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)

Taurine is important for the regulation of ionic fluxes in excitable tissues, especially in heart where it is the most abundant amino acid. To investigate a possible role of taurine in uremia, we measured the taurine concentrations in plasma, liver, muscle, heart, and brain tissues of young male Wistar rats. Two groups of rats were studied: (1) rats with acute renal failure (ARF) 12, 24, and 48 hours after bilateral nephrectomy and (2) rats with chronic renal failure (CRF) studied 3 weeks after 5/6 nephrectomy. In ARF animals, taurine increased in plasma and liver two to three times the normal levels, remained unchanged in muscle and brain, but decreased in heart tissue; this decrease (-20%) was significantly correlated with the concomitant increase of BUN and plasma creatinine. In CRF animals, taurine was unchanged in plasma, liver, muscle, and heart, but was increased by 70% in brain accompanied by a high content of gamma-aminoisobutyric acid. The data suggest that in uremia accumulation of taurine is counteracted by increased hepatic elimination and/or decreased synthesis. The depletion of taurine in cardiac muscle might be related to the development of uremic heart disease. The increased concentrations of brain taurine might represent a compensation for the increased neuroexcitability in CRF.
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PMID:Taurine metabolism in experimental renal failure. 658 73

During a consecutive 17 month period, 15 trauma patients were diagnosed as having a myocardial contusion on the basis of abnormal ECG in 14 patients, elevated creatinine phosphokinase (CPK) in 13 patients, and elevated CPK-Muscle Brain (CPK-MB) isoenzyme determination in 11 patients. Using these screening modalities, the incidence of myocardial contusion in patients with blunt chest trauma increased from 7% when viewed retrospectively to 15% when viewed prospectively. Five patients had determinations of cardiac index of which 4 were less than 2.9 L/min . M2. An additional 9 patients underwent a standard fluid challenge of 500 ml of 5% plasma protein faction infused over 30 min allowing construction of a Starling myocardial performance curve. Of these patients, 6 had biventricular dysfunction, 1 had isolated abnormal left ventricular function, and 2 had isolated abnormal right ventricular function in the absence of chronic obstructive pulmonary disease or preexisting heart disease. Multiple gated acquisition scans (MUGA) were abnormal in 6 patients and normal in 4 patients. Of the latter group, 3 had biventricular dysfunction and 1 had depressed cardiac index. Morbidity and mortality for myocardial contusion occurred in 40% (6 of 15) of patients in this series. Direct hemodynamic measurement with construction of a Starling curve was useful in monitoring the degree of impairment and subsequent recovery of myocardial function. This information was important in delaying semiurgent operations or in determining the best alternative of otherwise equally acceptable methods of patient management.
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PMID:Ventricular function in myocardial contusion: a preliminary study. 705 50

One hundred sixteen patients underwent surgery for ruptured abdominal aortic aneurysms with intraoperative and overall mortality rates of 20.7% and 51.7%, respectively. The correlation of multiple factors to morbidity and mortality was assessed with detailed statistical analysis. Eight preoperative factors were identified as predictors of mortality. Increased intraoperative mortality rates were associated with heart disease (29%), hypertension (30%), flank ecchymoses (57%), and pulsatile abdominal mass (24%). Increased intraoperative and overall mortality rates were associated with preoperative hypotension (39%, 78%) and BUN levels higher than 30 mg/dl (47%, 82%). Increased overall mortality rates were associated with creatinine levels higher than 3 mg/dl (71%) and a hematocrit of 30.0 to 32.5 vol% (75%) (P less than 0.05). Seven intraoperative factors were identified as predictors of mortality. Increased postoperative mortality rates were associated with a duration of operation of more than 400 minutes (100%), hypotension lasting longer than 110 minutes (88%), estimated blood loss more than 11,000 ml (75%), blood transfusion more than 17 U (68%), fluid administration in excess of 7000 ml (70%), and a blood pressure lower than 100 mm Hg at the conclusion of the operation (88%). Cardiac arrest was associated with increased intraoperative and overall mortality rates (77%, 82%) (P less than 0.05). In general these factors cannot be controlled by the surgeon, and future significant reduction in the operative mortality rate may be possible. These findings support the general concept of aggressive elective resection of abdominal aortic aneurysms.
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PMID:Abdominal aortic aneurysm rupture: statistical analysis of factors affecting outcome of surgical treatment. 707 47

Two groups of 15 children aged from 15 days to 6 years, undergoing surgery on cardiopulmonary by-pass for congenital heart disease have been retrospectively analyzed. Group A received a low-dose aprotinin treatment (30,000 KIU/kg in the priming solution); group C (control group) did not receive any aprotinin. Groups were homogeneous for pathology, cardiopulmonary by-pass time, aortic cross-clamping time, cyanotic/acyanotic patients ratio, temperature during cardiopulmonary bypass. A number of postoperative data were measured: activated clotting time was without any difference between aprotinin-treated and control patients; the same went for temperatures, urine output, intubation time, stay in Intensive Care Unit, coagulation tests, platelet counts, hematocrit, survival rate, and blood loss. Serum creatinine levels were significantly higher in group A than in group C both at the arrival in Intensive Care Unit (0.81 +/- 0.27 vs 0.66 +/- 0.12, p = 0.032) and in the first postoperative day (1.01 +/- 0.5 vs 0.72 +/- 0.19, p = 0.038). BUN was significantly higher in group A vs group C in the first postoperative day (43.6 +/- 21.1 vs 33.9 +/- 16.7, p = 0.043). We conclude that low-dose aprotinin did not reduce postoperative bleeding; we cannot exclude that higher dosages could be more effective, but the evidence of a moderate tubular function impairment suggests caution in using high-dose aprotinin in children.
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PMID:Renal effects of low dose aprotinin in pediatric cardiac surgery. 752 60

Haematological features of 64 patients suffering from non operable cyanotic congenital heart disease (CCHD) treated with hydroxyurea (HU) were compared with those of 43 patients suffering from the same disorder who had not yet received this drug. Patients with subclinical renal dysfunction were excluded by measuring plasma creatinine levels. MCV and HbF were higher among patients receiving HU, the increase in MCV being cumulative with HU dosage but the rise in HbF dose independent. HbF response to HU was found to be due to the coordinated increase in F-cell and F-reticulocyte production rather than to a selective survival of F-cells. Absence of a relationship between plasma erythropoietin and HbF levels excluded a dominant role of the former in increasing F-cell production and results determined after doubling the HU dosage or immediately after initiating therapy suggested genetic differences to be responsible for the individual variations in Hb F response. No irreversible toxic effects or malignancies were noted in this series of patients. HU was administered for a relatively long period of time, the mean duration of treatment exceeding 5 years, while the study also included patients below the age of 10 years.
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PMID:Fetal haemoglobin variations following hydroxyurea treatment in patients with cyanotic congenital heart disease. 753 99

The prevalence of peripheral vascular disease (PVD) was assessed in terms of ankle/brachial index by doppler studies in a large cohort of non-insulin-dependent diabetes mellitus (NIDDM) patients in South India. One hundred and ninety-two out of 4941 patients (3.9%) had evidence of PVD. There was a slight female excess in PVD patients. There was a linear increase in prevalence of PVD with increasing duration of diabetes. Multiple logistic regression analyses showed that serum cholesterol, serum creatinine, systolic BP, duration of diabetes and ishaemic heart disease are strong predictive factors for PVD. The prevalence of PVD in South Indians is lower than that reported in European populations.
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PMID:Peripheral vascular disease in non-insulin-dependent diabetes mellitus in south India. 755 7

Patients on dialysis have an age-adjusted death rate 3.5 times that of the general population. The most common cause of death in patients on dialysis is cardiovascular disease. We prospectively followed a cohort of 433 patients in three centers for a mean of 41 months. Mean hemoglobin level at the beginning of dialysis was 8.39 (+/- 1.7) g/dL, and the mean hemoglobin level during follow-up was 8.84 (+/- 1.5) g/dL. Using Cox's regression model, we found that anemia predicted mortality independently of age, diabetes mellitus, cardiac failure, hypoalbuminemia, serum creatinine, mean arterial pressure, or echocardiographic heart disease. The independent relative risk (RR) of mortality was 1.18 per 1.0 g/dL decrease in hemoglobin level. Anemia also independently predicted the de novo occurrence of congestive heart failure when the same covariates were controlled for (RR, 1.49 per 1.0 g/dL decrease). Anemia was also independently predictive of heart failure at the start of dialysis (RR, 1.14 per 1.0 g/dL decrease) and heart failure recurrence (RR, 1.25 per 1.0 g/dL decrease). Left ventricular hypertrophy is present in 75% of patients on dialysis at the start of therapy for end-stage renal disease. It independently predicts mortality. Our prospective cohort study identified increasing age, hypertension, and anemia as risk factors for its development. One controlled study and several uncontrolled studies demonstrated improvement (but not complete regression) of elevated left ventricular mass in patients on dialysis treated with recombinant human erythropoietin (epoetin).
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PMID:Cardiac function and hematocrit level. 770 71

A left ventricular assist system (LVAS, Toyobo CO., LTD., Japan) was used to provide life support for 190 days in a 44-year-old male patient with end-stage dilated cardiomyopathy. Before LVAS implantation, heart failure and cardiogenic shock with multi-organ dysfunction progressed despite the use of intra-aortic balloon pumping (18 days), mechanical ventilatory support (15 days), continuous veno-venous hemofiltration (two days) and intravenous administration of catecholamines. Before LVAS implantation, the patient had marked hepatic and renal dysfunction (total bilirubin 6.1, BUN 73 and serum creatinine 3.1 mg/dl). Those functions returned to normal (total bilirubin 1.2, BUN 11 and serum creatinine 0.6 mg/dl) one month after implantation. He was complicated by multiple cerebral embolisms occurring on the 9th, 57th and 175th postoperative days and died 190 days after surgery. Autopsy showed thrombi attaching to the diaphragm of the blood pump and multiple embolisms in the kidney and the spleen. By scanning electron microscopic examination, initial thrombi with attached erythrocytes were seen on the diaphragm surface without intimal lining formation. In conclusion, LVAS support can be useful for patients with end-stage heart disease complicated by multi-organ dysfunction. However, the LVAS may cause thromboembolic complications over the prolonged use.
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PMID:Efficacy and limitation of a left ventricular assist system in a patient with dilated cardiomyopathy accompanying multi-organ dysfunction. 779 Mar 33

The development of renal failure necessitating peritoneal dialysis after cardiac operations is associated with a reported mortality greater than 50%. Improved fluid removal and nutritional support have been reported with the use of continuous arteriovenous hemofiltration and continuous venovenous hemofiltration techniques. We have compared our experience with all three techniques in managing children who required renal replacement therapy after cardiac operations in terms of efficacy (fluid removal, calorie intake, and clearance of urea and creatinine), complications, and outcome. Over a 5-year period renal replacement therapy was initiated in 42 children, and in 34 of them it was successfully established for more than a 24-hour period: 17 were managed with peritoneal dialysis, 8 with continuous arteriovenous hemofiltration, and 9 with continuous venovenous hemofiltration. A net negative fluid balance was achieved in only 6 (35%) patients treated with peritoneal dialysis compared with 50% of those treated with continuous venovenous hemofiltration and 89% of those treated with continuous venovenous hemofiltration. In terms of nutritional support, calorie intake increased by 43% after peritoneal dialysis was started compared with 515% and 409% in the arteriovenous and venovenous hemofiltration groups, respectively, (p < 0.005). The serum urea levels fell by 36% (p = 0.02) and 39% (p = 0.005) compared with pre-therapy levels with arteriovenous and venovenous hemofiltration, respectively, and the creatinine content was reduced by 19% and 33% (p = 0.003). Neither parameter was reduced in the peritoneal dialysis group. We conclude that the use of hemofiltration as a renal replacement therapy after surgical correction of congenital heart disease offers significant advantages over the more traditional approach of peritoneal dialysis. In addition, we suggest that a more aggressive approach to the management of fluid overload and nutritional depletion with hemofiltration may result in a decrease in the very high mortality seen in renal failure after cardiac operations.
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PMID:Renal replacement therapy after repair of congenital heart disease in children. A comparison of hemofiltration and peritoneal dialysis. 785 85

The intention of this paper was to describe a reliable method for the diagnosis of cardiomyopathy (CMP) in adult cattle and, in particular, a clear distinction between CMP and inflammatory heart disease (IHD). In a first study we performed a linear discriminant analysis using serum and urine electrolyte concentrations (sodium, potassium, calcium, magnesium, chloride, phosphate, iron, creatinine) of 33 CMP-affected and 35 healthy cattle. This analysis allowed to classify all the animals of both animal groups correctly. In a second study, we examined the clotting reaction of the glutaraldehyde coagulation test (GCT) in cardiomyopathy (n = 49), inflammatory heart diseases (n = 9) and in healthy cows (n = 35). 96% of the CMP-sick and all the control animals showed a clotting time above 10 minutes. In the IHD group, the clotting time was always below 10 minutes. In a third study, we applied the combination of discriminant analysis and GCT to a new set of CMP- (n = 14) and IHD-affected (n = 9) as well as to healthy cattle (n = 15). The classification was correct in 93% of the CMP-sick and in all the IHD-affected and the control animals. The results are discussed.
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PMID:Diagnosis of bovine cardiomyopathy by electrolyte and protein analysis. 813 75


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