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

35 patients, of them 10 with aortic stenosis, 7 with idiopathic hypertrophic subaortic stenosis, 6 with asymmetric septal hypertrophy, and 12 with systemic hypertension were examined with the aim of a pathophysiological differentiation of various hypertrophic cardiopathies. The authors' own ECE digital echocardiographic system was used. The results attest to an abnormal diastolic function in hypertrophic cardiopathies. At the same time, the diastolic compliance is less affected in symmetric cardiopathies, even in their more advanced clinical stage, than in asymmetric ones.
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PMID:Some aspects of the pathophysiology of hypertrophic cardiopathies. An echocardiographic computerized study. 668 54

We investigated left ventricular (LV) function in 40 patients (pts) with hypertension (HT), 16 pts with hypertrophic cardiomyopathy (HCM), 3 pts with ASH and HT and in 27 control subjects by M-mode echocardiography using supine exercise (50 watts, 3 minutes). The hypertensive subjects were echocardiographically divided into three subsets; the normal LV (17 cases), the hypertrophied LV (17 cases) and the dilated LV (6 cases). Similarly, pts with HCM were echocardiographically and cineangiographically divided into three subsets; ASH (asymmetric septal hypertrophy, 6 cases), APH (predominant apical hypertrophy, 6 cases) and DFH (diffuse left ventricular hypertrophy, 4 cases). Changes of left ventricular dimension Controls and HT: Stroke volume was increased during exercise in the controls, normal LV and hypertrophied LV groups by decreasing LV end-systolic dimension ( LVDs ), but it was increased in dilated LV group by increasing LV end-diastolic dimension ( LVDd ) (Frank-Starling mechanism). LVDd was increased transiently in the controls and normal LV group during recovery, but its grade and duration were more pronounced in the latter. LVDd did not change significantly in hypertrophied and the dilated LV groups. HCM: LVDd and LVDs did not change significantly during exercise in all 3 groups. LVDd was increased transiently during recovery in ASH group, but not in the other groups. Changes of peak velocity of circumferential fiber shortening (VCF) and the ratio of peak systolic blood pressure to LV end-systolic volume (PSP/ LVVs ). Controls and HT: Peak VCF was increased during exercise most markedly in the normal LV group, but it was not increased in the dilated LV group. PSP/ LVVs was increased significantly during exercise in the controls, the normal and hypertrophied LV groups, but not in the dilated LV group. HCM: Peak VCF showed a significant increase during exercise in ASH group, but not in the other two groups. Changes of the D/S ratio. The ratio of systolic to diastolic velocity of the LV posterior wall was expressed as a D/S. This ratio did not change significantly in the controls, HT and APH groups, but it was decreased significantly in ASH and DFH groups. LV end-systolic wall stress and LVDs relationship ( ESWst - LVDs ).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Exercise echocardiography in different types of hypertension classified by left ventricular geometry; comparison with hypertrophic cardiomyopathy]. 668 25

Thirty eight acromegalic patients (A) and a control group (C) of subjects without heart disease, were studied with echocardiography. Acromegalies were divided in two groups, A1 and A2, who had increase or normal serum growth hormone (GH) levels respectively after treatment (pituitary adenectomy and/or bromocriptine), at the time of the study. In acromegalic patients (A) mean left ventricular (LV) dimensions were normal while LV wall and septal thickness, LV mass and left atrial (LA) dimension were increased compared to control subjects. LVH was present in 79% of acromegalic patients. Asymmetric septal hypertrophy (ASH) was found in 10,5% of our patients. In group A1, IVS, LVPW, LVMM/m2 were significantly increased as compared to group A2. Fractional shortening (FS), ejection fraction (EF), mean velocity of circumferential fibre shortening (Vcf), frequency-normalized Vcf (Vcfn), posterior left ventricular wall velocity (PWV), and normalized PWV (PWVn) were normal in both groups. In patients with active acromegaly (Al) IVS and LVMM/m2 correlated well with the total duration of the disease (r=0.550 p less than 0.01 for IVS; r=0.624 p less than 0.01 for LVMM/m2) and with the duration of acromegaly before treatment (r=0.568, p less than 0.01 for IVS; r=0.500 p less than 0.01 for LVMM/m2). Furthermore a positive correlation was found between IVS and GH levels (r=0,550 p less than 0.01). Concomitant coronary artery disease and or hypertension did not seem to play any role in causing the above mentioned echocardiographic changes. Echocardiography is useful in assessing the cardiac involvement in patients with acromegaly.
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PMID:[Acromegalic cardiomyopathy: an echocardiographic study]. 688 53

Cardiovascular complications are very common in uraemic patients on regular dialytic treatment and are often the cause of death. In these patients many echocardiographic studies have been carried out to establish the presence of cardiac alterations. In particular some M-mode echocardiographic investigating have shown a significant incidence of asymmetric septal hypertrophy (ASH), but often the patients had associated cardiomegaly or arterial hypertension. In the present paper M-mode echocardiogram and carotid pulse tracing were recorded after dialysis in 23 normotensive long-term hemodialyzed patients. The aim of the study was to detect the incidence of ASH and to assess the functional behaviour of the left ventricle in relation to the presence of the septal abnormality. ASH as ratio of interventricular septal to posterior wall thickness (IVS/PWT) of 1.3 or greater, without systolic anterior motion of anterior mitral leaflet (SAM), was found in 52.1% of patients. The group with ASH showed an obvious reduction of the cardiac index (CI), after dialysis, due to reduction of left ventricular size and to the abnormal septal function. CI was normal in patients without ASH. On the other hand the presence of ASH did not significantly influence the percentage of fractional shortening (FS%), the velocity of circumferential fiber shortening (Vcf) and the ejection fraction (EF%) which were similar in both groups of patients. A long-term echocardiographic follow-up of these patients may be important to outline the natural history of ASH and to evaluate its relation to chronic renal failure on hemodialytic treatment.
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PMID:[Asymmetric hypertrophy of the intraventricular septum in normotensive patients with chronic uremia during hemodialysis therapy. M-mode echocardiographic study]. 689 53

Cardiac function was evaluated by echocardiography (echo) in ten paediatric patients, 2.5 to 15 years of age, maintained on chronic dialysis. All had moderate to severe hypertension despite intensive antihypertensive medication. Four of ten patients showed, on echo, asymmetric septal hypertrophy (ASH) typical of hypertrophic cardiomyopathy (HCM). Two also had signs suggestive of outflow obstruction. Primary cardiomyopathy was excluded by a family survey of first-degree relatives. The incidence of HCM in our series is impressive (40%). The pathogenesis of this cardiac lesion in uraemia is unknown; long-standing severe hypertension may play a role. Early recognition of this form of cardiomyopathy has important clinical considerations. Echo should become a routine examination in the diagnosis, follow-up, and treatment of children with end-stage renal disease.
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PMID:Hypertrophic cardiomyopathy in children with end-stage renal disease and hypertension. 719 48

New clinical concept of "secondary atypical hypertrophy" was proposed for hypertrophic cardiomyopathy (HCM) associated with an acquired risk factors such as hypertension, strenuous exercise, etc, based on the following findings. 1) Case-control study suggested that history of hypertension, physical labor and weight gain were thought to be risk factors of apical hypertrophy. History of hypertension was also demonstrated in 55% of older cases of HCM (greater than 35 yrs) with asymmetric septal hypertrophy, and this figure was appreciably higher than that in general population (around 26% in our population survey). Thus hypertension was suggested to have a causal relationship to HCM as an important risk factor in older cases. 2) Even in cases without hypertension, 29% of non-obstructive HCM exhibited a marked increase in systolic blood pressure on bicycle ergometer stress test, suggesting an important of transient hypertension during exercise as a risk factor of unusual hypertrophy. 3) The cases of HCM with definite family history and the cases of HCM with secondary atypical hypertrophy, with acquired risk factors such as hypertension, presented different clinical features. The latter is older and predominant in males. In the former, QRS pattern was les distorted, suggesting milder congenital defect of the myocardium. Left ventricular function was less impaired in cases with secondary atypical hypertrophy if judged from diastolic descent rate of the mitral valve, left ventricular enddiastolic pressure and functional aerobic impairment (FAI). On the other hand, no differences were observed between cases with ventricular septal hypertrophy and left ventricular outflow obstruction. 4) Follow-up study demonstrated rather favorable prognosis in cases with secondary atypical hypertrophy because of the absence of sudden death despite of their older age. These distinctive difference in clinical features, prognosis and then management in cases with HCM with acquired risk factors suggested a validity of the concept of secondary atypical hypertrophy in clinical practice.
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PMID:[Secondary atypical hypertrophy: hypertrophic cardiomyopathy with acquired risk factors (author's transl)]. 720 89

The majority of hemodialysis patients die from cardiovascular disease. However, the contribution of myocardial infarction to mortality is relatively minor, despite the fact that coronary artery disease is common in uremic patients. Hypertension seems to be the major risk factor for the development of atherosclerosis in hemodialysis patients, although abnormalities of the lipid spectrum, characterized by an increase in triglycerides and very low density lipoprotein levels and a decrease in high-density lipoprotein levels, are frequent in hemodialysis patients. The existence of left ventricular (LV) hypertrophy is a serious risk factor for morbidity and mortality in hemodialysis patients. LV hypertrophy can present as a dilated cardiomyopathy or as concentric or asymmetric septal hypertrophy. Loss of myocardial contractility by coronary artery disease or carnitine deficiency can lead to systolic LV dysfunction with a compensatory dilated cardiomyopathy. Furthermore, the presence of a hypercirculation in uremic patients, resulting from anemia, the arteriovenous fistula, or fluid overload, can also lead to a dilated cardiomyopathy. Systolic LV dysfunction occurs when the increase in LV wall thickness is inadequate for the increase in LV radius, which might be caused by increased levels of parathyroid hormone. LV diastolic dysfunction, resulting from an increase in LV mass due to the effects of hypertension or to uremic interstitial fibrosis, can both lead to pulmonary edema and hypotensive periods during hemodialysis and is a severe risk factor for mortality in hemodialysis patients. Therefore, in uremic patients, anemia should be corrected and hypertension adequately treated early in the development of renal failure. Chronic fluid overload should be prevented by adequate estimation of optimal dry weight.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cardiovascular aspects in renal disease. 792 20

Cardiovascular problems have long been recognized as responsible for an increased morbidity and mortality in patients with acromegaly. The aim of the present study was to evaluate echocardiographically the prevalence of cardiomyopathy in a cohort of acromegalic patients and to analyze the results in relation to demographic, clinical and hormonal data. This study, a retrospective controlled clinical trial, was performed in 25 acromegalic patients, 12 men and 13 women aged 26-66 years (mean: 52.6). Fifteen patients had an active disease, 10 were cured by previous pituitary surgery. The same echocardiographic parameters were analyzed in 50 healthy subjects aged 30-70 years (mean: 51.4). Serum GH was determined on at least 4 samples drawn over 24 hours and plasma IGF-I on a single point. Standardized parameters of diastolic and systolic function were evaluated by real-time Doppler echocardiography. Twelve patients with active acromegaly underwent also 48-hour ECG registering. Left ventricular (LV) hypertrophy was found in 14/25 patients (56%). No difference was found between patients with active disease (53%) and patients with cured acromegaly (60%). LV mass index was significantly increased in acromegalics in comparison with healthy subjects (137 +/- 43 g/m2 vs 96 +/- 16 g/m2, p < 0.01) and also the indices of LV diastolic function were significantly impaired. Asymmetric septal hypertrophy was found only in one patient. Hypertension was detected in 9/25 patients (36%) without difference between patients with active or cured disease (40% vs 30%, NS). No significant correlation was found between hormonal or clinical data and echocardiographic findings. During Holter monitoring, heart rate of acromegalics was not significantly different from that of controls (78 +/- 12 bpm vs 72 +/- 10 bpm, NS) and only isolated supraventricular or ventricular premature complexes (Lown class 1) were detected. In conclusion, this study provides evidence of subclinical LV dysfunction in acromegaly in the absence of other known causes of heart disease and no significant difference in echocardiographic pattern was apparent between active or cured acromegalics.
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PMID:Doppler echocardiographic patterns in patients with acromegaly. 865 20

1. Using three strains, which showed severe hypertension, mild hypertension and normotension, respectively, the relationships between electrolytes or trace elements and vascular complications combined with the factor of ageing were investigated. 2. In ash materials of some tissues old female SHRSP and old WKY showed a decrease of selenium in many tissues when compared to adult female SHRSP and WKY, respectively. 3. In cellular supernatant fraction, SHRSP showed a decrease of magnesium in many tissues and an elevation of the calcium to magnesium ratio when compared to age-matched WKY and SHRSR. 4. In diabetic rats induced by streptozotocin, myocardial magnesium decreased, resulting in an elevation of the myocardial calcium to magnesium ratio. 5. Alpha tocopherol concentration was lower in both the myocardium and cerebrum of old female SHRSR when compared to that of adult female SHRSR. 6. From these findings the elevation of calcium to magnesium ratio was found in old rats and SHRSP, indicating the tendency of tissue deterioration in these rats. 7. Tissue selenium also decreased in old rats and SHRSP and this decrement was probably related to the peroxidation in tissue damage.
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PMID:Magnesium, calcium and trace elements in spontaneously hypertensive rats. 907 61

Many epidemiologic reports associate ambient levels of particulate matter (PM) with human mortality and morbidity, particularly in people with preexisting cardiopulmonary disease (e.g., chronic obstructive pulmonary disease, infection, asthma). Because much ambient PM is derived from combustion sources, we tested the hypothesis that the health effects of PM arise from anthropogenic PM that contains bioavailable transition metals. The PM samples studied derived from three emission sources (two oil and one coal fly ash) and four ambient airsheds (St. Louis, MO; Washington; Dusseldorf, Germany; and Ottawa, Canada). PM was administered to rats by intratracheal instillation in equimass or equimetal doses to address directly the influence of PM mass versus metal content on acute lung injury and inflammation. Our results indicated that the lung dose of bioavailable transition metal, not instilled PM mass, was the primary determinant of the acute inflammatory response for both the combustion source and ambient PM samples. Residual oil fly ash, a combustion PM rich in bioavailable metal, was evaluated in a rat model of cardiopulmonary disease (pulmonary vasculitis/hypertension) to ascertain whether the disease state augmented sensitivity to that PM. Significant mortality and enhanced airway responsiveness were observed. Analysis of the lavaged lung fluids suggested that the milieu of the inflamed lung amplified metal-mediated oxidant chemistry to jeopardize the compromised cardiopulmonary system. We propose that soluble metals from PM mediate the array of PM-associated injuries to the cardiopulmonary system of the healthy and at-risk compromised host.
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PMID:Bioavailable transition metals in particulate matter mediate cardiopulmonary injury in healthy and compromised animal models. 940 Jul


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