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

Right ventricular ejection fraction (RVEF), right ventricular peak filling rate (RVPFR) and right atrial early diastolic emptying rate (RAER) were measured with radionuclide gated blood pool scintigraphy in 19 healthy subjects and 15 cases of COPD with cor pulmonale and right heart catheterization was performed in the latter group. It was shown that RVEF in the group of cor pulmonale patients with pulmonary arterial hypertension (PAH) was significantly lower than that of the group of healthy subjects and cor pulmonale patients without PAH (P < 0.001, P < 0.001), no difference in RVEF was found between cor pulmonale patients without PAH and healthy subjects. As pulmonary arterial pressure increased, RAER and RVPFR decreased gradually, and the reduction of RAER and RVPFR occurred earlier than that of RVEF. It is suggested that right ventricular diastolic function may be impaired before right ventricular systolic function.
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PMID:[A study on the radionuclide method for assessment of right ventricular function in COPD with cor pulmonale]. 760 Aug 69

Ten days after surgical treatment of a gastric perforation a 70-year-old woman developed progressive dyspnoea and hypertension without any signs of deep vein thrombosis. Emergency echocardiography revealed acute cor pulmonale with a dilated right atrium and ventricle, as well as paradoxical ventricular septal motion. In addition it demonstrated an elongated, extremely mobile thrombus stuck in a patent foramen ovale with most of it floating in the right atrium, the remainder in the left atrium. Within 2 hours of the ultrasound examination she went into fulminant pulmonary embolism with circulatory arrest and paradoxical embolization from the atria to the brain, after which the intraatrial thrombus was no longer detectable. She was successfully resuscitated and thrombolysis was immediately started with tissue-plasminogen activator (100 mg over 90 min), with ensuing stabilization of the circulation. The patient was gradually weaned off the ventilator over the following few days, but she died 10 days after the resuscitation from the severe cerebral damage.
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PMID:[Transient thrombus in patent foramen ovale with pulmonary and paradoxical embolization]. 824 45

The necropsy findings of 18 patients with cor pulmonale and coronary heart disease (CHD) were compared with those of a control group of 30 patients with cor pulmonale alone. The results showed that there was no significant statistical difference between the two groups on average heart weight and average left and right ventricular thickness (P > 0.05). The results suggest that at the end stage of cor pulmonale left ventricule may be involved whether there are complicating left ventricular disease or not. In this study, cor pulmonale and CHD were both accurately diagnosed in 33.3%, CHD failed to be diagnosed in 38.9% and cor pulmonale failed to be diagnosed in 27.8% of the patients. Single diagnostic factor analysis for cor pulmonale with CHD indicated that age, history of hypertension, history of angina pectoris, history of MI, accentuation A2, presence of bundle branch block, abnormal Q wave and left axis or normal deviation, Cheng Xiansheng diagostic criteria and Selvester MI screening criteria are of significance (P < 0.05). Multiple factor logistic regression analysis indicated that independent prognostic factors including history of angina pectoris, Selvester MI screening criteria and Cheng Xiansheng diagnostic criteria are of help for diagnosis (P < 0.03-0.000). The above-mentioned diagnostic methods are, however, not so specific. At present the best method for diagnosis of CHD is coronary arteriography.
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PMID:[A clinicopathological study of cor pulmonale with coronary heart disease]. 764 41

The incidence of heart failure in octogenarians is high and its diagnosis not always easy. In many cases it is made by excess or by omission. Obtaining a history is often difficult. Signs may be masked, false or indicative of another disease process. Dyspnea, edema of the lower limbs and crepitations are relatively non-specific. Jugular distension, tender hepatomegaly and a diastolic gallop are much more valuable. Diagnosis of the underlying etiology also raises problems. While hypertension is commonplace and easy to identify, ischemic heart disease is common and often missed. Tight aortic stenosis must be identified since its treatment is surgical. Hypertrophic cardiomyopathy is often an echocardiographic discovery. Post-embolic chronic cor pulmonale, or secondary to chronic obstructive lung disease, must always be considered in the presence of right heart failure without hypertension or chest pain. Appropriate treatment is dependent upon accurate diagnosis.
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PMID:[Difficulties in the diagnosis of cardiac insufficiency in octogenarians]. 782 52

40 Patients with chronic cor pulmonale (CCP) were treated with Feiyaning (FYN), a Yiqi Huoxue compound prescription, and ligustrazine (LT) were reported. The results showed that FYN and LT could lower the pulmonary artery pressure (PAP) significantly; decrease the pulmonary vascular resistance (PVR) as well as the consumption of oxygen in cardiac muscle; increase cardiac output (CO); improve some indices in hemorrheology; while PaO2 and SaO2 didn't change apparently. Moreover, lowering of FYN on PAP and PVR were superior to that of LT. The experimental studies showed that LT and injection of FYN could completely inhibit the hypoxia caused increase of PAP and PVR in rats; reduce the hypoxia caused pulmonary artery hypertension (PAH) and improve PVR of rats, as well as increase CO. The effects of FYN were superior to LT's. Although LT and FYN could decrease systemic arterial pressure to certain extent, they didn't induce systemic artery hypotension. It suggest that LT could reduce PAH definitely.
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PMID:[Clinical and experimental studies of feiyaning in treating pulmonary arterial hypertension in cor pulmonale]. 784 54

Survival after closed-chest ablation of His bundle with DC shock for supraventricular arrhythmias was analyzed for a 10-year period (May 1982-December 1992) with 317 consecutive patients (167 males, 150 females; mean age 66 years; range 33-93 years). Of these, 54 patients died (17.3%) and 5 were lost to follow-up. The mean age at ablation was 70.3 +/- 8.3 years with a range of 49-93 years. Of those who died, the mean survival was 30.5 +/- 28.6 months with a range of 36 hours to 120 months; the diagnosis of heart disease was: hypertension (n = 14), cardiomyopathy (n = 8), ischemic (n = 7), valvular (n = 6), cor pulmonale (n = 3), valvular and ischemic (n = 2), hypertension and ischemic (n = 1), miscellaneous (n = 3), and none (n = 10). Of the patients who died after ablation, the arrhythmias at the time of the ablation were atrial fibrillation (AF; n = 33), sick sinus syndrome (n = 5), atrial flutter (AFL; n = 4), paroxysmal AV junctional tachycardia (PAVJT; n = 4), AF + AFL (n = 4), atrial tachycardia (n = 2), PAVJT + AFL (n = 1), and AF +AFL + atrial tachycardia (n = 1). Death was sudden in 13 patients (25%), due to heart failure in 10 (19.2%), myocardial infarction in 4 (7.7%), stroke in 4 (7.7%), aortic vascular accident in 3 (5.8%), miscellaneous in 18 (34.6%), and undetermined in 2.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term survival after closed-chest His-bundle ablation with DC shock for supraventricular arrhythmias: a 10-year experience with 317 consecutive patients. 784 34

The induction of cardiac effects in hard metal workers is uncertain. This study investigates cardiac function of a group of 31 hard metal workers with or without pulmonary disease. The average duration of exposure to cobalt containing dusts was 10.4 years (range 1-30), while the environmental levels of cobalt exposure ranged from 0.09 to 13.6 mg/m3 Co. Cardiac function has been studied by: ECG (electrocardiogram), exercise test (ET), ECG 24 h according to Holter (ECGH), echocardiogram (ECHO) and radionuclide angiocardiography with 99Tc (RNA). The aims of this work were (i) to show the existence of cobalt myocardiopathy in the workers analyzed and, (ii) to find an early indicator of cardiac dysfunction which could be used in the clinical examination of hard metal workers. Within the group of patients with hard metal lung disease, cases of myocardiopathy of doubtful aetiology have been found. The cardiac indexes obtained through RNA show ventricular dysfunction in healthy hard metal workers which could be a manifestation of initial pulmonary artery hypertension or of an early occult cor pulmonale due to an unknown fibrotic lung disease.
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PMID:Cardiac function study in hard metal workers. 793 94

Swan-Ganz catheterization, blood gas analysis, pulmonary function tests and two-dimensional echocardiography were performed in 10 patients with pulmonary heart disease and the effects of nifedipine were then observed. Mean pulmonary artery pressure (mPAP) correlated significantly to PaO2. PaO2 may be a useful parameter for predicting mPAP. Continuous oxygen breathing can correct hypoxemia, prevent and alleviate pulmonary artery hypertension (PAH). After using nifedipine, PaO2 and blood pressure of systemic circulation decreased significantly, while pulmonary physiological shunt increased and pulmonary artery pressure did not decrease. As a consequence, the use of nifedipine to treat pulmonary heart disease and PAH is not advocated.
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PMID:[Hemodynamic studies of pulmonary heart diseases and the effects of nifedipine]. 804 82

The high prevalence of obstructive sleep apnea (OSA) has only recently been appreciated, in part because the symptoms and signs of chronic sleep disruption are often overlooked in spite of their debilitating consequences. They typically develop insidiously during a period of years. We now know that the lives of millions of people each year are significantly impaired by the sequelae of OSA. Many of these patients go unrecognized, with tremendous medical and economic consequences for individual patients and for society. Evidence indicates that chronic, heavy snoring may be associated with increased long-term cardiovascular and neurophysiologic morbidity. Therefore considerable interest lies in the study of the epidemiology and the natural history of these related disorders. The fundamental problem in OSA is the periodic collapse of the pharyngeal airway during sleep. The pathophysiology of this phenomenon is reviewed in some detail. During apneas caused by obstruction, airflow is impeded by the collapsed pharynx in spite of continued effort to breathe. This causes progressive asphyxia, which increasingly stimulates breathing efforts against the collapsed airway, typically until the person is awakened. Hypopneas predominate in some patients and are caused by partial pharyngeal collapse. The clinical sequelae of OSA relate to the cumulative effects of exposure to periodic asphyxia and to sleep fragmentation caused by apneas and hypopneas. Some patients with frequent, brief apneas and hypopneas and normal underlying cardiopulmonary function may have considerable sleep disruption without much exposure to nocturnal hypoxia. Patients with sleep apnea often have excessive daytime sleepiness. As the disorder progresses, sleepiness becomes increasingly irresistible and dangerous, and patients develop cognitive dysfunction, inability to concentrate, memory and judgment impairment, irritability, and depression. These problems may lead to family and social problems and job loss. Cardiac and vascular morbidity in OSA may include systemic hypertension, cardiac arrhythmias, pulmonary hypertension, cor pulmonale, left ventricular dysfunction, stroke, and sudden death. The challenge for the clinician is to routinely consider the diagnosis and to incorporate several basic questions in the historical review of systems regarding daytime or inappropriate sleepiness. The diagnosis of OSA is made with polysomnography, and the decision to treat is based on an overall assessment of the severity of sleep-disordered breathing, sleep fragmentation, and associated clinical sequelae. The therapeutic options for the management of OSA are reviewed. Recognition and appropriate treatment of OSA and related disorders will often significantly enhance the patient's quality of life, overall health, productivity, and safety on the highways.
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PMID:Obstructive sleep apnea. 814 53

Incidence, type and clinical significance of cardiac involvement in advanced HIV infection was determined in 32 patients (30 men, two women; mean age 34.2 [21-52] years; mean CD4-cell number 52.2 [0-192]/microliters) over a period of 31 months. Any cardiac involvement was assessed diagnostically by one- and two-dimensional and Doppler echocardiography, complemented by other examinations and results of treatment. 14 patients (43.8%) had abnormal cardiac findings, presumably AIDS-associated. This included left ventricular pump dysfunction of various degrees of severity (n = 11), left ventricular dilatation (n = 2), pericardial effusion (n = 11), as well as cor pulmonale in primary pulmonary arterial hypertension (n = 2). In one patient the first manifestation of AIDS was tubercular pericarditis; in two patients there was a likely connection to disseminated pneumocystis infection and toxoplasmosis, respectively. In 11 patients no specific cause was found for the cardiac involvement. Nine of the 14 patients (64%) had symptoms due to the cardiac involvement. These findings indicate that the incidence and clinical significance of cardiac involvement must be taken into account in any treatment concept for AIDS.
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PMID:[Cardiac manifestations in advanced HIV infection]. 818 20


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