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)

Serum erythropoietin levels were measured by radioimmunoassay in 146 children and young adults with congenital heart disease to assess the relationship between erythropoietin and clinical factors (heart failure, anemia, cyanosis) and hemodynamic variables affecting oxygen delivery and utilization. Erythropoietin values were in the normal range (10 to 30 microU/mL) in 73% (58 of 80) of the patients with and 82% (54 of 66) of those without cyanosis. Elevated erythropoietin values in cyanotic patients were associated with lower mixed venous oxygen saturation and tension than in cyanotic patients with normal erythropoietin levels, even though the degree of polycythemia was similar. In contrast, most of the acyanotic patients who had elevated erythropoietin levels were anemic. Of the blood oxygen measurements, mixed venous oxygen saturation and tension had the closest inverse correlation with erythropoietin values. The normal erythropoietin values in most patients are in accord with other observations that show that an elevation in erythropoietin level in response to hypoxia will be transient if it results in a rise in hemoglobin concentration "appropriate" to the degree of hypoxia. Persistent elevation of erythropoietin in patients with congenital heart disease may indicate harmful impairment of hemoglobin production that is potentially correctable.
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PMID:Serum erythropoietin levels in patients with congenital heart disease. 355 1

Based on present clinical-chemical parameters a representative population were studied; importance and order of rank of 10 data chosen from a total data pool are determined by means of multivariant and discriminant analysis. As a result the validity of characters with and without apriori probabilities for 5 pairs of classes (persons suffering from a heart disease in comparison to healthy persons divided in sexes and overall, as well as examination of separate sexes for healthy persons and those suffering from a heart disease) are examined (alpha less than or equal to 0.05). This calculation tested the importance of the parameters hemoglobin and creatinine in being different in males and females. To diagnose persons suffering from a heart disease (X-ray-morphologically defined suspects of heart and vessel diseases) from healthy persons, the optimized number of characteristics were determined in cholesterol, erythrocyte sedimentation rate, ASAT, blood glucose (independent of sex). By means of these results it is possible to identify persons suffering from a heart disease from healthy persons and to call for illustrative laboratory examinations using already mentioned parameters and the function of discriminance W = p sigma i = 1 ai X Xi. The determination of sensitivity and specification yielded a value of up to 98 per cent resp. 94 per cent depending on whether with or without apriori probabilities. This enables use to be modified to suit different purposes.
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PMID:[Value and rank of diagnostic laboratory parameters in cardiovascular diseases. Results of multivariant and discriminant analyses of the Berlin EBMO-Cor population study]. 356 17

After the laboratory-diagnostical spectrum had been analysed by means of a representative check of probationer with a state suspected of heart and vessel diseases on the screen of the X-ray mass examination in longitudinal section and cross-section with derived conclusions the results had been checked by means of comparison with the dead and not dead of this population in the follow up. The parameter sedimentation rate of erythrocyte, blood sugar, the enzymes "ASAT" and "ALAT" and total cholesterol with stronger pronounced proneness could substantiate the causal connection to this population of persons suffering from a heart disease as well. Hence followed derived relations to the severe degree of heart and vessel disease and beside this to the prognostical estimation of the disease for the parameter uric acid, hemoglobin/hematocrit and creatinine in the serum. The number of leucocytes, the serum protein, the separation of fractions of serum protein and lability test of serum by electrophoresis did not result in any findings, which allowed any connection with heart and vessel diseases, also concerning the persons who died in the course of the study, so that the demand for a differentiated, well-aimed differential-diagnostical use of these expensive research methods also for this extreme situation is substantiated once more. The results are discussed in comparison as well as in connection with the results found out of the total check and in dependence of age and sexes.
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PMID:[Comparative biochemical parameters in deceased and living patients in a follow-up intervention study of cardiovascular patients]. 359 Aug 37

Serum immunoreactive erythropoietin (siEp) was measured in 27 cyanotic and 21 acyanotic children with congenital heart disease, age 4 months to 10 years. The geometric mean value was 9 mIU/mL for each group with 95% range from 3 to 26 mIU/mL and 4 to 22 mIU/mL for the cyanotic and acyanotic subjects, respectively. The levels are similar to those found in normal adults using the same assay system. Three cyanotic subjects showed increased siEp values. One was anemic relative to his hypoxemia, and the other two showed signs of increasing hypoxia. There was a significant negative correlation between siEp and arterial oxygen content. However, siEp did not correlate significantly with hemoglobin, hematocrit, PaO2, or SaO2. Despite normal siEp levels, the cyanotic children showed compensatory erythropoiesis with significantly elevated hemoglobin and hematocrit levels, which did correlate inversely with PaO2 and SaO2. Arterial oxygen content was also significantly higher in the cyanotic subjects (p less than 0.02). The cyanotic children seemed to display the same pattern as observed in man and animals exposed to prolonged hypobaric hypoxia, where after an initial rise in erythropoietin values the levels fall to normal, while increased erythropoiesis is sustained.
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PMID:Serum immunoreactive erythropoietin in children with cyanotic and acyanotic congenital heart disease. 362 Jul 2

A group of 71 chlorophenate-exposed sawmill workers were identified as part of a group undergoing an extensive health and environmental evaluation in a pulp mill. This group was compared with a group (N = 351) with no physical proximity to the area in which chlorophenates were used. Exposure was higher for those directly handling the wood and lower for those working in the area but not handling the wood. Those with chlorophenate exposure were not significantly more likely to report a history of jaundice or liver, kidney or heart disease. Moreover, the serum creatinine, bilirubin, glutamic oxaloacetic transaminase (GOT), and alkaline phosphatase values did not differ from those of the reference group. The hemoglobin level was similar in the three groups. But the peripheral blood leukocyte count was marginally lower in the exposed groups and their hematocrit was reduced, significantly so for the heavily exposed group. Urinalysis showed an increased prevalence of microscopic hematuria, especially with lower cell counts. No unequivocal explanation is available for the reduced hematocrit or the low level of hematuria.
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PMID:Occupational exposure to chlorophenates. Renal, hepatic and other health effects. 372 96

The physiology of oxygen delivery was studied in 118 stable patients from 3 months to 20 years old with congenital heart disease. During cardiac catheterization, oxygen consumption (VO2), arterial and venous blood gases and oxygen saturations (range 41% to 98%), hemoglobin concentration, diphosphoglycerate (2,3-DPG), and P50 levels were measured, and then cardiac output, systemic oxygen transport (SOT), arterial and venous oxygen contents, and the VO2/SOT ratio (fractional O2 extraction) were calculated. P50 averaged 31 mm Hg, compared with 27 mm Hg in 10 control children (p less than .01). The composite O2-hemoglobin dissociation curve in vivo was broad: Po2 varied from 37 to 65 mm Hg at 80% saturation. P50, 2,3-DPG, hemoglobin concentrations, and O2 saturation varied widely and inconsistently with Po2 and arterial and venous O2 content, but resulted in clustering of the arterial oxygen content near 165 +/- 23 (SD) ml/liter over a wide range of Po2 and hemoglobin concentrations. SOT varied in direct relation with flow (r = .82, p less than .001), but not with oxygen content, Po2, or P50. VO2 varied widely at normal or high levels of SOT, but decreased linearly at SOT levels below 400 ml/min/m2. Oxygen extraction varied inversely with venous O2 content, rising to about 50% and plateauing below venous contents of 100 ml/liter. O2 extraction did not correlate with Po2, arterial O2 content, or P50. These data suggest that: O2 saturation cannot be predicted or calculated accurately from measured Po2, but must be measured directly, 2,3-DPG, hemoglobin concentration, and P50 fluctuate to stabilize arterial oxygen content, SOT is determined primarily by cardiac output in subjects who are adapted chronically, O2 extraction rises, due to a fall in venous O2 content, to maintain VO2 as transport falls, below a critical level of SOT, O2 extraction ceases to rise and VO2 falls with further reduction in transport.
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PMID:Systemic oxygen transport in patients with congenital heart disease. 380 39

In summary, a shift to the right in the O2-Hb curve in patients with anemia and decreased cardiac output and normal PaO2 will increase PvO2. This shift is mediated through increases in red cell 2,3-DPG. The stimulus for the increase in 2,3-DPG is most likely due to the decrease in SvO2. In hypoxemia caused by a decreased PAO2 (altitude), an increase in P50 may have no effect on PvO2 and in fact if the PaO2 is low enough, a left shift may increase the PvO2. Animals and man most successful at adapting to high altitudes reflect this fundamental physiological effect and have a left-shifted curve. This decrease in P50 is probably related to an intrinsic property of the hemoglobin and not to changes in 2,3-DPG. In hypoxemia caused by shunt, an increase in P50 increase the PvO2 regardless of the PaO2. Patients with congenital cyanotic heart disease have an increased P50 mediated through an increase in 2,3-DPG.
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PMID:Clarification of the effects of changes in P50 on oxygen transport. 391

A group of eight adult patients with congenital cyanotic heart disease (CCHD) with PaO2 values of less than 32 mm Hg at rest and/or exercise were studied. Four of the patients were re-studied after heart-lung transplantation and restoration of PaO2 to normal values. All eight patients showed increased red cell counts (polycythemia), whereas frankly elevated hemoglobin concentrations were found in only one patient. There was no impressive change in the affinity of hemoglobin for O2 as compared to normal subjects. Blood lactate concentrations were normal at rest before transplantation, rose very modestly during moderate exercise, and were normal following transplantation indicating that the concept of anaerobic threshold is not valid in the present group of patients. Cardiac index was not elevated in the pretransplantation period, indicating that an elevated cardiac output is not an essential adaptive mechanism for dealing with hypoxia. In the pre-transplant period, O2 consumption was elevated as compared to normal values and almost doubled during exercise despite a further decline in PaO2 and SaO2; this establishes that the rate of mitochondrial O2 utilization is maintained despite profound reduction in PaO2. These patients are capable of moderate exercise and normal brain function despite severe hypoxia and the absence or attenuation of various adaptive mechanisms for dealing with hypoxia. Further study of the specifics of O2 transport and utilization in similar patients should prove rewarding.
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PMID:Impact of profound reductions of PaO2 on O2 transport and utilization in congenital heart disease. 391 37

During surgical correction of cyanotic heart disease with associated polycythemia, sufficient reduction of hemoglobin and hematocrit values has proved effective in preventing postoperative coagulopathies. Three groups of surgical patients were studied: Group I--a control group consisting of 75 adults undergoing uncomplicated correction of acquired heart disease and requiring no blood or blood component transfusion; Group II--15 patients with tetralogy of Fallot whose intraoperative hemoglobin values remained above 10 gm/dl with conventional hemodilution techniques; and Group III--21 cyanotic surgical patients whose intraoperative hemoglobin values were lowered to less than 10 gm/dl with sufficient hemodilution. Group III was further broken down into a subgroup of six patients (Group IIIa) who underwent sequential laboratory determinations, as in Group I. In Group IIIa, postoperative coagulation function tests were only slightly more abnormal than in the nonpolycythemic control group (Group I). Patients in Group III (who had ample hemodilution) experienced 45% less bleeding and required 54% fewer blood components than those in Group II (who underwent conventional hemodilution).
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PMID:Use of sufficient hemodilution to prevent coagulopathies following surgical correction of cyanotic heart disease. 398 66

Seventeen patients 1 day to 28 months old with congenital cyanotic heart disease underwent a modification of the Blalock-Taussig shunt. Eight were newborn infants weighing 2.6 to 4.8 kg. All infants had complex congenital heart defects that were not considered amenable to early correction. There were no early deaths and no shunt failures. Postoperative complications were restricted to prolonged intubation in 2 patients and a subcutaneous wound infection in a 14-day-old infant. Follow-up from 1 to 31 months revealed minimal cyanosis, stable hemoglobin levels, and good shunt murmurs, and there have been no upper extremity complications. There were 2 late deaths; 1 (the oldest patient) was related to medication, and the second resulted from small bowel necrosis. The concept of the azygos vein patch modified Blalock-Taussig shunt involves two factors: (1) mobilizing as much length as possible of the subclavian artery in spite of its distal small size to allow for a tension-free shunt to prevent tension on the anastomosis as growth occurs, and (2) enlarging the subclavian artery distal to the vertebral artery origin with an autologous azygos patch. During performance of a standard Blalock-Taussig shunt, a longitudinal incision is made through the pulmonary artery across the anastomosis into the upper subclavian artery. The appropriate length of harvested azygos vein is used as a patch angioplasty across the shunt. A tension-free shunt with a patulous distal portion is achieved. Pulmonary overcirculation is avoided by the limiting size of the proximal subclavian artery. Temporary occlusion of the shunt at operation resulted in an increased mean blood pressure from 6 to 18% in all infants.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Technique and experience with azygos patch modified Blalock-Taussig anastomosis for congenital cyanotic heart disease. 400 96


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