Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The etiology and clinical significance of asynchronous relaxation of the left ventricle during isovolumic relaxation period was studied. Fifty patient with angina pectoris, 50 with myocardial infarction, 40 with normal heart, 20 with mitral stenosis and 10 with mitral prolapse syndrome were investigated. Asynchronous relaxation was observed in the following order: 72% in angina pectoris, 46% in myocardial infarction, 30% in mitral valve prolapse and 10% in both pure mitral stenosis and normal heart. In left anterior descending coronary artery disease, asynchronous relaxation was observed in 80%. Asynchronous relaxation seen before aortocoronary bypass graft to the left anterior descending coronary artery either disappeared or decreased after surgery. The contractility of the site, where asynchronous relaxation was seen, was normal in most cases and akinetic in none. The results of this study suggest the possibilities that asynchronous relaxation is at least partially related to localized myocardial ischemia and that it may be an early phenomenon of the effect of myocardial ischemia. With regard to asynchronous relaxation and hemodynamic alterations, force-velocity lissajous was analysed. Distortion of the lissajous in relaxation phase was seen in 73% who showed asynchrony. This distortion can be interpreted as indication of ununiformity of the left ventricular relaxation.
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PMID:Asynchronous relaxation of the ischemic left ventricle. 697 48

Associated coronary atherosclerosis in patients with rheumatic valvular heart disease is an important finding under prognostic and therapeutic viewpoints. Selective coronary angiography was carried out in 300 patients with rheumatic valvular disease (157 cases with associated mitral and aortic lesions; 57 cases with aortic regkurgitation; 35 cases with aortic stenosis; 31 cases with mitral stenosis, and 20 cases with mitral regurgitation). Significant coronary atherosclerosis occurs in 11 percent of all patients. The distribution of the lesions was as follows: anterior descending artery (56 percent); right coronary artery (47 percent); circumflex artery (28 percent); marginal artery (22 percent); oblique branches (19 percent), and common left trunk (3 percent). Lesions in the common left trunk were only present in association with aortic regurgitation. Fourty-four percent of patients with significant atherosclerosis showed multiple lesions, and there was a distal coronary tree appropriated to coronary bypass in 78 percent of the cases. The distribution of significant coronary lesions in patients with rheumatic valvular heart disease is similar to that observed in patients with ischemic heart disease. The frequent finding, however, of a short common left trunk and/or a left coronary prevalence in patients with aortic lesions is stressed under diagnostic and therapeutic viewpoints.
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PMID:[Distribution of significant coronary lesions in patients with rheumatic valvular heart disease. Study of 300 consecutive cases (author's transl)]. 740 40

Spontaneous coronary artery dissection is a rare disease that occurs most commonly in young people, especially in peripartum or postpartum women. It has rarely been diagnosed during life and has never before been observed associated with any other non-ischaemic heart disease. We report a case associated with mitral stenosis, in which successful valvular and coronary surgery were carried out. We speculate whether rheumatic coronary arteritis was a cause of the dissection.
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PMID:Spontaneous coronary artery dissection in mitral stenosis. 758 35

Although no epidemiological studies are available to evaluate the exact risk of infective endocarditis complicating native cardiac disease, analysis of data in the literature shows that cardiac disease can be classified into three groups of decreasing risk: (1) high risk disease includes cyanotic congenital heart lesions, previous bacterial endocarditis, aortic valve disease, mitral regurgitation and uncorrected left-to-right shunt, but not atrial septal defect; (2) cardiac conditions of moderate risk include mitral valve prolapse with valvar regurgitation or leaflet thickening, isolated mitral stenosis, tricuspid valve disease, pulmonary stenosis and hypertrophic cardiomyopathy; (3) conditions of low or no risk include isolated atrial septal defect, ischaemic heart disease and/or previous coronary artery bypass graft surgery, surgically corrected left-to-right shunt with no residual shunt, mitral valve prolapse with thin leaflets in the absence of regurgitation, and calcification of the mitral annulus.
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PMID:Native cardiac disease predisposing to infective endocarditis. 767 19

This study investigated the changes in treatment procedures for mitral stenosis (MS) and mitral regurgitation (MR) against the background of a decrease in the incidence of rheumatic valvular disease. The study included 3,955 patients with MS undergoing closed mitral commissurotomy (CMC), open mitral commissurotomy (OMC), mitral valve replacement (MVR), or percutaneous transvenous mitral commissurotomy (PTMC) between 1952 and 1991, and 478 patients with MR undergoing MVR or mitral valvuloplasty in the Heart Institute of Japan, Tokyo Women's Medical College. The number of patients with MS undergoing surgical or catheter interventions has decreased and is now about 80 per year, a half of that experienced in the 1960s. CMC and OMC have been replaced by PTMC since the 1990s. The most popular treatment procedure is now MVR. The number of patients with MR undergoing surgery has increased to about 30 per year. Eighty percent of operations for MR are MVR and the others are mitral valvoplasty. Survey of the etiology of MR shows decreased rheumatic disease and increased degenerative disease. The incidence of MR due to ischemic heart disease and hypertrophic obstructive cardiomyopathy has slightly increased.
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PMID:[Change in the treatment procedures for mitral valve disease]. 777 92

The many changes in classification of cardiovascular disease during the twentieth century reflect changing etiology of diseases, clinical comprehension and technological advances. In particular, the etiology of valvular heart disease has changed dramatically in the last five decades. The significant reduction of acute rheumatic fever and its sequelae, and the recognition of non-rheumatic causes of valvular disease are responsible for the metamorphosis in the etiology of valvular disorders. Valvular heart disease can be classified as follows: 1) Heritable-congenital causes of valvular heart disease e.g., floppy mitral valve with mitral valve prolapse, bicuspid aortic valve, and the Marfan syndrome; 2) Inflammatory-immunologic causes such as rheumatic fever, acquired immune deficiency syndrome, endocardial proliferative disorders, and antiphospolipid syndrome; 3) Myocardial dysfunction-ischemic cardiomyopathy, dilated or hypertrophic cardiomyopathy-resulting in valvular heart disease; 4) Diseases and disorders of other organs as causes of valvular heart disease, e.g., chronic renal failure and carcinoid heart disease; 5) Valvular heart disease related to aging: calcific aortic stenosis and mitral annular calcification; 6) Valvular disease following interventions such as valvuloplasty, valve reconstructive surgery and valve replacement; and 7) Valvular disease related to drugs and physical agents, such as chronic ergotamine use, radiation therapy and trauma. In clinical practice the most common causes of mitral regurgitation are floppy mitral valve with mitral valve prolapse, ischemic heart disease, dilated cardiomyopathy and mitral annular calcification, while the most common cause of mitral stenosis is rheumatic fever. The most common causes of isolated aortic regurgitation are bicuspid aortic valve and floppy aortic valve, while the most common causes of isolated aortic stenosis are related to the bicuspid aortic valve and the development of calcific senile aortic stenosis. The most common causes of tricuspid regurgitation are dilated cardiomyopathy, ischemic cardiomyopathy, floppy tricuspid valve with tricuspid valve prolapse and infectious endocarditis. Combined mitral and tricuspid regurgitation occur with heritable connective tissue disorders, dilated or ischemic cardiomyopathy, while the most common cause of mitral stenosis plus aortic regurgitation is rheumatic fever. Statistics obtained from cardiac surgery and necropsy may underestimate the true incidence of certain valvular diseases by selection bias. This is particularly so with valvular disease associated with significant ventricular dysfunction, or in the elderly who may not be surgical candidates, or in cases where the valvular disease is not severe enough to require surgical intervention. Recent advances in hemodynamic and imaging technology allow clinicians to define valvular structure and function and to accurately classify valvular heart disease in clinical practice.
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PMID:Valvular heart disease: the influence of changing etiology on nosology. 800 Jun 16

Although there are no epidemiological studies allowing precise evaluation of the risk of infective endocarditis in given cardiac pathologies, a review of the literature allows classification of different conditions in three groups of decreasing risk: 1: high risk group: cyanotic, congenital heart disease, patients with previous infective endocarditis, aortic valve disease, mitral regurgitation and unoperated left-to-right shunts apart from atrial septal defects; 2: moderate risk group: mitral valve prolapse with myxoid valves or a systolic murmur, mitral stenosis, tricuspid valve disease, pulmonary stenosis, hypertrophic obstructive cardiomyopathy; 3: low or negligible risk: isolated atrial septal defect, operated or unoperated (bypass graft) ischaemic heart disease, operated left-to-right shunts without residual shunt, mitral valve prolapse with normal valve thickness and without a murmur, mitral ring calcification without regurgitation.
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PMID:[Risk of bacterial endocarditis and native heart diseases]. 802 94

Sixty-eight patients with valvular diseases (VD) were subjected to maximal, symptoms limited, exercise testing (ET) using a cycloergometer. The exercise was limited in 82% of the valvular patients by dyspnea attributed to pulmonary capillary pressure rising, even if in the 20 patients with mitral stenosis the relation between the effort intensity and mitral valve area (MVA) (echo) was absent (r = 0.26). Myocardial aerobic impairment (MAI) was absent in 17%, mild in 41%, moderate in 39% and severe in 3% of the patients with VD. It was considered overestimated, the effort being stopped, in 2/3 of the patients, before a heart rate of 85% of maximal heart rate (MxHR) was reached. This suggests that the patients with VD unlike coronary patients, still have a reserve of increasing MVO2 when exercise is stopped. Even in the above condition, the average difference between functional aerobic impairment (FAI) and MAI was 6% for NYHA I, 10.6% for NYHA II and 17% for NYHA III showing a physical deterioration in patients above the limit imposed by the valvular disease itself. ST segment depression of 1 mm or more at 0.08 s after J point was registered in 30% of the patients. Due to the insufficient rise of the heart rate (HR) in the majority (2/3) of the patients with VD, these data probably underestimate the myocardial ischemia. Consequently other stress testings whose main action is not the increase of HR and MVO2 i.e., dypiridamole and adenosine, are preferred in the investigation of myocardial ischemia in the patients with VD.
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PMID:Exercise testing in patients with valvular diseases. 808 7

Between April 1984 and December 1992, 8 patients with concomitant malignant tumor were treated surgically for cardiac disease. The mean age was 58 years (range: 51 to 69), and there were 6 males and 2 females. There were 2 cases of ischemic heart disease, 3 cases of valvular heart disease, and 1 case of atrial septal defect (ASD). Gastric cancer was present in 4 cases, malignant tumor of hepatobiliary tract in 2, rectal cancer in 1, and lung cancer in 1. All patients were operated on in a two-stage fashion. In 6 cases, cardiac surgery including coronary artery bypass grafting (4 patients) and valve replacement (2 patients) were performed with an average of 58 days prior to the tumor resection. The other 2 patients underwent radical operation for a gastric or rectal cancer, followed by cardiac surgery for ASD or mitral stenosis about 2 months later. One patient died of respiratory failure 56 days after lobectomy following coronary artery bypass. There was one late death of local recurrence of rectal cancer 2 years after the operation. In conclusion, good surgical result can be expected with sequential operations for cardiac disease and malignant tumor, if curative resection of the tumor is possible.
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PMID:[Surgical treatment for cardiac diseases in patients with concomitant malignant tumor]. 811 82

In 1990, 95 mitral valves from 54 women and 41 men (mean age, 61 years; age range, 8 to 85 years) were replaced (76%) or repaired (24%) at the Mayo Clinic. Functionally, 58% of the valves were purely regurgitant (MR), 25% were stenotic and regurgitant (MS-MR), and 17% were purely stenotic (MS). Postinflammatory (presumably rheumatic) disease accounted for 100% of MS cases, 92% of MS-MR cases, and 16% of MR cases. Other causes of pure MR included floppy valves (49%), ischemic heart disease (13%), infective endocarditis (9%), miscellaneous (9%), and indeterminate (4%). Thus, postinflammatory disease represented the major cause of both mitral stenosis (MS and MS-MR) and overall mitral valve disease in our surgical population. In contrast, floppy valves were the most commonly observed cause of pure MR. Among postinflammatory valves, 55% were completely excised and 45% had only the anterior leaflet removed; all were replaced. In contrast, floppy valves were incompletely excised in 96%; 67% were repaired and only 33% were replaced. Because mitral valves frequently are incompletely excised, rendering an accurate etiologic diagnosis requires not only a morphologic assessment of resected tissues but also a knowledge of the clinical history, operative details, and functional state of the valve.
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PMID:Evaluation of surgically excised mitral valves: revised recommendations based on changing operative procedures in the 1990s. 827 75


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