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

Recent multicenter clinical trials using platelet-suppressive agents for the secondary prevention of myocardial infarction have yielded inconclusive results, although some of the data suggest possible benefits. For transient ischemic attacks, after carotid artery surgery has been eliminated as an option, aspirin is the drug of choice for men; for women, and for men in whom aspirin fails, warfarin sodium should be considered. Warfarin is indicated after insertion of cardiac prosthetic disk valves, and if systemic emboli occur, dipyridamole should be added. Patients with atrial fibrillation should be treated prophylactically with coumarin agents, but only if underlying organic heart disease is demonstrable.
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PMID:Drug prophylaxis for arterial thromboembolism--1981. 702 18

The non-ionic contrast medium metrizamide was compared with a routine ionic medium (sodium methyl-glucamine diatrizoate) in a series of 16 patients with congenital heart disease, all under 11 kg body weight, undergoing angiocardiography. Despite a higher viscosity, metrizamide yielded images of equal quality to those of the ionic medium, and was clinically better tolerated. Metrizamide produced a significantly lesser effect on plasma osmolality, a parameter closely related to contrast medium toxicity. Other biochemical parameters showed insignificant changes. Metrizamide is therefore a more suitable contrast medium for angiocardiography and despite its cost should be considered for patients with serious congenital heart disease who are in poor clinical condition.
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PMID:Angiocardiography with metrizamide in the neonate and infant. 721 1

Antihypertensive drugs reduce cardiovascular morbidity and mortality. This was demonstrated by controlled clinical trials. While most complications are dramatically reduced it is not certain whether the incidence of myocardial infarction is decreased by treatment or whether the severity of the infarct is reduced. The prognosis in patients with borderline and mild hypertension varies widely depending on the number of other risk factors present. Patients with mild hypertension and low risk profiles may not obtain enough benefit from treatment to justify the side effects, inconvenience, and expense of such therapy. Such patients should be individually evaluated as to the need and desirability of treatment. Patients who are not treated with drugs should be seen for an annual follow-up to detect progression. Low sodium diets are effective but they are not practical because it is difficult to adhere to the required degree of sodium restriction. Weight-reducing diets also reduce blood pressure but compliance again is difficult, although it is worth advocating for the few patients who will maintain the diet more or less indefinitely. Between 1973 and 1977 in the United States there has been an 8% decline in deaths due to heart disease, a 17% decrease in deaths due to stroke, and an increase in average life expectancy from 71.3 to 72.8 years. Could this be the result of more widespread treatment?
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PMID:Treatment of hypertension in 1981. 729 38

Studies have shown that trans fatty acids may play a role in the development of chronic diseases such as heart disease and cancer. The objective of the present project was to examine the effect of supplementation with 18:1 isomers, both positional and geometrical, as compared to 18:0 on the growth, membrane fatty acid composition and the phosphoinositide cycle of HT-29 human colon cancer cells. Cells were supplemented with 30 microM stearic acid (18:0), elaidic acid (18:1, n9, trans), oleic acid (18:1, n9, cis), vaccenic acid (18:1, n7, cis) or trans-vaccenic acid (18:1, n7, trans) as sodium salts complexed to fatty acid-free bovine serum. Cells were grown in these media for 9 days. Cell growth was examined by counting the number of cells and expressed as percentage of control (18:0 supplemented cells). The phosphoinositide (PI) cycle was examined by measuring the inositol phosphate (IP) released from phosphoinositides in the absence (basal) or presence of stimuli (0.1 mM carbachol, 0.1 mM A23187 or 20 mM NaF). The results obtained indicated that cis and trans n7 fatty acids inhibited the growth of HT-29 cells by 11% and 23%, respectively, as compared to 18:0 supplementation. 18:1, n9 had no effect on tumor growth. Supplementation with all forms of 18:1 resulted in an increase in IP and IP2 production as compared to 18:0 supplemented cells without influencing IP3. The presence of the double bond at the 9 position in the supplemented fatty acid increases total IP production by 59% and in the cis form by 37% above the control. The breakdown of phosphoinositides in the absence and presence of several stimuli supports the observed finding on IP. Trans fatty acid supplementation resulted in lower hydrolysis of PI as compared to cis fatty acids. It is concluded that the observed inhibition of tumor growth by the vaccenic acids may be mediated by their effect(s) on the PI cycle which may be associated with their incorporation into membrane lipids.
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PMID:18:1 n7 fatty acids inhibit growth and decrease inositol phosphate release in HT-29 cells compared to n9 fatty acids. 775 95

The content of lymphocytic and erythrocytic K+, Na+, Ca++, Mg++ changed in patients with congestive heart failure, related to clinical treatment and prognosis. The longer the course of disease, the more significant the changes, with no relation to the etiology of heart disease. The changes were partially improved after treatment of the heart failure. The content of electrolytes is not significantly different in patients in NYHA Class III, compared to those in NYHA Class IV. The metabolic changes of electrolytes occur on the myocardial cells, skeletal muscle cells and peripheral erythrocytes in patients with congestive heart failure. However, serum electrolyte content does not reflect precisely overall electrolyte metabolism in the body. Whether similar changes of electrolyte content occur in the peripheral lymphocytes is rarely reported. We studied the lymphocytic and erythrocytic electrolyte content in patients with congestive heart failure, to provide some reference in the clinical treatment and prognosis of congestive heart failure.
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PMID:Lymphocytic and erythrocytic k+, Na+, Ca++, Mg++ content in patients with congestive heart failure. 777 95

The Nutrition Labeling and Education Act of 1990 states, in part, that a product is misbranded if it bears a claim that characterizes the relationship of a nutrient to a disease or health-related condition (health claim), unless the claim is made in accordance with Food and Drug Administration (FDA) regulations. In response to the new law, on January 6, 1993, the FDA promulgated regulations that described general requirements for health claims on foods in conventional food forms and specific requirements for seven authorized health claim topics. Three authorized claims are related to heart disease: dietary saturated fat and cholesterol and coronary heart disease; fruits, vegetables and grain products that contain fiber, particularly soluble fiber, and risk of coronary heart disease and sodium and hypertension. The general requirements regulation specifies the scientific standard for assessing the validity of claims, criteria for the qualification of claims, conditions for disqualification and general labeling requirements for health claims. Approval for health claims is based on the totality of publicly available scientific evidence and significant agreement among experts qualified by scientific training and experience to evaluate the relationship. On January 4, 1994, the FDA finalized similar requirements for health claims on dietary supplements.
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PMID:Diet and heart disease: health claims. 788 51

The pentavalent antimonial sodium stibogluconate is the mainstay of anti-leishmanial therapy. Sodium stibogluconate is less cardiotoxic than antimony and the trivalent derivatives, but has been associated with dose-related electrocardiographic changes. The effect of the currently-used regimen of sodium stibogluconate (20 mg/kg/day for 20 days) on cardiac function is uncertain. We studied 12 soldiers, mean age 24 years, with proven cutaneous leishmaniasis treated with this regimen. There were no significant changes in echocardiographic indices of left ventricular systolic or diastolic function during treatment. Indices of myocardial electrical stability (heart-rate variability and episodes of overt supraventricular and ventricular arrhythmias) were unchanged, but there was a reversible decrease in T-wave amplitude during treatment. Systolic and diastolic blood pressure fell and the heart rate increased during treatment. This regimen of sodium stibogluconate does not measurably impair left ventricular systolic or diastolic function. Minor T-wave changes occur during treatment, but there is no increase in arrhythmia frequency or change in heart-rate variability. In most young fit patients, this regimen has no cardiac side-effects. However, idiosyncratic reactions cannot be excluded, and patients with malnutrition, impaired renal function or pre-existing heart disease may be more sensitive to any cardiotoxic properties of sodium stibogluconate.
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PMID:Cardiac effects of sodium stibogluconate: myocardial, electrophysiological and biochemical studies. 792

Approximately 50 million Americans are at risk for cardiovascular and cerebrovascular disease as a result of hypertension (HTN). Education and treatment programs aimed at reducing HTN have been successful in decreasing morbidity and mortality from heart disease and strokes in recent years. In addition to pharmacologic means, prevention of HTN by lifestyle modifications has become a focus of public health education. One such modification, electrolyte therapy, has been associated with HTN control and is readily available through both dietary sources and supplementary tablets. This article presents an overview of electrolyte therapy as treatment for HTN, and reviews studies of the effects of sodium, potassium, and magnesium, and their combinations as treatment to reduce blood pressure. Strategies for nurses in educating the public on the effects of electrolytes and blood pressure are also discussed.
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PMID:Hypertension and electrolyte therapy. 797 36

From December 1980 through April 1992, 20 children 2 to 18 years of age underwent valve replacement with the St. Jude Medical prosthesis. Nine children underwent aortic valve replacement, eight underwent mitral valve replacement, and the three children with corrected transposition underwent left-sided tricuspid valve replacement. Of the 20 patients, 17 underwent 23 previous procedures. All but five patients received adequate adult-sized prostheses. There was one hospital death (5%). All hospital survivors received maintenance doses of sodium warfarin. Follow-up was 100% complete with a total of 106 patient-years. There were no late deaths and no thromboembolic or anticoagulant-related bleeding. None of the patients had prosthetic valve endocarditis or a periprosthetic leak. Reoperation was not required in any patient. The great majority of the children (16 of 19) were in New York Heart Association functional class I, two were in class II, and one with complex congenital heart disease was in class III at the time this article was written. This study illustrates the excellent results of cardiac valve replacement with the St. Jude Medical prosthesis in children and confirms the safety of sodium warfarin in this age group.
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PMID:St. Jude Medical prosthesis in children. 802 79

Substantial evidence indicates that T wave alternans is an intrinsic property of ischemic myocardium. The electrophysiologic basis appears to be spatial and temporal heterogeneity of repolarization resulting from changes in action potential morphology rather than in activation sequence. Ischemia-induced changes in postrepolarization refractoriness and depressed electrical restitution of action potential duration have also been implicated. The main underlying ionic basis for T wave alternans during coronary occlusion appears to be derangements in intracellular cycling of calcium. Accumulation of potassium in the extracellular space adjoining ischemic cells and disruption in electrogenic sodium-calcium exchange may also be involved. In humans, T wave alternans has been observed in Prinzmetal's and classical angina, angioplasty, and bypass graft occlusion. Under these conditions associated with acute myocardial ischemia, alternans is restricted to the ischemic zone, and alternation in action potential morphology is an underlying factor. Recently, repolarization alternans has been shown to be a statistically significant predictor of the results of electrophysiologic testing and arrhythmia-free survival in individuals with and without organic heart disease. Collectively, these observations provide a rationale for quantitation of T wave alternans magnitude for assessment of vulnerability to life-threatening ventricular arrhythmias both in response to and independent of the effects of myocardial ischemia.
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PMID:Electrophysiologic basis for T wave alternans as an index of vulnerability to ventricular fibrillation. 805 49


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