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)

Different anatomo-clinic aspects from three mitral valve prolapse cases are compared to those commonly presented in the literature and are also utilized as a basis for a new classification of this disease. The patients are more than 77 years old, what is in contrast with the current concept of MVP as a disease of young-middle aged women. The first case shows marked ostial dilation and many ruptured chordae: as a consequence, this patient showed severe cardiac dysfunction. The anterior, rather than the posterior leaflet, presented intense myxoid degeneration. In the second case, no ruptured chordae were detected and, consequently, the degree of heart failure was lesser than the first one, in spite of the same degree of ostial dilation. Both leaflets showed the same degree of myxoid degeneration. The third patient, who does not have heart failure, showed myxomatous degeneration of both cusps, but no ostial dilation or chordal rupture were present. These aspects reinforce the impression that isolated mixomatous degeneration of the cusps is not so deleterious when compared to those cases where the mitral valvar ring is dilated or its chordae are also involved by that degenerative process. Therefore ostial dimension (normal or enlarged) and the state of the chordae (with or without rupture) appears to be important points to be considered in MVP.
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PMID:[Mitral valve prolapse in the 8th and 9th decades of life. Anatomo-pathologic study of 3 cases]. 262 89

Between December 1985 and June 1987, 38 consecutive patients with mitral regurgitation underwent mitral valve reconstruction (MVP) with Carpentier rings. There were 16 men and 22 women, ranging in age from 16 to 63 years (mean 36.4 +/- 14.4). The underlying causes were rheumatic heart disease (55%), degenerative valvular disease (42%), and congenital heart disease (3%). Thirty patients were categorized in the New York Heart Association's functional classification III or IV preoperatively. The concomitant procedures included aortic valve replacement (AVR) in 6 patients, tricuspid valve repair (TVP) in 9, and closure of atrial septal defect in one. Hospital death happened to one patient (3%). All but one patient were followed up at 31 months postoperatively (rate 98.6%). There was one late death due to myocardial failure not related to the valves. The actuarial survival rate at 31 months was 96.8%. The thromboembolic rate was 1.44% per patient-year. No reoperation or endocarditis was encountered. All 36 survivors were in functional classes I and II. Twenty-one patients underwent Doppler echocardiography 3 to 12 months after surgery and 17 (81%) showed no or mild mitral regurgitation and 4 (19%) had moderate regurgitation. We conclude that MVP with Carpentier rings is a satisfactory method with low mortality and complication rates in Chinese patients.
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PMID:Mitral valve reconstruction with Carpentier ring for mitral regurgitation: experience with Chinese patients. 279 33

Sudden death in patients with mitral valve prolapse is a rare complication with a possible arrhythmic mechanism. We made a detailed postmortem examination of the conduction system in three patients with MVP who died suddenly. One patient who died in cardiac failure had a normal conduction system. The two other patients with no cardiac symptoms prior to death had both accessory atrioventricular pathways. These findings suggest a higher incidence than hitherto known of accessory bypass tracts in patients with MVP who die suddenly, and support the presumption of an arrhythmic cause of death.
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PMID:Sudden death in mitral valve prolapse: associated accessory atrioventricular pathways. 706 68

Myotonia atrophica, a neuromuscular disease marked by autosomal dominant transmission and delayed relaxation of skeletal muscle, has been associated with cardiac failure, conduction abnormality and mitral prolapse (MVP). In order to determine the relaxation rate of cardiac muscle, left ventricular (LV) size and function, and the presence of MVP, 30 patients with myotonia atrophica were studied using digitized M-mode echocardiography (MME). Intracardiac conduction intervals were determined by noninvasive His bundle recording (HBR) from surface electrodes using a high-resolution, R-wave triggered, signal averaging computer. Neurologically unaffected first-degree relatives of the patients with myotonia atrophica were also studied to determine if cardiac abnormalities may be present in the absence of neurologic manifestations of the disease. Peak normalized diastolic endocardial velocity in patients with myotonia atrophica (3.7 +/- 0.8 sec-1) did not differ from unaffected first-degree relatives (3.8 +/- 0.8 sec-1) or normal subjects (3.6 +/- 0.8 sec-1). Systolic LV function and LV dimensions on MME were normal in both groups. However, MVP was present in 7 of 24 (29%) of patients who could be evaluated, but not in unaffected first-degree relatives. Despite normal LV systolic and diastolic function, infranodal intracardiac conduction was prolonged in patients with myotonia atrophica (average HV interval 50 +/- 5 SD msec) but not in neurologically unaffected relatives (average HV interval 40 +/- 5 msec). Delay in proximal intracardiac conduction was also found in patients with myotonia atrophica (average PH interval 140 +/- 20 msec) but not in neurologically unaffected relatives (average PH interval 115 +/- 6 msec). Hence cardiac findings in myotonia atrophica include proximal and distal conduction delay by external HBR even in the absence of abnormality of the standard 12-lead ECG. There may also be an increased frequency of MVP; however, early diastolic relaxation of the LV is unimpaired, and cardiac manifestations of myotonia are not transmitted independently of neurologic abnormality.
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PMID:Left ventricular relaxation, mitral valve prolapse, and intracardiac conduction in myotonia atrophica: assessment by digitized echocardiography and noninvasive His bundle recording. 709 Sep 87

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

Floppy mitral valve/mitral valve prolapse (FMV/MVP) is a common valvular abnormality affecting 2% to 3% of the general population. It occurs in a heterogeneous group of patients with varying and age dependent expressions. FMV/MVP can be familial or sporadic, isolated (called non-syndromic) or as a part of a well-defined syndrome of heritable connective tissue disorders or other diseases. A wide range of phenotypic expression exists ranging from asymptomatic to non-specific symptoms related to neuroendocrine or autonomic nervous system functional abnormalities, varying degrees of mitral regurgitation that may require interventional therapy, heart failure, infective endocarditis, cardiac arrhythmias and/or sudden cardiac death. FMV/MVP is predominantly considered a heritable disorder with clinical manifestations not present at birth, but appearing later in life. Though a variant gene may initiate the development of FMV/MVP, precise phenotypic expression may be related to multiple other molecular, genetic and epigenetic factors that modify the final expression of the disease. A better understanding of these mechanisms will help to better define the natural history of the disease, inhibit disease progression and even prevent the phenotypic expression of FMV/MVP.
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PMID:Floppy mitral valve/mitral valve prolapse: A complex entity with multiple genotypes and phenotypes. 3220 Dec 87