Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixty-one patients (pts) with sleep apnea (SA), 35 with narcolepsy (N) and 24 with idiopathic hypersomnolence (H) were studied in the Clinical Research Center. The height to body weight ratio was less than normal in SA pts (0.32 +/- 0.01 vs 0.45 +/- 0.01, p less than 0.01), but normal in N and H pts (0.45 +/- 0.02 and 0.45 +/- 0.01, respectively). Twenty-four hour urinary epinephrine (E) plus norepinephrine (NE) was greater than normal (p less than 0.01), but not different among SA, N and H pts. The incidence of mitral valve prolapse (MVP) was greater in N (49%) and H (58%) compared to SA (20%) (p less than 0.01). The ratio of the pre-ejection period to the left ventricular ejection time (PEP/LVET) was abnormal (greater than 0.42) in 36% of the pts with SA and only in one pt with N and H (p = 0.02). The % shortening of the echocardiographic internal diameter (% delta D) was abnormal (less than 28%) in 28% of pts with SA and normal in all pts with N and H (p = 0.02). The incidence of malignant ventricular dysrhythmias (24 hour Holter) was 26% in SA, 3% in N and 4% in H (p = 0.04). Thus, pts with impaired alertness have high adrenergic tone despite evidence for a role of catecholamines in wakefulness. Left ventricular dysfunction, malignant dysrhythmias and obesity are common findings in SA, while MVP is very common in N and H.
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PMID:Anthropometric characteristics, cardiac abnormalities and adrenergic activity in patients with primary disorders of sleep. 658 Mar 72

Symptoms suggesting autonomic instability and increased adrenergic effect were identified in 53 patients with primary disorders of impaired wakefulness. Urine and plasma catecholamine concentrations were significantly increased in patients with sleep apnea. Excessive increases in heart rate during isoproterenol infusions suggested adrenergic hyperresponsiveness as an alternative explanation for symptoms of catecholamine excess in some individuals. Twenty-two patients demonstrated mitral valve prolapse (MVP), implicating primary neurologic disturbances as potential factors in the fatigue and lassitude often associated with MVP. The catecholamine abnormalities may explain some of the difficulties frequently encountered in using stimulants to treat sleep disorders.
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PMID:Adrenergic hyperactivity and cardiac abnormality in primary disorders of sleep. 718 91

Infective endocarditis (IE) has been increasingly diagnosed in patients without previously detected predisposing heart disease, but its clinical features have yet to be fully determined. A recent single-center study including echocardiographic images and surgical findings investigated the incidence of undiagnosed, clinically silent valvular or congenital heart diseases and healthcare-associated infective endocarditis (HAIE). The study confirmed that a large proportion of patients with IE have no previous history of heart disease. Analysis of underlying disease in these patients showed that undetected mitral valve prolapse was the most common disease, followed by an apparently structurally normal valve. The patients who developed IE of apparently structurally normal valves had different clinical characteristics and worse outcomes. IE involving a structurally normal valve was associated with both nosocomial and non-nosocomial HAIE, whereas community-acquired IE was more frequent than HAIE. The pathophysiologic mechanism involving the development of non-HAIE or community-acquired IE due to predominantly staphylococcal infection in an apparently structurally normal valve is not yet clearly understood. Structurally normal valves are not necessarily free of regurgitation or abnormal turbulence and, given the dynamic nature and fluctuating hemodynamic effects of conditions such as poorly controlled hypertension, end-stage renal disease, and sleep apnea, further investigation is necessary to evaluate the potential role of these diseases in the development of IE. An apparently normal-looking valve is associated with IE development in patients without previously recognized predisposing heart disease, warranting repartition of at-risk groups to achieve better clinical outcomes.
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PMID:Infective endocarditis involving an apparently structurally normal valve: new epidemiological trend? 2617 67

Introduction: The revised Ghent nosology presents the classical features of Marfan syndrome. However, behind its familiar face, Marfan syndrome hides less well-known features.Areas covered: The German Marfan Organization listed unusual symptoms and clinical experts reviewed the literature on clinical features of Marfan syndrome not listed in the Ghent nosology. Thereby we identified the following features: (1) bicuspid aortic valve, mitral valve prolapse, pulmonary valve prolapse, tricuspid valve prolapse, (2) heart failure and cardiomyopathy, (3) supraventricular arrhythmia, ventricular arrhythmia, and abnormal repolarization, (4) spontaneous coronary artery dissection, anomalous coronary arteries, and atherosclerotic coronary artery disease, tortuosity-, aneurysm-, and dissection of large and medium-sized arteries, (5) restrictive lung disease, parenchymal lung disease, and airway disorders, (6) obstructive- and central sleep apnea, (7) liver and kidney cysts, biliary tract disease, diaphragmatic hernia, and adiposity, (8) premature labor, and urinary incontinence, (9) myopathy, reduced bone mineral density, and craniofacial manifestations, (10) atrophic scars, (11) caries, and craniomandibular dysfunction, (12) headache from migraine and spontaneous cerebrospinal fluid leakage, (13) cognitive dysfunction, schizophrenia, depression, fatigue, and pain, (14) and activated fibrinolysis, thrombin, platelets, acquired von Willebrand disease, and platelet dysfunction.Expert commentary: Future research, nosologies, and guidelines may consider less well-known features of Marfan syndrome.
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PMID:Features of Marfan syndrome not listed in the Ghent nosology - the dark side of the disease. 3182 51