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)

Isovolumic relaxation period (IRP) was measured noninvasively from the onset of the aortic component of the second heart sound on the phonocardiogram to the point of separation of the mitral leaflets on the echocardiogram. IRP was measured in 83 patients with different cardiac diseases. The duration of IRP was 58 +/- 11 msec. in normal subjects. It was prolonged in hypertension (p < 0.001), HOCM (p < 0.001), in aortic stenosis (p < 0.05), and aortic incompetence (p < 0.001), and was shortened in congestive cardiomyopathyl (p < 0.05) and mitral stenosis (p < 0.01). In patients with coronary artery disease and normal over-all systolic LV function, IRP was prolonged (p < 0.001); IRP was shortened in four patients with coronary disease who had severe LV dysfunction and severe additional mitral incompetence. IRP was related to systemic blood pressure, percentage shortening of the LV in systole, and to the mitral EF slope. It tended to increase with increasing heart rate and a regression equation was developed for predicting IRP in relation to blood pressure and heart rate in normal sbjects. There was no relation to the PR-Ac time or to isovolumic contraction time. IRP is a useful measurement of LV dynamics in early diastole.
 ...
PMID:Isovolumic relaxation period in man. 741 37

Malondialdehyde (MDA), a product of platelet lipid peroxidation, was measured in human platelet-rich plasma. Levels of 3.19 n moles/10(9) platelets /+- 0.40 S.E. in 11 patients with prosthetic heart valves were elevated (p < 0.25) compared to 17 normal subjects (2.09 /+- 0.13 n moles/10(9) platelets). Reduced production (1.44 /+- 0.28 n moles/10(9) platelets, p < 0.5) was found in 10 patients with unstable angina. Normal levels were found in patients with mitral stenosis, cardiomyopathy or hypertension. Usual serum levels of drugs used in cardiac treatment reduced MDA levels as follows: acetaminophen, 47% (p < .01); aspirin, 58% (p < .05); furosemide, 32.6% (p < .005), and sulfinpyrazone, 41% (p < .05). Digoxin, dipyridamole, heparin, hydrochlorothiazide, lidocaine, nitroglycerin, procainamide, propranolol, quinidine, or warfarin had no significant effect at therapeutic concentrations. None of the drugs explained the enhanced production in patients with prosthetic valves while enhanced production in patients with prosthetic valves while analgesic therapy could explain the decreased levels in other cardiacs. The half-time of platelet survival, measured by suppression of malondialdehyde production, was 3.2 /+- 0.24 days in 9 normal subjects but could not be measured reliably in most patients because of multiple drug therapies. We conclude that the blood platelets of patients with prosthetic heart valves differ from those of normal subjects in their capacity to release malondialdehyde after stimulation with n-ethylmaleimide. Additionally, we find that inhibition of malondialdehyde production by several pharmacologic agents limits the usefulness of this method for the measurement of platelet survival in cardiac patients.
 ...
PMID:Platelet malondialdehyde in cardiovascular disease: effect of prosthetic heart valves and cardioactive drugs on production. 745 95

We report a 63-year-old woman, with a partial type of common atrioventricular canal and mitral stenosis, who was hospitalized because of dyspnea on exertion. Two-dimensional echocardiogram showed an ostium primum atrial septal defect with two well-formed AV valves located at the same level. However, both anterior and posterior mitral leaflets were markedly thickened with a thickened subvalvular apparatus, and the commisures were fused. Echocardiographic measurements demonstrated a mitral valve area of 1.48 cm2 with mild mitral regurgitation. Cardiac catheterization demonstrated mild pulmonary artery hypertension with a large left to right shunt (72%) at the atrial level. The combination of the partial type of common atrioventricular canal and mitral stenosis is rare; only one similar case has been reported previously in the literature.
 ...
PMID:Partial type of common atrioventricular canal defect associated with mitral stenosis. 764 18

Thirty nine consecutive cases of congenital left ventricular inflow obstructions (LVIO) diagnosed by two dimensional and Doppler echocardiography are described. The commonest referral diagnosis was severe pulmonary arterial hypertension. Confirmation by cardiac catheterisation and/or surgery was available in twenty one of these cases. The ages ranged from one month to 15 years (mean 3.8 +/- 4.5 years) and 28 were males. Four types of LVIO were defined: i) Congenital mitral stenosis (22 cases). Ventricular septal defect was the commonest association. ii) Cor-triatriatum (7 cases) Out of three patients operated, in one it was found to be a supravalvular mitral ring and not cor-triatriatum as earlier thought on echocardiography. iii) Pulmonary venous obstruction (8 cases). Atrial septal defect and ventricular septal defect were the common associations. iv) Supravalvular mitral ring (2 cases). Double outlet right ventricle and a large ventricular septal defect were associated with one case each. In our experience, two dimensional and Doppler echocardiography is a very useful and reliable investigation for defining the various types of congenital left ventricular inflow obstructions and their hemodynamic significance.
 ...
PMID:Congenital left ventricular inflow obstructions--an echocardiographic study. 782 38

Cost-effectiveness analysis of preventive therapies are reviewed in the following categories: lipid lowering, hypertension, smoking cessation, exercise, and anticoagulation. From review of 8 analyses, cost-effectiveness of primary prevention via cholesterol lowering drugs is generally expensive, whereas that of secondary prevention generally is favorable. However, targeting by age, coexisting risk factors, and gender strongly influence results that are also sensitive to drug costs. Treatment of hypertension (5 analyses) is cost-effective in virtually all patient populations and circumstances and for a wide variety of drugs. It is more so with coexisting risk. Issues relating to compliance and drug costs are important. Smoking cessation (4 analyses) is highly cost-effective and worthwhile. However, data on recidivism are incomplete, and cessation may be more difficult to achieve in the general population versus study patients. In one analysis, an exercise program was found to be cost-effective in prevention of coronary heart disease. Anticoagulants have been analyzed in various circumstances. Their cost-effectiveness is favorable for prosthetic valves, although sensitive to imprecision in monitoring. It is also favorable for mitral stenosis in the presence of atrial fibrillation but not normal sinus rhythm. Cost-effectiveness of heparinization for prosthetic valve patients undergoing surgery is rather variable and depends on type of surgery (major versus minor) and type of valve. Many topics in anticoagulant therapy remain to be explored from a cost-effectiveness point of view.
 ...
PMID:Cost-effectiveness analysis in heart disease, Part II: Preventive therapies. 783 69

A diagnosis of aortic insufficiency and mitral stenosis was made in a 24-year-old woman after an episode of heart failure following delivery. A double valvular replacement was performed 4 years later. At that time she suffered from recurrent episodes of erythema nodosum like lesions with an histological diagnosis of cutaneous polyarteritis nodosa. After another 4-year interval she presented with severe arterial hypertension and a biological inflammatory syndrome. An arteriography disclosed stenoses of the abdominal aorta, renal, and iliac arteries as well as occlusion of the right subclavian artery, diagnostic of Takayasu arteritis. We postulate that this woman presented a rare combination of cardiac and skin involvement of Takayasu's disease which preceded the classical arteritis of the aortic branches by 8 and 4 years, respectively.
 ...
PMID:Takayasu arteritis preceded by cardiac and cutaneous lesions. A case report. 790 68

Right ventricular contractility increases in response to catecholamine stimulation and greater ventricular preload, factors that increase with exercise workload. Thus, the maximum systolic dP/dt may be a potentially useful sensor to control the pacing rate of a permanent pacing system. The present study was designed to test the long-term performance of a permanent pacemaker that modulates pacing rate based on right ventricular dP/dt and to quantitatively analyze the chronotropic response characteristics of this sensor in a group of patients with widely varying structural heart diseases and degrees of hemodynamic impairment. A permanent pacing system incorporating a high fidelity pressure sensor in the lead for measurement of right ventricular dP/dt was implanted in 13 patients with atrial arrhythmias and AV block, including individuals with coronary artery disease, hypertension, severe obstructive pulmonary disease with prior pneumonectomy, atrial septal defect, dilated cardiomyopathy, restrictive cardiomyopathy, and mitral stenosis. Patients underwent paired treadmill exercise testing in the VVI and VVIR pacing modes with measurement of expired gas exchange and quantitative analysis of chronotropic response using the concept of metabolic reserve. The peak right ventricular dP/dt ranged from 238-891 mmHg/sec with a pulse pressure that ranged from 19-41 mmHg. There was a positive correlation between the right ventricular dP/dt and pulse pressure (r = 0.70, P = 0.012). The maximum pacing rate and VO2max were 72 +/- 6 beats/min and 12.61 +/- 4.0 cc O2/kg per minute during VVI pacing and increased to 124 +/- 18 beats/min and 15.89 +/- 5.9 cc O2/kg per minute in the VVIR pacing mode (P < 0.0003 and P < 0.002, respectively). The integrated area under the normalized rate response curve was 96.7 +/- 45.7% of expected during exercise and 100.1 +/- 43.4% of expected during recovery. One patient demonstrated an anomalous increase in pacing rate in response to a change in posture to the left lateral decubitus position. Thus, the peak positive right ventricular dP/dt is an effective rate control parameter for permanent pacing systems. The chronotropic response was proportional to metabolic workload during treadmill exercise in this study population with widely varying forms of structural heart disease.
 ...
PMID:Rate modulated pacing based on right ventricular dP/dt: quantitative analysis of chronotropic response. 797 96

Tricuspid valve regurgitation and pulmonary hypertension have been evaluated with echo-color-Doppler technique in 100 patients (80 females and 20 males, mean age 54 years) affected by mitral valve stenosis. Pure mitral stenosis was present in 13 patients; 87 had an associated mitral regurgitation. The severity of mitral valve disease was based on the planimetric and functional (Doppler-derived) evaluation of valvular area. No relationship was found between extent of tricuspid regurgitation and severity of mitral valve disease, whereas pulmonary artery hypertension was significantly related to mitral valve involvement, above all Doppler mean gradient (r: 0.63, p < 0.005) and valvular area (r: -0.52, p < 0.01). The study suggests that in patients with mitral valve disease tricuspid regurgitation is independent of the degree of mitral valve involvement, whereas pulmonary hypertension is related to transvalvular gradient and to mitral valve area, but does not depend on the duration of the disease. This is evident only in patients who maintain the sinus rhythm.
 ...
PMID:[Tricuspid insufficiency and pulmonary hypertension in mitral disease: an echocardiographic study]. 801 15

Nineteen women with cardiovascular disease underwent voluntary per-celioscopic sterilisation under local anesthesia at the La Rabta Maternity and Neonatology Centre, Tunis, Tunisia, between 1 July 1988 and 31 March 1989. There were 8 cases of hypertension, 1 of mitral insufficiency and 10 cases of surgically treated valve disease (6 cases of commissurotomy for mitral stenosis and 4 valve replacements). Mean parity of the women was 5 and mean age 35.4. Their educational level was low. Thirteen of them had never used contraception and 4 had had at least 2 therapeutic abortions. Local anesthesia with analgesia was well appreciated since 15 women remained calm and experienced no pain. The procedure involved minimal pneumoperitoneum and Trendelenburg. Recourse to minilaparotomy under general anesthesia was necessary in only one case. The authors stress the importance of counselling patients at the onset and of cooperation with cardiologists and anesthesiologists, and discuss peri-operative treatment protocols (anticoagulants, antibiotics) in particular.
 ...
PMID:[Voluntary surgical sterilization by laparoscopy in cases of cardiovascular diseases. Prospective study of 19 cases]. 810 55

Left ventricular end diastolic pressure (LVEDP) in 24 patients with coronary heart, hypertension or rheumatic heart disease (mainly aortic valve pathologic change, exclude mitral stenosis), who had unobvious clinical heart failure. Before left heart catheterization pulmonary function were tested by plethysmogram, results revealed: when LVEDP > 15 mmHg in the patients, pulmonary function parameter expectancy value percentage including FEF25-75%, V25, V50, V75, FVC, VC, FEV1.0 were obviously decreased. RV/TLC expectancy value percentage was obviously increased. Pulmonary function parameter expectancy value percentage including FEF25-75%, V25, V50, V75, FEV1.0, FVC, etc. had significant negative correlation with LVEDP (r = -0.715, P < 0.001; r = -0.699, P < 0.001; r = -0.678, P < 0.001; r = -0.671, P < 0.001; r = -0.648, P < 0.001; r = -0.516, P < 0.01; respectively). RV/TLC expectancy value percentage had significant positive correlation with LVEDP (r = 0.515, P < 0.05). The results indicate that testing pulmonary function parameter helps to evaluate left ventricular function and diagnose early (mesenchymal) pulmonary edema.
 ...
PMID:[The investigation of the correlations between left ventricular end diastolic pressure and pulmonary function parameters]. 840 54


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>