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

Three hundred and seventeen cases which included 100 normal individuals have been studied for roentgen significance of the thoracic paraspinal line (TPL). The descending thoracic aorta greatly determines the course and configuration of the TPL. In a right-sided aorta, the TPL is seen on the right side as a mirror image of a left-sided TPL. Lateral deviation of the TPL and descending aorta occur as an ageing process. In systemic hypertension where there is an aortic unfolding, the TPL also unfolds and the degree of TPL deviation has a fair degree of linear relationship with the severity and duration of hypertension in young individuals. Most cases of mitral valvular disease show lateral deviation of the TPL and descending aorta. In these cases the enlarged left atrium displaces the descending aorta and hence the posteromedial border of left lung posterolaterally tangential to the vertebral column resulting in deviation of the TPL and aorta. Perioesophageal spread of carcinoma of the oesophagus into the posterior mediastinum is indicated by changes in pleuro-oesophageal interface and TPL. Mediastinal lymphadenopathy in cases of testicular tumours may be detected by discovery of TPL deviation on frontal radiographs of the thoracic spine. In extradural masses such as granulomas, abscesses and metastatic deposits, the TPL shows a localised bulge corresponding to the clinical and myelographic level of spinal compression.
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PMID:The thoracic paraspinal line: further signficance. 45 8

The course of dosed insufficiency of the mitral valve in animals under lowland conditions is characterized by marked compensatory capacity of the organism. Under the effect of high-altitude hypoxia (3,200 m), the disease of the mitral valve is attended with overloading of the left atrium with the volume of blood and leads to acute hypertension of the pulmonary artery with subsequent decompensation of the right heart. In animals with mitral valvular disease under conditions of high altitude, strophanthin K produces a sufficiently complete cardiotonic effect which prevents weakening of the myocardial contractions, particularly in the early period of the defect in the mitral valve.
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PMID:[Effect of high-altitude hypoxia on the course of experimental mitral heart defect]. 71 42

Perfusion scintigraphy of the lungs has shown that a reverse direction of postural reactions of the pulmonary blood flow is observed in patients with mitral valvular disease: perfusion of the upper lung rather than the lower lung increases. It is accounted for by the action of gravitation on capillary hydrostatic pressure resulting in the localization of interstitial edema in pulmonary venous hypertension mainly in the lower lung, its microcirculatory bed being compressed and the blood flow redistributed to the opposite upper lung. Therefore successive perfusion scintigraphy of the lungs in the vertical position and in the lateral position with a RP administered twice, can serve as a sensitive test for diagnosis of interstitial lung edema in various pathological conditions.
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PMID:[Radionuclide diagnosis of interstitial pulmonary edema]. 199 78

Cine gradient-recalled magnetic resonance (MR) imaging, which has flow sensitivity and high temporal resolution, may potentially yield both morphologic and dynamic flow-related information in the pulmonary vasculature. The authors used this modality to evaluate pulmonary vessels in 12 healthy subjects and in 14 patients with a variety of cardiopulmonary disorders. Normal pulmonary arteries and veins were characterized by distinctive signal intensity and diameter variations as well as motion of the vessels during the cardiac cycle. Patients with pulmonary arterial hypertension demonstrated loss of the normal pulsatile systolic increase and diastolic decline in velocity-related signal intensity and in diameter of the proximal pulmonary arteries. Disorders of pulmonary venous signal and diameter profiles during the cardiac cycle, which show a characteristic biphasic pattern in healthy subjects, were identified in five patients with mitral valvular disease. These initial results indicate that cine MR imaging techniques hold promise in the evaluation of pathophysiologic conditions in the pulmonary circulation.
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PMID:Pulmonary vascular cine MR imaging: a noninvasive approach to dynamic imaging of the pulmonary circulation. 238 34

Pathologic signs of left atrial load are found very often in arterial hypertension. The diagnostic combinations are very slightly expressed, more often in the orthogonal ECG. Pathologic criteria found most often are: pathologic end-strength of the P wave in lead V1 (in 42% of the patients) and increased amplitude of PX (in 39% of the patients). The pathologic changes of the P wave increase with the development of left ventricular hypertrophy and heart failure. The values of the end-strength of the P wave in lead V1 when they are negative more than - 0.03 mm.s should be considered pathologic in contrast to mitral valvular disease.
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PMID:[Effect of arterial hypertension on the atrial portion of the electrocardiogram]. 296 39

In order to clarify the pathogenetic mechanism of stenosis in the intramural coronary branch, morphological changes were examined by postmortem coronary angiography and determination of the Coronary Stenosis Index of the Myocardium (CSIM) were made in hearts obtained by autopsy from 10 patients with hypertension, 15 with normotensive myocardial infarction, 25 with hypertensive myocardial infarction, 6 with mitral valvular disease, 7 with aortic stenosis and 14 control subjects. CSIM was significantly higher in patients with hypertension, infarction with hypertension and aortic stenosis than in other three groups, indicating higher incidence of stenosis in those with a left ventricular pressure load. There was no specific correlation between the degree of stenosis of the epicardial coronary artery and that of the intramural coronary branches supplied by the former in any groups examined. Major pathological changes of the intramural coronary branches were muscular hypertrophy of media and proliferation of internal elastic lamella, both observed with a high incidence in vessels with high CSIM values. These findings suggest that intramural pressure which exerted extravascular pressure played an important role in the pathogenetic mechanisms of stenotic changes in the intramural coronary branches.
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PMID:Pathogenetic mechanism of stenosis in the intramural coronary artery. 380 29

To determine the hemodynamic significance of increased lung thallium-201 uptake, resting thallium images in 23 normal subjects and 90 patients with various cardiac diseases were reviewed. Significant thallium uptake in the lung was observed in 60 cases and was especially frequently in mitral valvular disease (19 of 19 cases) and in myocardial infarction (25 of 37 cases). Chest radiographs of most of these patients showed pulmonary congestion or edema (50 or 69 cases). Pulmonary wedge pressure was measured in 25 of these patients and was significantly higher than in those of normal thallium uptake in the lung. Assessment of lung thallium uptake at the time of myocardial imaging can be used as a noninvasive means for evaluation of pulmonary venous hypertension.
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PMID:Hemodynamic significance of increased lung uptake of thallium-201. 645 27

Mitral valve disease is a common cause of morbidity and mortality in patients over age 65. The etiology, physical findings, and natural history of rheumatic mitral stenosis, rheumatic mitral regurgitation, chronic non-rheumatic mitral regurgitation, and acute mitral regurgitation may differ in older and younger patients. In addition, symptoms of mitral valve disease may be masked or exacerbated by coexistent coronary artery disease, pulmonary disease, hypertension, and other systemic disorders that commonly occur in older adults. The clinical evaluation, along with various non-invasive cardiac procedures, is important for identifying mitral valve disease as the cause of abnormal signs and symptoms in older patients. Recognition of mitral valve abnormalities has important implications, because mitral valve repair or replacement is usually associated with favorable short- and long-term results, even in patients over age 65.
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PMID:Valvular heart disease, Part 2. Mitral valve disease in older adults. 1456 40

Increased pulmonary precapillary vascular resistance due to vasoconstriction and vasoproliferative processes is the basic pathophysiological mechanism in the development of pulmonary hypertension (PH). With the exception of pulmonary venous hypertension, where the primary cause of PH is left ventricular failure or mitral valvular disease, all the other PH categories will benefit to a greater or lesser extent from pulmonary vasodilator and antivasoproliferative therapy. Today, for this purpose, in addition to intravenous prostacyclin (epoprostenol), which is restricted to severe pulmonary arterial hypertension (NYHA class IV and late class III), other therapeutic options such as treatment with more stable prostacyclin analogs (oral beraprost, aerosolized iloprost), endothelin-receptor antagonists (bosentan) or phosphodiesterase inhibitors (sildenafil) are also available and these are especially useful for the treatment of the early stages of the disease. The recent progress in medical therapy has markedly increased the life expectancy in patients with pulmonary arterial hypertension and substantially improved their quality of life. Chronic hemodialysis (HD) patients show higher endothelin-1 (ET-1) activity in comparison to healthy individuals and there is evidence that the increase of pulmonary vascular resistance in these patients is at least in part mediated by ET-1. Recent data show good results after PH therapy with the endothelin-receptor antagonist bosentan in HD patients. Also prostacyclin and its analogs, as well as phosphodiesterase inhibitors, can be useful for the treatment of pulmonary hypertension in patients with chronic renal failure.
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PMID:Advances in the medical treatment of pulmonary hypertension. 1653 27