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

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

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

Aneurysm of the coronary artery associated with aortitis syndrome is extremely rare. This is a case report of a left coronary artery aneurysm associated with aortitis syndrome. The patient was a 47-year-old woman who complained of palpitation and dizziness on exertion. Aortogram revealed occlusion of the arch vessels, infrarenal aortic stenosis, and a fusiform aneurysm of the left coronary artery. There was neither an intraluminal thrombus nor occlusive changes in the coronary arteries. Severe systolic hypertension nearing 300 mmHg was present in the ascending aorta. Severe hypertension and direct extension of inflammation to the coronary artery seemed to be important factors for the formation of the aneurysm. To resolve the severe hypertension, a bypass operation between the ascending aorta and the abdominal aorta distal to the stenosis was performed. The postoperative course was uneventful and blood pressure was reduced.
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PMID:Coronary artery aneurysm associated with aortitis syndrome diagnosed pre- and intraoperatively. 614 72

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

A woman with aortitis syndrome who had had severe hypertension for more than 30 years, despite the administration of various antihypertensive drugs, underwent percutaneous transluminal angioplasty (PTA) a total of three times. The operation resulted in good control of BP and with an improvement of other hemodynamics without any medication for one year after PTA.
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PMID:Usefulness of percutaneous transluminal angioplasty for aortitis syndrome. 623 49

A 53-year-old woman with nephroptosis and aortitis disease was found also to have orthostatic hypertension. When standing, she had high renin levels and normal catecholamine values, with a reduced baroreflex sensitivity. This orthostatic hypertension largely may be due to an activation of the renin system caused by nephroptosis and partly due to a reduced baroreflex sensitivity caused by aortitis. Captopril and propranolol hydrochloride were effective for the treatment of hypertension.
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PMID:Orthostatic hypertension with nephroptosis and aortitis disease. 636 95

The present study was done to investigate the relation between the prognosis and hypertension, especially hypertension due to renal arterial stenosis, atypical coarctation of the aorta and aortic regurgitation in patients with aortitis syndrome. Sixty-five patients including 25 with normotension and 40 with hypertension who were hospitalized during the last 20 years were included in this study. Out of the 40 patients with hypertension, a cause of hypertension was found in 37 patients: renovascular hypertension alone in 13, renovascular hypertension with atypical coarctation in 11, renovascular hypertension and aortic regurgitation in 2, atypical coarctation alone in 5, aortic regurgitation alone in 5 and all of the three in the remaining one. Thirty-two hypertensive patients out of 40 were treated with antihypertensive drugs and the remaining 8 underwent surgical operation (renal vascular repair in 6 and nephrectomy in 2 for relief of hypertension. In the present data, 13 out of 40 patients with hypertension died despite of the treatment, while only one out of 25 patients with normotension died. According to the mortality in each type of cardiovascular lesion, 6 patients died out of 13 with renovascular hypertension alone, 5 patients died out of 11 with renovascular hypertension associated with atypical coarctation and 2 patients with renovascular hypertension associated with aortic regurgitation died. In contrast, there was no death in hypertensive patients with aortic regurgitation alone or atypical coarctation of the aorta alone. These results indicate that hypertension, especially renovascular hypertension is one of the major determinant of the prognosis in the patient with aortitis syndrome.
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PMID:Clinical aspect of aortitis syndrome with special reference to the relation between prognosis and hypertension. 646 Jan 23

The case of a 5-year-old boy affected by autoimmune aortitis is reported. The onset was acute, the progression rapid. Hypertension, absence of right radial pulse, elevated ESRand immune globulin levels, cellular and humoral immunity against blood vessel wall were observed. The tests suggested an autoimmune origin of the aortitis. On immunosuppressive treatment the signs of activity disappeared and the condition improved and after captopril treatment the blood pressure decreased.
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PMID:Primary aortitis in childhood. 663 88

Renal revascularization is a proven means of treating patients with renal artery disease and resultant hypertension. Currently aortorenal bypass is the mainstay of surgical treatment in most institutions. Alternate methods for renal revascularization are now available when use of abdominal aorta would be hazardous for aortorenal revascularization. Relative contraindications for use of the aorta in reconstructive renovascular surgery are previous aortic surgery, severe atherosclerosis, and asymptomatic small abdominal aortic aneurysms. Absolute contraindications include atheromatous obliterative disease, postirradiation aortitis, and retroperitoneal suppurative process involving the infrarenal aorta. The indications and surgical techniques of various forms of extra-aortic renal bypass procedures are presented. These extra-aortic procedures have effectively restored renal blood flow and are less hazardous than aortic replacement and concomitant renal revascularization.
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PMID:Alternatives to aortorenal revascularization. 710 91

Thoracic aortic aneurysms were detected in 72 residents (44 women and 28 men) in a stable midwestern community over a 30-year period, for an age- and sex-adjusted incidence of 5.9 new aneurysms per 100,000 person-years. The incidence was equal in both sexes and decreased slightly over the 30 years. Ages ranged from 47 to 93 years (median 65 years for men and 77 years for women). The ascending aorta was involved in 37 patients, the aortic arch in 8, and the descending aorta in 27. Pathologic examination was performed in 51 patients. The cause was aortic dissection in 27 patients (53%), atherosclerosis in 15 (29%), aortitis in 4 (8%), cystic medial necrosis in 3 (6%), and syphilis in 2 (4%). All autopsied patients had pathologic evidence of significant hypertension. Eleven patients (25%) had concomitant abdominal aortic aneurysms. Rupture occurred in 53 patients (74%) and 50 died. Thirty-seven of these patients had no prior diagnosis of aneurysm. The median interval between diagnosis and rupture in the 16 remaining patients was 2 years (range 1 month to 16 years). Ninety-five percent of aortic dissections ruptured and 51% of nondissecting aneurysms ruptured. The actuarial 5-year survival for all 72 patients was 13%; for patients with aortic dissection, 7% and for patients without dissection, 19.2%.
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PMID:Thoracic aortic aneurysms: a population-based study. 714 88


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