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

The Marfan syndrome is an autosomal dominant disorder of the connective tissue with mutations on the fibrillin-1 gene encoding for fibrillin, a major component of the extracellular microfibrils. The prevalence of the syndrome is 7-17/100,000. The mean life expectancy for untreated patients with Marfan syndrome is 32 years with aortic dissection, aortic rupture or cardiac failure due to mitral and aortic valve regurgitation as the predominant cause of death in > 90% of the cases. In severely affected cases with neonatal Marfan syndrome, patients are likely to survive only a few months. According to the literature database the prevalence of aortic dilatation is 76%, 26% for aortic regurgitation, 62% for mitral valve prolapse, and 29% for mitral valve regurgitation in adult patients with classic Marfan syndrome. Pathogenesis and the natural cause of each cardiovascular manifestation is thoroughly discussed with the problems resulting from associated cardiac arrhythmias, sudden cardiac death, endocarditis, and less frequent cardiovascular manifestations of the Marfan syndrome. Special focus is placed on the analysis of cardiovascular complications during pregnancy.
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PMID:[Marfan syndrome: prevalence and natural course of cardiovascular manifestations]. 958 50

There is a high incidence of mitral valve prolapse (MVP), an abnormal displacement of one or both mitral valve leaflets during systole, in Cavalier King Charles Spaniels (CKCS). In humans, MVP is known to be associated with a low magnesium status. In this study, the plasma magnesium concentration was measured in 30 CKCS without heart failure. It was also investigated whether MVP-severity and degree of regurgitation correlated with plasma magnesium and a number of parameters of the renin-angiotensin system, and whether 4 weeks magnesium supplementation affected plasma magnesium or the high renin/low aldosterone profile associated with MVP. A high prevalence of hypomagnesemia was observed: plasma concentrations < 0.70 mmol/l were found in 15 dogs (50%) before and in 12 dogs (40%) after 4 weeks magnesium supplementation. The mean plasma level was 0.69 +/- 0.07 mmol/l before and 0.71 +/- 0.07 mmol/l after magnesium (P = 0.22). Plasma magnesium concentrations did not correlate with MVP-severity and degree of regurgitation. Plasma aldosterone levels correlated negatively with MVP-severity and positively with the degree of regurgitation, and serum angiotensin-converting enzyme activities correlated negatively with the degree of regurgitation. Magnesium supplementation had no effects on renin and aldosterone nor on the ratio between the two. In conclusion, many CKCS without heart failure have hypomagnesemia whether they are fed supplementary magnesium or not--a finding which may be associated with the high prevalence of MVP in this breed. Further studies, however, are needed to clarify the role of a low magnesium status in canine MVP.
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PMID:Hypomagnesemia and mitral valve prolapse in Cavalier King Charles spaniels. 992 43

Four hundred and sixty-six patients (277 males, 189 females; mean age 23.2 years) diagnosed as cases of infective endocarditis during the past 15 years were retrospectively analysed. Two-thirds of patients belonged to the 15 to 35 years age group. The most common predisposing cardiac lesion was rheumatic heart disease seen in 73.4 percent patients. Mitral valve prolapse and right-sided endocarditis were infrequent, seen in four patients each. Blood culture positivity was 28.7 percent in adults and 61 percent in children. Commonest organism isolated was staphylococcus aureus in adults (39.3%) and streptococcus viridans in children (48%). Salmonella typhi was detected in 17 patients and showed excellent response to ciprofloxacin and gentamycin. Overall mortality was 13.9 percent and resistant heart failure was the leading cause of death. Our study presents the clinical spectrum of infective endocarditis and highlights the comparison with western studies.
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PMID:Clinical spectrum of infective endocarditis: 15 years experience. 1005 75

The data from patients with mitral valve prolapse and infective endocarditis were analysed. Twenty-one patients were found, including 13 males and 8 females, with a mean age of 32 years old (range 9 to 61 years). They accounted for 23% of all patients with infective endocarditis, and 48% of those with mitral valve endocarditis diagnosed in our hospital between Jan, 1984 to Dec, 1996. The clinical features were indistinct onset, high incidence of serious complications such as cardiac failure and emboli to large vessels, especially cerebral vessel. Echocardiography played an important role in the diagnosis of the disease.
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PMID:[Mitral valve prolapse and infective endocarditis]. 1045 33

We report a successful surgical case of billowing mitral leaflet syndrome combined with severe mitral regurgitation. A 45-year-old man suffered from congestive heart failure and admitted our institution for precise examination. A heart murmur was pointed out by a medical examination at his high school, and mitral valve prolapse was detected by echocardiography at 23 year of age. No medication was applied because he showed no symptom. From 44 year of age, he noted palpitation on exercise. Holter monitor showed blocked PAC and Wenckebach A-V block, and transesophageal echocardiography indicated severe mitral regurgitation due to the billowing of voluminous both leaflets. At his operation, we recognized the billowing of both leaflets with torn chordae, and size of the mitral valve orifice was 8.5 x 5 cm. The huge mitral valve was replaced with a CarboMedics 31M prosthetic valve by plicating mattress stitches of native mitral annulus. Histopathologic findings showed accumulation of acid mucopolysaccharide. Postoperative echocardiography showed reduction of the left ventricular volume and preservation of the left ventricular function. Relatively slow progression of the billowing mitral leaflet syndrome did not cause apparent symptoms of heart failure in this patient. Therefore, proper selection of the procedure and timing of surgical treatments might be important for successful long-term results after operation of the billowing mitral leaflet syndrome.
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PMID:[A successful surgical case of billowing mitral leaflet syndrome (Barlow syndrome) combined with severe mitral regurgitation]. 1058 84

A 51-year-old woman with overt congestive heart failure with pleural and pericardial effusion was treated with furosemide and nifedipine, leading to improvement in her condition and a decrease in effusions. An echocardiography demonstrated mitral and aortic regurgitation with mitral valve prolapse, which caused the congestive heart failure. Since leukocytopenia and lymphocytopenia with arthralgia could be observed, serological investigations were performed. She was diagnosed as having systemic lupus erythematosus (SLE) with antiphospholipid syndrome, and started on a treatment of prednisolone and aspirin. Based on the treatment, the pleural and pericardial effusion went into complete remission, indicating that the serositis related to SLE had overlapped the heart failure. Since there was no evidence of any other diseases that could be responsible for the valvular lesions, we concluded that they were due to antiphospholipid syndrome. The administration of prednisolone had no significant effect on valvular morphology or function as demonstrated by echocardiography. When patients with valvular disease are seen, a valvulopathy related to antiphospholipid syndrome should be considered as part of the differential diagnosis.
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PMID:Overt congestive heart failure with mitral and aortic regurgitation due to antiphospholipid syndrome in a patient with systemic lupus erythematosus. 1085 59

During recent 8 years, combined procedures of valve surgery and coronary artery bypass grafting (CABG) were performed in fifty-five patients at Omiya Medical Center. AVR (31 cases), MVR (12 cases), MVP (8 cases), DVR (1 case), TVR (1 case), TAP (2 cases) were performed with the average of 2.0 bypass graftings in this series. Five patients died due to organ ischemia (3 cases), cerebral embolism and heart failure. Organ ischemia occurred in dialysis patients and the results of combined surgery in dialysis patients were unsatisfactory (3/5 cases, mortality rate is 60%). On the other hand, the results of combined surgery in non-dialysis patient is reasonable (2/50 cases, mortality rate is 4%). Before the combined surgery in dialysis patient, careful analysis of surgical risk including organ ischemia is needed and avoiding the prolonged perfusion time is important to achieve a successful surgical result.
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PMID:[Results of valve surgery combined with CABG]. 1093 79

In the most patients the mitral valve prolapse (MVP) syndrome has a good prognosis. The gradual progression of MR may cause the progressive LV dysfunction and development of heart failure. Long-term prognostic studies showed, that complications like endocarditis, cerebrovascular accidents occur frequently in pts. with mitral systolic murmur, thickened mitral valve leaflets and presence of MR. The diagnosis of MVP is made by cardiac auscultation and confirmed by echocardiography. The procedures usefulness in sudden death stratification are discussed. The management of the symptomatic patients, particularly the indication for prophylaxis of endocarditis and cerebrovascular accidents has been demonstrated. The indications for cardiac catheterisation and surgical treatment are presented.
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PMID:[Mitral valve prolapse--diagnostic and therapeutic implications]. 1108 30

This review discusses the clinically relevant effects of thyroid hormone excess on the heart. Tachycardia and atrial fibrillation are usually reversible after euthyroidism is restored. Atrial fibrillation may, however, take several months to return to sinus rhythm. The increase in contractility leads to an increase of cardiac output. The development of a relative myocardial hypertrophy following long-term high-dose therapy with thyroid hormones is controversial. Cardiac failure at stress in spite of an increased cardiac output at rest is a phenomenon typical for thyrotoxicosis. Reports of dilated cardiomyopathy associated with Graves' disease and evidence for TSH-receptors in the human myocardium suggest a relationship between these two diseases. Endomyocardial biopsy studies have, however, failed to prove this hypothesis. Mitral valve prolapse is more frequent in hyperthyroid patients than in normals. Thyroid hormone excess as well as the autoimmune origin of the disease are suggested as etiology for this phenomenon. The frequently observed angina pectoris seems to be a consequence of the increase in consumption of oxygen in the presence of an unchanged oxygen supply rather than of obstruction of coronary circulation. Well documented cases of myocardial infarction patients with thyroid hormone excess and normal coronary arteries in angiography substantiate this theory. Finally diagnostic and therapeutic options of the two forms of thyrotoxicosis induced by the antiarrhythmic drug amiodarone are presented.
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PMID:[Hyperthyroidism and heart]. 1129 43

Anorexia nervosa is an eating disorder that may be accompanied by cardiac symptoms of varying severity. So far disturbances like arrhythmias, mitral valve prolapse and loss of cardial ventricle mass have been described. Other somatic complications consist of electrolyte and acid-base imbalances, which in turn influence cardiac function. Between 1990 and 1999 we observed ten case reports from inpatient anorexic female adolescents, who developed pericardial effusions in the course of their illness. The diagnosis and course was revealed by echocardiography. No signs of heart failure could be noticed. In eight patients pericardial effusion remitted completely or partly by a concurrent increase in weight. A distinct pathophysiology for the development of pericardial effusion could not be revealed, but a correlation to restoration of weight seems to exist. Our report suggests that pericardial effusions are more frequent cardiac complications in anorexia nervosa than previously known. In most cases the clinical significance is doubtful.
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PMID:Pericardial effusions in anorexia nervosa. 1131 36


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