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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Smooth muscle proliferation has been recognized as central to the pathology of both major forms of vascular disease: atherosclerosis and hypertension. Recent advances in our knowledge of the mechanisms of control of proliferation suggest that events occurring in adult animals may recapitulate portions of the developmental biology of the smooth muscle cell. This review will consider the current state of knowledge of the mechanisms controlling smooth muscle proliferation in these 2 diseases, put that knowledge into the context of what is known about smooth muscle biology and offer 2 hypotheses as to possible roles of smooth muscle developmental biology in manifestations of atherosclerosis and hypertension in adult humans.
Am J Cardiol 1987 Jan 23
PMID:Replication of arterial smooth muscle cells in hypertension and atherosclerosis. 354 85

Over a 10-year period we encountered 5 infants with a pulmonary artery branch arising from ascending aorta. Surgical re-implantation of this vessel was carried out at ages 2.5, 5, 8, 9, and 19.5 months. Pre-operative cardiac catheterization demonstrated severely raised pulmonary artery pressures in all, equal to systemic in 3, and suprasystemic in 2. Four patients had origin of the right pulmonary artery from ascending aorta with a left aortic arch, and the remaining patient had an anomalous left pulmonary artery associated with a right-sided aortic arch. All patients had substantial reduction in pulmonary artery pressures immediately following surgery. One patient died 18 days post-operatively from extensive lung disease. In all 4 of the survivors, post-operative cardiac catheterization (11 to 85 months after surgery) has shown a drop in pulmonary artery pressures. One patient has been left with mildly elevated systolic values but normal diastolic levels. In 2 of the children, mild stenosis has been found at the site of reimplantation of the pulmonary artery. This anomaly should always be considered as a cause in the setting of a large left to right shunt with tricuspid incompetence and severe right ventricular hypertrophy. Prompt surgical repair, after confirmation of the diagnosis, should prevent death from heart failure or the development of irreversible pulmonary vascular disease.
Int J Cardiol 1987 Sep
PMID:Surgical correction for one pulmonary artery arising from ascending aorta--report of five cases. 365 23

Patients with portal hypertension of varying etiology may develop pulmonary artery hypertension. In the present autopsy study, pulmonary and hepatic tissue was studied in 12 patients in whom pulmonary and portal hypertension coexisted. Plexogenic pulmonary arteriopathy was present in 10 patients, 7 of whom had coexistent thromboembolic lesions. One patient had isolated medial hypertrophy, which may be an early stage in the plexogenic category, whereas isolated thromboembolic pulmonary vascular disease was observed in one subject. Hepatic disease was consistent with alcoholic cirrhosis in seven patients, cryptogenic cirrhosis in four and extrahepatic portal hypertension without cirrhosis in one. Thrombocytopenia was present in all 10 patients whose platelet count was determined. This study suggests that pulmonary hypertension associated with portal hypertension commonly has a plexogenic appearance on histologic examination. However, thrombosis (whether embolic or in situ) may also contribute to vascular obstruction.
J Am Coll Cardiol 1987 Dec
PMID:Coexistent pulmonary and portal hypertension: morphologic and clinical features. 368 Jul 90

Five patients with ventricular inversion, corrected transposition of the great arteries, and atresia of the left-sided atrioventricular (tricuspid) valve have been observed. Three patients died in infancy, two had large interatrial communications, one with an early stage of arterial-type hypertensive pulmonary vascular disease, and the third patient had a very small interatrial communication and severe cyanosis. The other two patients survived into adulthood; both had small interatrial communications, and one had severe venous-type hypertensive pulmonary vascular disease. The longer survival of the two patients is attributed to a balance between resistance and blood flow in the pulmonary circulation influenced by the size of the interatrial communication.
Pediatr Cardiol 1986
PMID:Ventricular inversion and tricuspid atresia (VITA complex): long survival without surgical treatment. 370 90

The goal of banding the pulmonary artery (PA) in children with complex heart disease is to reduce PA pressure and blood flow, relieve symptoms of circulatory congestion, and insure low pulmonary vascular resistance for future repair. To assess the hypothesis that two-dimensional echocardiography (E) measurements could be used to predict noninvasively the tightness of the PA band by measuring its diameter, we examined 15 patients with PA band. Of the 12 patients who underwent cardiac catheterization, nine with no symptoms of circulatory congestion had distal systolic PA pressure less than 0.5 systemic, and three symptomatic patients had distal PA pressure of more than 0.5 systemic. None had left ventricular outflow tract obstruction or pulmonary vascular disease. The E measurements were the internal diameter of the PA band (d), and PA annulus (D) in diastole. The d/D ratios correlated significantly with the ratios of measured distal to proximal PA systolic pressure (r = 0.98, P less than 0.001). Of the three patients not catheterized, one had a d/D ratio of less than or equal to 0.4 and two greater than 0.4. The former one had an excellent clinical improvement after banding, while the latter two remained in circulatory congestion. Doppler echocardiographic evaluation in five patients did not improve upon the data from the d/D ratios.(ABSTRACT TRUNCATED AT 250 WORDS)
Pediatr Cardiol 1986
PMID:Two-dimensional echocardiographic assessment of adequacy of pulmonary artery banding. 372 27

Although the Heath-Edwards classification has been used for more than 25 years to evaluate pulmonary vascular changes, its potential to predict the long-term course after successful ventricular septal defect closure has not been proved. Operative lung biopsy slides obtained at the time of closure from 57 infants and children who had been among the first survivors (between 1954 and 1960) of such surgery were graded in blinded fashion according to the Heath-Edwards classification system, and the resultant biopsy grade of each was compared with the eventual long-term outcome of each child. In 53 (93%) of the 57 cases, the Heath-Edwards system correlated well with long-term clinical or hemodynamic status of the patient. Grade IV changes were predictive of a usually fatal outcome, while grade I and II changes were generally benign. Death from pulmonary vascular disease occurred, however, in four children whose operative lung biopsy had been classified as either grade I or II, indicating that the focal nature of the higher Heath-Edwards grades, or human error, must be considered when this classification system is employed.
J Am Coll Cardiol 1986 Nov
PMID:Predictive value of lung biopsy in ventricular septal defect: long-term follow-up. 376 Mar 84

This study identifies the medical, psychologic and social factors that independently affect employment in patients with coronary artery disease (CAD). At coronary angiography, extensive clinical, psychological and social profiles were collected on 814 men younger than 60 years with documented CAD. Clinical factors studied included measures of symptom severity, prior myocardial infarction, coronary anatomy and left ventricular function. Psychosocial factors studied included the Minnesota Multiphasic Personality Inventory (MMPI), Zung Depression and Anxiety Scales, a type A structured interview, Jenkins Activity Survey and measures of education and social support. Multiple logistic regression analyses were used to assess the relative strength of the relation between these different factors and the patients' employment status. Many single factors differed between the 204 men (25%) who were disabled and the 610 (75%) who were not. Disabled men were less educated but no different in age, marital status or number of dependents. Disabled men had lower ejection fractions and higher indexes of angina, previous myocardial infarction and coexisting vascular disease. Disabled men also were more depressed and anxious and had lower ego strength and higher hypochondriasis scores on the MMPI, but were no different in type A behavior. By multivariable analysis, the most significant (p less than 0.01) independent predictors of work disability were, in decreasing order of importance, low education level, history of myocardial infarction, high levels of depression and high levels of hypochondriasis. It is concluded that psychological and social factors are strongly related to work status in patients with CAD, and may be more important than medical factors.
Am J Cardiol 1986 Nov 01
PMID:Medical, psychological and social correlates of work disability among men with coronary artery disease. 377 48

The advent of ultrasound recording has expanded the capabilities for treatment of the fetus in utero. The diagnosis of specific disease processes has allowed for prenatal intervention by new techniques designed to improve fetal survival. The application of ventricular pacing in a hydropic fetus with complete atrioventricular (AV) block is reported. Complete AV block resulted from maternal collagen vascular disease. The application of ventricular pacing was to allow for further in utero development and for reversal of hydrops fetalis after improvement in cardiac output. Despite fetal death 4 hours after placement of the ventricular pacing lead, this procedure when applied earlier in the development of hydrops may allow for fetal survival. Ventricular pacing was accomplished without apparent trauma to mother or fetus and no evidence of fetal injury was seen at necropsy. Therefore, in the fetus who would otherwise die in utero before the point of viability ex utero, fetal ventricular pacing may be a rational alternative to current observation.
J Am Coll Cardiol 1986 Dec
PMID:Fetal ventricular pacing for hydrops secondary to complete atrioventricular block. 378 46

Lung biopsy specimens from 10 consecutive cases of congenital heart disease and pulmonary hypertension (2 months-6.5 years) were examined by light and electron microscopy. By light microscopy, 8 cases showed a reduction in number of patent alveolar wall arteries associated with the structural features of early pulmonary vascular disease-extension of muscle, a significant increase in pulmonary arterial medial thickness (P less than 0.001) and little if any intimal proliferation (Heath & Edwards Grade I or II). In one additional child with Grade IV disease, arterial number could not be determined accurately. For all 10 cases, all blocks of tissue examined by light and electronmicroscopy showed absence of any lumen in structures identified as alveolar wall arteries by their position, shape and the presence of an external (or single) elastic lamina. In 3 additional similar cases, endothelial cells of narrowed and occluded arteries were marked by labelling with the lectin Ulex europaeus. Occluded arteries were identified consisting of mature smooth muscle cells and remnants of degenerating endothelial cells. Occlusion of alveolar wall arteries appears to be an early event in the development of pulmonary vascular disease, is associated with differentiation of smooth muscle cells in normally thin walled precapillary arteries and precedes significant obliterative intimal changes in more proximal vessels.
Int J Cardiol 1986 Nov
PMID:Occlusion of intra-acinar pulmonary arteries in pulmonary hypertensive congenital heart disease. 379 78

Pulmonary vascular structure was analyzed in lung biopsy specimens taken from 28 children, aged 2 months to 15 years, with transposition of the great arteries and ventricular septal defect. Cellular intimal proliferation occurred in infants as young as 2 months, but it increased markedly between ages 7 to 9 and 10 to 12 months, and the increased obstruction was associated with a lower mean percent arterial medial thickness in patients older than 10 months than was found in younger patients. Early generalized arterial dilation appeared without the intimal fibrosis and dilation lesions characteristic of classical grade III and IV pulmonary vascular disease. Intimal abnormalities increased with age and pulmonary artery pressure, but mean percent arterial medial thickness was inversely related to mean pulmonary artery pressure (r = -0.5; p less than 0.0001). Nine patients survived intracardiac repair and six did not. Five of the patients who died were of similar age (12 months or less), had similar preoperative hemodynamic and pulmonary vascular abnormalities compared with the survivors and died after a clinical course compatible with pulmonary vascular disease. The findings emphasize that potential structural reversibility is not synonymous with "operability." Further studies are indicated on the function of the excessively muscularized pulmonary vascular bed of such infants.
J Am Coll Cardiol 1987 Feb
PMID:Lung biopsy findings in transposition of the great arteries with ventricular septal defect: potentially reversible pulmonary vascular disease is not always synonymous with operability. 380 23


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