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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The author dwells on placental characteristics typical for some perinatal disturbances. Ultrasonic investigation in antigen incompatibility of maternal and fetal blood yields the snowdrift picture, in maternal hypertension ultrasonic placental appearance is cellular, microscopically plasma-saturated, affected by fibrinoid necrosis, hyalinosis, and hypertrophic in arterial muscular coat. Electron microscopically, there are significant changes in a villous chorion. Late gestosis involved marked destructive changes in subsyncytial and subendothelial basilar membranes. The above placental characteristics can provide explanation for functional perinatal cardiac insufficiency. Placental evaluation is presented for maternal diabetes mellitus and macrosomia. There is also evidence for a relationship between disintegration of the maternal regulatory system and predisposition to neonatal atherosclerosis.
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PMID:[The importance of pathomorphological research on the afterbirth in perinatology]. 341 16

Late changes are frequent in saphenous vein grafts. About 10 to 12 years after bypass, about one-third are occluded, one-third have wall irregularities and narrowings attributed to atherosclerosis and one-third are seemingly intact. These changes are associated with recurrence of angina and other deleterious clinical events such as unstable angina, acute myocardial infarction, heart failure and death. Intimal fibrous hyperplasia may be a precursor of these changes, which could be minimized by appropriate surgical technologies and perhaps antiplatelet therapy. These late changes appear related to serum hyperlipidemia and smoking. Optimal control of these risk factors may retard their development and subsequent clinical deterioration. Although internal mammary artery (IMA) graft is the conduit of choice because of its apparent immunity to premature atherosclerosis, and hence its longer durability, saphenous vein grafts are still placed in many old patients and others, when a short operation time is a priority, and above all in combination with IMA grafts in order to obtain complete revascularization.
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PMID:Late changes in saphenous vein coronary artery bypass grafts and their implications in clinical practice. 350 31

Fatty acids of plasma lipids, red cells and platelets were analyzed from 38 demented patients (age 53-88 years), comprising 11 patients with Alzheimer's disease (AD), 19 with multi-infarct dementia (MID) and 8 with probable vascular dementia (PVD). The mean age, body mass index, duration of dementia and content of triglycerides, total cholesterol and HDL-cholesterol in plasma were similar in AD and MID. The patients with PVD were older. As compared to AD, in MID and PVD the linoleic acid (LA) and other n-6 and n-3 polyunsaturated fatty acids (PUFA) were significantly lower in red cells and tended to be lower also in serum triglycerides, cholesterol esters (CHE) and phospholipids (PL), and platelets. The LA content of red cells was significantly correlated with that of serum CHE and PL, and n-6 PUFA (including arachidonic acid) of red cells. The low LA content of red cells was associated with old age, coronary heart disease and heart failure, but not with the severity of dementia.
Atherosclerosis 1987 Jun
PMID:Fatty acids of plasma lipids, red cells and platelets in Alzheimer's disease and vascular dementia. 361 88

Five out of 15 homozygotes and 41 out of 527 heterozygotes of familial hypercholesterolemia (FH) died during the past 10 years. Sudden death or heart failure was the cause of death in each of the 5 deceased homozygotes. Twenty heterozygotes died of myocardial infarction, 9 of sudden death, and 1 died after AC bypass surgery. Thus, 30 heterozygotes (73.2%) died of coronary heart disease (CHD). The mean age of death was significantly younger in male heterozygotes (54 years) than in the females (68 years). Rate of death from CHD in heterozygotes was 11 times higher than in the general population in Japan. Rate of death from pancreas cancer in FH was significantly higher than in the general population. These results suggest that FH is highly associated with pancreas cancer as well as CHD.
Atherosclerosis 1986 Jul
PMID:Causes of death in patients with familial hypercholesterolemia. 373 50

A prospective five-year study and medicinal treatment were conducted in 317 coronary patients with stable angina in the absence of any signs of heart failure, and stenosing coronary arterial atherosclerosis as evidenced by selective coronary angiography. Total mortality was 2.8%, and the incidence of documented non-fatal myocardial infarction was 3.8% per year. The mortality was mostly dependent on the severity of angina's functional class and the number of affected major coronary arteries (narrowed by more than 70%). A group of patients with unfavorable prognosis was identified (functional class III to IV, low physical stress tolerance, the involvement of two or three major coronary arteries). The results demonstrate the efficiency of long-term medication in coronary patients with stable angina due to stenosing coronary atherosclerosis.
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PMID:[Results of a 5-year prospective observation of ischemic heart disease patients with stable stenocardia due to stenosing coronary arteriosclerosis]. 376 19

Progression of coronary artery stenosis was measured using a quantitative, computer-assisted cinevideodensitometric method in 144 arterial segments in 44 subjects undergoing coronary arteriography on two separate occasions at least 6 months apart. Projected coronary arteriograms were digitized into 512 X 512 pixel mode and percent stenosis was calculated by comparing background-corrected videodensitometric values over stenotic and normal segments. Subjects underwent repeat coronary arteriography because of worsening symptoms of angina or heart failure; subjects with renal failure, coronary artery bypass grafts or cardiac transplant were excluded. Clinical variables determined at the time of the first arteriogram included age, sex, serum cholesterol, systolic blood pressure and presence or absence of cigarette smoking, diabetes mellitus and left ventricular hypertrophy. The mean interval between arteriograms was 29.3 months. Overall progression of coronary stenosis was observed in 40 of the 44 subjects; the mean progression at 24 months was 39% (90% confidence interval, 33 to 45%) and at 36 months was 48% (40 to 56%). The degree of overall progression was related to the length of time between arteriograms (F = 5.81, p less than 0.05) and to serum cholesterol level (F = 4.37, p less than 0.05). These data indicate that using an accurate, quantitative method, it is possible to measure progression of coronary artery atherosclerosis within 2 to 3 years of the initial arteriogram. Serum cholesterol appears to be an important determinant of disease progression.
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PMID:Progression of coronary atherosclerotic disease assessed by cinevideodensitometry: relation to clinical risk factors. 378 37

Cardiac transplantation is now accepted as the therapy of choice for irreversible, advanced heart failure. Improving results have been observed since 1980. This is the consequence of better defined criteria for selection of recipients, refined use of antilymphocyte serum, improved myocardial preservation methods, and the introduction of cyclosporine. Cyclosporine, a metabolite of a soil fungus, is one of the most potent and specific immunosuppressants yet discovered. Its main drawbacks are nephrotoxicity and hepatotoxicity. The immunosuppressive protocol usually includes cyclosporine and low dose steroid. Overall one-year survival has reached 80% to 85%, with a two-year survival of 65% to 75%. The incidence of rejection remains stable despite the use of cyclosporine, but rejection-related morbidity and mortality have been decreasing since 1980. Endomyocardial biopsy of the right ventricle provides good morphologic criteria for assessing the degree of rejection. The absence of myocardial edema during rejection in cyclosporine treated patients appears to be responsible for the limited hemodynamic deterioration and electrographic changes. Morbidity and mortality due to infection have been reduced with cyclosporine, as well. Lymphoma is still common after heart transplantation and may be related to high cyclosporine doses used in the beginning of the clinical trials. Accelerated coronary atherosclerosis of the graft is now the major factor limiting long-term survival and is probably related to chronic rejection. Human heart-lung transplantation began in 1981 at Stanford after excellent clinical results with cardiac transplantation. The success of early attempts was attributed to the use of cyclosporine and the use of combined heart-lung replacement.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Heart transplantation. 389 77

SLE affects most aspects of cardiac function, and recent studies have reported increasing cardiovascular morbidity and mortality. Pathologically, SLE is characterized by a pancarditis involving pericardium, myocardium, endocardium, and coronary arteries. In autopsy series, pericarditis has been found in 43% to 100% (mean 62%, Table I), and myocarditis was found in 8% to 78% (mean 40%, Table II), but both have been underdiagnosed clinically. Libman-Sacks lesions have been noted in 25% to 100% (mean 43%) and infective endocarditis in 1.1% to 4.9% of clinical and autopsy studies (Table III). Coronary disease may be due to arteritis, which should be treated with high-dose steroids, or it may be due to atherosclerosis, which is amenable to medical or surgical therapy. Valvular disease has been treated surgically, but with a combined surgical mortality as high as 25%. Aortic insufficiency and mitral regurgitation are the most common valvular problems, although aortic and mitral stenosis have also been reported. Hypertension has been noted in 14% to 69%, and heart failure in 5% to 44%. Evidence for a lupus cardiomyopathy, which may be subclinical, is reviewed. While steroids may ameliorate SLE pancarditis, they have also been associated with hypertension, LV hypertrophy, purulent and constrictive pericarditis, mitral regurgitation, and perhaps accelerated atherosclerosis. It remains to be seen if improved diagnosis and treatment of the cardiovascular manifestations of SLE can enhance survival.
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PMID:Cardiovascular manifestations of systemic lupus erythematosus. 390 17

Thirty-four elderly patients with right bundle-branch block and left axis deviation were studied vectorcardiographically utilizing the McFee-Parungao system. Atherosclerosis, arterial hypertension, angina pectoris, cardiac enlargement, and heart failure were common clinical features in this series. Moreover, intermittent advanced degree of atrioventricular block was present in 10 out of the 34 patients. The vectorcardiograms might be readily classified into two basic patterns, types A and B. In type A (19 cases), the frontal plane loop was open-faced. The initial vectors were directed anteriorly, inferiorly, and to the right. The mid-temporal vectors were located in the left postero-superior octant, and the late portion of the loop was inscribed anteriorly to the right with conspicuous conduction delay. Those vectorcardiographic features associate the characteristic patterns of left superior intraventricular block with complete right bundle-branch block. The type B vectorcardiograms (15 cases) demonstrated anterior clockwise loops in the horizontal plane and superior counterclockwise loops in the frontal plane. From a review of the published reports and from personal data, the authors assume that both vectorcardiographic patterns may result from an abnormal spread of excitation resulting from bilateral branch conduction disturbances.
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PMID:Vectorcardiographic study of QRS loop in patients with left superior axis deviation and right bundle-branch block. 424 91

The pathology and clinical features of 258 cases of mitral ring calcification were reviewed. The overall incidence in patients over 50 years of age was 8.5%; it was more than twice as high in women (11.5%) as in men (4.5%) and rose sharply with age. Cardiac failure and systolic murmurs were each noted in over half the patients. Hypertension was slightly commoner than in age- and sex-matched groups without ring calcification, although the difference was not statistically significant. Small nodules of calcification were more frequent in men and heavy deposits in women. Distortion and atrial displacement of the posterior mitral cusp was present in 26% of the hearts with early ring calcification, in 56% of the hearts with moderate, and in almost all hearts with marked changes. Systolic murmurs had been heard in 73% of these cases. ;Caseation' of the calcified ring was seen in seven hearts and haemorrhagic valvulitis in three. Calcium had ulcerated through the cusp in 12 cases, with thrombotic and/or bacterial endocarditis in five. Aortic valve calcification was present in 36% of men and was quantitatively related to the severity of mitral ring calcification. In women the incidence was 30% and there was no corresponding quantitative relationship. Microscopy showed nonspecific chronic inflammatory changes adjacent to calcium in about half the cases in both sexes, with foreign body type giant cells in 6%. Similar inflammatory changes in the valve cusp were almost twice as common in women as in men. There was no evidence that previous endocarditis was responsible for mitral ring calcification, neither did parity influence its incidence. Severe coronary atherosclerosis was unrelated but severe aortic atherosclerosis was commoner in patients with calcified mitral rings. The difference, in women, was statistically significant. The higher incidence of severe degrees of ring calcification, complications, and valvular inflammation in women suggests a sex-determined difference in tissue response in the mitral area. Possible provoking factors apply to both sexes and both left side valves, and such a difference would account for the relative frequency and sex incidence of mitral ring calcification.
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PMID:Pathological and clinical study of calcification of the mitral valve ring. 543 Apr 24


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