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

To examine the relation of short- and long-term changes in glucose metabolism to cardiac function, radionuclide cineangiography and echocardiography were performed in 10 young insulin-dependent diabetic patients without clinical evidence of heart disease. Cardiac assessments were performed before and after both acute variations in blood glucose, and induction of chronic "tight glucose control" involving normalization of hemoglobin A1 concentrations. In diabetic patients, left ventricular (LV) ejection fraction (EF) at normal blood glucose concentration was indistinguishable from values in 11 normal subjects. However, during hyperglycemia (about 300 mg/dl), the average EF at rest was 61%, significantly higher than that during normoglycemia (56%, p less than 0.001). No significant change in LV diastolic dimension was noted in association with shifts between high and normal blood glucose concentrations. Normalization of hemoglobin A1 was achieved within 6 to 25 weeks. This alteration had no significant effect on LVEF, mitral valve E-F slope, or the response of systolic function to blood glucose levels. In addition, no correlation was found between LVEF and hemoglobin A1 concentrations in 4 of 5 evaluation periods. Thus, in young insulin-dependent diabetic patients without overt heart disease, variation in blood glucose concentration is associated with small but significant variation in EF at rest; normalization of hemoglobin A1 has no significant effect on LVEF or the response of systolic function to blood glucose levels.
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PMID:Relation of hemoglobin A1 and blood glucose to cardiac function in diabetes mellitus. 405 Jul 2

The relation between degree of cardiac functional impairment and changes in hemoglobin-oxygen affinity and 2,3-diphosphoglycerate (2,3-DPG) has been studied in 39 patients with noncyanotic heart disease. A progressive decline in hemoglobin-oxygen affinity was found with worsening cardiac function as assessed by cardiac index, arteriovenous oxygen (A-V O(2)) difference, and cardiac symptoms; this alteration in hemoglobin-oxygen binding represents a significant mechanism for adaptation to the limited oxygen supply imposed by the cardiac lesion. The highly significant correlation of mixed venous blood oxygen saturation (S[unk]V(VO2)) with 2,3-DPG and the position of the oxygen dissociation curve suggests that the level of deoxygenated hemoglobin is an important in vivo regulator of hemoglobin-oxygen affinity.
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PMID:The effect of cardiac disease on hemoglobin-oxygen binding. 543 70

Blood from patients with erythrocytosis secondary to arterial hypoxemia due either to congenital heart disease or to chronic obstructive pulmonary disease was shown to have a decreased affinity for oxygen; the average oxygen pressure required to produce 50% saturation of hemoglobin with oxygen was 29.8 mm Hg (average normal, 26.3 mm Hg). Such a displacement of the blood oxygen equilibrium curve promotes the release of oxygen from blood to the tissues. Studies were also performed upon blood from a man with complete erythrocyte aplasia who received all of his red cells by transfusion from presumably normal persons. With mild anemia (hematocrit, 28%), the affinity of his blood for oxygen was slightly diminished (an oxygen pressure of 27.0 mm Hg was required to produce 50% saturation of hemoglobin with oxygen). With severe anemia (hematocrit, 13.5%), however, his blood had a markedly decreased oxygen affinity (an oxygen pressure of 29.6 mm Hg was required to produce 50% saturation of hemoglobin with oxygen). We conclude that patients with various conditions characterized by an impairment in the oxygen supply system to tissues respond with a diminished affinity of their blood for oxygen. Although the mechanism which brings about this adaptation is not known, the displacement of the oxygen equilibrium curve is associated with an increase in heme-heme interaction. The decrease in blood oxygen affinity need not occur during erythropoiesis, but may be imposed upon mature circulating red cells.
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PMID:Improved oxygen release: an adaptation of mature red cells to hypoxia. 566 14

Figures of incidence and risk factors of neurological complications (NC) endangering children with cyanotic congenital heart disease (CCHD) are very different. We examined 308 children with CCHD over an 8 years' period finding 39 cases (= 12,7) of NC. There were 5 hypoxic attacks and 3 brain abscesses. In 31 patients a cerebro-vascular accident was proven or probable. 56% of NC occured during the first year of life, most frequently in children with simple TGA. Mortality was not influenced by NC. Children without NC, surviving the first year of life represent the control group for comparison of the following hematologic parameters: erythrocytes, hematocrit, MCHC, hemoglobin, O2-saturation, platelets count. Only the last two were significantly lower in patients with NC, but no parameter allows to predict NC. The hypothesis of hypochromic, microcytic anemia as essential pathogenetic factor for cerebro-vascular accidents has no base in our material.
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PMID:[Neurological complications in children with congenital cyanotic heart disease (author's transl)]. 610 46

Left-ventricular (LV) function in type 1 diabetics without clinical heart disease was compared with that found in matched normal subjects. Although diabetics had a normal LV ejection fraction (66% +/- 6%), they showed a trend toward smaller left ventricles. Their cardiovascular response to a cold pressor test was abnormal and cardiac function after the cold pressor test correlated with hemoglobin A1c levels: Average hemoglobin A1c was inversely related to ejection fraction and early filling volume and directly related to the ratio of pre-ejection period to ejection time (PEP/LVET) after a cold pressor test. Hemoglobin A1c at the time of study correlated more closely with PEP/LVET after cold pressor test than did the six-month average hemoglobin A1c level, suggesting that cardiac function fluctuates with recent changes in blood glucose control. Thus, even when diabetics have a normal LV ejection fraction, an abnormal cardiovascular response to stress may still be present, and such abnormalities correlate with blood glucose control.
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PMID:Abnormalities of the cardiovascular response to cold pressor test in type 1 diabetes. Correlation with blood glucose control. 669 73

When assessing patients' serial ECG changes, the clinician implicitly compares those changes to the limits of change expected in a healthy population. Prospective epidemiological studies, too, develop their criteria from the limits of normal serial ECG changes. Surprisingly then, few studies have reported normal limits for changes between serial ECGs taken six months or longer apart, and all are based on small samples. The present study has a large sample size: 243 white middle-aged and older males, after exclusions for heart disease. Each had at least four consecutive annual examinations with ECGs. Limits of serial variability were computed for 52 measurements. The ECG measurements included durations, amplitudes, ratios, angles and spatial magnitudes. Clinical measurements included blood pressure, cholesterol relative weight and hemoglobin. Year-to-year ECG variabilities were compared to day-to-day variabilities of the same measurements reported earlier. Year-to-year variation was virtually identical to the reported day-to-day variation in most measurements. In only two measurements was year-to-year variation over 25% greater than the reported day-to-day variation.
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PMID:Year-to-year variation of the orthogonal electrocardiogram and vectorcardiogram among 243 normal white males. 673 32

An increase in hemoglobin concentration characterizes the normal compensatory response to chronic tissue hypoxia. We observed no such increase in 42 chronically hypoxic patients with cystic fibrosis, in whom the mean concentration was 12.6 gm/dl; one third of the patients were anemic. Compared with patients with cyanotic heart disease, patients with cystic fibrosis did not have a compensatory increase in P50 or 2,3-diphosphoglycerate. Despite anemia, erythropoietin levels in patients with cystic fibrosis were not significantly different from normal control values. The growth of colony-forming units-erythroid in patients with cystic fibrosis was similar to that in control subjects, and there was no inhibition of growth with the addition of autologous serum. Erythropoietin sensitivity, determined by measuring the CFUe dose response curve, was normal in both patients and controls. Results of iron studies were consistent with iron deficiency in the majority of patients. Impaired absorption of iron was observed in six of 13 iron-deficient patients with cystic fibrosis. An inverse correlation between erythrocyte sedimentation rate and peak serum iron was obtained during the iron absorption study. Eight patients who underwent a therapeutic trial of iron demonstrated a 1.8 gm/dl rise in hemoglobin concentration. Two patients with previously documented iron malabsorption responded to parenteral iron therapy after failure to respond to oral supplementation. These studies demonstrate that patients with cystic fibrosis not only have an impaired erythroid response to hypoxia, but are frequently anemic. Their inadequate erythroid response to hypoxia results in part from disturbances in erythropoietin regulation and iron availability.
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PMID:Inadequate erythroid response to hypoxia in cystic fibrosis. 673 32

The medial thickness of intrarenal arteries was assessed morphometrically at autopsy in 15 patients with acyanotic heart disease, 30 patients with cyanotic heart disease, and in 33 normal individuals of the same age range. The arterial media was not influenced by age but was thinner in patients with cyanotic heart disease than in acyanotic patients and normal persons. This difference was apparent at any blood pressure level, though the medial thickness showed a positive correlation with the height of the systolic blood pressure. There was also a significant negative correlation between the medial thickness of the intrarenal arteries and the hemoglobin value in the patients with congenital heart disease. The thin media may result from atrophy or dilation. Possibly both factors contributed through combination of arterial relaxation, dampening of systolic pressure peaks, and increase of blood volume.
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PMID:Medial thickness of intrarenal arteries in congenital heart disease. 689 2

To define the prevalence, frequency and characteristics of premature ventricular complexes (PVCs) in adults free of recognizable heart disease, we performed 24-hour ambulatory electrocardiography on 101 subjects (51 men and 50 women, mean age 48.8 years) in whom physical examination, chest x-ray, ECG, echocardiogram, maximal exercise stress test, right- and left-heart catheterization and coronary arteriography were normal. Thirty-nine subjects had at least 1 PVC/24 hours, but only four had more than 100 PVCs/24 hours and fewer than five had more than five PVCs in any given hour. The probability of having at least 1 PVC/24 hours increased with age (chi square = 11.789, p = 0.019). The number of PVCs/24 hours was also positively associated with age (4 = 0.33, p = 0.001). These was no consistent relationship between the presence or number of PVCs/24 hours and sex, blood pressure, weight, height, body mass index, serum potassium or calcium, cholesterol and triglyceride, hemoglobin, the ingestion of coffee, tea or alcohol, and cigarette smoking. Four subjects had multiform PVCs, two of whom had early PVCs.
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PMID:Premature ventricular complexes in the absence of identifiable heart disease. 722 80

Hemoglobin (Hb), hematocrit (Hct) and mean corpuscular hemoglobin concentration (MCHC) were determined in 36 acyanotic and 38 cyanotic patients with congenital heart disease. Serum iron (SI) was also determined in 16 cyanotic patients. Patients were classified as follows: Gp I, 0.5-5 years old and Gp II, 6-12 years. In acyanotic patients, anaemia (Hb 11 gr%) was present in 35% for Gp I and 18.7% for Gp II (Hb 11.5 gr%), a figure which is similar to the general Greek children's population. In cyanotic patients which have normal or high Hb concentration, when SI was used as an index, anaemia (SI 60 g%) was found in 37.5% for Gp I and 12.5% for Gp II. Furthermore, when using as index the MCHC the percentage of anaemia (MCHC 31%) was further increased in those patients (44% for Gp I and 23.8% for Gp II). Four cyanotic infants with MCHC 31% developed cerebrovascular accidents. The data show 1) that the MCHC is a convenient and accurate index of iron deficiency anaemia in children with cyanotic heart disease and 2) that the incidence of hypochromic anaemia is high in cyanotic patients.
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PMID:[Incidence of anaemia in congenital heart diseases (author's transl)]. 734 22


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