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)

We investigated a large Old Colony (Chortitza) Mennonite kindred with branches across Canada. Six generations of the kindred were traced. There was intermarriage among numerous family members. Insulin-dependent diabetes mellitus (IDDM) was identified in 10 members; all 7 living patients were found to carry the immunogenetic marker HLA-DR4. Nine other close relatives had disorders of carbohydrate metabolism, including gestational diabetes mellitus and non-insulin-dependent diabetes mellitus progressing to insulin use. Ten other relatives had autoimmune diseases, including rheumatoid arthritis, hyperthyroidism, hypothyroidism and multiple sclerosis. Cases of Alport's syndrome, congenital malformations, inborn errors of metabolism and unusual malignant diseases were also found in the kindred. In the small Alberta community in which the kindred was ascertained there were people of Old Colony Mennonite descent with genetic conditions such as Gilles de la Tourette's syndrome and congenital malformations, including congenital heart disease. This kindred represents the largest reported familial aggregation of IDDM. This disease and other disorders of carbohydrate metabolism occur in the context of a strong familial predisposition to autoimmune disease. Study of this family may permit empiric testing of proposed models of inheritance of diseases of complex origin such as IDDM. We report this Old Colony (Chortitza) Mennonite community because it is one of the settlements populated by this religious and genetic isolate, which extends across Canada and Central and South America and affords opportunities for the study of both common and rare inherited diseases.
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PMID:Unusual clustering of diseases in a Canadian Old Colony (Chortitza) Mennonite kindred and community. 337 May 69

To estimate the number of adults medically eligible to donate blood, the percent of the general population over the age of 16 deferrable by 13 current American Red Cross donor guidelines was calculated using the best available United States data. Categories examined included age, weight, hematocrit, pregnancy, blood pressure, heart disease, diabetes requiring insulin, male homosexual activity since 1977, intravenous drug use, sexual partner of high-risk group member, recent transfusion, history of cancer, and other (medical, surgical, travel history). Sex-specific total eligibility rates were estimated by serial multiplication of individual eligibility rates (1.0 minus deferral rates) to account for the proportionate overlap of independent categories, with corrections for expected associations between categories. The resultant eligibility rates for women (57%) and men (70%) indicate fewer eligible donors than commonly stated. Surrogate testing (ALT, anti-HBc) for non-A, non-B hepatitis would further reduce the percent of eligible donors to 55 and 67%, respectively. Based on the actual numbers of women and men in the population, these calculations indicate that an equal number of women and men are medically eligible to donate.
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PMID:An estimate of blood donor eligibility in the general population. 337 67

Indexes of left ventricular diastolic filling were measured by pulsed Doppler echocardiography in 21 insulin-dependent diabetic patients and 21 control subjects without clinical evidence of heart disease. No patient had chest pain or electrocardiographic changes during exercise testing. The mean age of patients was 32 years. All patients had a normal ejection fraction. Six (29%) of the 21 diabetic patients had evidence of diastolic dysfunction as assessed by the presence of at least two abnormal variables of mitral inflow velocity. The ratio of peak early to peak late (atrial) filling velocity was significantly decreased in diabetic compared with control subjects (1.24 +/- 0.21 versus 1.66 +/- 0.30, p. less than 0.001). Atrial filling velocity was significantly increased in diabetic patients (74.3 +/- 16.7 versus 60.3 +/- 12.2 cm/s, p less than 0.004), whereas early filling velocity was reduced by a nearly significant degree (88.8 +/- 12.6 versus 98.5 +/- 18.8 cm/s, p less than 0.057). The atrial contribution to stroke volume as assessed by area under the late diastolic filling envelope compared to total diastolic area was also significantly increased in diabetic compared with control subjects (35 versus 27%, p less than 0.001). Left ventricular diastolic filling abnormalities in diabetic patients did not correlate with duration of diabetes, retinopathy, nephropathy or peripheral neuropathy. These data suggest that approximately one-third of such patients have subclinical myocardial dysfunction unrelated to accelerated atherosclerosis. Doppler echocardiography may offer a reliable noninvasive means to assess diastolic function and to follow up diabetic patients serially for any deterioration in cardiac status before the appearance of clinical symptoms.
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PMID:Diastolic abnormalities in young asymptomatic diabetic patients assessed by pulsed Doppler echocardiography. 337 97

Digitized M-mode echocardiograms were obtained during semisupine bicycle exercise in 10 relatively young (less than 40 years) long-term (greater than or equal to 12 years) type 1 (insulin-dependent) diabetic men, without overt heart disease, and 10 controls. Recordings were done at rest and during workloads of 50 and 100 W. At rest, heart rate was similar in the groups, while at peak exercise it was higher in the diabetics whose left ventricular (LV) end-diastolic dimension was smaller at all study phases. From baseline to peak exercise the diastolic period decreased in both groups, while the LV diastolic peak rate of dimension increase, normalized for end-diastolic dimension, the rapid filling period and the LV dimension change during this period increased. The normalized peak rates of dimension increase and heart rates correlated positively in the groups. However, diabetics had a lower normalized peak rate of dimension increase after adjusting for heart rate by covariance analysis, both at rest (18%) and during peak exercise (20%). Thus, compared to controls, this well defined group of type 1 diabetic men had a consistent subclinical decrease in their peak rate of dimension increase, both at rest and during exercise. Furthermore, the peak rate of dimension increase remained lower in the diabetic subjects after normalization for their smaller end-diastolic dimension and after adjustment for their higher heart rate.
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PMID:Left ventricular diastolic function in young long-term type 1 (insulin-dependent) diabetic men during exercise assessed by digitized echocardiography. 338 78

In order to determine whether low levels of high-density lipoprotein cholesterol (HDL-C), which are predictive of ischemic heart disease in the general population, can also predict death from ischemic heart disease among diabetic men, we contrasted lipoprotein and other heart disease risk factors in 62 men with non-insulin-dependent diabetes mellitus, 14 of whom died of ischemic heart disease during a 12-year follow-up period. Compared to all other diabetic men, those who died of ischemic heart disease were older, had higher levels of fasting plasma glucose (FPG) total plasma cholesterol, and triglycerides, lower HDL-C levels, and higher low-density lipoprotein cholesterol (LDL-C) levels and were more likely to have been cigarette smokers; only total cholesterol, LDL-C, and the LDL/HDL ratio were statistically significant. Age, FPG, total plasma cholesterol, and LDL-C were all independently predictive of fatal heart disease by multivariate analysis. Neither HDL-C nor the LDL/HDL ratio predicted ischemic heart disease death better than the total plasma cholesterol or LDL-C. The use of HDL-C, LDL-C, or total plasma cholesterol level in the model did not eliminate the significant association with FPG, which suggests that the noxious effect of hyperglycemia is independent of the changes in blood lipids.
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PMID:Lipoproteins as predictors of ischemic heart disease in non-insulin-dependent diabetic men. 345 58

In addition to radionuclide ventriculography and thallium scintigraphy, already well established in nuclear medicine, assessment of myocardial metabolism is also of interest for diagnosis and follow-up observations in heart disease. Under aerobic conditions and in the fasting state, the heart muscle primarily oxidizes fatty acids; during ischemia, in contrast, there is slowing of fatty acid turnover and increased anaerobic glycolysis. With 11C-palmitic acid, in humans, reduced fatty acid uptake has been documented in infarcted myocardial regions. The analysis of 11C-palmitic acid in dogs showed a three-phased elimination curve in normal myocardium. In ischemic myocardium, there was diminished utilization of free fatty acids and the glucose utilization was concomitantly increased. After insulin-glucose infusion, as well, there was increased glucose utilization and a reduction in fatty acid utilization. Studies with 11C-palmitic acid require the equipment for positron emission tomography (PET); because of the short half-life of 20.3 minutes, the nuclide must be generated by a cyclotron in the immediate vicinity. In the search for well-suited isotopes for use in planar scintigraphy employing a gamma camera, the uptake and elimination of a variety of isotopically-marked fatty acids were measured and compared with the characteristics of 14C-palmitic acid. For 17-123I-heptadecanic acid (IHA) the elimination curve was similar to that of 14C-palmitate: disadvantage, however, was the relatively high percentage of water soluble marked catabolites which required dual parameter analysis by means of 99-m-technetium pertechnetate or 123I sodium iodide to quantify the amount of myocardial fatty acid utilization through subtraction of the externally measured water soluble catabolite from the externally measured total activity. In studies with the gamma camera in fasting patients in whom 2 to 3 mCi IHA was injected intravenously after symptom limited bicycle ergometry, in healthy subjects the elimination halftime for the first rapid phase was 24.4 +/- 4.7 minutes. Patients with angiographically-documented coronary artery disease, in the afflicted myocardial segments, had diminished fatty acid uptake and prolonged elimination halftime as compared with normally perfused segments. In patients with dilated cardiomyopathy there was an inhomogeneous distribution of activity in the myocardium and, in contrast to coronary artery disease, a discordance between local fatty acid uptake and turnover rate. After chronic and acute alcohol consumption there were comparable findings which were shown to be reversible after several weeks of abstinence.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Planar scintigraphy versus PET in measuring fatty acid metabolism of the heart]. 349 62

Evidence for an abnormal myocardial cell function in diabetes mellitus, influenced by acute metabolic changes, has appeared within recent years. Few but interesting clinical studies focus on this aspect of diabetic cardiopathy, and experimental studies have delivered possible explanations at the cellular level. These are concerned with the intracellular calcium homeostasis and transsarcolemmal receptor signaling. Because these changes are reversible by short-term insulin treatment, a new aspect for the study of diabetic heart disease has appeared.
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PMID:Myocardial cell dysfunction in diabetes mellitus. A review of clinical and experimental studies. 353 Aug 45

Echocardiography was performed on 71 young (mean age 26 years) insulin-dependent diabetic women without clinical evidence of heart disease and on 36 healthy women of the same age. 39 diabetic women had microvascular complications and 9 of them also had abnormalities in autonomic function tests. The diabetic women had smaller left ventricular (LV) end-diastolic diameters (44 vs. 47 mm, p less than 0.001) than the controls, although the left atrial sizes did not differ between the groups. They also had higher heart rates (80 vs. 70 bpm, p less than 0.001) and shortening fractions (35 vs. 33%, p less than 0.01), smaller stroke volumes (66 vs. 76 ml, p less than 0.01) and thicker interventricular septae (9 vs. 8 mm, p less than 0.01) than the controls. The diminution of LV size was most prominent in patients with severe microvascular complications. These data suggest that the myocardial contractility of young insulin-dependent diabetic women is not depressed, but rather exaggerated. The observed diminution of LV size in combination with normal left atrial diameter may reflect increased LV wall stiffness, a possible pre-clinical manifestation of the specific heart disease of diabetes.
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PMID:Increased left atrial size relative to left ventricular size in young women with insulin-dependent diabetes; a pre-clinical sign of the specific heart disease of diabetes? 369 Sep 55

To determine if cardiac autonomic neuropathy (CAN) contributes to diabetic cardiomyopathy, left ventricular function was assessed by resting and exercise radionuclide ventriculography (RVG) in 30 patients with long-standing insulin-dependent diabetes mellitus who had no clinical, electrocardiographic, or tomographic thallium scan evidence of heart disease. In 11 of 30 patients (37%), RVG revealed abnormal left ventricular performance. CAN was found in 91% of these patients. RVG was abnormal in 59% of patients with CAN and in only 8% of patients without CAN (P less than 0.005). There were significant reductions in mean (+/- SE) ejection fractions (EF) in patients with CAN at rest (62.8 +/- 2.2% vs. 75.2 +/- 2.5%; P less than 0.001) and with maximal exercise (65.8 +/- 2.6% vs. 80.9 +/- 2.3%; P less than 0.001) compared to patients without CAN. There was an inverse correlation between the autonomic function score and both resting EF (r = -0.53; P less than 0.002) and exercise EF (r = -0.55; P less than 0.002). Systolic function did not correlate with age, sex, duration or control of diabetes, microvascular complications, or plasma norepinephrine levels. Thus, approximately one third of our study population had evidence for depressed left ventricular function in the absence of ischemic heart disease, and the cardiac dysfunction was related to the severity of CAN. CAN may be a contributor to cardiac dysfunction in diabetes mellitus.
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PMID:Abnormal cardiac function in diabetic patients with autonomic neuropathy in the absence of ischemic heart disease. 371 Dec 60

Eleven type-I (insulin-dependent) diabetic patients with abnormal changes in left ventricular function in response to cold stress (CS) were investigated to try and determine the cause of these abnormal responses. Resting M-mode echocardiography demonstrated that all 11 patients had normal left ventricular dimensions and wall motion, thereby excluding overt cardiomyopathy. Thallium-201 scintigraphy was used to assess myocardial perfusion during CS and eight patients were found to have perfusion defects during stress which persisted in four. It is possible that CS unmasks evidence of myocardial ischemia but it is also possible that the abnormal responses to CS reflect altered vasomotor reactivity in the diabetic patient, producing coronary spasm. Left ventricular function may be influenced by many factors in diabetes and an abnormal CS test may not necessarily indicate structural disease. Such tests, however, may help in the further understanding of the pathophysiology of heart disease in diabetes.
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PMID:Assessment of myocardial perfusion during cold stress using thallium-201 scintigraphy in diabetic patients with abnormal changes in left ventricular function during cold stress. 378 4


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