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)

Forty-four elderly patients (mean age 80 +/- 7 years) with elevated left ventricular outflow tract velocities and corresponding outflow tract gradients documented by continuous wave Doppler are reported (mean peak gradient 50 +/- 28). They had severe left ventricular hypertrophy, small left ventricular end-diastolic dimensions, and supernormal ejection fractions. Thirty-nine percent had a history of hypertension. They were predominantly female, had uniform concentric left ventricular hypertrophy, and had a high incidence of congestive heart failure. Diastolic function was found to be reduced in the elderly group compared to young patients with hypertrophic cardiomyopathy and to age- and sex-matched normal controls. It is concluded that most elderly patients with increased left ventricular outflow tract velocities are etiologically distinct from young patients with hypertrophic cardiomyopathy.
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PMID:The significance of increased left ventricular outflow tract velocities in the elderly measured by continuous wave Doppler. 272 58

Subject of our study are 293 patients with diseases of the myocardium, 212 males and 81 females at the average age of 45.2 years who were examined invasively including biopsy of the endomyocardium on account of clinical symptoms and changes of the ECG. Patients with hypertension, vitia, coronary stenoses as well as with hypertrophic cardiomyopathy were excluded. The aims of our study were a precised assessment of the degree of severity by a score from invasive parameters, the characterization of so-called latent or beginning cardiomyopathies and their relations to the dilatative cardiomyopathy as well as the aetiological classification by the biopsy of the endomyocardium. The score resulted from the number and the degree of individual pathological parameters, in which case the degree of the deviation was confirmed with points between 0 and 3. By summarizing of the score three degrees of severity were defined, to which clinical, electrocardiographic and bioptic results were coordinated. In the degree of severity 1 were 170 patients, in the degree of severity 2 42 patients, in the degree of severity 3 81 patients. In the higher degree of severity dyspnoea was significantly more frequently stated. In all degrees of severity the decrease of function was nearly of the same frequency. Of the degree of severity 3 died 28 patients, of the degree of severity 2 1 patient. In the degree of severity 1 by the biopsy of the endomyocardium in greater than 80% aetiological clues were detected, only in 35% in the degree of severity 3. Inflammatory changes were relatively frequently observed in all degrees of severity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Differential assessment of myocardial diseases: hemodynamic-angiocardiography studies and etiologic classification]. 281 93

Sudden death in young competitive athletes is most commonly due to underlying cardiovascular disease. Echocardiography has the potential to identify structural cardiovascular abnormalities, such as hypertrophic cardiomyopathy (HC), that have been incriminated in such events. In this study, echocardiography (2-dimensional and M-mode) was used as a primary screening test to assess 265 Howard University collegiate athletes for cardiovascular disease; 262 (99%) were black. Most athletes (234, 88%) had no definitive echocardiographic evidence of HC or other major cardiovascular diseases, but 30 (11%) had mitral valve prolapse, and 1 other athlete had a small atrial septal defect. In addition, 4 athletes were identified as having mild systemic hypertension. Most athletes (236 of 265) showed normal left ventricular wall thickness of less than or equal to 12 mm, but an important minority (29, 11%) had maximal ventricular septal thicknesses of greater than or equal to 13 mm that could not always be distinguished (by morphology alone) from mild anatomic expressions of nonobstructive HC. Based on this experience, preparticipation athletic screening using echocardiography as the primary test does not appear to be justified on a cost-effective basis. In addition, the substantial minority of subjects with increased wall thickness made clinical interpretation of the echocardiographic findings difficult in individual athletes.
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PMID:Preparticipation echocardiographic screening for cardiovascular disease in a large, predominantly black population of collegiate athletes. 281 33

Hypertrophic cardiomyopathy is a newly recognized, potentially fatal complication of ACTH therapy. We report the clinical, echocardiographic, and pathologic findings of an infant who was treated with ACTH for seizure disorder and subsequently developed severe systemic hypertension. Echocardiography revealed marked cardiac hypertrophy with disproportionate septal hypertrophy. Decreasing the dose of ACTH reduced the systemic blood pressure, but the cardiac hypertrophy progressed and the child subsequently died. Children who develop hypertension during ACTH therapy should be considered at risk for hypertrophic cardiomyopathy and should undergo routine echocardiographic evaluation.
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PMID:Cardiac hypertrophy associated with ACTH therapy for childhood seizure disorder. 282 Oct 97

Clinical uses of calcium channel blockers are expanding. In addition to the established uses in patients with arrhythmias, angina pectoris or hypertension, newer and to some extent investigational uses indicate widespread application. For instance, their use has been reported in hypertrophic cardiomyopathy and cold cardioplegia, as well as in pulmonary hypertension, antiplatelet therapy, asthma, achalasia and oesophageal spasm, increased intraocular pressure and in cerebral vasospasm. Their use in obstetrical practice has been proposed. Thus, the presentation of a patient who is treated with calcium channel blockers and who requires anaesthesia will become more common. Calcium channel blockers may, under certain circumstances, potentiate haemodynamic and MAC depressive effects of inhalation agents. There is also evidence that the effects of neuromuscular blocking agents may be potentiated. The anaesthetist should be aware that the potential for interactions exists with digoxin, propranolol, quinidine, theophylline or dantrolene. Of interest and some significance are the anaesthetic implications of pathophysiological alterations that can be induced by calcium channel blockers, by affecting lower oesophageal tone, intracranial hypertension, bronchomotor tone (asthma), muscular dystrophy, neuromuscular function, hypoxic pulmonary vasoconstriction, malignant hyperthermia, inhibition of platelet aggregation and hyperkalemia. Despite these significant potential anaesthetic implications and because, at this time, in some instances withdrawal has clearly demonstrated increase in the signs of myocardial ischaemia, it would not seem necessary to recommend preoperative discontinuation of calcium channel blocker medication in patients presenting for anaesthesia. It is, however, appropriate that there is a high index of awareness of potential problems, unless there is some modification in inhalation anaesthetic concentrations and neuromuscular blocker dosage. Monitoring of cardiovascular and neuromuscular functions is essential. Calcium channel blockers would appear to be currently the drugs of choice for angina pectoris, arrhythmias or hypertension in patients with associated chronic obstructive pulmonary disease.
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PMID:Anaesthetic implications of calcium channel blockers. 286 80

beta-Adrenergic blocking drugs have been available for several years to treat ischemic heart disease and other cardiovascular and noncardiovascular disorders. There are multiple drugs in this class with various pharmacodynamic and pharmacokinetic properties that may be important in specific clinical situations and in avoiding certain adverse reactions. These drugs have been shown to be efficacious in relieving anginal symptoms and prolonging exercise tolerance, in reducing high blood pressure, for treating various arrhythmias, in therapy of hypertrophic cardiomyopathy, and for prolonging life in many survivors of acute myocardial infarction.
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PMID:Beta-adrenergic blockers. 289 86

beta-Blocking therapy is used extensively is conditions as diverse as hypertension, angina pectoris, arrhythmias, thyrotoxicosis, hypertrophic cardiomyopathy, migraine, glaucoma, and myocardial infarction. Studies show they beneficially influence sinus node and atrioventricular conduction, but excessively high doses may cause sinus arrest or sinoatrial block. Nonselective beta-blockade in asthmatic patients may aggravate bronchoconstriction, whereas increased airways resistance is less likely with beta 1-selective, partial agonist, or alpha-beta-blocking drugs. Hypoglycemia can be prolonged; beta 1-selective or partial agonist drugs may cause less interference with glucose metabolism. beta-Blockade affects free fatty acids, lipids and lipoproteins, thyroid hormones, and parathormone. beta-Blockade may normalize abnormal platelet aggregation. Finally, the choice of the most effective drug depends on the clinician's knowledge of the various pharmacodynamic and pharmacokinetic drug profiles, allied with familiarity of the patient's medical condition.
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PMID:Circulatory and metabolic aspects of beta-adrenoceptor blockade. 290 49

The striking clinical and pathologic features of hypertrophic cardiomyopathy have been defined almost exclusively in the young. Little is known about this condition in the elderly, although it is assumed to be part of a single disease. Accordingly, we studied 28 patients who were 65 years of age and older (mean age, 72 +/- 6.4 years) who were diagnosed as having hypertrophic cardiomyopathy by M-mode, two-dimensional, and Doppler echocardiography and compared them with a group of 28 consecutive patients with this disease who were younger than 40 years of age (mean age, 26 +/- 9.5 years). No clinically detectable differences existed between the two groups, except for an increased incidence of mild hypertension in the elderly. Echocardiography in both groups showed hypertrophy with a small left ventricular cavity, and Doppler outflow tract velocity or cardiac catheterization in most patients showed systolic anterior motion of the mitral valve or a systolic outflow tract gradient or both. Significant differences existed between both groups, however, concerning left ventricular size and shape. The elderly group had a predominantly ovoid cavity contour with normal septal curvature. In contrast, in the young group, a markedly abnormal cardiac shape predominated (p less than 0.0001) with a crescent-shaped left ventricular cavity and a reversed curvature of the interventricular septum. The right ventricular free wall was prominent by echocardiography in the young compared with the elderly group (p less than 0.001). Apart from a more frequent history of mild hypertension in the elderly, likely related to age, these findings show that hypertrophic cardiomyopathy, when present in the elderly, has similar clinical features to that in the young.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hypertrophic cardiomyopathy in the elderly. Distinctions from the young based on cardiac shape. 291 89

Hypertensive hypertrophic cardiomyopathy may be a distinctive cardiac condition resulting from hypertension. Alternatively, this disease may represent the coincidence of a common disease, hypertension, with a relatively rare cardiomyopathy. A consecutive series of patients with hypertrophic cardiomyopathy and hypertension were studied and compared with age- and gender-matched patients with cardiomyopathy alone. Thirty-nine patients were identified as having hypertension; they ranged in age from 31 to 84 years (average 60 +/- 13); 82% were greater than 50 years old; 18 (46%) were women. When these patients were compared with the age-matched group with hypertrophic cardiomyopathy alone, there were no clinical or electrocardiographic differences between the two groups. By echocardiography, the hypertensive and nonhypertensive groups had a similar incidence of systolic anterior motion (77 versus 64%, respectively), mitral annular calcification (31 versus 31%), septal thickness greater than 20 mm (56 versus 46%) and outflow tract gradient greater than 20 mm (59 versus 67%). A posterior wall thickness greater than 13 mm was more frequent in the hypertensive group (54%) compared with the nonhypertensive group (31%) (p = 0.02). The findings show that hypertrophic cardiomyopathy with associated hypertension is a disease of the elderly. But, with the exception of thicker walls, the clinical and echocardiographic features of the patients with hypertension were indistinguishable from those of the age-matched and, hence, elderly group of patients with cardiomyopathy without hypertension. These findings suggest that hypertension may make hypertrophy worse, but that it is not the primary cause of the cardiomyopathy. Thus, the condition might be better termed "hypertrophic cardiomyopathy with hypertension."
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PMID:Hypertensive hypertrophic cardiomyopathy or hypertrophic cardiomyopathy with hypertension? A study of 78 patients. 291 63

Ultrasound tissue characterization, the evaluation of certain physical properties of a tissue based on its acoustic properties, is an evolving application in echocardiography. The ability to identify acutely and chronically injured tissue has been demonstrated in a number of animal studies, but data in humans are limited. The present study tested the hypothesis that quantitative echocardiographic texture analysis, a method of evaluating the spatial pattern of echoes in echocardiographic images, would differentiate amyloid and hypertrophic cardiomyopathy from normal myocardium. Routine clinical echocardiographic data were obtained on 34 subjects at the Mayo Clinic (10 normal subjects, 10 patients with amyloid heart disease, 8 patients with hypertrophic cardiomyopathy and 6 patients with left ventricular hypertrophy due to hypertension). Standard videotape recordings of these echocardiograms were analyzed at the University of Iowa. Echocardiographic data were digitized with use of a calibrated, 256 gray level digitization system. Quantitative texture analysis was performed on data from the ventricular septum and posterior left ventricular wall in end-diastolic and end-systolic, short-axis and long-axis echocardiographic images. The gray level run length texture variables were able to discriminate hypertrophic cardiomyopathy and amyloid heart disease from normal myocardium and from each other (p less than 0.0083 for comparisons of the quantitative texture features of amyloid versus hypertrophic cardiomyopathy versus normal by multivariate analysis of variance). The texture of the myocardium in hypertensive left ventricular hypertrophy not associated with amyloid or hypertrophic cardiomyopathy was in general not significantly different from that of normal myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Feasibility of identifying amyloid and hypertrophic cardiomyopathy with the use of computerized quantitative texture analysis of clinical echocardiographic data. 292 37


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