, which reflects renal perfusion. Taking into consideration changes in the hematocrit, one may consider that there is a reduction in renal blood flow at all stages of anesthesia. Taking into consideration concomitant variations in blood pressure, one may calculate that intrarenal resistances are increased. The diuresis/minute increases in very great proportions during induction of anesthesia. Plasma osmolality also increases, urinary osmolality becomes reduced and osmolar clearance rises. The ratio between osmolar clearance and creatinine clearance rises. The clearance of free water rises from negative values. The serum sodium becomes slightly reduced, and sodium diuresis increases. Serum potassium becomes slightly reduced and urinary potassium rises. The interpretation of these phenomena is difficult and should take into consideration the experimental conditions. Comparison with published results shows that there are definite differences depending on whether pure or diluted blood is used. It is however, possible to seek the role of the anesthetic, the thoracotomy or the extracorporeal circulation itself and its load, quite independent of prior changes due to decompensation or not of the congenital heart disease, whether or not it has been treated. The study of these changes in renal function permits one to understand better the precariousness of renal perfusion during extracorporeal circulation, imperfectly corrected by osmotic diuresis and responsible for transient and reversible renal hypofunction, liable to lead however, in cases of complications and prolonged low blood flow, to organic renal failure.
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PMID:[Renal functions and extracorporeal circulation]. 110 26

In order to study the occurrence of postbypass hyperamylasemia, 75 patients undergoing cardiopulmonary bypass (CPB) were studied from March 1989 to January 1990. There were 49 males and 26 females. Among them, 27 had congenital heart disease, 30 had valvular disease, and 18 had coronary artery disease. There were 27 patients with at least one elevated serum amylase sample after operation. Thus, the overall incidence of hyperamylasemia was 36%. As compared with the preoperative data (1.3%), there was a statistically significant difference in the occurrence of hyperamylasemia (p less than 0.05). Three patients had overt clinical pancreatitis postoperatively. There was no positive correlation between the serum amylase level and the occurrence of pancreatitis (p greater than 0.05). Forty-two cases had a significant elevation of the amylase creatinine clearance ratio (ACCR) after CPB. However, there was no significant difference between the groups with pulsatile and nonpulsatile CPB (p greater than 0.05). Three patients (4%) died in our series. The causes of death were heart failure in two and fulminant pancreatitis associated with low cardiac output in one. Although our experience in dealing with pancreatitis improved survival, mortality was still high (33.3%) in our series. Nevertheless, there was no apparent correlation between mortality and postbypass hyperamylasemia (p greater than 0.05). Logistic regression analysis was used to analyze the risk factors of the occurrence of hyperamylasemia, and the analysis revealed that patients with coronary artery disease were susceptible to postbypass hyperamylasemia. Our studies indicate that the use of total serum amylase or ACCR to monitor for the occurrence of pancreatitis in postbypass patients is inadequate.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hyperamylasemia following cardiopulmonary bypass. 137 42


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