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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In open-chest anesthetized dogs we measured phasic coronary blood velocity in an epicardial artery (left anterior descending), a small epicardial artery (within 0.5 cm before penetration into the myocardium), and an intramyocardial artery (septal) during changes in perfusion pressure and extravascular pressure. Circumflex artery diameter was also measured during pressure changes to directly assess vascular compliance. At low and normal arterial pressures (less than 125/86 mmHg) and during aortic insufficiency, the phasic character of blood flow velocity in the large epicardial arteries was markedly different from that in the small epicardial and septal arteries: there was retrograde systolic blood flow velocity in the septal artery and small epicardial artery, whereas antegrade blood flow velocity persisted in the left anterior descending artery. At pressures greater than 150/106 mmHg, the differences in the phasic character of blood flow velocity in the left anterior descending artery from that in the septal artery and small epicardial artery were small and decreased as aortic pressure increased. At pressures greater than 125 mmHg, the cross-sectional area change per millimeter of mercury was approximately three times less than at pressures between 30 and 75 mmHg, indicating decreased coronary compliance at the higher pressures. Increasing extravascular pressure in the septum (right ventricular hypertension) greatly increased retrograde systolic blood flow velocity in the septal artery (P less than 0.05). However, right ventricular bypass (0 right ventricular pressure) did not alter the phasic nature of blood flow velocity in the septal artery. From these results we confirmed that epicardial capacitance is inversely related to distending pressures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of coronary and extravascular pressure on intramyocardial and epicardial blood velocity. 397 Feb 21

The cardiac helical fiber concept was introduced in 1969 and was shown mathematically to provide better approximations of normal ejection fractions compared with the conventional circumferential fiber model. The clinical applicability of this concept was evaluated noninvasively by M-mode and two-dimensional echocardiography in 55 subjects: 10 with aortic insufficiency, 10 with congestive cardiomyopathy, eight with hypertension, eight who were long-distance runners, 12 who were active and seven who were sedentary normals. Comparison of myocardial shortening by the circumferential and helical fiber models showed that the former discriminated only two groups of subjects, while endocardial and epicardial helical shortening discriminated three and four groups, respectively. Regression analyses suggest that more than 90% (r2 = 0.92) of variation in ejection fraction may be accounted for by variation in endocardial shortening, and that more than 75% (r2 = 0.77) of variation in observed endocardial shortening may be accounted for by variation in epicardial contraction. The study demonstrates that the helical fiber length concept may be useful for the noninvasive evaluation of left ventricular function in man.
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PMID:Clinical evaluation of left ventricular function using the cardiac helical fiber model: an echocardiographic study. 407 79

Three cases of pyoderma gangraenosum were associated with Takayasu arteritis (pulseless disease), characterized by disappearance of pulse, hypertension and/or aortic insufficiency. Another 11-year-old boy, suffering from a serious congenital heart malformation, presented skin lesions of pyoderma gangraenosum. In spite or rather low incidence of association of ulcerative colitis (10.4 p. 100), Japanese cases show frequent association of cardiovascular diseases, especially Takayasu arteritis (27.1 p. 100).
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PMID:[Pyoderma gangraenosum and cardio-vasculopathies, particularly Takayasu arteritis. Review of the Japanese literature (author's transl)]. 611 60

The dilatation of the aortic valve portion was evaluated by angiography in 70 patients with aortitis syndrome (Takayasu's arteritis). The diameter at aortic valve commissure was 20 +/- 2.8 min/M2 (NS, vs control) in 46 patients without aortic insufficiency (AI), 23 +/- 2.0 (p less than 0.02, vs without AI) in 11 patients with AI (I or II in grade), 27 +/- 2.0 (p less than 0.01, vs I or II in grade) in 13 patients with AI (III or IV in grade). The diameter was 20 +/- 2.0 in 13 normal control cases and 20 +/- 4.0 in 6 patients with rheumatic AI. The diameters at the levels of aortic valve annulus, sinus of Valsalva and ascending aorta increased also significantly in the patients with AI secondary to aortitis syndrome. The diameter at aortic valve commissure in 24 patients with AI was correlated (r = -0.48, p less than 0.05) to the diastolic blood pressure. Any diameter at the aortic valve portion was not different significantly by the complication of systolic hypertension (greater than or equal to 180 mmHg) in both groups of cases with and without AI. These results indicated that the dilatation of the aortic valve portion was observed in the patient with AI secondary to aortitis syndrome and might be the primary and common cause of AI in all grades, and that the dilatation might not be accelerated by the associated hypertension.
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PMID:Dilatation of the aortic valve portion in aortitis syndrome. Angiographic evaluation of 70 patients. 611 66

The natural history of Takayasu's disease remains a highly controversial subject. Whereas for some authors it is a progressive disorder with an extremely poor vital prognosis requiring aggressive medical or surgical treatment, for others it runs a slow course with few symptoms, and has a relatively good prognosis, depending on the presence of four factors: arterial hypertension and its cardiovascular, renal, and cerebral complications, retinopathy, aortic incompetence, and aneurysmal lesions. Based on the presence or absence of these complications, the disease can be classified as benign, moderately progressive, or severe forms, therapy, including surgery, being adapted to the type of affection present.
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PMID:[Takayasu's disease. Spontaneous course and treatment (author's transl)]. 612 3

Three patients with mitral regurgitation (MR) associated with aortitis syndrome are presented. All had multiple lesions of the large sized arteries, calcification of the aorta, mild inflammatory findings, a chronic course, and congestive heart failure. MR was observed by ventriculography in all 3 patients. Case 1 had mitral valve prolapse and secondary systemic hypertension. Case 2 showed mildly thickened mitral valve leaflets and had moderate aortic regurgitation (AR). Case 3 had massive AR. The grade of MR was moderate in Cases 1 and 2, and massive in Case 3. The left ventricle was moderately dilated in Cases 1 and 2 but contracted sufficiently and symmetrically in all 3 patients. Other than the prolapse, no significant mitral valve deformity or left ventricular asynergy was evident by ventriculography. The incidence of MR was 3.1% of 128 patients with aortitis syndrome observed in our clinic. MR may be found in the late stage of aortitis syndrome. It may be caused by a mild valvular lesion related to aortitis syndrome and be exacerbated by increased hemodynamic loads such as those which occur in secondary hypertension and AR.
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PMID:Mitral regurgitation associated with aortitis syndrome. 613 11

Takayasu's disease is a syndrome of inflammatory arteritis involving the aorta and its branches due to varying etiologies. The diagnosis is usually made after clinical, radiological and biological investigations, but the pathognomonic sign of the disease is inflammatory sclerosis of the adventitial media. There appear to be five prognostic factors: hypertension, arterial aneurysm, aortic regurgitation, coronary insufficiency, and retinopathy.
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PMID:[Takayasu's disease: diagnosis]. 613 73

In order to asses the importance of cardiac damage in Takayasu's arteritis, 125 cases were studied and followed for 5.8 +/- 5.5 years. The arterial lesion involved the aorta and the principal abdominal branches in 10.4% of cases. Isolated lesions of the supraaortic vessels were present in 25.6% of cases. The rest of cases had obstructions in both arterial territories (64%). Cardiac damage was present in 82.4% of cases with the following manifestations: precordial murmurs (65%), cardiac enlargement (70%), heart failure (28%), angor pectoris (13.6%), abnormal electrocardiogram (60%): left ventricular hypertrophy (40.8%), right ventricular hypertrophy (8.8%) and conduction defects (12%). Aortic regurgitation secondary to enlargement of the aortic root was seen in 11.2%. Mitral incompetence due to left ventricular enlargement was documented in 13.6% of cases. In 2 patients rheumatic heart disease was associated to Takayasu's arteritis. Mortality was 4.8%; mostly due to congestive heart failure. The high incidence of cardiac damage was attributed to systemic arterial hypertension secondary to renovascular obstructions or coarctation of the aorta. Aortic and mitral regurgitation, pulmonary hypertension, and coronary arterial lesions contributed to cardiac damage.
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PMID:[Cardiac damage in Takayasu's arteritis. Study in 125 patients]. 613 79

The clinical features and course of aortitis syndrome were studied in 11 women older than 40 years of age. The patients were Japanese women, mean age 57 +/- 6 years old, who were followed for 6.9 +/- 3.8 years. Data from 24 young patients were used for comparison. In the older patients, systemic hypertension (73%), calcification of the aorta (73%), left ventricular hypertrophy (92%) and cardiomegaly (82%) were frequent, whereas the erythrocyte sedimentation rate was normal in 5 patients and only slightly accelerated in 6. C-reactive protein was positive in 2. The incidence of cardiac involvement and inflammatory signs was significantly different from findings in the young patients. Aortic regurgitation (AR) (55%) was significantly more frequent and renal artery stenosis was not observed. Other arterial lesions revealed a pattern similar to those seen in the young patients. An irregular luminal surface, kinking and calcification were present in the lesions in the older patients. The survival rate at 5 years was 80%. Five of 6 patients with AR had congestive heart failure, 4 of whom died. One died after a stroke. Thus, aortitis syndrome in older patients has a long course. There is usually an associated AR, renal artery stenosis is rare and other arterial lesions do not change a great deal. The prognosis may be good, but depends on the association of AR.
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PMID:Clinical features and course of aortitis syndrome in Japanese women older than 40 years. 614 41

A series of 58 patients of aortitis syndrome were analyzed from the standpoint of the pathogenesis and surgical treatment. Investigations of HLA revealed a high incidence of HLA-A9, BW52, MT1 and DR2 antigens with statistically significant differences in the chi-square test. These data indicate that a haplotype composed of A9, BW52, MT1 and DR2 is common in patients with aortitis syndrome and suggest that a genetic factor plays an important role on the pathogenesis of the disease. Experiences with the surgical treatment of various types of aortitis syndrome, such as operation for cerebrovascular insufficiency (7 cases), for hypertension produced by coarctation or renovascular stenosis (14 cases), for aortic regurgitation (2 cases), and for aneurysm (7 cases) were analyzed. Reconstructive surgery is difficult in many of them because of the complicated lesion produced by inflammatory changes. Attention should be paid to the selection of the most suitable time for operation, application of special surgical technique, and prevention of the complications to obtain favorable results.
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PMID:Pathogenesis and surgical treatment of aortitis syndrome. 617 99


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