Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prognostic value of several functional respiratory and haemodynamic variables was studied in a group of 212 patients with chronic bronchitis, who were examined in steady state, without cardiac or respiratory failure, at rest and when possible during moderate exercise (195 patients). Follow-up interval ranged from 5 to 12 years. Results were processed using two methods: estimation of actuarial survival rate and discriminant analysis. Survival rate curves for the patients showed a reduction relative to the general population of the same ages: 74% within five years compared to 91% in the general population, 56% within nine years compared to 82%. Survival rate was significantly lower in patients with PPA above 30 mmHg, or driving pressure (PPA--PW) above 15 mmHg, or pulmonary vascular resistance higher than 210 dyn . s . cm-5, or when PPA increased more than 10 mmHg during exercise. Discriminant analysis underlined the predictive value of three haemodynamic variables: PPA change from rest to exercise, pressure developed by the right heart (PPA--PRVED) and stroke volume: together, they predict the death of 3 over 4 patients with the criteria chosen.
 ...
PMID:[The prognostic value of haemodynamic tests in chronic bronchitis (author's transl)]. 50 83

Cardiovascular functions were evaluated beat by beat during 29 spontaneous deep breaths in three conscious dogs. When pleural pressure was significantly lower than during quiet breathing, stroke volume was reduced, heart rate elevated, as well as transmural pressure in the pulmonary artery (PPA-Ppl) and in the thoracic aorta (PAO-Ppl); the left ventricular filling pressure (LVEDP-Ppl) did not decrease. The authors suggest that these findings are not consistent with the classical hypothesis which explains the decrease in left ventricular output primarily by a reduction in the venous return to the left heart. The results indicate that the decrease in pleural pressure is responsible for an increase in the afterload on the left heart and suggest that this is the predominate factor in the reduction of the stroke volume without decrease in left ventricular filling pressure.
 ...
PMID:Cardiovascular changes in conscious dogs during spontaneous deep breaths. 117 May 47

Cor pulmonale is present in 54-64% of patients with respiratory failure (mean PaO2: 52-54 Torr) receiving home oxygen therapy in Japan. This may imply that the development of clinical symptoms of cor pulmonale in the course of the disease more strongly reflects far advanced stage than the presence of respiratory failure. In this paper, clinical data from subjects with various forms of precapillary pulmonary hypertension were analysed with respect to correlation between the prognosis and the pulmonary vascular response to various therapeutic modalities such as acute administration of oxygen, vasodilator drugs, and surgery. The results were as follows: 1) In subjects with COPD, there was a significant correlation between mean pulmonary arterial pressure (PPA) and prognosis. Patients who showed decreased pulmonary vascular resistance (% delta PVR less than -10) after 100% oxygen inhalation had a good prognosis. 2) In subjects with sequelae of pulmonary tuberculosis, there was no apparent correlation between the prognosis and % delta PVR after 100% oxygen inhalation. 3) In subjects with both COPD and sequelae of pulmonary tuberculosis, the lowest value of desaturation during sleep was significantly correlated to the PPA during wake. 4) Analysis of 232 cases with primary pulmonary hypertension revealed the following prognostic factors: PPA, cardiac output, stroke volume index, pulmonary vascular resistance, mixed venous oxygen tension, right atrial pressure, total bilirubin, and total protein.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Clinical aspects of precapillary pulmonary hypertension]. 162 93

Right heart overload is one of the most important prognostic factors in patients with chronic lung diseases. To clarify hemodynamic and therapeutic significance of atrial natriuretic peptide (ANP) in pulmonary circulation, plasma ANP concentrations were measured during right heart catheterization (RHC) in patients with chronic lung diseases under static and dynamic conditions. 1) Mixed venous, arterial and venous plasma ANP levels in 45 patients were significantly different one another (p less than 0.01). Significant relationships were also seen between ANP concentrations, and mean pulmonary arterial pressure (PPA; r = 0.85, p less than 0.01), right ventricular systolic pressure (r = 0.91, p less than 0.01), mean right atrial pressure (PRA; r = 0.48, p less than 0.01), and pulmonary vascular resistance (r = 0.84, p less than 0.01). 2) Arterial ANP levels were measured before and after 28% supplemental oxygen inspiration and administration of intravenous aminophylline (5 mg/kg) in patients with chronic obstructive pulmonary disease (COPD). Plasma ANP levels were significantly reduced concomitantly with the reduction of PRA after oxygen, and stroke volume, PRA, pulmonary capillary wedge pressure (Pcw) after aminophylline, respectively. 3) Plasma ANP levels were markedly elevated during both exercise with and without aminophylline (5 mg/kg), but the degree of elevation was significantly less with aminophylline. The reductions of PPA, Pcw and PRA were also observed during aminophylline exercise compared with control exercise, whereas plasma catecholamine levels increased similarly in both studies. These findings suggest that plasma ANP levels reflect the state of right heart load in patients with chronic lung diseases and that its levels are useful to evaluate therapeutic value as for right heart overload.
 ...
PMID:[Hemodynamic and therapeutic significance of plasma atrial natriuretic peptide in chronic lung diseases]. 182 35

Studies of hemodynamics in 22 patients with Fallot's tetrade in the operative and early post-operative periods were analysed. The stroke and cardiac output were studied in all patients as well as the pressure in the cavities of the heart with subsequent calculation of coefficients PRV/PLV, PPA/PRV, and P.P-Q diagrams were constructed to characterize the pathophysiological processes in the heart ventricles. Correction of the anomaly was considered adequate in PRV/PLV less than or equal to 0.6. Coefficient PRV/PLV greater than 0.6 calls for additional analysis for the purpose of identifying residual stenosis or blood dumping at the level of the interventricular septum.
 ...
PMID:[Cardio-hemodynamics in patients with Fallot's tetrad during operative and early postoperative period]. 281 Nov 68

Twenty-eight COPD patients underwent right heart catheterization while in clinically stable condition. Pulmonary vascular response to oxygen was evaluated by the percent change in pulmonary arteriolar resistance after 100% oxygen inhalation (% delta PAR), and its relation to the pressure-flow relationship during incremental exercise was assessed. Mean pulmonary arterial pressure (PPA) during exercise was plotted against the cardiac index (C.I.) from rest to maximal exercise in each patient. In most of the patients, the changes in PPA were nearly linear to the C.I. Therefore, a slope could be obtained from the regression equation in each patient. Patients were divided into two groups according to whether their % delta PAR was greater than 20 defined as a responder (RES), or less than five defined as a non-responder (N-RES). Seven out of 28 patients were RES, nine were N-RES, RES showed a higher %FEV1.0 level, C.I. and stroke volume index (S.I.) at maximal exercise, and a lower level of RV/TLC as well as slope. The slope correlated significantly with %DLCO (r = -0.724, p < 0.01), baseline PAR (r = 0.562, p < 0.01) and % delta PAR (r = -0.522, p < 0.01). These results suggest that the diminished pulmonary vascular bed, and the distensibility of pulmonary vessels, appear to contribute to the steepness of the slope and reduced % delta PAR in patients with COPD.
 ...
PMID:[Relation of pulmonary vascular response to pressure-flow relationship during incremental exercise in patients with chronic obstructive pulmonary disease (COPD)]. 818 42

We examined a relationship between tissue hypoxia and pulmonary hemodynamics or ventilatory capacity during rest and exercise in patients with tuberculosis sequelae. Nine patients performed exercise test until their symptom limit. Mean pulmonary arterial pressure (PPA) during exercise was plotted against cardiac index (C.I.) from rest to maximum exercise in each patient. In most of the patients, the changes of PPA showed linear relation with the C.I., and a slope (P-F slope) was obtained from the regression equation in each patient, and it was used as an index of circulatory disability during exercise. At the same time a coefficient of oxygen delivery (COD) was calculated and mixed venous oxygen tension (PvO2) was measured to evaluate a tissue hypoxia at rest and during exercise. The changes of COD were similar to those of PvO2 during exercise. COD positively correlated with PvO2 (R = 0.873, P < 0.01) from rest to maximal exercise, indicating that the values of PvO2 depended on those of COD. P-F slope negatively correlated with S.I. (R = -0.887, P < 0.01), oxygen transport (R = -0.780, P < 0.01), COD (R = -0.827, P < 0.01) and PvO2 (R = -0.760, P < 0.01) at maximal exercise. Whereas no significant relationship between ventilatory variables and COD or PvO2 was noted at maximal exercise. In conclusion, the patients with pulmonary tuberculosis sequelae who had a step P-F slope showed low mixed venous oxygen tension during exercise as a result of limited oxygen transport in consequence of low stroke volume.
 ...
PMID:[Relation of pulmonary hemodynamics and ventilation to tissue hypoxia during exercise in patients with tuberculosis sequelae]. 867 90

Primary pulmonary hypertension (PPH) is a progressive disease of unknown etiology usually followed by death within 5 years after diagnosis. Although heart-lung or lung transplantation is now offered to patients with advanced PPH, adequate criteria assessing an accurate prediction of life expectancy in PPH has been difficult to establish. The aims of this study were to identify the characteristic features associated with a poor prognosis in patients with PPH, and to attempt to establish an individual prognostic index that predicts with great accuracy survival or death of PPH after one year, thereby helping to define criteria for patient selection for transplantation. In 1991, a retrospective nation-wide survey on PPH was conducted in Japan, and the clinical and cardiorespiratory variables of 223 PPH cases (female; 144, male; 79) in the period from 1980-1990 were obtained. The mean pulmonary arterial pressure (PPA) was 57.5+/-17.2 mm Hg (mean+/-SD), and the overall median survival time was 32.5 months since the first diagnostic catheterization. The characteristic features of 61 patients who died within one year of catheterization (Nonsurvivors group) were compared to 141 patients who survived one year or more from the time of catheterization (Survivors group). Among several clinical and cardiorespiratory variables, heart rate, PPA, right atrial pressure (PRA), stroke volume index (SI), pulmonary vascular resistance, and partial pressure of carbon dioxide (PaCO2) were significantly different between the two groups. As the independent factors, PPA, PRA, SI, and PaCO2 were selected for the multiple logistic analysis. Using a 0.7 probability cut-point to separate Nonsurvivors from Survivors, 84.6% of Nonsurvivors and Survivors could be correctly predicted from this logistic regression equation. Predictive equations like the present preliminary one can be used in the future to better assess life expectancy in patients with PPH in whom transplantation will be considered.
 ...
PMID:Prediction of life expectancy in patients with primary pulmonary hypertension. A retrospective nationwide survey from 1980-1990. 1005 31

The purpose of this investigation was to assess the effects of acute hypoxia on left (LV) and right ventricular (RV) contractility in clinically stable chronic obstructive pulmonary disease (COPD) patients. Eleven male patients (mean age 52.4 +/- 12.6 years) who were diagnosed to have COPD were included into the study. All of the patients underwent left and right heart catheterization. RV contractility was measured according to the method of Ferlinz and LV contractility according to the method of Kennedy and colleagues using indirect digital substraction angiography. Mean pulmonary artery pressures (Mean PPA) and oxygen saturation of the pulmonary artery (SaO2) were measured before and at each stage of graded hypoxic exposure 14%, 12%, and 10% of O2. Right atrial pressures (PRA,syst, PRA,diast, PRA,mean), RV pressures (PRV,syst, PRV,diast, PRV,mean, PRV,end-diast), RV and LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume index (SVI), cardiac index (CI), ejection fraction (EF), and heart rate (HR) were calculated before and after breathing a hypoxic mixture of 10% of O2 for 30 minutes. Acute hypoxia induced significant elevation of mean PPA, PRA,syst, PRA,diast, PRA,mean, PRV,syst, PRV,mean, PRV,end-diast, RV EDVI, RV ESVI, LV EDVI, LV ESVI, confidence interval, and HR (p < 0.05). Whereas SaO2 decreased significantly after acute hypoxia (p < 0.05). These findings suggest that the systolic performance of the right and left ventricles were well-maintained during acute hypoxia in patients with COPD.
 ...
PMID:Effects of acute hypoxia on left and right ventricular contractility in chronic obstructive pulmonary disease. 1804 69

Right hemisphere recruitment of areas homotopical to affected left-sided language areas has classically been described in aphasia following stroke or brain tumors. It may also be a clinically significant mechanism in frontotemporal lobar degeneration (FTLD) and Alzheimer's disease (AD). In a pooled analysis of previous functional magnetic resonance imaging studies of a modified version of the Pyramids and Palm Trees test, we probed the language network in 19 patients with primary progressive aphasia (nine semantic (SV) and ten agrammatic variant; neuropathologically confirmed FTLD in three cases to date), 15 patients with AD (14 clinically probable and one neuropathologically definite AD to date), and 37 healthy controls. The upper and lower bank of the left posterior superior temporal sulcus (STS) was affected in AD and the left anterior temporal pole (ATP) in primary progressive aphasia (PPA; mainly driven by SV). In the right hemisphere, the posterior STS showed an activity increase in both patient groups compared with controls. In AD, this activity increase correlated positively with naming accuracy. Both in AD and in PPA, the connection strength between right STS and right ATP was decreased compared with controls and this correlated with naming and comprehension scores, respectively. Only in PPA did the right anterior temporal pole show an activity increase, which correlated negatively with comprehension. Right-hemispheric recruitment and disconnections within the right temporal lobe may affect the degree of aphasia in cortical neurodegenerative disease.
 ...
PMID:Right hemisphere recruitment during language processing in frontotemporal lobar degeneration and Alzheimer's disease. 2182 94


1 2 Next >>