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

In 71 patients with chest deformity (Group B) and in 43 patients who underwent thoracotomy due to heart disease (Group BN), cartilage of the ribs was removed intraoperatively. Analyses of trace elements showed a highly significant decrease in zinc, coupled with a significant increase in magnesium and calcium in Group B. Electron microscope studies in the cartilage of patients with chest deformity revealed chondrocytes with a normal structure only in some parts, but many degenerative altered chondrocytes with vacuoles of fat and osmiophilic depositions, as well as atypical fibrils and so-called "long-spacing collagen".
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PMID:[Pathogenesis of chest wall abnormalities--electron microscopy studies and trace element analysis of rib cartilage]. 367 80

Parathyroid hormone (PTH) influences the calcium metabolism of many different mammalian cell types; indeed, hypertension due to changes in muscle tone is a frequent symptom of hypercalcemic hyperparathyroidism. In a blind study of 81 patients with various forms of heart disease undergoing coronary angiography, the plasma concentrations of the midcarboxyl regional PTH immunoreactivity were determined. PTH concentrations were elevated in 26 of the 56 patients exhibiting organic coronary artery disease (CAD). The plasma PTH levels were highest in those patients with CAD affecting three vessels and in patients with evidence of myocardial infarction. PTH levels were not influenced by previous drug treatments, and did not correlate to stress hormone levels. We propose that increased PTH levels may be a marker for initiation or potentiation of calcium-dependent changes in vascular smooth muscle behavior inducing coronary functional and anatomic lesions typical of CAD.
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PMID:Parathyroid hormone in coronary artery disease--results of a prospective study. 378 41

The effect of human serum diluted in Tyrode solution (1:1) on the cardiac contractility has been studied. Fragments of the right auricle myocardium from patients with congenital and acquired heart disease have been used to study serum effect on the contraction force. Myocardial strips were repeatedly stimulated with electrical impulses at a frequency of 0.1 to 1.5 Hz. All the perfusion solutions were maintained at 31-33 degrees C and Ca++ ion concentration was 2 +/- 0.2 mM/l. The serum increased the contraction force in the isolated myocardial fibers from patients with congenital and acquired heart disease. Positive inotropic serum action on the myocardium of patients with acquired heart disease was accompanied by a marked diminution of mechanical oscillations. At the same time human serum does not affect the form of force-frequency curves in both types of the preparations. The results suggest that human serum increases calcium ion homeostasis in the cardiac cells of patients during contraction-relaxation cycle.
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PMID:[Intensification of human myocardial contractile activity as affected by blood serum]. 382

A review of factors altering the safety margin between a therapeutic and a toxic dose of digitalis includes the consideration of: clinical conditions to which digitalis action may be undesirable, allergy and hypersensitivity to digitalis, physiologic factors modifying tolerance to digitalis, factors that change the amount of digitalis in the body, nervous and metabolic factors modifying tolerance to digitalis, modifications of digitalis tolerance produced by the status of the myocardium, and modifications of digitalis tolerance produced by diseases of other organs. The problems related to digitalis toxicity are more common than those of resistance to treatment. The most important factors contributing to decreased tolerance and risk of toxicity are: heart disease, poor renal function, hypokalemia and hypothyroidism. The roles of impaired liver function, chronic lung disease, acid-base disturbances, anesthesia, autonomic imbalance, calcium and magnesium are less important and less well established.
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PMID:Factors affecting tolerance to digitalis. 388 54

Catheterization of the umbilical artery is a common procedure in neonatal intensive care units. The authors studied the records of 100 consecutive newborns who underwent this procedure to review the indications for and complications of umbilical artery catheterization and to discuss preventive measures and alternative techniques. Only polyvinylchloride barium-impregnated catheters were used (nos. 3.5 and 5.0 French). The commonest indications were respiratory distress syndrome, asphyxia and congenital heart disease. Of the 100 infants, 75 weighed less than 2500 g. Ampicillin and calcium were the commonest medications infused (70 and 65 babies respectively). There were three major complications, two of which were gangrene of the lower extremity. Amputation of the foot was necessary in one and amputation of the toes in the other. The third complication was the development of gluteal necrosis. In all three cases, catheter placement was low and the infusion was ampicillin. In two of the babies, calcium was also administered. Minor complications were seen in 32 cases, with vascular spasm in the lower limb being the most common. All catheter tips were cultured; there was bacterial colonization in 13%, Staphylococcus epidermidis being the commonest organism. Proven necrotizing enterocolitis was seen in eight infants and was suspected in eight others. Blanching is a serious sign and was seen in the three infants with major complications. The infusion should be stopped immediately. When necrotizing enterocolitis is suspected, the catheter should be removed.
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PMID:Catheterization of the umbilical artery in neonates: surgical implications. 397 Dec 40

Idiopathic hypoparathyroidism was diagnosed in a 55-year-old patient following rather unusual circumstances: he informed the emergency ward physician attending him for congestive cardiac insufficiency consequent to coronary cardiopathy that on the two preceding occasions when such insufficiency had been relieved by the injection of a diuretic, a tetanic seizure had ensued which was corrected by intravenous administration of calcium. Treatment of the cardiac insufficiency was nonetheless instituted with the mercurial diuretic: tetany appeared a few hours later, subsiding after intravenous injection of calcium. The various possible ways in which a tetanic seizure may be triggered by a mercurial diuretic are discussed.
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PMID:[Idiopathic hypoparathyroidsm: provocation of a tetanic seizure by the injection of a mercurial diuretic]. 583 82

Retrospective review of 5,942 patients who underwent open-heart surgery for acquired heart disease revealed that 123 patients (2.1%) required permanent cardiac pacing postoperatively; 4.6% of these underwent predominantly valvular surgery and 0.6% had coronary bypass. The most important factors appeared to be: 1) preoperative evidence of a conduction disorder; 2) advanced patient age; 3) dense calcium in the aortic annulus; 4) valvular surgery and, especially, tricuspid valve surgery; and 5) poor myocardial protection. Postoperative permanent pacing had a considerable impact on patient morbidity from maintenance operations; most complications were lead-related problems.
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PMID:Permanent cardiac pacing after open-heart surgery: acquired heart disease. 620 88

In this article we have briefly reviewed the role of Ca2+ in the excitation contraction coupling in the myocardium and have indicated that cardiac contraction and relaxation are initiated upon raising and lowering the intracellular concentration of free Ca2+, respectively. Different mechanisms for the entry of Ca2+ through sarcolemma as well as release of Ca2+ from sarcoplasmic reticulum and possibly mitochondria have been outlined for initiating cardiac contraction. Relaxation of the cardiac muscle appears to be intimately dependent upon efflux of Ca2+ through sarcolemma as well as sequestration of Ca2+ by the intracellular storage sites, particularly sarcoplasmic reticulum and possibly mitochondria. The actions of some pharmacological and pathophysiological interventions have been explained on the basis of changes in subcellular Ca2+ movements in myocardium. Quinidine, which produced an initial positive inotropic action on rat heart was also found to increase sarcolemmal Ca2+-ATPase activity without any changes in the Na+-K+ ATPase. Other antiarrhythmic agents, procainamide and lidocaine, also increased sarcolemmal Ca2+-ATPase activity without affecting the Na+-K+ ATPase. On the other hand, both Ca2+-ATPase and Na+-K+ ATPase activities were increased in heart sarcolemma obtained from cardiomyopathic hamsters. In this model the increased Ca2+-ATPase activity may promote the occurrence of intracellular Ca2+ overload in the cardiac cell whereas the increased Na+-K+ ATPase activity may increase Ca2+ efflux through Na+-Ca2+ exchange systems as an adaptive mechanism. It has been suggested that some caution should be exercised while interpreting the data from in vitro experiments in terms of functional changes in the myocardium. Furthermore, it has been proposed that the pathophysiology and pharmacology of Ca2+ movements at different membrane sites be understood fully in normal and diseased myocardium in order to improve the therapy of heart disease.
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PMID:Progress and problems in understanding the involvement of calcium in heart function. 623 64

Myocardial calcium uptake in response to isoproterenol (ISO, 10(-4) M) was investigated in control and streptozotocin-induced diabetic rats using an in vitro heart perfusion model. An initial labeling with 45Ca added to the perfusate (with or without ISO) was followed by a cold calcium-free washout, thus clearing the myocardial interstitium of 45Ca. In this way the remaining 45Ca was an estimate of the myocardial calcium uptake during the labeling period. In control rats ISO induced a statistically significant increase in myocardial calcium uptake within the first 5 minutes, as well as from the 5th to the 15th minutes after exposure to this strong beta-receptor agonist. In contrast to this, diabetic hearts showed no increase in calcium uptake during any of these periods. The toxic effect of ISO was expressed by a leak of creatinine phosphokinase to the perfusate. In control rats the concentration of creatinine phosphokinase increased after ISO with a statistically significant correlation to the calcium uptake, whereas no enzymatic leak was seen after perfusion of the diabetic hearts. This abnormal response to strong beta-receptor stimulation in experimental diabetes is in accordance with our earlier in vivo finding of a myocardial protection against toxic doses of ISO. These results indicate a decreased catacholamine-induced calcium transport through the myocardial sarcolemma in streptozotocin-induced diabetic rats. This might hypothetically have relevance for diabetic heart disease as well as diabetic neuropathy.
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PMID:Decreased myocardial calcium uptake after isoproterenol in streptozotocin-induced diabetic rats. Studies in the in vitro perfused heart. 629 40

In this overview of the achievements of the National Heart, Lung, and Blood Institute (NHLBI), the major developments in each major form of heart disease since the birth of the Institute 35 years ago are reviewed. In the case of congenital heart disease, it has become possible to establish an accurate diagnosis, often by noninvasive methods, and to correct by surgical treatment almost all congenital cardiac malformations. The major challenge now is to eliminate these disorders; this will require an understanding of the fundamental molecular basis of these lesions. Acquired valvular heart disease can also now be characterized by hemodynamic, angiographic, as well as noninvasive techniques, principally echocardiography. Surgical treatment is usually successful, but improvement in the durability of valves without thromboembolic potential remains an important challenge. While essential hypertension can now be managed pharmacologically in almost every patient and while such management reduces the excess mortality resulting from this condition, current research focuses on elucidating the underlying basis of this disorder. Atherosclerosis remains the most common cause of cardiac and vascular disease. Although its cause has not been defined, several abnormalities in lipid metabolism that play an etiologic role in many patients with atherosclerosis have been identified. The treatment of these disorders with cholesterol-binding resins, which increase the number of cellular receptors for low-density lipoprotein, and with inhibitors of the enzyme required for cholesterol biosynthesis holds considerable promise. Noninvasive techniques will be used increasingly for detection of atherosclerosis in asymptomatic persons and for determining the efficacy of therapy. The mortality resulting from acute myocardial infarction has been reduced in half by the development of coronary care units and the prompt treatment of potentially fatal ventricular tachyarrhythmias. Current research is focused on preventing pump failure by limiting infarct size; lysis of coronary thrombi now appears to be the most promising method of accomplishing this. Chronic angina pectoris can be relieved by the judicious use of three classes of drugs--organic nitrates, beta-adrenergic blockers, and calcium antagonists, and two mechanical approaches--percutaneous transluminal coronary angioplasty and coronary artery bypass grafting--are usually successful in relieving angina in patients who do not respond adequately to medical management. Whether or not any of these approaches prolong life is not yet settled.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Thirty-five years of progress in cardiovascular research. 638 25


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