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

We set out to examine the prevalence of echocardiographically-determined left ventricular hypertrophy (LVH) in a hospital-based population of untreated elderly hypertensives and to study the relationship between left ventricular mass index and clinic and 24h ambulatory BP, urinary electrolyte and microalbumin excretion and ECG changes. We studied 52 untreated elderly hypertensives, mean age 76 years, with no evidence of stroke or heart disease. Subjects underwent 24h ambulatory BP recording together with 24h urine collection for electrolytes and microalbumin estimation. A standard ECG was examined for LVH by commonly used criteria. Subjects were examined by 2-dimensional guided M-mode echocardiography; left ventricular mass was calculated from the formula of Devereux and Riechek and corrected for body surface area (left ventricular mass index, LVMI). Mean LVMI was 168 +/- 39 g/m2 for men and 153 +/- 36 g/m2 for women; 43 (83%) subjects had LVH. LVMI was significantly related to clinic SBP (r = 0.27, P = 0.05), ambulatory daytime SBP (r = 0.27, P = 0.05), nighttime SBP (r = 0.41, P = 0.003) and nighttime DBP (r = 0.29, P = 0.04). LVMI was also related to the difference in mean SBP between day and night (r = -0.32, P = 0.02) and subjects with a day-night SBP difference of > or = 10 mmHg (n = 27) had significantly lower LVMI than those with a day-night SBP difference < 10 mmHg (141 +/- 32 g/m2 vs. 176 +/- 35 g/m2, respectively; P = 0.0005). Fifteen subjects had LVH by ECG criteria giving a sensitivity of 28% and specificity of 66%. LVMI was not related to urinary sodium, potassium or albumin excretion. This study shows that in elderly hypertensives it is measures of nighttime BP which are most closely related to LVMI and subjects with a greater nocturnal fall in BP have lower LVMI, presumably reflecting differences in 24h BP load.
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PMID:Clinical correlates of left ventricular mass in elderly hypertensives. 808 25

The renin-angiotensin system (RAS) is known as a system which constricts vessels and enhances renal retention of sodium and water to raise the blood pressure. Recent studies have shown that the RAS is related to pathogenesis of cardiovascular diseases: 1) angiotensin-converting enzyme (ACE) inhibitor has been known to regress the cardiac hypertrophy, 2) high renin activity before treatment of hypertension has been reported to be one of the risk factors of myocardial infarction, 3) and there was a study that the gene expression of ACE was related to the susceptibility to myocardial infarction. Recently, in addition to the circulating RAS, the existence of the tissue RAS in various organs has been demonstrated. However, the existence of the tissue RAS in the human heart and its pathophysiological significance have not been fully investigated. To confirm the existence of the tissue RAS in the human heart, and clarify its pathophysiological role, we focused on the important elements of the system, renin and ACE, and studied the presence of renin and ACE mRNAs and their proteins in the human autopsied hearts. Samples were taken from the organs from 15 cases without heart disease. Renin mRNA was examined using reverse transcription-polymerase chain reaction. In all of 15 cases, renin mRNA was detected in the right atrium, but not in the left ventricle. Renin protein was found both in the right atrium and the left ventricle by Western blot. In addition to renin, ACE mRNA was also detected both in the right atrium and left ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Synthesis of renin and angiotensin-converting enzyme in human heart]. 811 8

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

Samoans are known to be the most overweight population in the world. They suffer from high rates of weight-related diseases such as heart disease, hypertension, and diabetes mellitus. In the past, dietary intervention has either been nonexistent or reliant on food exchange lists that do not include foods traditionally part of a Samoan diet. Therefore, exchange lists specific for Samoan foods were developed. A literature search, personal interviews, and site visits at local grocery stores and village homes were conducted to determine what foods are common to the Samoan diet. These foods and recipes were then computer-analyzed. Foods that are high sources of vitamins A and C, sodium, and fat are also high-lighted in the Samoan exchange lists. The Samoan exchange lists are now being distributed worldwide to health care professionals who work with Samoan clients. An ongoing effort is being made to revise and update this tool so that Samoans can eat foods familiar to them, and in doing so, better manage their diet-related problems.
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PMID:Development of a Samoan nutrition exchange list using culturally accepted foods. 817 30

This prospective investigation was conducted in an attempt to identify noninvasive predictors of mortality for patients with Chagas' heart disease through a multivariate stepwise logistic regression study. Fifty-six patients with a positive complement fixation test for Chagas' disease were followed up at the Cardiomyopathy Clinic of our institution from April 1990 to April 1992. Patient age was 59 +/- 17 years; 28 (50%) were male. Upon admission, 19 patients (33%) were in the New York Heart Association (NYHA) class III and 8 (14%) in the NYHA class IV. Systolic blood pressure was 125 +/- 23 mm Hg, diastolic blood pressure 76 +/- 11 mm Hg and resting heart rate 77 +/- 11 beats/min. Forty patients (71%) were given digitalis and 39 (69%) angiotensin-converting enzyme inhibitors. Plasma Na+ was 140 +/- 4 mEq/l, K+ was 4.34 +/- 0.73 mEq/l and creatinine level 1.34 +/- 0.31 mg/100 ml. Cardiomegaly was observed in the chest X-ray of 41 of 51 (79%) available patients. Atrial fibrillation was observed in the resting ECG of 24 of 54 (44%) available patients, premature ventricular contractions in 23 (41%), right bundle branch block in 26 (46%) and left anterior hemiblock in 26 (46%) patients. Echocardiography revealed a left ventricular ejection fraction of 0.45 +/- 0.16, left ventricular systolic dimension of 51.23 +/- 13.53 mm and left ventricular diastolic dimension of 62.94 +/- 19 mm. Sixteen (28%) patients died during the 2-year study, 11 of them suddenly.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Noninvasive predictors of mortality for patients with Chagas' heart disease: a multivariate stepwise logistic regression study. 818 10

The common underlying heart diseases were ischemic heart disease (39%), valvular heart disease (27%), hypertensive heart disease (10%) in 104 patients (mean age 79 yrs) with congestive heart failure (CHF). Cardiomyopathy (5%) and congenital heart disease (2%) such as atrial septal defect were less common. In addition, many extracardiac diseases including anemia, hypothyroidism, renal failure and pulmonary disease contributed to the etiology of CHF in the elderly. Cardiac amyloidosis should be considered as an uncommon cause of refractory CHF. While the precipitating factor was not found in half of the 104 patients with CHF, the most common factors were respiratory infection, myocardial ischemia and arrhythmia. In addition, inappropriate drug usage including poor drug compliance, the use of beta-blockers and excessive intake of sodium and fluid precipitated or exacerbated heart failure. Renal failure was a most important complication and predisposed to refractory CHF. Aged patients with mild CHF (NYHA class II) showed an insufficient production of cyclic AMP and GMP in proportion to the increases of norepinephrine and atrial natriuretic peptide in comparison with health aged subjects after the submaximal treadmill exercise test. This finding may suggest that an inadequate compensation of neurohumoral factors is prone to cause CHF in the elderly. Appropriate management of acute CHF in the elderly begins with recognition of the underlying heart disease, complications and the severity of cardiac function. In addition to medical management including loop diuretics, vasodilator, beta-receptor agonist and phosphodiesterase inhibitor, cases associated with respiratory and renal failure require mechanical ventilation and continuous hemofiltration.
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PMID:[The etiology and management of congestive heart failure in the elderly]. 820 67

An epidemiological study was carried out into the risk factors for the following atherosclerotic cardiovascular diseases: lipemic disorders, obesity, hypertension, diabetes mellitus as related to some factors which characterize life-style (sedentary, drinking, smoking and eating habits). The population studied belongs to the metropolitan area of S. Paulo. The research project had the following objectives: a) the development of an epidemiological baseline for the study of the risk factors for the atherosclerotics cardiovascular diseases represented by the lipimic disorders, obesity, hypertension and diabetes mellitus and their relationship with personal, family and social characteristics; b) the for clinical-educative treatment of patients or people at risk. In view of the objectives above it was decided that the project should in an integrated way with the local health centers and community associations in the field work phase. For this purpose, the methodology adopted was that of establishing small geographical areas, denominated "study areas", in accordance with socioeconomic criterion. Clinico-biochemical and eating surveys were carried out and interviews held with a view to obtaining data on socioeconomic and demographic and life-style characteristics. The clinical survey collected data on anthropometric measurements, arterial pressure, electrocardiogram and symptoms of heart disease. The biochemical survey consisted of the measurement of the following constituents of the blood: total cholesterol, HDL cholesterol, triglyceride, magnesium, glucose, sodium, potassium and phosphorous. The eating survey covered data of historic food consumption. By means of indicators such as income, schooling, occupation, position held in the occupation, ownership of property and respective size of property and employment of labour, the social classes were established. The clinico-educative intervention was carried out in the following way: a) the team made contact with the community associations and the health centers, that begin to participate in the project, permitting the use of their physical space for the carrying out of surveys and clinical exams and taking part in the work of publishing and explaining the project; b) those individuals with positive diagnosis or who are found at risk were referred to the health centers which then include assistance for the diseases in question in their permanent activities. After the end the project the team gave to the community a report on the prevalence of the morbidities researched in their population.
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PMID:[Atherosclerotic cardiovascular diseases, dyslipidemia, hypertension, obesity, and diabetes mellitus in a population of the metropolitan area of southeastern Brazil. I--Research methodology]. 820 56

An unselected series is presented of 17 infants born to epileptic mothers and exposed to sodium valproate during pregnancy. Nine infants had minor abnormalities and of these infants five also had major malformations, described as the 'fetal valproate syndrome'. The most frequent malformation was congenital heart disease. Nine of the infants had manifestations of withdrawal, such as irritability, jitteriness, abnormalities of tone, seizures, and feeding problems. Four of these infants had an unrelated hypoglycaemia. The frequency of withdrawal symptoms was significantly related to the dose of valproate given to the mothers in the third trimester, and there was a tendency for both the frequency of the minor abnormalities and the major malformations to be related to the valproate dosage in the first trimester.
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PMID:Malformations, withdrawal manifestations, and hypoglycaemia after exposure to valproate in utero. 821 67

Most patients with a history of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) are at high risk of recurrence. Implanted defibrillators (ICDs) are highly effective in sensing and converting VT or VF to a perfusing rhythm. "Conventional" antiarrhythmic agents, which primarily block cardiac sodium channels, are relatively ineffective in preventing arrhythmia recurrence; amiodarone and sotalol appear to be effective in reducing recurrence and mortality rates, although the extent of benefit is not well understood. Despite the apparent advantage of ICDs, they have short- and long-term complications, are costly, and their benefit in prolonging the quantity or quality of life remains unproven. Randomized clinical trials which compare the effect of ICDs with that of antiarrhythmic drugs on mortality, cost, and quality of life will be necessary to understand how patients with malignant arrhythmias ought to be treated. If an ICD is implanted, adjunctive therapies need to be considered to treat the underlying heart disease and to derive optimum benefit from the device. Drugs may have beneficial or adverse interactions with devices, and the full understanding of these interactions requires further study.
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PMID:The implantable defibrillator and antiarrhythmic drugs--competitive and complementary treatment for severe ventricular arrhythmia. 826 62

Using an enzyme-linked immunosorbent assay, we measured anti-adenine nucleotide translocater (ANT) antibody in control subjects and in patients with dilated cardiomyopathy (DCM), myocarditis, and other heart disease. Analysis with sodium dodecyl sulfate-polyacrylamide gel electrophoresis, Western blotting, and immunoabsorption tests confirmed accurate purification of the ANT protein and correct measurement of anti-ANT auto-antibody. Anti-ANT antibody was detected in 6 of 37 cases (16%) of DCM and in 5 of 12 cases (42%) of myocarditis. This antibody was not positive in other heart diseases or in apparently healthy controls. There were no differences between anti-ANT autoantibody-positive and -negative DCM or myocarditis patients in any of the cardiac parameters examined (left ventricular ejection fraction, LVEF; left ventricular end-diastolic dimension, LVDd; and cardiothoracic ratio, CTR). Moreover, in patients who were positive for anti-ANT auto-antibody, no positive correlations were found between the parameters and anti-ANT antibody titers in either DCM or myocarditis. Although these results indicate that the detection of anti-ANT antibody was achieved at a high specificity and could have certain diagnostic value in DCM and myocarditis, there was no statistically significant relationship between the cardiac parameters (LVEF, LVDd, and CTR) and anti-ANT antibody titers in either DCM or myocarditis. Some compensatory mechanism of ventricular function may mask the effects of the anti-ANT auto-antibody or alternatively, this auto-antibody may have mimic effects on the pathogenesis and/or progression of DCM and myocarditis.
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PMID:Auto-antibody against adenine nucleotide translocator in dilated cardiomyopathy and myocarditis--incidence and relation to cardiac function and morphology. 828 7


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