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

A variety of DNA markers for apolipoprotein genes were examined among patients with angiocardiographically proven heart disease and among a variety of normal individuals with various lipid values. An increased frequency of an apoAI-CIII SstI RFLP and an apoB minisatellite (allele 5) was found among patients with CHD. Higher levels of cholesterol were found among carriers of the rare apoB TaqI and the common apoCII TaqI variants, whereas higher levels of triglycerides were found in carriers of the common apoAII MspI and the rare apoB XbaI variants. Lower levels of HDL were found among carriers of the common apoAII MspI and the rare apoB PvuII variants. The biological significance of these results and those of other investigators for the pathogenesis of CHD and hyperlipidemia is suggestive but not yet fully clarified. Additional genetic epidemiologic studies and family investigations will be required. Currently used statistical methodology may lead to false inferences regarding the genetic equilibrium or disequilibrium status of closely linked DNA variants. Conclusions regarding the presence of genetic equilibrium if closely linked flanking markers are in disequilibrium may be faulty.
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PMID:Molecular genetics of apolipoproteins and coronary heart disease. 288 66

In 1984, 435,759 deaths were attributed to CHD among persons greater than or equal to 65 years of age. CHD was the leading cause of death in this group. Death rates rose steeply with age among the elderly. Men had higher death rates than women, but the male-to-female ratio declined with increasing age. Considerable geographic variation in CHD mortality in the elderly was noted. Since 1968, CHD death rates have declined in persons greater than or equal to 65 years of age in each age, sex, and race group. However, prevalence of self-reported CHD in the elderly population has increased. Prevalence rates increased with age except for a slight decrease above age 75 in men. In 1985, 436,000 persons aged greater than or equal to 65 years were discharged with a principal diagnosis of acute MI. The hospital case fatality rate was 21.8%. Since 1970, hospitalization rates for acute MI have generally increased, while hospital fatality rates have decreased for persons greater than or equal to 65 years of age. Since 1979, utilization of coronary artery bypass surgery and coronary arteriography have dramatically increased among the elderly. In 1980 and 1981, elderly persons made six million visits to physicians' offices for chronic CHD. CHD contributed importantly to the 1980 expenditures of 3.3 billion dollars in men and 4.8 billion dollars in women greater than or equal to 65 years of age for heart disease care. Although mortality rates from CHD in the elderly have decreased since 1968, increasing hospitalization rates and utilization of other health care services emphasize the need for more vigorous efforts at prevention.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Coronary heart disease in the elderly. 304 67

Myocardial ischemia without symptoms (= silent ischemia = Sl) has become a well known clinical entity in subjects with heart disease and in apparently healthy subjects. Detection of Sl is easiest and least expensively done with exercise ECG-testing (X-ECG). Data on the significance of Sl in the present report is derived from long-term follow-up of 2014 men aged 40-59 yrs, studied 1972-75, restudied in 1979-81 and 1986-88. The sources of information are: 1) 50 men with Sl detected with X-ECG/coronary angiography in 1972-75; 2) subjects with positive X-ECG in 1979-81 (but not in 1972-75); 3) preliminary data from the last follow-up study; and 4) complete data on cardiovascular mortality by Aug. 1987. The survey data indicate: a) Sl detected with X-ECG, confirmed with angiography is an indicator of later severe CHD-complications over 12-15 yrs; b) positive X-ECGs (not validated invasively) increase the risk of future CHD events and death from CHD 2-4 fold compared with subjects with normal X-ECG of similar age; c) limited isotope studies from the 1986-88 study indicate a very high specificity of a positive X-ECG in CHD, and d) cardiovascular mortality is very accurately predicted by factors known to be associated with the development of CHD. In accordance with the world literature, Sl is frequently observed in apparently healthy middle-aged and old men, and increases the risk of future CHD considerably when encountered.
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PMID:Coronary heart disease without angina pectoris: silent ischemia. 322 15

The development of myocardial scintigraphy (MS) reflects the clinical success of a representative procedure in nuclear medicine. Radiopharmaceuticals for visualizing vital and damaged myocardium and techniques (planar-qualitative, planar-quantitative, SPECT-qualitative-quantitative with comparative sensitivities) are briefly reviewed with the main focus on their clinical application in coronary (CHD) and noncoronary heart disease, where recent literature from the United States and Europe is considered. The limited value of MS for screening of CHD is outlined and its present and future role in detecting asymptomatic (silent) ischemia/infarction and symptomatic patients at professional risk is stressed. The present state of MS in coronary heart disease is discussed for single and multivessel disease, previous infarction, and risk stratification (myocardial washout, pulmonary uptake, ischemic dilation, absent heart sign), reflecting the importance of the procedure in exercise-induced ischemia as well as in ischemia at rest for prognostication of the natural and therapeutic course, i.e., therapy control (angioplasty, bypass, lysis, cardiac drugs). More marginal but upcoming clinical indications are mentioned, such as progressive systemic sclerosis, cardiac transplantation, pediatric cardiology, and problems of nephrology/urology. The "normal" values and the impact of digital radiology and of contrast cardiography are touched upon. Preliminary cases with 111In-antimyosin and 99mTc-Isonitriles are presented including correlative results between global ejection fraction determination according to gated 99mTc-isonitrile and conventional 99mTc-erythrocyte ventriculogram (r = 0.75; n = 10).
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PMID:Myocardial scintigraphy--25 years after start. 328 85

The Belgian Heart Disease Prevention Project was a controlled, randomized multifactorial intervention trial in middle-aged men which lasted 6 years. Significant net differences between intervention and control groups were observed in change in risk profile, in total mortality and in CHD incidence. The net difference in risk profile change was greatest at two years, intermediate at four years and minimal at six years. Total and cause-specific mortality rates were systematically followed from the 6th to the 10th year. Follow-up at 10 years was 99.3% complete. The differences between intervention and control groups in total, coronary and cardiovascular mortality reduced from the 6th to the 10th year. The results suggest that changes in risk profile are rapidly followed by changes in cardiovascular mortality, but this applies in both directions. Thus risk reduction should be maintained in order to achieve a long-lasting preventive effect.
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PMID:The Belgian Heart Disease Prevention Project: 10-year mortality follow-up. 328 30

The effect of congenital heart disease on growth is reviewed. Whether being small matters is questioned, and reasons why infants with congenital heart disease are small are discussed. Methods of improving growth, and catch-up growth are described. Finally management of the child with CHD and failure to thrive is considered.
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PMID:Food, growth and congenital heart disease. 332 17

The results presented above indicate that the risk factors associated with the development of coronary heart disease in women are not that different than those identified for men. It is encouraging to note that while the prevalence of hypertension in women has not changed over the past twenty years, the proportion of treated hypertensive women has increased dramatically and the proportion with controlled blood pressure has doubled since 1960. It is also encouraging to note that the number of adult women who smoke cigarettes has decreased since 1960, but the number of young girls who smoke has increased at an alarming rate. It has been noted by researchers that among women who smoke, the number of cigarettes smoked per day has increased from the 1950s to the present. From the Framingham data it can be seen that womens' serum cholesterol level increases substantially with age and women should take steps to eat a healthy low-saturated fat, low cholesterol diet in order to maintain a low blood cholesterol level. It has been shown from the Framingham Study data that although the same risk factors operate in men and women, the standard risk factors do not explain the marked differences in morbidity and mortality from heart disease between the two sexes. We must continue to study the epidemiology and biology of coronary heart disease in women both to better understand the disease process in women and to understand the large sex differential for CHD in most westernized countries.
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PMID:Coronary heart disease in women. 337 75

The effects of long-term (10 years) management at a special out-patient hypertension clinic with respect to dropout rate, side effects, blood pressure (BP) control, target organ involvement, prognostic factors and cardiovascular morbidity have been studied in 686 middle-aged male hypertensives. The impact of antihypertensive treatment, as one ingredient of multiple risk factor intervention, on mortality and morbidity in an urban, male population have been analysed. The hypertensive patients were derived from a random sample of men, aged 47-54 years at entry, constituting the intervention group (n = 7,455) of a multifactorial primary prevention trail. The whole population sample was studied regarding the effect of treatment on morbidity. The 10-year drop-out rate (declined follow-up/unknown reasons) was low (5%) being highest during the first year. The frequency of severe adverse drug effects was low (3% per year) after the initial period when treatment was started. An acceptable BP reduction was achieved in the majority of patients, but in many cases first after a few years' treatment and requiring combination drug therapy. Two-thirds of the patients achieved the goal BP (i.e. less than 160/95 mm Hg). These results are attributed to the organisation of the clinic and emphasise the need for frequent check-ups during the early phase of treatment and an easy accessibility to nurses and physicians. Except for a significant regression of ST- and T-wave changes on the conventional ECG during the first treatment year signs of heart (conventional ECG, chest X-ray) and kidney (albuminuria, serum creatinine) involvement remained unchanged or increased slightly during follow-up. Angina pectoris (AP), intermittent claudication (IC) and congestive heart failure (CHF) were common complications. The prevalence increased steadily with an average annual incidence of 1.3% (AP), 0.6% (IC) and 0.6% (CHF). ECG signs indicating subclinical heart disease were risk factor for AP and CHF. Smoking was an independent risk factor for any one of these cardiovascular disorders. The 10-year incidence of total mortality was 11.1%, and of CHD and stroke morbidity 12.2% and 4.1%, respectively. Independent risk factors (entry variables) for CHD were diastolic BP, smoking, serum cholesterol, AP and proteinuria. A previous stroke, smoking and proteinuria were independently associated with stroke morbidity. Hence, the risk factor pattern was similar to that known to operate in the general population.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Hypertension in middle-aged men. Management, morbidity and prognostic factors during long-term hypertensive care. 386 85

A combined morphometric, ultrastructural, and biochemical study was done on carotid bodies (CBs) obtained at autopsy from 213 patients in a pediatric and young adult population. The objective was to determine whether this group had statistically significant differences in sudden infant death syndrome (SIDS, n = 38), cystic fibrosis (CF, n = 30) and cyanotic heart disease (CHD, n = 17), compared with an age-matched control population (n = 128). Average combined weights of CBs in CF and CHD were significantly greater than those of controls in most age intervals (Student t test, P less than 0.05), and computerized planimetry showed an increase in both total surface area and area of "functional" parenchyma. There was diminished chief cell argyrophilia in 72% of CF CBs, and in 8 cases studied ultrastructurally there was moderate to marked depletion of dense-core neurosecretory granules. Most CBs from patients with CHD showed intense cytoplasmic argyrophilia similar to that of controls. Quantitative analysis for tissue catecholamines showed that dopamine was present in greatest concentration in each group of patients but was significantly elevated in CHD. There were no significant differences in morphometry, ultrastructure, or catecholamine content of CBs from SIDS victims, compared with age-related controls. These data add further support to CBs having a chemoreceptor role in humans with compensatory hypertrophy and hyperplasia occurring in most patients with chronic hypoxia due to CF and CHD. There were no significant findings to indicate that CBs play a direct role in the etiopathogenesis of SIDS.
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PMID:Carotid body hyperplasia in cystic fibrosis and cyanotic heart disease. A combined morphometric, ultrastructural, and biochemical study. 399 43

The ultrastructural correlates of a decrease in cardiac function resulting in heart failure are unknown. For this reason, transmural needle biopsies were taken during cardiac surgery from patients with aortic valve disease (AD, n = 143) and coronary heart disease (CHD, n = 136) and examined by electron microscopy. Ultrastructural features were: occurrence of abnormal but still viable nuclei and mitochondria combined with lack of myofibrils in greatly enlarged myocardial cells plus an increased amount of fibrosis in patients with AD. In CHD most myocardial cells were of normal size or atrophic, reduced in number and showed signs of subcellular degeneration. Fibrosis was greatly increased. These findings were confirmed in both groups of patients by quantitative analysis (morphometry). Cardiac failure was diagnosed and clinically treated in about 25% of all patients investigated in this study. The loss of specific myocardial cellular components or loss of entire cells are the morphological correlates of cardiac failure in different types of heart disease.
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PMID:Ultrastructural correlates of reduced cardiac function in human heart disease. 622 Aug 99


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