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

Magnetic resonance (MR) is a new concept in the diagnostics of the cardiovascular system. The basic principle of MR is nuclear magnetism. MR tomography is based on induction and spatial encoding of a nuclear magnetic resonance signal. Due to the high tissue concentration and MR sensitivity, medical MR imaging chiefly uses protons of water, 1H. MR tomography of protons presents highly contrasted images of soft tissue organs with spatial resolution in millimeters. Parametric analysis of the MR signal enables quantitative assessments of physico-chemical tissue properties, blood flow and perfusion. The method is noninvasive and without serious biological side effects. Ionising radiation or traditional contrast agents are not utilized. Using conventional ECG synchronized MR tomography the cardiac and great vessels anatomy are superbly resolved, exceptions being the resolution of coronary vasculature and cardiac valve apparatus. The excellent spatial resolution and flexible spatial image orientation are important advantages of quantitative assessment of cardiac function by MR imaging. Preliminary studies demonstrated clinical utility of tomographic assessments of T1 and T2 relaxation parameters as well as phase angle analysis for definition of myocardial ischemia, blood flow rates and wall motion dynamics. The first comparative studies between imaging modalities in diagnostics of specific cardiac disorders point to a superior anatomic resolution of the heart and vascular morphology by MR tomography. The utilization of MR tomography in cardiovascular medicine is new and it would be premature to assign a definite value to this costly technique in clinical evaluations of patients with heart disease. However, there is unequivocal evidence that MR technology will play a decisive role in cardiology in the future, and MR imaging already represents significant progress in the evaluation of patients with cardiac disease.
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PMID:[Imaging of the heart using nuclear magnetic resonance tomography. I: Tomography]. 404 93

In order to examine the relation between cardiac state and the capacity to excrete a water load, 10 normal subjects and 61 patients with heart disease were studied during water diuresis. Under these conditions, urine flow approximates to the rate of delivery of filtrate, and therefore of sodium, from the proximal tubule of the kidney to the loop of Henle, while free water clearance is a function of distal sodium reabsorption. In 12 patients with complete heart block, ventricular pacing was associated with increased urine flow and free water clearance. Oral propranolol in 3 normal subjects and in 9 patients with intact atrial septa caused a reduction, and oral practolol in 4 normal subjects and 8 patients caused no change. In 6 patients with atrial septal defect, propranolol was without effect. Maximum urine flow correlated with left ventricular end-diastolic pressure but not mean left atrial pressure in 16 patients with chronic rheumatic heart disease. In 7 patients with ischaemic heart disease, maximum urine flow was higher than in those with chronic rheumatic heart disease and similar increase in left ventricular end-diastolic pressure. These results reflect a close relation between proximal tubular sodium reabsorption and cardiac state, and suggest that inappropriate sodium reabsorption at this site may contribute to fluid retention in heart disease.
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PMID:Assessment of proximal tubular sodium reabsorption during water diuresis in patients with heart disease. 439 57

Relative rates of proportionate mortality from cancer of six sites based on total cancer deaths and the proportions expected in all towns, and from four types of cardiovascular disease based on total deaths from all causes, have been related in the 80 county boroughs of England and Wales to the sources of water supply and to the average hardness of water in the towns. The sources of water, from upland surfaces, artesian wells and rivers, were classified in eight groups, and significant associations were found for cancers of the stomach, oesophagus, prostate, male bladder and female breast, and for hypertensive and chronic rheumatic heart disease. No associations were apparent with intestinal cancer, vascular disease of the nervous system or arteriosclerotic heart disease. Hardness or softness of the water was classified in seven groups and significant associations were found for the same diseases as for source of water, none being evident for coronary disease.
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PMID:Mortality from cancer and cardiovascular diseases in the county boroughs of England and Wales classified according to the sources and hardness of their water supplies, 1958-1967. 451 76

The present investigation was undertaken to evaluate the utility of constant-rate injection of a nonrecirculating indicator (H(2)) for the measurement of cardiac output in man. 42 patients were studied during cardiac catheterization and 8 during acute complications of arteriosclerotic heart disease, including acute myocardial infarction. Pulmonary (or systemic) arterial H(2) concentration was measured chromatographically from 2.0 ml blood samples drawn during constant-rate injection of dissolved H(2) into the systemic venous circulation (or left heart). The chromatograph was a thermal conductivity unit housed in a constant-temperature water bath to achieve an improved signal-to-noise ratio. Intrapulmonary H(2) elimination from mixed venous blood was measured directly in 14 patients and averaged 98 +/-1.5% (SD). Reproducibility of output measurements was evaluated using triplicate determinations obtained over 45-60 sec in 25 consecutive patients. Coefficients of variation (SD/Mean x 100) averaged 3.4 +/-2.0%, making it possible to evaluate relatively small changes in measured output with conventional statistical tests. Individual measurements could be repeated at 10-15 sec intervals. Comparisons of H(2) and direct Fick measurements were made in 14 patients; H(2) outputs averaged 106 +/-4% (SEM) of Fick outputs (P > 0.1). Comparisons of H(2) and dye dilution measurements were performed in an additional 24 patients. Seven had angiographically-negligible valvular regurgitation and dye outputs averaged 106 +/-3% of H(2) outputs (P > 0.1). 17 had moderate-to-severe regurigation and dye outputs averaged 91 +/-4% of H(2) outputs (P < 0.05), suggesting a small but systematic error due to undetected recirculation of dye. The H(2) technique appears advantageous for rapidly repeated determinations of output, for quantitation of small changes in output, and for situations in which recirculation of conventional indicators is a potentially significant problem.
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PMID:Measurement of cardiac output in man with a nonrecirculating indicator. 493 84

Exchangeable sodium and potassium, total body water, and sulphate space were measured in 42 patients with severe valvular heart disease who were free of oedema. Compared with normal subjects of the same height, no increase in exchangeable sodium was found but a mean potassium depletion of 27% was shown. This depletion was not related to diuretic therapy, and no relationship between the degree of depletion and postoperative arrhythmias was found. It is concluded that the major cause of the low exchangeable potassium is the reduction in cell mass that occurs in chronic heart disease, and that there is no significant fall in the intracellular potassium concentration.
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PMID:Potassium depletion in severe heart disease. 579 71

Previous studies have demonstrated that the anesthetic amine, chlorpromazine hydrochloride (CPZ), prevents cell necrosis in experimentally induced ischemic liver and heart disease and decreases the extent of galactosamine-induced cell death in the liver. The present model was designed to determine whether CPZ exerts a similar beneficial effect in kidney in a nephrotoxic model of acute renal failure in rats induced by the administration of mercuric chloride (2 mg/kg of body weight). The functional and structural changes in the kidney were evaluated and quantitated in animals pretreated with CPZ (40 mg/kg of body weight) or saline and then subjected to nephrotoxic injury. Compared to controls, the glomerular filtration rate was significantly lower (p less than 0.001) in saline- and CPZ-pretreated rats receiving mercuric chloride. Twenty-four hours after mercuric chloride administration the glomerular filtration rate was 446 +/- 38 microl/minute/gm of kidney weight, the fractional sodium excretion was 0.4 +/- 0.2%, and the urinary osmolality was 1440 +/- 193 mOsmoles/kg of H2O in the CPZ-treated animals compared to 26 +/- 18 microl/minute/gm of kidney weight (p less than 0.001), 10.1 +/- 9.8% (p less than 0.025), and 353 +/- 28 mOsmoles/kg of H2O (p less than 0.005), respectively, in the animals receiving mercuric chloride alone. The percentage of proximal tubule cell necrosis was 26.5 +/- 8.9% in the CPZ-pretreated group compared to 88.1 +/- 3.6% in the untreated group (p less than 0.001). Metabolic cage studies were performed to follow the time course of this model for 48, 72, and 96 hours after mercury injection. The serum creatinine values and fractional sodium excretions were significantly less in animals receiving CPZ compared to the untreated group at all time intervals examined. The serum urea nitrogen concentration and glomerular filtration rate were similar for the two groups after 48 hours, but the serum urea nitrogen level was significantly lower and the glomerular filtration rate higher after 72 and 96 hours in the animals pretreated with CPZ. In agreement with these findings were observations that animals pretreated with CPZ had significantly fewer necrotic cells 48 and 72 hours after mercury administration, and tubular regeneration appeared to be markedly accelerated. These results suggest that pretreatment with CPZ markedly lessens the degree of structural and functional impairment seen in mercuric chloride-induced acute renal failure in rats and increases the rate of recovery.
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PMID:Partial protection by chlorpromazine in mercuric chloride-induced acute renal failure in rats. 623 24

Fluid movement from the pulmonary capillaries into the interstitial space occurs continuously and is drained by the lymphatics. With increased leakage or decreased clearance, excessive extravascular lung water accumulates, initially as interstitial edema and subsequently as alveolar edema. The most common cause of pulmonary edema is an increase in microvascular hydrostatic pressure. An increased permeability of the capillaries is the other mechanism of production of pulmonary edema. An acute, critical reduction in colloid osmotic pressure may play a contributory role in pulmonary edema even at normal hydrostatic pressures. Dyspnea, diaphoresis, and anxiety characterize the clinical picture. A history of heart disease and congestive heart failure may be present in CPE, whereas evidence of an inciting event or disease process suggests NCPE. Hypoxia, decreased lung compliance, and increased shunt fraction are seen in both types of pulmonary edema, but the duration of pulmonary edema tends to be more severe and prolonged in NCPE. Evidence of increased permeability in NCPE distinguishes it from CPE. Clinically, this is assumed when pulmonary edema is demonstrated at normal PCWP and when edema fluid protein concentration and COP are close to those of plasma. The management of pulmonary edema consists of the improvement of gas exchange by methods that range from supplemental oxygen administration to mechanical ventilatory support with PEEP, depending on the severity of the disturbance in lung function. Improvement in myocardial function and a decrease in pulmonary congestion are accomplished with diuretics and morphine; in those patients who do not respond to this therapy, manipulation of preload, afterload, and myocardial contractility by vasodilators and inotropic agents may be required. In acute pulmonary edema, intravenously administered agents with a short half-life and rapid onset of action are preferred. The role of colloids in the treatment of pulmonary edema is controversial. The indications for the use of corticosteroids in ARDS are controversial, and an optimum dose has not been determined. Many clinicians tend to choose steroids to treat these patients, but the value of these agents in this setting awaits the results of controlled trials now under way.
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PMID:Acute pulmonary edema. 644 44

The effects of right atrial injections of Renografin 76 (meglumine diatrizoate), hypertonic (5%) sodium chloride, and iohexol, a new nonionic contrast medium, on sequential measures of left atrial pressure and extravascular lung water in anesthetized dogs were studied. Renografin 76 caused significant transient elevations of extravascular lung water; control levels were reestablished at 15-20 minutes after injection. These changes occurred in the absence of significant changes in left atrial pressure. Iohexol reduced extravascular lung water slightly while hypertonic saline transiently increased it. The increased extravascular lung water after right atrial injections of ionic contrast medium can only partially be explained by the tonicity of the medium. This increase was not observed with nonionic medium, suggesting that nonionic media may be preferable imaging agents in patients with underlying lung or heart disease, and may be more suitable for digital intravenous examinations.
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PMID:Extravascular lung water: effects of ionic and nonionic contrast media. 662 79

Extravascular lung water (EVLW) was measured in 17 patients with congenital heart disease by the cold-green-dye, double indicator-dilution technique. In 5 control patients, EVLW was 4.7 +/- 0.5 ml/kg (111 +/- 13 ml/m2) (mean +/- standard deviation). Twelve patients were studied immediately after correction of their heart defects. In 6 patients with normal or decreased pulmonary blood flow preoperatively (Group I), EVLW was 6.2 +/- 1.9 ml/kg (122 +/- 46 ml/m2). This value is not significantly different from that of the control patients. In 6 patients with increased pulmonary blood flow and congestive heart failure preoperatively (Group II), EVLW was 15.7 +/- 3.8 ml/kg (270 +/- 60 ml/m2), which is significantly different from both control and Group I patients (p less than 0.01). There was no correlation of EVLW with pre- or postoperative left atrial pressure, length of cardiopulmonary bypass or deep hypothermic circulatory arrest, postoperative serum protein, albumin, hematocrit or cardiac index. Thus, EVLW in the immediate postoperative period is determined by preoperative pathophysiologic characteristics rather than by intraoperative management, and patients with congestive heart failure resulting from left-to-right shunts have increased EVLW despite normal left atrial pressures.
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PMID:Measurement of extravascular lung water in infants and children after cardiac surgery. 674 8

Water fluoridation is the preferred method of caries prevention. It should be promoted wherever technically feasible, whereas fluoridation of other vehicles, such as salt, milk, and sugar, should be considered (18) where no reticulated water supplies exist, as in many developing communities where caries prevalence is increasing sharply (7). Fluoride treatment of osteoporosis results in tangible improvement, but its pharmacological basis is incompletely understood and therapeutic doses are not tolerated indefinitely or by all patients. Epidemiological studies are needed to examine further the possible benefits of optimal fluoridation in relation to the prevalence off osteoporosis and heart disease.
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PMID:Fluoride and health: dental caries, osteoporosis, and cardiovascular disease. 676 23


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