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

The arterial-coronary sinus lactate difference was measured in 17 patients after each step of a programmed ventricular stimulation protocol consisting of single, double, and triple extrastimuli, first at a basic drive cycle length of 600 msec, then at 400 msec, with an inter-train interval of 4 seconds. Four patients had no structural heart disease, four had an idiopathic dilated cardiomyopathy, and nine had coronary artery disease with a significant stenosis in at least one branch of the left coronary artery. Net myocardial lactate production during programmed ventricular stimulation was observed in three patients with coronary artery disease, but not in any patient without coronary artery disease. Among the patients who had coronary artery disease, net myocardial lactate production generally occurred in the patients who had more severe coronary artery disease. Exercise-induced ischemia, as demonstrated by a stress thallium-201 test, did not correlate with myocardial lactate production during programmed ventricular stimulation. Programmed ventricular stimulation, with a stimulation protocol typically used in many electrophysiology laboratories, is capable of inducing myocardial ischemia in at least some patients who have coronary artery disease. This finding suggests that myocardial ischemia may potentially influence the results of programmed ventricular stimulation in some patients with coronary artery disease.
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PMID:Effect of programmed ventricular stimulation on myocardial lactate extraction in patients with and without coronary artery disease. 394 67

The mortality rate of infants who require renal replacement therapy after surgical repair of congenital heart disease has been reported to be 30%-79%. We report our experience with early initiation of continuous manual peritoneal dialysis (CPD) to treat fluid overload in 20 consecutive critically ill children who underwent CPD post cardiotomy. CPD catheters were inserted at the discretion of the cardiothoracic surgeon. CPD was started for evidence of total body fluid overload with inadequate urine output, and stopped when negative fluid balance was achieved and urine output improved. Median age was 10 days (range 3-186 days), mean time to start CPD post-operatively was 22 h (range 5-40 h), and mean duration of CPD was 50 h (range 13-92 h). CPD resulted in mean ultrafiltration of 93 ml/kg per day (range 43-233 ml/kg per day). Net negative fluid balance was 106 ml/kg per day (range 49-273 ml/kg per day). During CPD, the mean number of inotropes decreased from 2.2 to 1.6 (P<0.05) and urine output increased from 2.2 to 3.9 ml/kg per hour (P<0.01). No patient died during CPD or had CPD discontinued due to adverse hemodynamic effects. The overall mortality rate was 20%. We conclude that early initiation of CPD can safely and effectively promote fluid removal in infants after repair of congenital heart disease, with a lower mortality rate than has previously been reported.
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PMID:Early initiation of peritoneal dialysis after surgical repair of congenital heart disease. 1050 18

The Indian government's plan to introduce the new long-acting contraceptive Norplant in the National Family Planning Program under pressure from the US government is opposed because Norplant has not been adequately tested. The government has reduced the funding for the national program for eradication of malaria and tuberculosis, but it is proposing to finance a Norplant based population project for the State of Uttar Pradesh. The powers that can turn a deaf ear to the possible hazards of Norplant. Implanted in the arm of a woman, the chemical is released into the bloodstream providing contraception for 5 years. Severe adverse reactions include depression, heart disease thromboembolism, high blood pressure, and ovarian cysts. Many such long-acting contraceptives are being developed including injectables, vaccines, nasal sprays, and vaginal rings with potential permanent impairment to fertility. One of the major objectives of the Family Planning Program is the improvement of the health status of women, but the introduction of Norplant would harm healthy young women. Therefore, the group Saheli and others in the campaign demand: 1) that plans for introduction of Norplant in the Family Planning Program be halted immediately; 2) that the introduction of any other long acting invasive contraceptive such as Net-En, vaginal ring, nasal spray, and anti-fertility vaccine be banned, both on the grounds of inadequacy of the health services and loss of user controls; 3) that information on the safety aspects of Norplant and the basis on which the Drugs Controller has granted his approval be made public; 4) that each and every one of the hundreds of women who still have the implant should be located, and the implant removed; and 5) that all hormonal contraceptive preparations be banned in the social marketing program as their use involves extensive monitoring.
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PMID:Norplant campaign in India. 1228 26

The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI) in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95% CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95% CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95% CI: -$22,843, $14,863]). This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most.
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PMID:Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease. 2665 44

With the BMBF's funding program "Structural Development in Health Services Research" the Cologne Research and Development Network CoRe-Net is being set up by various partners from both clinical practice and health services research. The network focuses on the further development of healthcare according to the concept of learning organizations. On the basis of three research projects, the Cologne network CoRe-Net aims to establish itself in a sustainable manner and analyze healthcare delivery for two vulnerable patient groups. The two groups include a) deceased patients in Cologne and b) people suffering from heart disease and an associated mental comorbidity. The Cologne network CoRe-Net is based on M.E. Porter's value-based healthcare approach.
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PMID:[Report from an ongoing research project: The Cologne Research and Development Network (CoRe-Net) and the value-based approach to healthcare]. 2926 71

In this paper, we present an automated procedure to determine the presence of cardiomegaly on chest X-ray image based on deep learning. The proposed algorithm CardioXNet uses deep learning methods U-NET and cardiothoracic ratio for diagnosis of cardiomegaly from chest X-rays. U-NET learns the segmentation task from the ground truth data. OpenCV is used to denoise and maintain the precision of region of interest once minor errors occur. Therefore, Cardiothoracic ratio (CTR) is calculated as a criterion to determine cardiomegaly from U-net segmentations. End-to-end Dense-Net neural network is used as baseline. This study has shown that the feasibility of combing deep learning segmentation and medical criterion to automatically recognize heart disease in medical images with high accuracy and agreement with the clinical results.
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PMID:CardioXNet: Automated Detection for Cardiomegaly Based on Deep Learning. 3044 Apr 71

Fetal echocardiography (FE) is a widely used medical examination for early diagnosis of congenital heart disease (CHD). The apical four-chamber view (A4C) is an important view among early FE images. Accurate segmentation of crucial anatomical structures in the A4C view is a useful and important step for early diagnosis and timely treatment of CHDs. However, it is a challenging task due to several unfavorable factors: (a) artifacts and speckle noise produced by ultrasound imaging. (b) category confusion caused by the similarity of anatomical structures and variations of scanning angles. (c) missing boundaries. In this paper, we propose an end-to-end DW-Net for accurate segmentation of seven important anatomical structures in the A4C view. The network comprises two components: 1) a Dilated Convolutional Chain (DCC) for "gridding issue" reduction, multi-scale contextual information aggregation and accurate localization of cardiac chambers. 2) a W-Net for gaining more precise boundaries and yielding refined segmentation results. Extensive experiments of the proposed method on a dataset of 895 A4C views have demonstrated that DW-Net can achieve good segmentation results, including the Dice Similarity Coefficient (DSC) of 0.827, the Pixel Accuracy (PA) of 0.933, the AUC of 0.990 and it substantially outperformed some well-known segmentation methods. Our work was highly valued by experienced clinicians. The accurate and automatic segmentation of the A4C view using the proposed DW-Net can benefit further extractions of useful clinical indicators in early FE and improve the prenatal diagnostic accuracy and efficiency of CHDs.
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PMID:DW-Net: A cascaded convolutional neural network for apical four-chamber view segmentation in fetal echocardiography. 3196 86

Accurate segmentation of pulmonary vein (PV) and left atrium (LA) is essential for the preoperative evaluation and planning of total anomalous pulmonary venous connection (TAPVC), which is a rare but mortal congenital heart disease of children. However, manual segmentation is time-consuming and insipid. To free radiologists from the repetitive work, we propose an automatic deep learning method to segment PV and LA from Low-Dose CT images. In the method, attention mechanism is incorporated into the widely used V-Net and a novel grouped attention module is applied to enforce the segmentation performance of the V-Net. We evaluate our method on 68 3D Low-Dose CT images scanned from patients with TAPVC. The experiment result shows that our method outperforms the popular 3D-UNet and V-Net, with mean dice similarity coefficient (DSC) of 0.795 and 0.834 for the PV and LA respectively.Clinical relevance-We proposed a CNNs-based method for the automatic segmentation of PV and LA with good accuracy, which can be used for the preoperative evaluation and planning of TAPVC. Our method can improve the efficiency and reduce the workloads of radiologists (400 milliseconds vs. 2-3 hours per-case).
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PMID:Automatic Pulmonary Vein and Left Atrium Segmentation for TAPVC Preoperative Evaluation Using V-Net with Grouped Attention. 3301 4