Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 56-year-old male patient was submitted to coronary artery bypass graft surgery. Pericarditis and dilatation of the right ventricle with thinning of the walls of the right ventricle was observed. Intraoperative right ventricle biopsy revealed fibro-adipose tissue. The diagnosis of concomitant Uhl's syndrome was made.
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PMID:[Uhl's anomaly in adults associated with coronary disease]. 184 Apr 65

Evidence of acute infarct expansion and the frequency of the acute infarct expansion syndrome (acute infarct dilatation and thinning associated with hypotension and left ventricular failure but no evidence of new necrosis) occurring at two days or more after a first acute Q-wave myocardial infarction were studied using serial two-dimensional echocardiography in 221 consecutive patients (100 anterior, 121 inferior). Patients with symptomatic pericarditis were treated with indomethacin (group 1, n = 73) or ibuprofen (group 2, n = 49) and those without symptomatic pericarditis received neither drug (group 3, n = 99). The overall frequency of the acute infarct expansion syndrome was 13% and 69% of these were among the pericarditis groups. The syndrome was significantly more frequent in group 1 (22%) than group 2 (8%) (P less than 0.05) or group 3 (9%) (P less than 0.025). Serial echocardiograms revealed more expansion with greater percentage increase in the infarct containing segment length in group 1 than group 2 or group 3 (18% versus 9% versus 9%, P less than 0.005). However, the decreases in infarct segment thickness were similar in groups 1 (24%) and 2 (25%) but greater (P less than 0.001) than in group 3 (7%). Despite similar infarct size and infarct thinning in groups 1 and 2, the degree of infarct expansion was greater and the infarct expansion syndrome more frequent in group 1. However, when allowance was made for the potential protective effect of prior use of intravenous nitroglycerin and concomitant use of nifedipine, indomethacin and ibuprofen had similar effects on expansion. Thus, indomethacin or ibuprofen should be used with caution after Q-wave infarction so as to avoid further expansion. The fact that short term use of other drugs might modify infarct remodelling should be considered in studies attempting to assess efficacy of one particular drug.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Myocardial infarct expansion during indomethacin or ibuprofen therapy for symptomatic post infarction pericarditis. Influence of other pharmacologic agents during early remodelling. 256 3

It is difficult to distinguish between restrictive cardiomyopathy and constrictive pericarditis on the basis of clinical findings and simple investigation. Cardiac catheterisation has been the reference standard for diagnosis but even this does not always permit an accurate distinction. A Summagraphics digitiser and Prime 750 computer system were used to digitise the echocardiograms of 15 patients with restrictive cardiomyopathy, 10 with constrictive pericarditis and a group of 20 age and sex matched normal subjects of similar age and sex distribution. Compared with controls, patients with restrictive cardiomyopathy showed a significant reduction in the following variables (a) decreased fractional shortening, (b) decreased peak left ventricular filling and emptying rates, (c) decreased percentage posterior wall thickening, and (d) decreased peak left ventricular posterior wall thickening and thinning rates. Whereas patients with constrictive pericarditis only had significantly reduced peak left ventricular filling and posterior wall thinning rates and significantly increased posterior wall thinning rate. When patients with restrictive cardiomyopathy were compared with those with constrictive pericarditis the significant differences were: (a) decreased peak left ventricular emptying rate, (b) decreased percentage posterior wall thickening, and (c) decreased peak left ventricular posterior wall thickening and thinning rates. Digitisation of M mode echocardiograms, with particular attention to posterior wall function, may be a useful adjunct to cardiac catheterisation in distinguishing restrictive cardiomyopathy from constrictive pericarditis.
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PMID:Restrictive cardiomyopathy and constrictive pericarditis: non-invasive distinction by digitised M mode echocardiography. 291 96

Gated magnetic resonance imaging (MRI) provides excellent anatomic evaluation of the heart, but its capability for assessing cardiac physiology is less clear. Accordingly, regional left ventricular (LV) wall thickening was evaluated by multiphasic transverse images in 37 patients with a variety of myocardial diseases and in 9 normal subjects. Angiography and 2-dimensional echocardiography (2-D echo) were used for comparison. End-diastolic and end-systolic wall thickness, absolute systolic wall thickening and percent systolic wall thickening were determined in 7 regions. Mean systolic wall thickening in normal subjects was not significantly different among the regions. However, there was considerable individual variation in wall thickening, ranging from 18 to 100%. Patients with LV hypertrophy (n = 4), amyloid cardiomyopathy (n = 1), constrictive pericarditis (n = 5), and hypertrophic cardiomyopathy (n = 3) had absolute and percent systolic wall thickening within normal limits. Infarcted segments in patients with ischemic heart disease (n = 17) had reduced absolute and percent systolic wall thickening, often combined with diastolic wall thinning, whereas mean percent systolic wall thickening in adjacent normal myocardial regions was higher than in normal volunteers (p less than 0.001). In patients with coronary artery disease, MRI had a sensitivity and specificity of 93% in detecting regional wall motion abnormalities. Because sagittal images were not acquired, inferior wall motion abnormalities were not assessed by MRI due to parallel wall sectioning in transverse images.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Regional left ventricular wall thickening by magnetic resonance imaging: evaluation in normal persons and patients with global and regional dysfunction. 294 75

The validity of X-ray CT in the functional diagnosis of several cardiovascular diseases was evaluated. CT was useful for assessing the amount and the characteristics of intrapericardial fluid, and it was also useful for the diagnosis of cardiac tamponade and constrictive pericarditis. A dynamic scan was found to be useful for determining the location, direction and the magnitude of intracardiac shunts, and for differentiating the true lumen from the false lumen in dissecting aortic aneurysms. As direct evidence of myocardial infarction, a filling defect in the infarcted area and late enhancement of the same area on delayed scan were noted. Regional wall motion abnormalities could be demonstrated by ECG gated CT, and other findings such as myocardial thinning, ventricular aneurysm and mural thrombi in the infarcted area were documented.
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PMID:Advance of cardiac computed tomography--functional evaluation of the cardiovascular system. 405 36

A diastole is a non specific haemodynamic syndrome which may result from constrictive pericarditis or from a restrictive cardiomyopathy. The aim of this study was to differentiate these two types of condition by analysis of computerised M mode recordings of the left ventricle. Three groups of patients were studied: 5 cases of confirmed cardiac amyloidosis (Am); 5 cases of constrictive pericarditis confirmed surgically (CP) and 10 normal subjects (NL). The study was based on analysis of parameters of ventricular filling and of diastolic thinning of the LV free wall. A significant difference was observed between AM and CP but not between PC and NL. Amyloidosis was characterised by a reduction in the maximum velocity of endocavitary diameter lengthening (AM 0,84 +/- 0,56 cir/sec; PC 3,95 +/- 0,77, p less than 0,01), prolongation of the rapid filling phase (AM 0,42 +/- 0,17 sec; PC 0,16 +/- 0,06 sec, p less than 0,02) and a decrease in maximum velocity of free wall thinning (AM 0,45 +/- 0,23 th/syst/sec; PC 4,79 +/- 2,1, p less than 0,01). The diastolic thickness of the free wall was greater in the amyloidosis group (AM 1,73 +/- 0,61 cm; PC 1,05 +/- 0,21, p less than 0,05) and correlated with the reduction of maximum velocity of free wall thinning. Parameters of global diastolic filling did not distinguish the two conditions. The M mode recordings were therefore digitalised to provide graphs of chamber filling and wall thinning and their derivatives.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Differential diagnosis between constrictive pericarditis and cardiac amyloidosis by computerized M-mode echocardiography]. 643 26

Constrictive pericarditis and restrictive cardiomyopathy are difficult to distinguish at the bedside and occasionally at routine cardiac catheterization. Left ventricular diastolic function was studied by computer analysis of digitized M-mode echocardiograms in four patients with constrictive disease and three with restrictive disease, and the data were compared with those of normal subjects. The respective distinguishing echographic features of constrictive pericarditis and restrictive cardiomyopathy were as follows: the major filling period of the left ventricle was 78 +/- 9% of normal versus 128 +/- 4% (p less than 0.01), minimal left ventricular dimension to peak filling interval was 50 +/- 10 versus 110 ms (p less than 0.05) and the maximal rate of left ventricular posterior wall thinning was -4.9 versus -2.3 seconds-1 (p less than 0.05). This preliminary study suggests that it may be possible to accurately diagnose the two disease entities using this technique at the bedside and to avoid cardiac catheterization.
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PMID:Differentiation of constrictive pericarditis and restrictive cardiomyopathy using digitized echocardiography. 682 63

A 42-year-old male patient, previously in good health, developed signs of pericarditis, pericardial effusion and possible myocarditis 3 weeks after a virus infection of the upper respiratory tract. Because of enlargement of the previously normal cardiac silhouette, an M-mode-echocardiogram was performed. A pericardial effusion and pericardial thickening was diagnosed. Disproportionate septal thickening was noted (septum/posterior wall = 1.4). 3 days after institution of cortisone therapy gradual clinical improvement started. on day 6 a repeat M-mode-echocardiogram showed regression of the pericardial effusion of the septal thickening. Consecutive echocardiograms showed complete disappearing of the pericardial effusion, regression of the pericardial thickening, and complete normalisation of the left ventricular dimensions. Computer-assisted analysis of the first echocardiogram revealed reduced rate of septal and posterior wall thinning and prolongation of the early diastolic period of rapid filling, while peak VCF remained within normal limits. These changes were much less apparent on day 6. On day 26 all relaxation- and contraction parameters were within normal limits. It is concluded that in this case transient disproportionate thickening of the interventricular septum, prolongation of the early diastolic period of rapid left ventricular filling and reduced rate of diastolic septal and posterior wall thinning may have represented edematous and/or inflammatory changes of the myocardium. It is supposed that these findings may represent early changes in acute peri-myocarditis.
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PMID:[Reversible asymmetric septal thickening in the echocardiogram in a case with suspected perimyocarditis (author's transl)]. 726 25

We reported a patient with a saccular ascending aortic aneurysm located just above the non-coronary sinotubular junction. The aneurysm produced severe aortic regurgitation and two episodes of cardiac tamponade. By intraoperative inspection, the border between the aneurysmal wall and non-dilated portion of the normal aortic wall was distinct, and the aortic valve leaflets and aortic annulus appeared normal. Aortic valve dysfunction appeared to be caused by dilation of the noncoronary sinotubular junction and mild distortion of the noncoronary sinus because of the aneurysmal formation. We performed patch closure of the aneurysmal ostium and repaired the dilated noncoronary sinotubular junction. Postoperative echocardiography and aortography demonstrated a good coaptation of the aortic valve leaflets with trivial aortic regurgitation. Although a rupture site, dissection or carcinomatous pericarditis which is attributable to the two episodes of cardiac tamponade could not be found, pathologic examination of the aneurysm wall revealed intramural blood leakage between the mucoid degenerated media and notably thickened adventitia. In addition, there was thinning and interruption of the elastic fibers of the media. These findings are consistent with a leaking aneurysm which cause the slow development of cardiac tamponade.
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PMID:Surgical treatment for a supra sinotubular junctional saccular aneurysm associated with aortic regurgitation. 1022 13

We searched the medical literature for articles containing markers of cardiac ischemia and echocardiography in the evaluation of patients presenting to the emergency department to determine their combined clinical use. Several published articles indicate two-dimensional echocardiography is a useful and cost-effective imaging technique for the evaluation of patients with chest pain in the emergency department. New studies are emerging that evaluate ischemic markers in combination with echocardiography to assess patients presenting to the emergency department with chest pain. We searched the MEDLINE Database for English-language articles published from December 1980 to August 1998 using the key words troponin, echocardiography, myocardial infarction, and emergency. These key words were crossed referenced to determine publications in this area. Pertinent trials and reviews were selected from the database. There were six articles evaluating biochemical markers of ischemia and echocardiography to assess patients presenting with acute coronary syndromes in the emergency department. Very few studies combined the information obtained from novel ischemic markers and echocardiogram analysis to help delineate potential cardiac etiologies of acute coronary syndromes. However, the limited studies available indicate that echocardiography is both sensitive and specific for detecting acute myocardial infarction. The presence of regional wall motion abnormalities increases the chance of in-hospital complications and likelihood of developing congestive heart failure after admission for unstable angina. The combined use of troponin T levels and echocardiographic imaging was a more powerful predictor of adverse events than were isolated results. Myocardial scarring with ventricular wall thinning or aneurysm may allow for rapid diagnosis of 'occult' coronary artery disease in a patient presenting with chest pain who does not have a previous history of a cardiovascular event. Echocardiography may also help identify other cardiovascular causes of chest pain, such as aortic dissection, aortic stenosis, cardiac tamponade, pericarditis, and hypertrophic cardiomyopathy. The clinical use of combining ischemic markers of disease with echocardiographic imaging seems justified given their unique clinical advantages. Future clinical trials are needed to determine whether the combination of novel ischemic markers and echocardiography can provide for a more expedient and accurate diagnosis, resulting in improved patient care and a safe reduction in unnecessary hospitalization.
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PMID:Clinical Use of Ischemic Markers and Echocardiography in the Emergency Department. 1117 40


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