Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0264733 (ventricular dilatation)
 2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over 200 children with acquired immunodeficiency syndrome (AIDS) have been followed at our institution. We retrospectively evaluated 45 children from the above group. 26 of the 45 children had a pericardial effusion documented at echocardiography and/or at post-mortem examination. This report describes the association of pericardial effusion, myocarditis, and pericarditis in children with AIDS and the implications for imaging. Half of the children with a pericardial effusion had a normal cardiac silhouette on chest radiography. 18 children with a pericardial effusion, had associated cardiac abnormalities. These abnormalities were ventricular dilatation and/or hypertrophy, myocarditis, or pericarditis. The presence of pericardial effusion also correlated highly with pleural effusion and ascites. The presence of a pleural effusion and a pericardial effusion was almost exclusively seen in the children with cardiac abnormalities. Pericardial effusion and cardiac disease should not only be suspected in any child with radiographic signs of cardiomegaly, but be strongly suspected in any child with pleural effusions or ascites, even with a normal cardiac silhouette, especially if they are not responding to conventional medical therapy and their respiratory condition is not improving.
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PMID:Pericardial effusion and its relationship to cardiac disease in children with acquired immunodeficiency syndrome. 149 23

Twenty patients with decreased left ventricular (LV) function and endomyocardial biopsy-proved myocarditis (9 patients) or borderline myocarditis (11 patients) were studied to determine whether these 2 histologic subsets of patients with inflammatory heart disease differed in their response to a 6- to 8-week course of immunosuppressive therapy. All patients received a regimen of prednisone, 1.0 mg/kg/day, and azathioprine, 1.5 mg/kg/day, followed by repeat endomyocardial biopsy and reevaluation of LV function. LV function improved significantly in the group with borderline myocarditis, as assessed by LV stroke work--end-diastolic volume ratio (0.26 +/- 0.17 to 0.54 +/- 0.31 kg.m.ml-1, p less than 0.02), heart rate corrected velocity of circumferential shortening (0.49 +/- 0.30 to 0.80 +/- 0.29 circ.s-1, p less than 0.05), and LV ejection fraction (0.30 +/- 0.15 to 0.47 +/- 0.13, p less than 0.05). LV end-diastolic and end-systolic volume indexes also decreased significantly from 129 +/- 40 to 94 +/- 38 (p less than 0.05) and 90 +/- 37 to 49 +/- 26 ml (p less than 0.02), respectively. No significant change in these indexes of LV function or volume occurred in the myocarditis group. Whereas salutory improvements in cardiac output and filling pressures were found in both groups, objective improvement in LV function assessed by complementary indexes of contractility was greatest in the borderline myocarditis group. It is concluded that short-term immunosuppressive therapy improves LV contractile function and appears to be associated with regression of ventricular dilatation in patients with borderline myocarditis to a greater extent than patients with myocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of immunosuppressive therapy in biopsy-proved myocarditis and borderline myocarditis on left ventricular function. 185 78

The purpose of the study was to assess the prevalence and the type of cardiac abnormalities in patients with HIV infection. Echocardiographic examination (M-mode, two-dimensional and Doppler) was performed in 51 patients (40 male, 11 female), whose mean age was 29 +/- 10 years; 48 of them (94%) were intravenous drug addicts, 3 (6%) homosexuals. Diagnosis was AIDS in 19 (37%) patients, AIDS related complex in 19 (37%) and asymptomatic infection in 13 (26%). Echocardiography was normal in 13 subjects. Pericardial effusion was found in 19 patients (in 8 of them, this was the only cardiac abnormality). Valve vegetations were found in 16 patients (3 of them had pericardial effusion, 5 had ventricular dilatation or wall motion abnormalities, 1 had both pericardial and myocardial impairment). Myocardial dysfunction was found in 18 patients: 11 had left ventricular dilatation (5 with wall hypokinesia), 1 had right ventricular enlargement, 1 had biventricular dilatation and 5 had only wall motion abnormalities (diffuse or localized). During the follow-up 9 patients died: 8 had AIDS, 1 was asymptomatic. Eight subjects died during hospitalization (none because of cardiac causes) and one at home for sudden unexplained death. Echocardiography had displayed myocardial dysfunction in 6 of them, thickened pericardium in 1 and was normal in 2. Pathologic examination (performed in 8 subjects) showed cardiac enlargement in 3 subjects, thickened pericardium in 2 and valve vegetation in 1. One subject had histopathologic diagnosis of myocarditis and 7 had non specific histologic abnormalities. The study shows a cardiac involvement in 75% of HIV infected patients: 35% had myocardial dysfunction, 37% pericardial disease, 31% infective endocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Echocardiographic evaluation of HIV-positive subjects]. 189 21

A 22-year-old man presented with congestive heart failure following flulike symptoms. The diagnosis of acute myocarditis was confirmed by endomyocardial biopsy, which revealed mild infiltration of inflammatory cells. A favorable response to beta-adrenergic receptor blockade was seen, and the patient was discharged without symptoms. Five months later, however, congestive heart failure recurred, and intracardiac thrombi were demonstrated. The patient died after two months. Postmortem examination revealed left ventricular dilatation with slight interstitial fibrosis; the diagnosis was dilated cardiomyopathy. Thus, progression of biopsy-proven myocarditis to dilated cardiomyopathy 10 months after the onset of disease was documented.
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PMID:A case of biopsy-proven myocarditis progressing to autopsy-proven dilated cardiomyopathy. 197 28

There is a complex network of collagen throughout the heart. It is composed of a hierarchy of fibrils and fibers ranging from 10 nm to 2-3 microns in diameter. This network can be broken down by ischemia, adriamycin administration, or disulfide administration in laboratory animals. Following loss due to coronary artery ligation, the ischemic area begins bulging within 3 h. General loss of portions of the collagen matrix is induced by intravenous oxidizing glutathione, and results in marked diffuse ventricular dilatation. Generalized collagen loss in the ventricles, as induced by disulfide administration or adriamycin infusion, persists for 6 months at which time evidence of some replacement is visible, and evidence of diffuse fibrosis is present. In humans, cardiac dilatation occurs in a variety of disease states without overstretch of sarcomeres. This presumes rearrangement of the muscle bundles, which can only occur with marked alterations of the collagen matrix. Ventricular dilatation, associated with viral myocarditis or puerperal cardiomyopathy, may persist for months, suggesting the collagen loss, as with the experimental animals, takes many months to repair. The cardiac dilatation may ameliorate, or, in some patients, deteriorate into heart failure. The animal experiments with loss of the collagen matrix, ventricular dilatation, and failure to replace the matrix for many months provide an explanation for persistent cardiac dilatation in various human diseases.
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PMID:Myocardial connective tissue alterations. 209 Dec 28

Among a total of 634,440 autopsy cases in "The Annuals of Pathological Autopsy Cases in Japan" from 1958 to 1984, 929 cases with nonspecific myocarditis were registered. The average incidence was 0.15%, fluctuating around 3- to 5-year intervals with a remarkable rise observed after 1974. The major complications in cases of myocarditis were pneumonitis, hepatitis or hepatic cirrhosis, pancreatitis, malignancies, lymphatic or thymic involvements. A clinicopathological study of 36 cases of myocarditis and 27 cases of postmyocarditic cardiomegaly indicated a classification of acute, subacute, healing and chronic or recurrent stages as well as dilatation-hypertrophy- and right ventricle-dominant types. Acute myocarditis was characterized by diffuse inflammatory cell infiltration and showed various types of arrhythmias and shock. Subacute myocarditis showed ventricular dilatation, edematous interstitium and severe congestive heart failure. Chronic myocarditis with dilatation and/or hypertrophy and irregular fibrosis included right ventricular involvement, endomyocardial disease, sick sinus syndrome in selected cases, congestive heart failure in most cases, and showed a male predominancy. Postmyocarditic cardiomegaly was similar to chronic myocarditis but showed more hypertrophy, preexcitation waves and prominent negative T waves in electrocardiography and sudden death.
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PMID:Nonspecific myocarditis: a statistical and clinicopathological study of autopsy cases. 252 82

In the Annuals of Autopsy Records for Japan from 1958 to 1977, 377,841 autopsy cases were registered; a short summary of pathologic findings was included. Of the 377,841 cases, 409 (0.11%) were registered as idiopathic, nonspecific, interstitial, or viral myocarditis and 25 cases (0.007%) as giant-cell myocarditis. The annual incidence of the myocarditis varied at 5-year intervals and a remarkable increase was observed after 1974. An analysis of 19 cases of myocarditis and 19 of postmyocarditic cardiomegaly (PMC) showed a preponderance of males. Dilatation of ventricles was found in all cases of acute, subacute, and healing myocarditis, which histologically showed interstitial mononuclear cell infiltration, necrosis, and disarray of myocytes. Hypertrophy with ventricular dilatation, ventricular dilatation without hypertrophy, endo- or epicardial involvement, and right ventricular lipomatosis were found in 70%, 20%, 30%, and 10% of cases with chronic myocarditis and PMC, respectively. In these cases, residual inflammation, fibrosis, and hypertrophy was observed histologically.
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PMID:Myocarditis in autopsy. 295 38

The indications for endomyocardial biopsy were evaluated from 116 consecutive cases. The diagnostic value of this invasive but well tolerated procedure was in agreement with data from the literature. An accurate diagnosis, unforseeable in 8% of the patients, was established in 12%. The diagnosis of apparently primary myocardiopathy with ventricular dilatation was confirmed in 45 out of 59 cases; there were 3 cases of myocarditis, 3 cases of restrictive cardiopathy (haemochromatosis, fibroplastic endocarditis) and 1 case of hypertrophic cardiopathy. No tissue abnormality was noted in 6 cases. An accurate diagnosis was obtained by biopsy in 1 case of "eosinophilic lung" without overt cardiac involvement. In malignant diseases treated with anthracyclines in doses reaching maximal theoretical total dosage (30 patients), severe tissue lesions were present in 10% of the cases, incipient haemochromatosis in 16.6% and subendocardial fibrosis in 3.3%. However, total doses of up to 600 mg/m2 could be administered to 90% of the patients. Myocardial lesions could be demonstrated in 1 of 2 patients with collagen disease. Endomyocardial biopsy therefore seems to be justified in myocardiopathies with ventricular dilatation, in some collagen diseases with a tendency to cardiac involvement and to monitor treatment with anthracyclines in total doses higher than the theoretical maximum dosage.
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PMID:[Right intraventricular biopsy. Indications and results. 116 cases]. 315 91

The clinical characteristics and prognosis of 16 cases of mitral regurgitation (MR) secondary to Kawasaki disease (KD) were studied, and its pathogenesis was discussed. The observation period ranged from 3 years and 17 months to 15 years. Six of the 16 patients died, and 10 are alive. MR has disappeared spontaneously in 2 of these survivors. Thirteen of the 16 patients were male and 3 were female, there being a predominance in male, which is a striking contrast to rheumatic mitral regurgitation which is predominant in females. The age at the time of diagnosis ranged from 3 months to 7 years. The appearance time of MR showed two different patterns, one with early onset within a few weeks to one month after affliction with KD and the other with MR developing months or years later during the course of the follow-up. The cardiothoracic ratio was greater in those who had a progressively downhill course, and whose sigma RV1-6 decreased with time course. This was considered to be due to the decrease of the remaining functioning myocardial mass. The outcome of the patients with a severe degree of coronary arterial stenosis and occlusion observed on the coronary angiogram was poor. The prognosis of the patients with severe left coronary arterial stenosis was especially poor. MR due to KD is regarded as a new clinical entity, and its pathogenesis is thought to be due to ischemia, papillary muscle dysfunction, coronary angitis, myocardial failure and valvulitis. Incidence of MR will increase when examined by Doppler echocardiography especially in the acute stage. Our experience as well as that of others indicates the presence of valvulitis, myocarditis or left ventricular dilatation leading to MR in the acute stage.
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PMID:Mitral regurgitation in Kawasaki disease. 342 45

To investigate the pathogenesis and pathophysiology of dilated cardiomyopathy (DCM), we studied 28 patients with DCM by echocardiography and endomyocardial biopsy, and compared their findings with those of 34 patients including eight with myocarditis, seven with alcoholics, 12 with hypertensives and seven patients with hypertrophic cardiomyopathy. All 12 patients in the hypertensive group had congestive heart failure without accompanying high blood pressure, and prominent dilatation and uniform wall motion abnormality of the left ventricle observed echocardiographically on admission. After medical management, both heart failure and the echocardiographic abnormalities gradually resolved. Those in the alcoholic group had larger left ventricles and uniform wall motion abnormality compared to those in the other groups. The myocarditis and hypertrophic cardiomyopathy groups had smaller left ventricles, non-uniform wall motion and larger % myocardial fibrosis. Both ventricles in the hypertrophic cardiomyopathy group were thicker than those of the other three groups. Each patient with DCM had individual echocardiographic abnormalities, which could be categorized as two subsets depending on the degree of left ventricular dilatation and uniformity of the wall motion. The one was characterized by a prominently dilated left ventricle and uniform wall motion abnormality similar to the alcoholic group, and the other had less marked left ventricular dilatation and heterogeneous wall motion abnormality similar to the myocarditis group. From these findings, it was suggested that there are common factors to specific myocardial disease in the pathogenesis and pathophysiology of DCM, and thus, DCM might include many subsets of different etiologies.
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PMID:[Pathogenesis of dilated cardiomyopathy: a study based on comparison of the clinical features with other related conditions]. 342 22


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