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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The cardiac status of 102 consecutive black stroke patients entered to the Medunsa Stroke Databank was determined. Cardiological examination, echocardiography and a gated blood pool scan revealed structural and/or functional cardiac abnormalities in 73.6% of patients. Rheumatic heart disease was diagnosed in 15.6%, mitral valve prolapse in 5.8% and mitral annulus calcification in 4.9% of cases. 'Possible' cardiac sources of cerebral embolism were detected in 22.5% and 'definite' sources in 23.5% of patients. Hypertensive heart disease was diagnosed in 35.2% and cardiomyopathy in 13.7% of the study population. Ischaemic heart disease was present in 6.86%. Ultrasonography revealed ventricular bands in 29.4% of patients. The high incidence of structural cardiac abnormalities detected by non-invasive means is in keeping with recent studies in white stroke patients.
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PMID:The cardiovascular status of the black stroke patient. 268 43

Left atrial function in patients with hypertensive heart disease was compared with that in control subjects. In patients with hypertensive heart disease, the time constant of left ventricular relaxation was significantly greater than that in controls (54 +/- 18 vs 31 +/- 16 msec; p less than 0.01). The ratio of left ventricular filling volume before atrial contraction (left atrial reservoir volume/left atrial emptying volume before atrial contraction, and conduit volume/flow volume from the pulmonary vein into the left ventricle) to left ventricular stroke volume was significantly smaller than that in controls (65 +/- 13 vs 76 +/- 7%; p less than 0.05). In patients with hypertensive heart disease, the ratio of reservoir volume to stroke volume was not significantly different from that in controls, while the ratio of conduit volume to stroke volume was significantly smaller than that in controls (43 +/- 13 vs 57 +/- 9%; p less than 0.05). The latter ratio was inversely correlated with the time constant of left ventricular relaxation (r = -0.05, p less than 0.05). In patients with hypertensive heart disease, the ratio of left ventricular filling volume during atrial contraction to stroke volume was significantly larger than that in controls (35 +/- 13 vs 24 +/- 7%; p less than 0.05). The ratio of left ventricular filling volume during atrial contraction to stroke volume had a significant inverse correlation with the ratio of conduit volume to stroke volume (r = -0.84, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Assessment of left atrial function in patients with hypertensive heart disease. 294 77

In the elderly, drug treatment is used for the prevention and control of cardiovascular disease. Prevention of cardiovascular disease includes management of hypercholesterolemia to reduce risk of myocardial infarction, treatment of acute myocardial infarction to reduce the risk of recurrence, and treatment of hypertension to reduce the risk of hypertensive heart disease and stroke. Management of chronic cardiovascular disease with permanent disability is the major therapeutic goal. The most commonly treated disorders of the heart and peripheral vascular system include congestive heart failure, arrhythmias, angina, and thromboses. Reduction of plasma lipid levels may be undertaken by drug therapy as a means of preventing myocardial infarction.
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PMID:Drug and nutrient interactions in elderly cardiac patients. 307 53

A cohort of 1,804 residents of Rochester, Minnesota, who were at least 50 years old, free of stroke, and who underwent examination at the Mayo Clinic in 1960, was followed for 13 years. During this period, there were 110 first ischemic strokes and 616 deaths without stroke. The time of onset, if available, or the time of diagnosis of potential risk factors was determined for all patients during the study and was used to construct a proportional hazards model of time to occurrence of stroke with time-dependent risk factors. The model included 8 risk factors (2 fixed and 6 time-dependent). For these, the individual relative risks are: 1.6 for age (per 10 years), 2.0 for males, 4.0 for definite hypertension, 3.9 for transient ischemic attacks, 2.2 for hypertensive heart disease, 2.2 for coronary heart disease, 1.7 for congestive heart failure, and 1.7 for diabetes mellitus. Atrial fibrillation was not a significant risk factor using time-dependent multivariate analysis.
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PMID:Risk factors for ischemic stroke: a prospective study in Rochester, Minnesota. 367 97

Prenalterol administration (150 micrograms/kg i.v.) exerted beneficial effects on resting and/or exercise cardiac performance in patients with congestive cardiomyopathy (n = 12) and 1 patient with hypertensive heart disease (= group I, n = 13), while the haemodynamic response in patients with severe coronary heart disease (n=3) or cor pulmonale (n = 1) was non-uniform. At rest mean right and left ventricular filling pressures decreased by 26 and 19% (p less than 0.02 and p less than 0.02), respectively, while stroke volume increased by 8% (p less than 0.05), cardiac index by 25% (p less than 0.01) and heart rate by 15% (p less than 0.005) 5 min after prenalterol administration in group I. During exercise there was no further increase in heart rate, while filling pressures decreased and cardiac index increased significantly compared to control exercise. This typical inotropic response to prenalterol was observed in fully digitalised patients. Maximal effects occurred about 15 min after i.v. administration.
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PMID:Effects of i.v. prenalterol in patients with severe cardiac failure at rest and during exercise. 612 97

The hemodynamic and contractile effects of clonidine were studied in hypertrophied hearts of spontaneously hypertensive rats (Okamoto-Aoki strain, SHR). The hemodynamic pattern was characterized by dose-dependent decreases in systolic blood pressure and systolic wall stress, ie, the afterload imposed upon the left ventricle, whereas left ventricular ejection fraction and stroke volume were unchanged. Even at extremely high doses (10(-5)M/L) there was found no depression of isometric tension development and maximum isotonic shortening velocity of the isolated LV papillary muscle. It is concluded that clonidine may be beneficial in hypertensive heart disease, if ventricular unloading associated with a reduction in myocardial energy demand is desired.
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PMID:The role of clonidine in hypertensive heart disease. Influence on myocardial contractility and left ventricular afterload. 621 55

The spontaneously hypertensive rat (SHR) exhibits both a compensated phase of cardiac hypertrophy in which forward output is maintained despite persistently elevated systemic arterial pressures and a decompensated phase in which cardiac performance has deteriorated in spite of further hypertrophic growth. To determine whether chronic antihypertensive therapy prevents the development of heart failure and the progression of cardiac hypertrophy in SHR with advanced hypertension, captopril (2 g/l of drinking water), a converting enzyme inhibitor, was administered to 14 month old female SHR and normotensive American Wistar rats (NWR) for 10 months. The severe left ventricular hypertrophy of the 24 month old untreated SHR (4.37 +/- 0.2 mg/g v. 2.50 +/- 0.06 mg/g, untreated NWR) was markedly reduced (P less than 0.02) by captopril (3.01 +/- 0.1 mg/g). Chronic therapy prevented the reduction of both baseline and maximal cardiac indices in SHR, but did not alter blood flow in NWR. Left ventricular dilatation was present in 24 month old SHR and, as peak stroke volume index was diminished, the ejection fraction index of the SHR was reduced. Captopril restored this index in SHR to normal. The relation of ejection fraction index and afterload (peak systolic wall stress) was depressed in untreated SHR, but was normal in treated SHR. Thus, chronic therapy with captopril prevented the development of severe cardiac dysfunction and produced a marked regression of cardiac hypertrophy in SHR with advanced hypertensive heart disease.
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PMID:Prevention of the development of heart failure and the regression of cardiac hypertrophy by captopril in the spontaneously hypertensive rat. 622 Aug 93

Scanning 3000 cases admitted for rehabilitation after cerebrovascular accident over a 20 year period produced a sample of 1369 subjects, without age restrictions, admitted within six months of a first stroke of thrombotic etiology. In this sample, survival rates showed no significant difference between men and women. Age at onset, however, clearly influenced survival changes; the expected mean survival was 6 years at 40 and 2 at age 80; average loss of life was 14 years for the whole sample, meaning a vital prognosis two to three times worse than that of the general population. At least 86% of the sample presented one or more of five etiological antecedents to stroke: hypertensive heart disease, peripheral vascular disease, diabetes mellitus, myocardial infarction and atrial fibrillation. In 87% of those, HHD and/or PVD were present. Presence of hypertension significantly lowered life expectancy and so did PVD; their influence is felt from the earliest stages. In contrast, diabetes mellitus, the next most common factor, has a late influence, starting about the fifth year after stroke. MI and AF were present in relatively fewer patients, but they contributed towards a considerable decrease in life expectancy, evident from the first stages, the more drastic reduction being observed in the AF group.
Stroke
PMID:Hemiplegics after a first stroke: late survival and risk factors. 665 53

Left ventricular hypertrophy is now recognised to be an important risk factor associated with such adverse cardiovascular events as myocardial infarction, heart failure, stroke and sudden cardiac death. This is true for the general population and those with uncomplicated hypertension. Herein the what, why and how of hypertensive heart disease (HHD) is reviewed: what is it, why does a structural remodelling of the myocardium occur and how can it be prevented on the one hand or regressed on the other. Clinical and experimental studies are presented to address each of these issues.
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PMID:The what, why and how of hypertensive heart disease. 780 96

Oxidative modification of low-density lipoprotein (LDL) cholesterol may contribute to atherosclerosis by several mechanisms demonstrated in vitro. Antioxidants have been shown to inhibit this process in vitro, and there is evidence from animal studies that they protect against atherosclerosis in vivo. The results of human studies examining the association between antioxidants and cardiovascular disease (coronary heart disease, hypertensive heart disease, and stroke) have been equivocal, although evidence is accumulating that suggests a beneficial effect. Recently, monounsaturated fatty acids incorporated into LDL have been shown to be resistant to oxidation in vitro, compared to polyunsaturated fatty acids. Results from short-term clinical studies are consistent with this finding, as are some epidemiologic data, which suggest that diets containing monounsaturated fatty acids are associated with decreased mortality from cardiovascular disease. The overall roles of antioxidants and particular fatty acids in preventing atherosclerosis require further elucidation.
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PMID:Antioxidant status, fatty acids, and cardiovascular disease. 802 72


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