Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To investigate the clinical significance of carbohydrate antigen 125 (CA125), an antigen related to ovarian cancer, in patients with pericardial effusion, we examined the relationship between serum levels of CA125 and the presence or severity of pericardial effusion. Fifty-seven patients (25 with heart failure, 22 with pericardial metastasis, 4 with hypothyroidism, 4 with renal failure, and 2 with other diseases) in whom pericardial effusion was confirmed by echocardiography or autopsy, were used as subjects. Thirty-seven of these patients (65%) tested positive for CA125 in the serum. Of these, no significant differences in serum levels of CA125 were found between patients with benign and those with malignant underlying diseases or between those with, or without, pericarditis. However, CA125 values were higher in the patients with larger pericardial effusions and the serum level decreased when the pericardial effusion reduced. In some cases, the serum level normalized before the effusion resolved. Pericardial drainage was performed on 6 patients with cardiac tamponade. Four of these 6 patients had high serum CA125 levels and recurrent pericardial effusion. The other 2 patients had normal serum CA125 levels and no recurrence of effusion. An immunohistological study showed that a positive stain of pericardial tissues reacting to CA125 antibodies correlated to higher serum and pericardial fluid levels of CA125 than the levels of groups staining negative to the antibody. These results suggest that CA125 can be useful in assessing the status and clinical course of this disease.
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PMID:Usefulness of serum CA125 measurement for monitoring pericardial effusion. 834 Sep 95

Hyperthyroidism and hypothyroidism are common disorders in the elderly and may remain unrecognised until a patient presents with an apparently unrelated problem. The finding of an elevated level of thyroid stimulating hormone (TSH) with a normal serum thyroxine (T4) level represents "subclinical hypothyroidism", which does not necessarily require treatment. Iodine can precipitate hyperthyroidism in patients with autonomous thyroid tissue and the iodine-rich antiarrhythmic agent, amiodarone, may cause either hyperthyroidism or hypothyroidism. The metabolism and clearance of numerous therapeutic agents is altered when thyroid status is abnormal, so that dose adjustment may be necessary. In cardiac failure secondary to hyperthyroidism, great care must be taken in prescribing beta-blockers and diuretics; dosage of digitalis preparations may need to be increased. Thyroid replacement therapy can aggravate myocardial ischaemia and it may be appropriate to consider coronary artery bypass grafting before hypothyroidism is fully corrected. Antithyroid drugs, surgery and radioactive iodine all have a place in the treatment of hyperthyroidism in the elderly, depending on factors such as disease severity and the characteristics of the goitre. T4 may be given together with an antithyroid drug in a "block-replace" regimen.
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PMID:Thyroid disease. 834 Nov 92

Children with congenital hypothyroidism are prone to die unexpectedly. In order to test this hypothesis, the primary and contributing causes of death were studied in a case series of sixteen consecutive children coming to autopsy. Four patients with absent thyroid died undiagnosed and untreated. The remaining twelve cases had documented hypothyroidism with low T3 and T4 levels. Diagnosis was established after the age of two months. Nine of the sixteen cases died unexpectedly, three while in the hospital and six at home. Autopsy findings suggested bronchoaspiration in five and heart failure in four. The remaining seven cases died under predictable circumstances with serious infections. Children with congenital hypothyroidism with delayed treatment may die unexpectedly as a result of the organic dysfunction caused by their primary disease.
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PMID:[Causes of death in congenital hypothyroidism. An autopsy study]. 854 2

To determine the outcomes of percutaneous transluminal angioplasty (PTCA) in patients with subclinical hypothyroidism and to compare them with those in euthyroid patients, we studied retrospectively 48 hypothyroid (4 overtly and 44 subclinically hypothyroid) and 122 euthyroid patients who had a PTCA in Boston's Beth Israel Hospital between 1984 and 1994. No significant differences were detected in bradycardia (relative risk, RR: 0.96), tachyarrhythmia (RR: 0.62), heart failure (RR: 2.27), hypotension (RR: 1.95), or bleeding (RR: 2.48) in the immediate postprocedure period between euthyroid and subclinically hypothyroid patients. There was a trend towards an increased incidence of chest pain (43.2 vs 27.5%, RR: 1.57, p = 0.084), dissection (50 vs 33%, RR: 1.51, p = 0.06) as an immediate, and reocclusion as an early (within 2 weeks) postprocedure complication (6.25 vs .9%, RR: 6.81, p = 0.08). However, chest pain accompanied by electrocardiographic changes was not significantly different between the two groups (20.5 vs 14.7%, RR: 1.4, p = 0.47). There was no difference in the number of procedures rated as successful (subclinically hypothyroid vs euthyroid: 90.2 vs 92.7%). Hospital charges, discharge destination, interval to next admission to the hospital, and in-hospital mortality were not different between the two groups. Subclinical hypothyroidism does not appear to be a risk factor for significant morbidity or increased mortality following PTCA. Prospective long-term studies with increased statistical power are needed to clarify whether there is an association between hypothyroidism and complications (especially chest pain, dissection, and/or reocclussion) in the early (2 weeks) and late (6 months) post-PTCA period.
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PMID:Outcome of percutaneous transluminal coronary angioplasty in patients with subclinical hypothyroidism. 856 77

The long-term results of 68 cases of thyrotoxic heart disease (THD) treated with 131I were analysed. 17 of 68 patients have been followed for 2-4 years, 32 for 5-9 years, 7 for 10-14 years, 8 for 15-19 years and 4 for 20-33 years. The mean period of follow up was 9 years. Of the 68 patients, 47 did not respond to antithyroid drug (ATD) therapy. Before 131I therapy, all the patients suffered from one or more of cardiac abnormalities caused by hyperthyroidism such as paroxysmal or permanent atrial fibrillation, cardiac enlargement, cardiac failure, frequent atrial or ventricular extrasystoles, angina pectoris and so on. All patients were given individualized therapeutic 131I dose of 2.59-4.44 MBq per gram of thyroid weight. The total 131I dose for patients was 85.1 MBq to 462.2 MBq. The long-term results showed that 55 cases were cured and 11 cases achieved complete remission. The total effective rate was 97 percent. There was no relapse of hyperthyroidism. Except that 4 cases of early hypothyroidism and 5 of delayed hypothyroidism were diagnosed, there were no other complications. The incidence of postradioiodine hypothyroidism at 5-9 years was 7.4 percent and at 10-33 years 20 percent. Our results indicate that 131I is a simple, safe, economic and effective treatment for THD. Pre-treatment with ATD for hyperthyroidism with cardiac complications is not necessary. 131I should be considered as the treatment of first choice for hyperthyroidism with cardiac abnormalities.
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PMID:[Long-term results following 131I treatment of thyrotoxic heart disease: a report of 68 cases]. 869 23

We have made a prospective study of 23 patients diagnosed of subclinical hypothyroidism and 45 of overt hypothyroidism, aged 68.3-70.3 years and with a mean illness of 4.5 and 6.5 years respectively. It has been proved a higher prevalence of females in both groups. The most frequent clinical symptoms, similar in both groups, were fatigue, constipation and dyspnea. The most repeated initial diagnosis at the entry were prymary hypothyroidism, heart failure, hypertensive urgencies and stroke. We have found differences of statistical significance between the Free Thyroxine (fT4), triiodothyronine (T3), total serum cholesterol (CT), triglycerides (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and thyrotropin (TSH) initial and ending serum levels in patients with overt hypothyroidism (p < 0.05). We only have found significant differences in TSH serum levels in patients with subclinical hypothyroidism. The antithyroglobulin and antimicrobial antibodies, have been both positive in two and one patient respectively. Both are more useful as a predictor than their diagnostic value. The levothyroxine (L-T4) daily dose needed to normalize the TSH serum concentration, was lesser in subclinical hypothyroidism (71.8 micrograms opposite 107 micrograms-p < 0.001). We didn't find significant differences between the different groups in the time necessary for normalizing TSH. It seems that the L-T4 therapy should be started in all patients with subclinical hypothyroidism and TSH > or = 10 microU/ml or with TSH > 5 and goiter or with thyroid antibodies. The aim to reach is to normalize the TSH serum levels. The mean daily necessary L-T4 dose is 50-100 micrograms.
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PMID:[Clinical and subclinical hyperthyroidism: two faces of the coin?]. 892 46

A continuously increasing production level in poultry breeding has resulted in changes in metabolism. Selection procedures in breeding programmes are focused on an increase in growth rate and on a decrease in feed conversion ratio (less feed intake per unit of deposited tissue). These procedures do not pay attention to the maintenance requirements of birds. Imbalances between production (protein and fat deposition) and supply of energy for maintenance requirements lead to homeostatic dysregulation and to diseases of organs which supply the energy for production and maintenance. The alarming increase in metabolic diseases, such as heart failure syndrome, ascites, and oedema in the lungs and heart, can be directly related to an insufficient oxygen supply. A low oxygen consumption and heat production is one of the mechanisms by which a low feed conversion ratio can be achieved, as is induced hypothyroidism by which physical activity and thus heat production is reduced. Other diseases, such as liver cirrhosis, malabsorption syndrome, sudden death syndrome in broilers, and fatty liver-hemorrhage syndrome, which is nowadays the most important disease in laying hens in the Netherlands, can be related to an imbalance between the production rate and maintenance requirements. A continued selection on the basis of retained energy (in protein and fat) without paying attention to the maintenance requirements of birds will be detrimental for the health and welfare of poultry. These undesirable developments in poultry husbandry should be a challenge for sciences focused on welfare and stress in animals. Such a scientific approach to animals suffering from dysgenic changes in metabolism is needed to solve serious problems in poultry breeding.
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PMID:Pathological changes in metabolism of poultry related to increasing production levels. 932 54

Heart failure is not a common manifestation of hypothyroidism if there is no underlying heart disease. We report a case of familial primary hypothyroidism in a young male, that clinically onset with dyspnea, hemoptysis and serum CPK elevation, and in which further explorations revealed a dilated cardiomyopathy due to hypothyroidism. Because of its bad prognosis, we underline the need to identify those cases of dilated cardiomyopathy that can be treated with the appropriate therapy.
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PMID:[Heart insufficiency as first manifestation of familial primary hypothyroidism]. 938 Sep 39

1. The Na+,K+-ATPase or Na+,K+-pump, mediating the active transport of Na+ and K+, which was first identified 40 years ago, is a central target for acute and long-term regulation, as well as for therapeutic intervention. Acute stimulation of the Na+,K+-pump in skeletal muscle by insulin, catecholamines, beta2-agonists or theophylline increases the intracellular uptake of K+ and accounts for the hypokalaemia elicited by these agents. Conversely, digitalis intoxication elicits hyperkalaemia via acute inhibition of the Na+, K+-pump. 2. Simple and accurate methods have been developed for the quantification of the total concentration of Na+,K+-pumps in small (0.5-5 mg) fresh or frozen biopsies of human skeletal muscle, myocardium or other tissues. This has allowed the identification of several long-term regulatory changes in the concentration of this transport system in human tissues. In skeletal muscle, upregulation is induced by training, thyroid hormones or glucocorticoids. Downregulation is seen in hypothyroidism, cardiac insufficiency, myotonic dystrophy, McArdle disease, K+ deficiency and after muscle inactivity. 3. Since the skeletal muscles contain one of the major pools of Na+,K+-pumps, these changes are important for the ability to counterregulate the hyperkalaemia elicited by exercise or the ingestion of K+. Moreover, downregulation or inhibition of the Na+, K+-pumps in skeletal muscle interferes with contractile performance. Since digitalis glycosides bind to the Na+,K+-pump, the muscles constitute a large distribution volume for these agents and are therefore an important determinant for their plasma level. 4. In cardiac insufficiency, the decrease in the concentration of Na+, K+-pumps in the myocardium is over a wide range correlated to the concomitant reduction in ejection fraction. The regulatory and pathophysiological changes in the activity and concentration of Na+, K+-pumps are important for the contractile function of skeletal muscle and heart as well as for K+ homoeostasis and the response to digitalization.
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PMID:Clinical and therapeutic significance of the Na+,K+ pump*. 966 81

We studied survival and disease complications in 1,146 patients with thalassemia major, born from January 1, 1960 to December 31, 1987. At last follow-up, in March 1997, probability of survival to age 20 years was 89% and to age 25 years was 82% for patients born in the years 1970-1974. Patients who died had a serum ferritin level, measured the year before death, significantly higher than those who survived. Diabetes was present in 5.4% of the patients; heart failure in 6.4%; arrhythmias in 5.0%, thrombosis in 1.1%, hypothyroidism in 11.6%, HIV infection in 1.8%. Hypogonadism was diagnosed in 55% of 578 patients who had reached pubertal age: 83.5% of hypogonadic females and 78.6% of males were receiving substitutive hormonal therapy. In conclusion, the survival of patients with thalassemia major is good and improving, but the prevalence of severe complications is still high.
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PMID:Survival and disease complications in thalassemia major. 966 44


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