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)

To determine whether any associated electrocardiographic findings in persons with newly acquired complete left bundle branch block (LBBB) correlate with the prevalence of associated clinically apparent cardiovascular abnormalities, electrocardiograms (ECGs) from all 55 members of the Framingham Study cohort in whom LBBB developed during 18 years of routine prospective biennial examinations were reviewed. A QRS axis left of or equal to 0 degrees, left atrial conduction delay and an inverted T wave in lead V6 on the first ECG with LBBB, and an abnormal ECG in the Framingham examination preceding the appearance of LBBB each correlated with the prevalence of systemic hypertension, cardiomegaly, coronary heart disease and congestive heart failure. However, neither the PR interval nor the duration of the QRS complex on the first ECG with LBBB correlated with the prevalence of any of the associated cardiovascular abnormalities. The 8 patients with neither left atrial conduction delay nor a QRS axis left of or equal to 0 degrees on the first Framingham ECG with LBBB nor an abnormal ECG on the examination preceding the appearance of LBBB were 6 times more likely to remain free of all of the clinical cardiovascular abnormalities than the 47 patients with 1 or more of these 3 electrocardiographic findings (p less than 0.001).
 ...
PMID:Clinical-electrocardiographic correlates of newly acquired left bundle branch block: the Framingham Study. 315 91

Although silent myocardial ischemia (SI) occurs frequently in patients with angina and is of prognostic significance, little is known of its occurrence in other subgroups. We assessed the incidence of SI in offspring of Framingham Heart Study (FHS) patients following unrecognized myocardial infarction (UMI) and in controls without MI but who were matched for age, sex, hypertension, diabetes, smoking, and total cholesterol at entry into the FHS. Of the 20 UMI patients, six had died and one with left bundle branch block was excluded. The remaining 13 UMI patients and 26 control patients underwent 24-hour ambulatory electrocardiographic monitoring (AECG) for SI. Two patients (one from each group) with angina were excluded from the AECG analysis. Only two (15.4%) of the UMI patients and two (7.7%) of the control patients had any AECG evidence of SI. These preliminary results suggest that routine monitoring for SI is not indicated in asymptomatic long-term survivors of UMI or in asymptomatic patients without prior MI but with otherwise similar risk profiles.
 ...
PMID:Silent myocardial ischemia in asymptomatic survivors of unrecognized myocardial infarction and matched controls. 319 32

Two hundred consecutive patients undergoing only coronary bypass surgery were studied. Forty-five patients (group A) developed new fascicular conduction blocks and 155 patients (group B) did not. The 45 patients in group A developed the following fascicular conduction blocks: right bundle branch block 47%, right bundle branch block and left anterior hemiblock 8%, right bundle branch block and first-degree atrioventricular block 2%, left anterior hemiblock 11%, left bundle branch block 18%, right bundle branch block-left anterior hemiblock and first-degree atrioventricular block 5%. There were no significant differences in sex, incidence of diabetes, number of grafts performed, ejection fraction (less than 55%), and perioperative infarction. Group A patients were older (p less than 0.01). Hypertension was found frequently in group A (27 vs 45 patients; p less than 0.01) and was present for a mean of 12.4 years in group A and 4.9 years in group B (p less than 0.01). Preoperative use of digitalis was found in 14 (31%) patients in group A and in 18 (12%) patients in group B (p less than 0.01). Twenty-one (47%) patients in group A had significant disease (greater than 70%) of the left main coronary artery as compared to 17 (10.9%) in group B (p less than 0.001). There was no difference in the recurrence of angina or the survival rate at 14 months. In conclusion, the incidence of new fascicular conduction block after bypass surgery is 22.5%. Long-standing hypertension, left main coronary disease, and the preoperative use of digitalis appear to be predisposing factors. New fascicular conduction block does not affect prognosis.
 ...
PMID:Etiology and clinical significance of new fascicular conduction defects following coronary bypass surgery. 348 81

In the International Prospective Primary Prevention Study in Hypertension, electrocardiographic changes before and during 3- to 5-year antihypertensive treatment were investigated in a cohort of 5819 men and women aged 40 to 64 years with entry diastolic blood pressures of 100 to 125 mm Hg. They were randomly allocated to treatment regimens that either included or excluded the slow-release beta-blocker oxprenolol. Electrocardiograms (ECGs) were assessed using the Minnesota Code and assigned to groups of normal ECGs or ECGs with pressure-related, ischemic, "intermediate," or "other" abnormalities. Antihypertensive treatment was associated with a decrease (mainly in men) of pressure-related and (mainly in women) of intermediate abnormalities. Ischemic abnormalities increased, particularly in men. Inclusion of the beta-blocker resulted in a greater reduction in intermediate abnormalities and in a lesser increase in ischemic abnormalities. Better blood pressure control was associated with a lesser increase in ischemic abnormalities and in a regression of pressure-related abnormalities. The presence of ST segment depression and of a complete left bundle branch block in the entry ECG was associated with a significant risk for sudden death and myocardial infarction. Optimal blood pressure control prevents pressure-induced cardiac target organ damage and, hence, heart failure, and may delay the progression of ischemic abnormalities. This tallies with the lower critical cardiac event rate associated with lower blood pressure that was observed in the same study.
Hypertension 1987 Jun
PMID:Electrocardiographic changes during antihypertensive therapy in the International Prospective Primary Prevention Study in Hypertension. 359 89

During a 10-year period a series of 114 patients was studied to determine if Trypanosoma cruzi and arboviruses could be the etiologic agents of idiopathic cardiomyopathy (ICM) in Cali, Colombia. In this area, ICM (together with rheumatic and artherosclerotic cardiopathy) represents the second most frequent cause (determined by necropsy) among adult patients with cardiopathies, hypertension being the first. No association was observed between ICM and any of the arboviruses assessed by hemagglutination tests. Only 10 of 114 cases (8.7%) showed positive seroparasitological tests for T. cruzi. Autopsy was performed in 4 of these 10 cases; 1 had Chagas myocarditis and the other 3 were patients with non-inflammatory ICM. In all 9 T. cruzi-negative cases the autopsies showed non-inflammatory ICM lesions. In contrast to typical Chagas cases, the most frequent EKG change in ICM is left bundle branch block rather than right. Since the EKG varies within either group, this distinction may not be valid in individual cases. Because of the similarities in clinical characteristics and variations in EKG between Chagas myocarditis and ICM, it is suggested that autopsies should be done in populations in endemic areas of T. cruzi to assess the frequency of ICM and its importance in the differential diagnosis of Chagas myocarditis.
 ...
PMID:Trypanosoma cruzi and virological studies in idiopathic cardiomyopathy in Cali, Colombia. 421 66

The detection of left ventricular hypertrophy (LVH) in the presence of left bundle branch block (LBBB) remains a difficult clinical problem. Its prevalence and significance have not previously been studied in a group of living patients. M-mode echocardiography was utilized to determine the prevalence of anatomic LVH in 28 patients with LBBB. Various ECG and chest x-ray criteria as predictors of LVH were assessed. Anatomic LVH was present in 89% by echocardiography. A left atrial abnormality on ECG and a cardio-thoracic ratio greater than .50 were the best predictors of LVH. Hypertension and/or ischemic heart disease was present in 78.5% of the patients while only one patient was free of any evidence of cardiovascular disease.
 ...
PMID:Left ventricular hypertrophy in left bundle branch block. 623 73

Following detailed clinical and electrocardiographic analysis, twenty-five patients with incomplete left posterior hemiblock without associated complete right or left bundle branch block are presented. First-degree atrioventricular block was relatively common in these patients and associated incomplete right or left bundle branch block was also present in a few. Hypertension was the commonest underlying cardiovascular disease but two of them, without any clinically overt cardiovascular disease, presented with a history of episodic dizziness or syncopal attacks. With the present knowledge of the anatomy and histopathology of intraventricular conduction system, the relevance of tendency for Africans to form excessive fibrous tissue has been emphasized. Considering the unexpectedly low average age of these patients, suggestions have been made with a view to reducing the rate of progression of such atrioventricular conduction defects to the need for implanted cardiac pacemakers.
 ...
PMID:Early onset and significance of imcomplete left posterior hemiblock in Nigerians. 628 48

Cardiovascular abnormalities were prospectively identified in all 55 persons who acquired left bundle branch block and all 70 persons who acquired right bundle branch block during 18 years of follow-up of the Framingham Study cohort. Those with left and right bundle branch block did not differ from each other in the overall prevalence of either hypertension, clinical coronary disease or diabetes. In men, but not in women, left bundle branch block was associated with a significantly greater prevalence of cardiac enlargement and congestive failure than was right bundle branch block. A trend suggesting a higher mortality rate from cardiovascular disease in those with left than in those with right bundle branch block was more apparent in men than in women. It is concluded that in the general adult population, men who acquire left bundle branch block are more likely to have or subsequently acquire advanced cardiovascular abnormalities than are men who acquire right bundle branch block. In women, however, the clinical correlates of the two conduction abnormalities are similar.
 ...
PMID:Comparative features of newly acquired left and right bundle branch block in the general population: the Framingham study. 645 50

Of 1,164 (= 89.7%) of all diabetics established in the district department for diabetes Prenzlau the electrocardiograms in rest were evaluated and the frequency of hypertension, adiposity and left hypertrophy in the photofluorogram were registered. Altogether only 13% of all patients with an average age of 65 years had a normal ECG. In comparisons to the population with healthy metabolism the frequency of hypertension *84.0%), adiposity (62.7%) and in the ECG of repolarization disturbances (68.9%), myocardial infarction (6.4%), atrioventricular blockings (16.9%), absolute arrhythmia (4.4%), tachycardia (5.5%), a left hypertrophy (18.2%; in the photofluorogram 52.3%), of forms of bundle branch blocks (9.1% left-anterior hemiblock, 4.5% right bundle branch block and 3.1% left bundle branch block) and of an overturned left type (13.1%) were evident in diabetics. Pathological changes of the ECG could be proved no more infrequently in females with diabetes than in males with diabetes. The connection between the appearance of a coronary arteriosclerosis and the intake of tolbutamide supposed by the UGDP-study could be confirmed also for the intake of glibenclamide.
 ...
PMID:[Incidence of pathological ECG findings, hypertension and obesity in diabetic patients depending on their mode of therapy]. 645 56

Rate-dependent left bundle branch block (LBBB) occasionally occurs during anaesthesia when the heart rate exceeds a critical value. While it is usually a benign disorder, it may mask the electrocardiographic manifestations of myocardial ischaemia and the ST-T wave pattern associated with LBBB may be mistaken for those of ischaemia. This case report presents two cases in which rate-dependent LBBB was clearly documented during the perioperative period. It demonstrates the use of pharmacologic agents (e.g., atropine and neostigmine) and physiologic manipulations (e.g., carotid sinus massage) to alter the heart rate and confirm the diagnosis of benign rate-dependent LBBB in the operating room. These interventions should be used with caution in patients who have hypertension, angina, cerebrovascular, or AV node disease or in the setting of myocardial ischaemia or severe bundle branch disease.
 ...
PMID:Intraoperative diagnosis of rate-dependent bundle branch block. 672 21


<< Previous 1 2 3 4 5 6 7 Next >>