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)

In counseling the patient with a fetus with CHD, attempts should be made to determine the exact cardiac diagnosis and whether there are associated extracardiac or chromosomal abnormalities. A careful family history and examination of appropriate family members may lead to the diagnosis of a genetic syndrome. An evaluation of the maternal medical and obstetric history will explore the possibility of maternal disease states, teratogens, or environmental exposures as cause for the cardiac lesion. The information obtained from a prenatal evaluation may lead to a possible cause of CHD in the fetus and thus more accurate counseling regarding recurrence risks and the prognosis for the present pregnancy. With further improvement in the prenatal diagnosis of structural cardiac disease, a knowledge of possible causes is essential for the clinician providing counseling. In addition, a multidisciplinary approach with the involvement of obstetricians, neonatologists, pediatric cardiologists, cardiac surgeons, and geneticists will optimize care in pregnancies complicated by a fetus with structural heart disease.
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PMID:Prenatal diagnosis of congenital heart disease. 827 46

Despite over 30 years of increasingly vigorous research it is still not possible to claim with acceptable certainty that there is an identifiable pattern of coronary prone behaviour nor to say with any confidence that the idea is misguided. The scientific process that leads from initial tentative findings through generation of a hypothesis, to rigorous and cumulative tests of that hypothesis has not happened. Instead there has been a rather erratic series of positive and negative studies, and the generation and modification of essentially rather similar hypotheses. As a result we are still in the position of claiming that there may be a pattern of behaviour that predicts CHD and that it is probable that hostility is involved. It is not clear why the idea is so persistent but it may well lie in the combination of a widely held lay belief that heart disease relates to stress and personality, with tantalizing positive findings occurring every few years. While there has been little increase in understanding of the role of behavioural factors in CHD as a result of this 30 years of endeavour there have been clinical benefits. It has clearly been shown that what are regarded as coronary prone behaviours can readily be modified and that their modification appears to confer some health benefits and no detectable health hazards.
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PMID:The current status of the coronary prone behaviour pattern. 804 17

Combining the wealth of epidemiological, metabolic and recent mechanistic data, it would appear biologically plausible that HRT, either oestrogen alone or in combination with progestogen, is cardioprotective. Further research is required, as information is lacking on cardiovascular effects of HRT instigated at an older age. There is a need to identify cardiovascular benefit, indirect and/or direct, of combined oestrogen/progestogen therapy using randomized trials. The various progestogen types and doses also need to be investigated. Studies are also required to investigate the effect of HRT use in higher risk patients with established CVD. There is scant information on the effect of HRT on blood pressure of patients with hypertension. Cardiovascular risk factor profiles and incidence surveys need to be conducted in developing countries to characterize their female population and to identify the prevalence of CVD; this needs to be undertaken before widespread recommendations on CVD prevention and the role of HRT can be made. If HRT is to be used effectively in the future treatment of heart disease in women these questions need to be addressed. At present HRT is indicated for the relief of menopausal symptoms and the prevention of osteoporosis. In women without these indications, ORT may be recommended in those who have had a premature menopause, and possibly in those who have established CHD or who are at high risk of developing CHD. It is too early to suggest a blanket recommendation for the use of HRT in the treatment of the symptoms of women with established CVD, but HRT after the menopause may at least be safely used in the secondary prevention of CHD.
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PMID:The menopause and the cardiovascular system. 893 7

In order to make an actual perspective about prenatal diagnosis of congenital heart disease in the area of influence of our department, a prospective study including 948 fetus and 185 newborn was done, 348 fetus and 20 newborn evaluated during 1993 (group I) and the remaining during 1994 (group II). In both groups indications for fetal echocardiography were mainly maternal (18%) and familiar (14%) factors, but occurrence of CHD were respectively 2% and 0% for them. Fetal factors for echocardiography account for 7%, namely arrhythmias (7%) and obstetric suspicion of CHD (6%), but occurrence of CHD was respectively 13% and 32% for group I and 36% and 48% for group II. In the newborn with serious CHD, risk factors could be identified in 30% in group I and 36% in group II, being respectively 15% and 7% referred for fetal echocardiography. It is concluded that although a rise in the number of fetus evaluated and a better obstetric accuracy have occurred, the rate of prenatal diagnosis of CHD is still very low, pointing to necessity of continuing our actual policy of teaching and spreading this area, specially in the primary health care units.
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PMID:[Prenatal diagnosis of congenital cardiomyopathies. Current reality in the south of the country]. 896 9

Overwhelming evidence indicates that the Western diet plays a major role in atherogenesis. Clinicians are only now beginning to tease out the precise components of the diet that are harmful or beneficial. With respect to fat intake, it remains unclear whether it is the amount or type of fat that promotes atherosclerotic disease. There appears to be a consistent positive association of cholesterol, saturated fat, and possibly trans-fatty acid intake and atherosclerotic disease. Although there is general agreement that reducing intake of these dietary components would be beneficial, controversy remains on what should replace these harmful fats. Some researchers advocate massive reductions in total fat consumption with replacement with carbohydrates for everyone, whereas others recommend a Mediterranean-style diet, which replaces saturated animal fats with vegetable fats. Very low-fat diets have been shown to lower the chance of a heart attack among those with severe coronary artery disease, but for the majority of Americans who do not have obvious artery disease, there is no convincing evidence that a very low-fat diet is optimal. There may be other adverse health effects of this Asian diet, such as increased rates of hemorrhagic stroke. Further research is required to refine thinking on the optimal composition of fats in diet. The effects of alcohol consumption on chronic diseases are complex. The strength and consistency of the observational and experimental evidence strongly suggests a causal link between light to moderate alcoholic beverage consumption and reduced risks of CHD. These reductions in risk of CHD appear to be mediated largely by raising HDL cholesterol levels, although additional mechanisms remain possible and do not appear to be beverage specific. Maximal benefit in terms of CHD appears to be at the level of one drink per day. From a public policy standpoint, whether the benefits for CHD persist at heavy drinking levels or are attenuated is moot because clear harm of heavy drinking in terms of overall mortality outweighs any benefits in the reduction of heart disease. Although the association of alcohol and CHD is likely to be causal, any individual or public health recommendations must consider the complexity of alcohol's metabolic, physiologic, and psychological effects. With alcohol, the differences between daily intake of small to moderate and large quantities may be the difference between preventing and causing disease. A discussion of alcohol intake should be a part of routine preventive counseling. Given the complex nature of alcohol disease relationships, alcohol consumption should not be viewed as a primary preventive strategy; also, it should not necessarily be viewed as an unhealthy behavior. Based on the totality of available evidence, antioxidants represent a possible but as yet unproven means to reduce risks of cardiovascular disease. Although it remains unclear whether supplementation of diet with antioxidant vitamins will reduce risks of atherosclerotic disease, most researchers agree that consumption of fruits and vegetables is an important part of a healthy diet. The U.S. Department of Agriculture recommends two to four servings of fruit and three to five servings of vegetables per day.
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PMID:Diet and heart disease. The role of fat, alcohol, and antioxidants. 907 92

To confirm the usefulness of head-up tilt test (HUT) in neurocardiogenic syncope (NCS) with complicating clinical features, retrospective analysis were done on 12 selected children. The age at onset was 12.7 +/- 1.9 (mean +/- SD) years. Associated clinical features were postoperative congenital heart disease (PO CHD) in 3, coexistent arrhythmia in 8 (persistent ventricular arrhythmia during exercise in 3, premature ventricular contractions in 2, ventricular couplets in 1, sinoatrial exit block in 1 and resting sinus bradycardia in 1) and ST segment depression during exercise in 1. Four of them had a history of exercise-related syncope. All 3 patients with PO CHD had arrhythmia (ventricular tachycardia in 1, sinus bradycardia in 1 and atrioventricular block in 1). HUT provoked NCS in 8 (2 during baseline tilt, 6 during isoproterenol infusion). In one each, ventricular tachycardia and loss of consciousness without hypotension and bradycardia were induced. Atenolol was tried in 5 with improvement of NCS in 4 and aggravation of dizziness in 1. During follow-up, 7 became asymptomatic (2 with atenolol) and 5 were stationary. In conclusion, HUT was valuable in diagnosing NCS even in children with complicating clinical features such as arrhythmias or PO CHD. HUT could be done as apart of initial diagnostic tests if the past history suggests NCS, regardless of associated clinical features. In some cases, the unexpected results of the test turned out useful in managing children with syncope or dizziness.
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PMID:Head-up tilt test in complicated neurocardiogenic syncope in children. 914 59

Chromosome 21 is a model for the study of human chromosomal aneuploidy, and the construction of its physical and transcriptional maps is a necessary step in understanding the molecular basis of aneuploidy-dependent phenotypes. To identify the gene(s) responsible for Down syndrome congenital heart disease (DS-CHD), we constructed a physical map of the D21S55 to MX1 region. A bacterial artificial chromosome (BAC) library was screened using several YACs spanning the interval, and a P1-derived artificial chromosome (PAC) library was screened using radiolabeled STS PCR products and whole BACs in gap-filling initiatives. FISH confirmed the location of all BAC and PAC clones to 21q22.2-q22.3. Overlaps were established using clone-to-clone Southerns and 24 new STSs, generated from the direct sequencing of BAC and PAC ends, along with 35 preexisting STSs. Approximately 3.5 Mb of the 4- to 5-Mb D21S55 to MX1 interval is covered in 85 BACs and 24 PACs, representing fourfold coverage within the contigs. These BAC and PAC contigs are valuable reagents for isolating the genes for DS-CHD.
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PMID:BAC and PAC contigs covering 3.5 Mb of the Down syndrome congenital heart disease region between D21S55 and MX1 on chromosome 21. 914 97

To evaluate whether polymorphisms in the 5' region of the apolipoprotein(a) gene alter the risk for myocardial infarction, 289 Russian male patients with myocardial infarction (MI) and 284 subjects in a control group were investigated regarding the distribution of pentanucleotide repeats (PNRs) at position -1373 and a C/T transition at position +93. For detection of the C/T (+93) allele, we developed a rapid, nonisotopic method by mismatch PCR-mediated site-directed mutagenesis and restriction enzyme digestion. We observed significant differences in prevailing alleles with over eight (TTTTA) repeats among MI patients, including those with MI younger than 55 years of age. We observed the prevalence of the T (+93) allele in children without a family history of CHD compared to young MI patients. These findings support the notion that PNR alleles with over eight (TTTTA) repeats may play a pathogenic role, and the T (+93) allele may have a protective effect for the inherited predisposition to heart disease.
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PMID:Comparative analysis of apo(a) gene alleles: distribution of pentanucleotide repeats in position -1373 and C/T transition in position +93 among patients with myocardial infarction and a control group in St. Petersburg, Russia. 925 86

Coronary heart disease remains the leading cause of morbidity and mortality in older adults, despite improved survival and declining mortality. This article describes the prevalence and impact of heart disease on people's lives, singly and in combination with other diseases. It then reviews current findings as to the risk factors for CHD in older adults and the underlying physiologic changes of aging plus pathophysiologic changes of hypertension and CHD in impairing the ability of older adults to respond to exercise and other stressors, and the effects of exercise training in attenuating the adverse cardiovascular changes of aging. This information provides a basis for considering opportunities for prevention of heart disease and maximizing heart function. The article concludes by describing the known contribution of preventive measures to declines in heart disease in older adults.
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PMID:Heart health in older adults. Import of heart disease and opportunities for maintaining cardiac health. 934 54

The administration of NO has become an important and effective therapy in the clinical management of pulmonary hypertension associated with cardiopulmonary disorders in infants and children. It is likely to become a routine therapy in the treatment of PPHN, although dosing and timing strategies, early indicators of treatment failure, and long-term outcomes are not completely understood. The use of NO has also been beneficial in the evaluation and management of pulmonary hypertension associated with congenital heart disease. The role of NO in the management of pediatric ARDS holds promise, although further clinical trials are needed. Additional research should also be directed toward the use of NO in preterm infants and those born with CDH. Future endeavors may also include the use of NO in the evaluation and management of asthma.
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PMID:Inhaled nitric oxide in the management of cardiopulmonary disorders in infants and children. 939 Sep 20


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