Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this study three problems concerning interactions between thyroid and cardiovascular system are discussed. Cardiac arrhythmias, congestive heart failure, pleural effusion, hyperlipidaemia, arterial hypertension may be consequences of thyroid disorders leading to inappropriate hormone secretion. During such illnesses as heart failure, myocardial infarction and in patients undergoing coronary artery bypass surgery profound changes may occur in thyroid hormone metabolism known as sick euthyroid syndrome. Treatment with amiodarone may lead to changes in thyroid tests results and to development of hypothyroidism or thyrotoxicosis.
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PMID:[Thyroid and cardiovascular disorders]. 1551 16

Left ventricular hypertrophy is an important risk factor of cardiovascular complications during the course of hypertension. Increased QT dispersion is associated with sudden cardiac death in congestive heart failure and in other cardiovascular diseases. Our aim was to compare QT dispersion from routine ECG in hypertensive patients with and without left ventricular hypertrophy defined by echocardiography. Authors examined 71 hypertensives treated in our medical department. Left ventricular hypertrophy was defined by echocardiography (Penn convention) as left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women. QT dispersion was defined from routine ECG (QTmax - QTmin). Presence of LVH was found in 26 patients (mean age 59.3 years), absence of LVH in 45 patients (mean age 57.8 years). Hypertensives with secondary hypertension, hypertrophic cardiomyopathy, sings of ischemia in ECG, arrhythmias, myocardial infarction, heart failure, diabetes mellitus and patients treated by antiarrhythmic drugs of the Ic and III groups were excluded. Both groups of hypertensives were matched by demographic parameters, and by the presence of hypertension, obesity, hyperlipidemia and smoking habites. There were statistically significant longer QT dispersion and QTc dispersion (59.0 +/- 20.1 ms, 64.0 +/- 23.7 ms) in LVH-positive patients than in LVH-negative once (43.2 +/- 9.5 ms, 48.4 +/- 11.1 ms). Left ventricular hypertrophy in patients with hypertension brings usually a complicated course of the disease. Authors recommend to look after left ventricular hypertrophy presence in hypertensives as it carries much more complicated course of the disease. Measurment of QT dispersion adds farther stratificational information to these patients.
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PMID:[QT dispersion intervals in hypertensives with left ventricular hypertrophy]. 1563 64

This study assessed whether a gender gap exists in therapy, procedure use, and outcomes in patients who have a new diagnosis of congestive heart failure (CHF) at the population level. The Quebec hospital discharge database was linked with the physician and drug claims databases to identify a cohort of patients who had a diagnosis of CHF (code 428 in the International Classification of Diseases, Ninth Revision) between January 1998 and December 2002. There were 16,017 men and 16,622 women. Women who had CHF were older (78 +/- 11 vs 73 +/- 11 years, p <0.001), had more hypertension (41% vs 28%, p <0.001) and hyperlipidemia (18% vs 14%, p <0.001) but less frequent myocardial infarction (19% vs 25%, p <0.001). Women were less likely to see a cardiologist (30% vs 34%, p <0.001) and required a longer hospital stay (12.0 +/- 14.8 vs 10.6 +/- 13.3 days, p <0.001). During the first year after a first CHF hospitalization, women were less like to have an assessment of left ventricular function (61% vs 65%, p <0.001), diagnostic cardiac catheterization (11% vs 15%, p <0.001), and revascularization procedure (4% vs 6%, p <0.001). Women were less likely to be prescribed an angiotensin-converting enzyme inhibitor (60% vs 66%) and more likely to be prescribed a beta blocker (38% vs 34%). Women and men had similar yearly numbers of rehospitalizations for CHF (1.4 +/- 1.0 vs 1.5 +/- 1.0) and emergency room visits (1.7 +/- 1.2 vs 1.8 +/- 1.3). The adjusted risk of death was minimally higher in men than in women (hazard ratio 1.06, 95% confidence interval 1.03 to 1.1, p <0.01). Thus, despite less frequent cardiologist assessment, fewer cardiac-related procedures, and less frequent use of standard medical therapy, clinical outcomes in women and men who had CHF were similar.
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PMID:Effect of gender on treatment, resource utilization, and outcomes in congestive heart failure in Quebec, Canada. 1582 Jan 61

Hawthorn (Crataegus) may play a role in the prevention and treatment of cardiovascular diseases such as hypertension, hyperlipidemia, and in particular, congestive heart failure. Evidence is accumulating that hawthorn may induce anti-ischemia/reperfusion-injury, anti-arrhythmic, hypolipidemic and hypotensive effects. These beneficial effects may in part be due to the presence of antioxidant flavonoid components. While a number of studies have been performed to evaluate the clinical efficacy of hawthorn, an international, multicenter, prospective clinical study including a large number of New York Heart Association (NYHA) class II/III heart failure patients is ongoing to test hawthorn's long-term therapeutic effects. Further clinical trials as well as pharmacokinetic and mechanistic studies are needed to explore and confirm its effectiveness, safety and pharmacological mechanism.
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PMID:Hawthorn: potential roles in cardiovascular disease. 1584 28

Atrial septal defects are among the most common congenital heart defects seen in the adult population. The diagnosis is usually made in children and closure is attempted before they are school age. In other cases, where the diagnosis is missed until adulthood, atrial arrhythmias and congestive heart failure are commonly seen. We report the case of an atrial septal defect (secundum type), which was diagnosed in a 72-year-old woman with paroxysmal atrial fibrillation. She also had a history of hypertension and hyperlipidemia. Transthoracic and transesophageal findings were consistent with right-sided volume overload and an atrial septal defect of approximately 1 cm in size. This was corroborated by the findings on cardiac catheterization with a shunt ratio of 1.8. The pulmonary artery pressures were within normal limits. The patient was referred for closure of the atrial septal defect. Presently, the options for septal defect closure are direct suture repair, Dacron patch repair depending on the size of the defect, and percutaneous transcatheter closure. Transcatheter closure is also available in treating selected patients with patent foramen ovale.
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PMID:Transcatheter closure of atrial septal defect (secundum type): the role of echocardiography in evaluating interatrial defects. 1596 32

Pre-operative cardiac assessment is important in the evaluation of patients undergoing major vascular surgery. Our study aims to evaluate the value of absence of a transient myocardial perfusion defect during radionuclide myocardial perfusion study for prediction of cardiac events (myocardial infarction, sudden cardiac death, unstable angina, coronary artery revascularization and congestive heart failure) in patients undergoing major vascular surgery. We studied 63 consecutive patients (ages 35-83 [avg. 64], male 39, female 24) with radiographically proven, abdominal aortic aneurysm or severe aortofemoral occlusive disease who underwent major vascular surgery (abdominal aortic aneurysm repair [38] or aortofemoral bypass [25]). The subjects all had multiple coronary artery risk factors (hypertension 48, diabetes 10, hyperlipidemia 23, tobacco use 39, family history of coronary artery disease 10), but a negative pre-operative stress myocardial perfusion study for myocardial ischemia. Of these 63 patients, 17 patients were able to exercise and achieve their adequate 85% maximal predicted heart rate. Thirty-eight patients received adenosine infusion of 140 microg/kg/min for 6 min. Six patients received dipyridamole infusion of 0.56 mg/kg over 4 min. Two patients received dobutamine infusion at 5, 10, 20, 30, and 40 mg/kg/min. Of the 63 patients, 60 received 3-4 mCi of thallium-201 ((201)Tl) and 3 patients received 8-9 mCi of technetium-99m (99mTc) at rest and 25-30 mCi 99mTc during stress. The subjects all underwent major vascular surgery and were followed up to one year for any cardiac events. Of the 63, who underwent pre-operative cardiac assessment with myocardial perfusion testing, 25 had a fixed myocardial perfusion defect (scar) and none had evidence of transient myocardial perfusion defect (ischemia). One subject had coronary artery bypass grafting 11 months after aortofemoral bypass surgery. One died from a stroke one month after aortofemoral bypass surgery. Of the remaining 61 patients, none had any cardiac events up to one year after major vascular surgery.
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PMID:Value of absence of a transient myocardial perfusion defect during stress myocardial perfusion study in patients undergoing major vascular surgery. 1601 40

From January 2001 through June 2002, 128 consecutive patients undergoing lung resection for various diseases were evaluated preoperatively by a cardiologist at our institution in order to predict postoperative cardiac complications in pulmonary surgery. Our assessment algorithm consisted of the following: Smoking, hypertension, hyperlipidemia, advanced age, diabetes mellitus, and history of cardiac disease or angina pectoris were considered as risk factors. A stress test was performed when at least 2 of the first 3 risk factors or at least 1 of the last 3 risk factors was present. Coronary angiography was performed in the case of a positive stress test. Patients were classified as low-risk when there was no need for a stress test. Patients were considered as intermediate-risk when a stress test revealed no ischemia or if there was a history of congestive heart failure or valvular disease. Patients in whom coronary artery disease was detected on angiography were classified as high-risk. Ninety-five of our patients were in the low-risk group, and 29 were in the intermediate-risk group. After lung resection, cardiac complications developed in 4 patients in the low-risk group (atrial fibrillation) and in 8 patients in the intermediate-risk group (5 atrial fibrillation and 3 paroxysmal atrial tachycardia). The overall cardiac complication rate was 9.7%. No death occurred due to cardiac events. The difference in the incidence of arrhythmias between the low- and the intermediate-risk groups was significant (P < 0.05). We present this simple algorithm for preoperative cardiac evaluation in patients scheduled to undergo lung resection, and we suggest that it may be possible to predict postoperative cardiac complications with this method.
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PMID:A new algorithm for preoperative cardiac assessment in patients undergoing pulmonary resection. 1610 6

The small but very focused meeting of 60 delegates from academia, small biopharmaceutical companies and large pharmaceutical companies aimed to give an overview of current R&D approaches in the cardiovascular disease area. Most of the new therapeutic approaches were presented by small biopharmaceutical companies and addressed disease targets in the vasculature for the following indications: thrombosis; atherosclerosis; restenosis; hyperlipidemia; and hypertension. Cardiac disease targets were addressed in the following indications: congestive heart failure (CHF); chronic angina; reperfusion injury; and atrial arrhythmia. The technologies presented included small molecule drugs, protein drugs and gene therapeutics as well as vaccines and an integrated target definition platform. The therapeutic approaches were complemented by the presentation of two innovative diagnostic products for thrombosis and stroke related brain injury.
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PMID:Therapeutic innovation. 1615 40

Psoriasis is a chronic inflammatory disease of the skin affecting approximately 2% of the world's population. Traditional systemic treatments, including methotrexate, ciclosporin, psoralen plus UVA (PUVA), oral retinoids and fumaric acid esters, are widely used for severe disease and are effective in the short term. Severe psoriasis is a chronic disease and patients and physicians have expressed concerns about possible harm from organ toxicity, such as skin cancer (PUVA), hyperlipidaemia (retinoids), renal (ciclosporin) or hepatotoxicity (methotrexate). Long-term monitoring is required and may not detect early organ damage. The pathophysiology of psoriasis remains to be clarified, but advances toward the understanding of the immunological basis of psoriasis have uncovered the involvement of immunological pathways; for example, the role of tumour necrosis factor (TNF)-alpha, T cell proliferation and T cell activation, and migration to the epidermis. This advancement in knowledge combined with developments in recombinant technologies has led to the development of target-specific therapies. Biological agents are defined as proteins that can be extracted from animal tissue or produced via recombinant DNA technologies and possess pharmacological activity. Adalimumab, alefacept, infliximab, efalizumab and etanercept are examples of biological agents currently used for the treatment of psoriasis. Some of these are also therapy for other autoimmune conditions, such as rheumatoid arthritis and Crohn's disease. These biological agents are effective in psoriasis but raise new safety concerns. Information on the safety of biological agents in conditions such as rheumatoid arthritis and Crohn's disease can not be directly extrapolated to psoriasis. An increased incidence of lymphomas has been postulated to be associated with etanercept, infliximab and adalimumab; serious infections, such as tuberculosis, have also been reported with these three biologicals, all of which target TNF-alpha. Demyelinating disorders, such as multiple sclerosis, have been reported with some biologicals as has congestive heart failure. Alefacept, because of its mechanism of action of lowering the number of active T cells, is associated with low T cell counts. Efalizumab has been associated with thrombocytopenia and haemolytic anaemia. Data on the safety of >2.5 years' continuous treatment with efalizumab are reassuring and a valuable beginning to understanding the role and risk of harm of long-term therapy for a chronic disease. Longer follow-up studies and safety databases, for each of the biologicals used in psoriasis, are needed to ensure both prolonged efficacy and minimal risk of harm.
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PMID:Fulfilling an unmet need in psoriasis : do biologicals hold the key to improved tolerability? 1645 34

An increasing number of patients with tetralogy of Fallot (TOF) are reaching older age. We encountered a 75-year-old woman with uncorrected TOF and concomitant severe coronary artery disease (CAD) with congestive heart failure. Her CAD risk factor was hyperlipidemia, which had been untreated. Successful percutaneous coronary interventions have improved her clinical condition and provided long-term survival. Although CAD is considered to be a rare complication in adults with TOF, both strict modification of CAD risk factors and early detection of CAD would be also required in this population, given the residual TOF lesions relating to acute exacerbation of clinical presentation.
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PMID:Three-vessel coronary artery disease complicated with congestive heart failure in a highly aged patient with tetralogy of Fallot having undergone palliative surgeries. 1710 59


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