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)

During aortic clamping, drug protection of the myocardium, far from supplanting hypothermia, complements it, particularly in the case of left ventricular hypertrophy. Ultramicroscopy and new techniques of histobiological exploration of the myocite have enabled one to distinguish the lessions provoked by anoxia from those induced by reperfusion. At present, drug protection, extended to energetic solutions and electrolytes, aim at preserving energy metabolism by stocking of the substrate and at avoiding interferences which precipitate exhaustion of the adenosine triphosphate and phosphocreatinine reserves. In order to do this, hemodilution in particular is limited in subjects with decompensated cardiopathy; choice of anesthetics is orientated towards neuroleptanalgesia or fluothane, and it is attempted to neutralize the adrenergic reaction by the use of beta-blocking substances. Furthermore, it is preferred to interrupt electrogenesis at the stage of polarization: depolarizing cardioplegic solutions rich in potassium and sodium are rejected and in preference membrane stabilizers are used (procaine, magnesium, tetrodoxine...) The ultramicroscopic analysis of the structural modifications leads to sparing of the integrity of the lysosomial membrane by corticoids and alkalines. The use of calcium is deferred, anti-calcium techniques are even proposed (washing poor in calcium, verapamil). Cellular edema is prevented and treated by solution (mannitol - sorbitol) whose osmolarity must be less than 300 M osm/l. A conditioning of the biochemical and physicial structures and of cardiac work is being more and more thought of which leads to the classification of beta stimulating substances as negative, and their indications must be seriously thought of and used with reserve.
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PMID:[Drug protection of the myocardium during cardiac surgery]. 1 31

Human cardiac myosin isolated from operatively obtained samples of ventricular septum and left ventricular free wall of subjects with asymmetric septal hypertrophy (ASH) was compared, with respect to structural and enzymatic properties, to myosin isolated from hearts of subjects without heart disease. The following parameters were studied: (1) activation of myosin ATPase activity by K+-EDTA and Ca2+, (2) molecular weight of the heavy and light chains of myosin as determined by electrophoretic migration in polyacrylamide-sodium dodecyl sulfate (SDS) gels and (3) ability to form bipolar aggregates at low ionic strength, as examined by electron microscopy. No difference was present in any of these parameters between human cardiac myosin from subjects with ASH and from subjects without heart disease. Thus, the genetic defect present in subjects with ASH is not expressed in the particular structural and functional characteristics of myosin evaluated in this study.
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PMID:Isolation and characterization of myosin from subjects with asymmetric septal hypertrophy. 14 25

Human cardiac myosin isolated from operatively obtained samples of ventricular septum and left ventricular free wall of patients with asymmetric septal hypertrophy (ASH) was compared, with respect to structural and enzymatic properties, to myosin isolated from hearts of patients without heart disease. The following parameters were studied: 1) activation of myosin ATPase activity by K+-EDTA and Ca2+,2) molecular weight of the heavy and light chains of myosin as determined by electrophoretic migration in SDS-polyacrylamide gels, and 3) ability to form bipolar aggregates at low ionic strength, as examined by electron microscopy. No difference was present in any of these parameters between human cardiac myosin from patients with ASH and from patients without heart disease. Thus, the genetic defect present in patients with ASH is not expressed in the particular structural and functional characteristics of myosin evaluated in this study.
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PMID:Characterization of myosin from patients with asymmetric septal hypertrophy. 14 40

A 68-year-old man with a history of organic heart disease and marked weight loss was found to have apathetic thyrotoxicosis and hypercalcemia. Oral propranolol, 20.0 mg four times a day, provoked a gradual fall in serum calcium and alkaline phosphatase. It is concluded that relatively small doses of oral propranolol may be effective in the management of hypercalcemia accompanying thyrotoxicosis and that beta-blocking agents may not only inhibit the enhanced bone resorption caused by thyroid hormones but also block the stimulated osteoblastic activity.
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PMID:Oral propranolol in hypercalcemia associated with apathetic thyrotoxicosis. 66 23

In 44 patients with congenital or acquired heart disease, functional class II--IV NYHAC, the effects of calcium gluconate (10 ml 10%) and calcium chloride (10 ml 5.5%) on hemodynamics, inotropy and myocardial oxygen consumption were investigated during and immediately after cardiosurgical procedures. There was a significant increase in blood pressure, left ventricular pressure, total systemic resistance, cardiac index, stroke index, peak dp/dt and myocardial oxygen consumption as well as in arterial perfusion pressure during extracorporeal circulation due to i.v.-injection of either one of the drugs. The positive inotropic effects were more pronounced after application of calcium chloride. In emergency situations during anaesthesia or resuscitation, therefore, calcium chloride seems to be of more advantage than calcium gluconate.
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PMID:[Effects of calcium gluconate and calcium chloride on cardiocirculatory parameters in man (author's transl)]. 72 23

In general, the results to date in humans and experimental animals seem to indicate that substantial regression of advanced atherosclerosis is possible. The results also indicate that the advanced atherosclerotic lesions are much more likely to respond favorably if the serum cholesterol concentrations are reduced to the minimum that prevails in animals or people who consume a low-fat low-cholesterol diet. In human subjects and in rhesus monkeys, this value appears to be about 150 mg%. Under these circumstances, much of the lipid disappears from the plaques, and the remaining fibrous tissue and cells appear to condense and undergo remodeling, as they do in fracture or wound healing. Additional effort will be required to ascertain how rapidly and how much of the fiber proteins and calcium can be removed from the advanced plaques and to work out methods that will consistently produce regression of advanced atherosclerotic lesions in human subjects. This goal would appear to be worth working toward. Interruption of progression of atherosclerosis appears to be more easily achieved, and it also would appear to be a worthwhile goal. The diagram that is reproduced as FIGURE 2 presents the multiple methods of intervention in atherosclerosis that are now available to the physician and to the patient. To those of us who look on atherosclerosis as an almost completely preventable disease and one that is largely reversible, the following quotation from the perceptive essay by Lewis Thomas seems to be prophetic and most appropriate. An extremely complex and costly technology for the management of coronary heart disease has evolved, involving specialized ambulances and hospital units, all kinds of electronic gadgetry and whole platoons of new professional personnel to deal with the end results of coronary thrombosis. Almost everything offered today for the treatment of heat disease is at this level of technology, with the transplatned and artificial hearts as ultimate examples. When enough has been learned for us to know what really goes wrong in heart disease, we ought to be in a position to figure out ways to prevent or reverse the process; and when this happens, the current elaborate technology will be set to one side.
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PMID:Studies of regression of advanced atherosclerosis in experimental animals and man. 82 28

Elderly participants in Title VII congregate feeding programs in Indianapolis can be characterized generally as being retired, usually living alone, and often reporting some disease condition, particularly arthritis, hypertension, and/or heart disease. On an average weekday, the nutrient intake of these people, except for zinc, approximated the amounts suggested in the Recommended Dietary Allowances. Fifty-nine per cent of the subjects consumed less than two-thirds of the allowance for zinc. Generally, they consumed over half of their allowances for eight nutrients at the site meal. The nutritional significance of apparent low intakes of dietary zinc among subjects is not clear. Eleven per cent had hair zinc levels below 100 mcg. per gram, but none were below 70 mcg. Therefore, on the basis of hair zinc levels, none could be absolutely calssified as zinc deficient. Although hair zinc levels were not correlated to dietary zinc intake, they were inversely correlated to dietary calcium and fat intake. Taste acuity by these elderly participants was generally less than that reported for young adults. However, women had greater taste acuity for sodium chloride than men. Sixteen per cent of the subjects were particularly insensitive to the taste of sodium chloride. Finally, there was no correlation between taste acuity and dietary zinc intake.
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PMID:Zinc nutriture of elderly participants in an urban feeding program. 83 Jul 6

The major difference between heart disease in the old and the young is that elderly people almost have one or more other major, even life-threateninng conditions. These associated diseases challenge the physician in establishing a diagnosis and prognosis, understanding the pathogenesis of the symptoms and signs, and determining the best managemnt. Another important difference is that old persons have senescent changes in all organ systems, whether the heart is normal or diseased. Dyspnea, especially on exertion, is common, and so is edema of the feet and ankles. Chest x-rays show changes typical of old age, e.g., small lung fields, mild to moderate pulmonary fibrosis, and calcium plaques in the aorta. In the absence of cardiac disease, the heart is normal in size or even small. Translationg experience in managing heart disease in young patients to elderly patients must be done cautiously. Old people tend to be confused, delicate, mentally and physically slow, feeble, and unreliable, and they are more sensitive to most-if not all-drugs, especially digitalis. The physician should see them often and question them routinely about their symptoms, signs, and medication. Decisions on management should not be hurried, except in an emergency situation.
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PMID:The special problems of heart disease in old people. 83 77

185 cases of pregnancy in cardiac patients followed since 1965 included 48 therapeutic abortions, 20% premature deliveries, 36 Caesarean sections, and 101 vaginal deliveries. Abortions, done by dilatation and curettage or hysterotomy, usually with tubal ligation, were performed in class III or IV cardiopathies (inoperable or relapses) and in those with decompensation in first trimester or in previous pregnancies. 10 women were operated by closed heart technique during pregnancy, usually mitral valvotomy procedures. Treatments during pregnancy included bed rest, hospitalization 2 weeks before term, low salt diet, diuretics, digitalis, calcium heparin, sedatives, and antibiotics. Prognosis depends on severity and nature of the cardiopathy, age, parity, obstetric history, and the patient's ability to follow instructions. Deliveries were originally done by Caesarean section if sterilization was planned, but recently tubal ligation is done within 2 months postpartum. 55% of the vaginal deliveries were by forceps under local anesthesia; 40% by natural chiildbirth. 4 neonates died, and 36 were premature or dysmature. Lactation was suppressed by ethinyl estradiol in almost all patients.
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PMID:[Cardiac disease and pregnancy. 2. Pregnancy in the cardiac patient. 185 cases studied at the Boucicaut maternity hospital]. 100 Sep 14

Changes of the mineral concentrations of the heart muscle can point at disturbances of myocardial metabolism. Disturbances of heart muscle with functional loss and without coronary or inflammatory heart disease are called myocardosis, especially cardioplegic myocardosis after open-heart surgery with extracorporal bypass. 30 dogs were examined in three groups varying the method of induced cardiac arrest: 1. ischemic cardiac arrest by clamping the ascending aorta, 2. functional cardiac arrest by electrically induced fibrillation and 3. ischemic cardiac arrest and in addition injection of a Mg-aspartate-procain-solution. Sodium, potassium, magnesium, calcium, copper and zinc were analyzed by atomic absorption spectrophotometry. Specimens from the left and right ventricular wall were examined before and after extracorporal circulation. After a recovery period for one hour the dogs were killed and specimens from the right and left ventricular wall and from the basis and apex of the interventricular septum were taken and reduced to ashes with mineral acids. In all animals changes of the mineral content were most marked after the recovery period. In all forms of cardiac arrest mineral metabolism showed monotone reactions: water content increased, potassium and magnesium decreased. Variations of mineral concentrations were more expressed in the right ventricular wall than in the left. Animals with cardiac arrest by electrically induced fibrillation indicated the smallest deviations from the basic values. The comparison of the values of dogs with sufficient circulation at the end of the experiments and those dogs with medicamentally or mechanically supported circulation at this time showed a more increased water content and simultaneously a decrease of all cations in the group with supported circulation. The decrease of the osmolality of the cations seems to be the metabolic answer to the increased cardioplegic damage of heart muscle.
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PMID:[Myocardial electrolytes in "cardioplegic" myocardosis (author's transl)]. 122 Jun 68


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