Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although the direct approach to the aortic isthmus is unquestionable for an isolated coarctation of the thoracic aorta, recurrent coarctations of coarctation with associated cardiac lesions require a concomitant procedure, raise difficult surgical problems and expose to a high operative risk. Another technique consists of performing an ascending aorta-abdominal aorta by-pass, with a prosthetic tube. From 1977 to 1988, this technique was performed in 8 patients: 3 with recurrent coarctations, 4 with coarctation associated with a surgical aortic insufficiency (2 ascending aortic aneurysms with aortic insufficiency) and 1 with abdominal aorta coarctation. The mean age was 48.3 years (range from 31 to 72 years), the mean follow-up was 44.3 months (range from 4 months to 10 years 5 months). There was no mortality and no morbidity during the follow-up. The functional result is good, without high blood pressure and with no blood pressure difference between the arms and the legs. Postoperative angiographies showed that all the by-passed were patent.
 ...
PMID:[Interposition of a prosthetic graft between the ascending aorta and the abdominal aorta in the treatment of complicated or longstanding coarctations in adults]. 160 34

Thirty-eight women with Takayasu arteritis were studied using thallium-201 stress myocardial scintigraphy to assess the prevalence and pathophysiology of the perfusion abnormality. Twenty (53%) had abnormal scintigraphic findings (group A). Abnormal scans were divided into 3 groups: permanent defects in 6, reversible defects in 7 and slow washout in 7. The remaining 18 patients had normal scintigrams (group N). Group A had a tendency to be older and to have a high prevalence of complicated significant aortic regurgitation. Interventricular thickness plus left ventricular posterior wall thickness (26 +/- 7 vs 17 +/- 2 mm, p less than 0.01) and left ventricular mass (267 +/- 121 vs 133 +/- 39 g, p less than 0.01) were all greater in group A on echocardiography. The mean value of the central aortic pressure in systole was 170 +/- 15 mm Hg in the 7 catheterized patients in group A. Coronary ostial stenoses were present in 2 group A patients who showed reversible defects on scintigrams. These data indicate that the abnormal perfusion detected by imaging in patients with Takayasu arteritis was responsible for a decrease in coronary reserve or myocardial damage, or both, due to long-standing systemic hypertension or aortic regurgitation. Coronary artery disease should be considered if a reversible defect is present.
 ...
PMID:Thallium-201 stress scintigraphy in Takayasu arteritis. 167 84

Fifty-four patients (18 males and 36 females, ages 2 to 37 years) with nonspecific aortoarteritis (NSAA) were studied. Evaluation revealed hypertension in 35, congestive heart failure (CHF) in 24, mild to moderate mitral regurgitation in six, and mild aortic regurgitation in two. Erythrocyte sedimentation rate was raised (greater than 35 mm in the first hour) in 38 patients. The arterial lesions included type I in seven, type II in eight, and type III in 34. Pulmonary artery involvement was present in 4 (type IV) of the 20 patients in whom it was studied. Selective coronary angiography was done in 11 patients and revealed 90% left main stenosis in one patient. Hemodynamic data revealed raised (greater than 7 mm Hg) mean right atrial pressure in nine, raised mean pulmonary artery pressure (greater than 20 mm Hg) in 29, and raised left ventricular filling pressure (greater than 12 mm Hg) in 27 patients. Radionuclide ventriculography revealed reduced (less than 45%) left ventricular ejection fraction (LVEF) in 27 patients. The myocardial morphology as evaluated on right ventricular endomyocardial biopsy revealed normal histology in nine, features of inflammatory myocarditis in 24, and nonspecific changes suggestive of dilated cardiomyopathy in six patients. Marked right ventricular endocardial thickening was present in three. All patients with CHF had some histologic abnormality. We emphasize that myocardial involvement including myocarditis is common in NSAA and may precipitate CHF in these patients.
 ...
PMID:Cardiac involvement in nonspecific aortoarteritis (Takayasu's arteritis). 168 19

Takayasu's arteritis in a pregnant white patient is described. This case highlights the fact that, irrespective of race, any patient who presents for the first time in pregnancy with pulseless hypertensive disease or other features suggestive of Takayasu's arteritis, should have their management in labour determined by the number of complications that are present. These are retinopathy, arterial aneurysms, hypertension and aortic regurgitation. These prognostic criteria will result in a classification of patients that will lead to appropriate management.
 ...
PMID:Takayasu's arteritis in a pregnant woman. A case report. 168 80

A radionuclide ventriculographic procedure for the accurate quantification of aortic insufficiency has been developed, and its use in follow-up, pharmacotherapy and surgical planning tested. In 28 patients, follow-up over a period of 20 months revealed only slow progression of the chronic aortic insufficiency; worsening of the symptoms leading to the need for valve replacement was associated with a rapid deterioration of objective parameters. In patients with a stable condition, captopril administered for 4-8 weeks failed to reduce left ventricular overload to any significant extent, while reduction in volume overload was observed in patients with accompanying congestive heart failure or systemic hypertension. Clinical analysis revealed that, as a rule, the indication for valve replacement must be based on follow-up examination. If radionuclide ventriculography reveals a disproportionate enlargement of the ventricle, surgery is indicated even in the absence of symptoms.
 ...
PMID:[Aortic valve insufficiency. Diagnosis, course, therapy]. 183 Feb 85

To investigate the predisposing factors and the clinical significance of the musical aortic component of the second heart sound (musical S2), 18 patients with musical S2 (musical group) among the consecutive 2,000 patients with phonocardiographic examination were noninvasively studied by analyzing underlying diseases, phonocardiographic findings, organic changes of the aortic valve, severity of aortic regurgitation and left ventricular dysfunction. Organic changes of the aortic valve were assessed by two-dimensional echocardiography, and aortic regurgitation was assessed by color Doppler flow imaging. Twenty-two normal subjects (normal group) and 17 patients with essential hypertension (hypertensive group) served as controls. Mean ages were matched among the three groups. 1. Left ventricular dilatation (seven patients) and hypertension (six patients) were the dominant part of underlying disease in the musical group. 2. Musical S2 was classified in the following two types based on the phonocardiographic characteristics; musical vibrations followed immediately after the accentuated S2, and the S2 which was replaced by regular vibratory waves. 3. Frequency of the musical vibrations ranged from 120 to 200 Hz, and its duration ranged from 60 to 120 msec. Amplitude of the musical vibrations decreased by inhalation of amyl nitrite, but increased by infusion of methoxamine. In a case with mild rheumatic valve disease, methoxamine induced marked intensification of the amplitude and prolongation of the duration of the musical vibrations, finally giving a typical cooing murmur. 4. Echo intensity of the aortic valve tended to be higher in the musical group than in the other two groups. 5. Echocardiographically, aortic regurgitation appeared more frequently in the musical group (88%) than in the normal (36%) and hypertensive (41%) groups. Area of the aortic regurgitant signal was significantly larger in the musical group (4.1 +/- 1.4 cm2) than in the normal (1.2 +/- 0.8 cm2) and hypertensive (2.3 +/- 1.2 cm2) groups. 6. Left ventricular end-diastolic dimension was significantly larger in the musical group (5.8 +/- 0.6 cm) than in the normal (4.7 +/- 0.5 cm) and hypertensive (4.8 +/- 0.7 cm) groups. Fractional shortening of the left ventricle was significantly smaller in the musical group (26 +/- 10%) than in the normal (37 +/- 5%) and hypertensive (37 +/- 8%) groups. In a case of the musical group, musical vibrations following the S2, which was large in amplitude at the state of heart failure, decreased markedly after the recovery from heart failure.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Possible mechanism of production of the musical second heart sound and its clinical significance]. 188 56

Five hundred patients with aortoarteritis were studied in this series. The long-term administration of small dosage of corticosteroid is effective in treating this disease in its active stage. The patients with renal vascular hypertension should be treated by percutaneous transluminal renal angioplasty or by surgery if indicated. About one third of the pulsations of the involved arteries were improved. The incidence of complications was 17% and the mortality rate was 11% in this series. Cerebral thrombosis was found as a common complication and hemorrhage as a common cause of death. Three patients died of heart failure without aortic regurgitation. Five-year and ten-year survival rates were 93.1% and 91.1% respectively.
 ...
PMID:Clinical studies in 500 patients with aortoarteritis. 197 90

Takayasu's arteritis is an inflammatory arteriopathy that often progresses to obliteration of multiple large arteries. Variable results have been reported after medical and surgical management. Twenty female patients with Takayasu's arteritis were treated from 1973 to 1989. Eleven (55%) patients had hypertension. Upper or lower extremity ischemia was present in 12 (60%) patients and cerebrovascular insufficiency in seven (35%). Nine patients initially managed with corticosteroids had no improvement in signs or symptoms of arterial insufficiency. Eleven patients had 16 vascular procedures for the following indications: renovascular hypertension (6), extremity ischemia (5), cerebrovascular insufficiency (2), dilation ascending aorta with aortic insufficiency (1), thoracic aortic aneurysm (1), abdominal aortic aneurysm (1). Procedures included aortorenal bypass (5), carotid-subclavian, axillary, or brachial bypass (4), aorto-carotid bypass (2), aneurysm resection (2), supra-celiac aorto-femoral bypass (1), ascending aorta/aortic valve replacement (1), and nephrectomy (1). Clinical improvement occurred in all patients. There were no operative deaths. All are alive at a mean follow-up of 5.75 years (6 months to 16 years). Revision of the initial reconstruction has been required for recurrent renovascular hypertension in one patient and extremity ischemia in another. The other nine patients remain symptomatically improved. Symptomatic Takayasu's arteritis frequently requires arterial reconstruction. Symptomatic improvement and excellent long-term graft patency can be expected after arterial reconstruction.
 ...
PMID:Surgical procedures in the management of Takayasu's arteritis. 197 28

Proximal aortic dissection in a 79-year-old woman was complicated by cardiac tamponade, aortic regurgitation, and pleural leak. Following pericardiocentesis and control of her hypertension, she survived without an operation for more than four years.
 ...
PMID:Proximal aortic dissection with cardiac tamponade. Long-term survival without surgery. 200 67

Echocardiographic left ventricular hypertrophy is thought to be helpful in grading the severity of aortic stenosis. This study compared M-mode echocardiographic left ventricular wall dimensions with Gorlin aortic valve area. Good quality echocardiograms were obtained in 294 patients with aortic stenosis who also underwent cardiac catheterization. Patients with grade 3 or 4 aortic regurgitation were excluded. The correlation was calculated between the aortic valve area and the left ventricular wall dimensions. Correlation coefficients were poor; r = 0.13 for the septum, r = 0.15 for the posterior wall, and r = 0.17 for the mean wall dimension. Correlation was not improved significantly if patients with poor left ventricular function or systemic hypertension were excluded. Correlation with other hemodynamic parameters was better, peak left ventricular systolic pressure having r values of 0.36 and 0.30 for posterior wall and septum. Mean and peak aortic valve gradient had r values approaching 0.30 for both dimensions. If the peak gradient was included in multivariate analysis, the wall dimensions then had no predictive power for severity of aortic stenosis. This study demonstrates that the degree of left ventricular wall hypertrophy is not related to the severity of aortic outflow obstruction and therefore cannot be used to grade the severity of aortic stenosis.
 ...
PMID:Echocardiographic left ventricular wall thickness: a poor predictor of the severity of aortic valve stenosis. 201 79


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>