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)

The internal mammary artery (IMA) is increasingly used as a coronary bypass conduit because of better long-term patency and improved prognosis as compared with venous grafts. Previous investigators have suggested that the "steal" of blood flow of the IMA graft via the subclavian artery or a persistent large side branch of the graft may lead to its thinning. However, only a few reports have described the embolization of a large side branch using a transcatheter procedure. We present a case of repeated embolization of a large lateral costal side branch of the left internal mammary arterial graft applying gelatin sponge particles and micro coils, as well as angioplasty to the graft conduit, with resulting easing of chest pain.
Cathet Cardiovasc Diagn 1995 Mar
PMID:Repeat embolization of the side branch of the internal mammary artery graft by gelatin sponge particles and micro coils. 749 94

We wished to determine whether prolonged therapy with the Ca2+ channel blocker verapamil has beneficial structural and functional cardiac effects. Nine hypertensive outpatients [systolic blood pressure (SBP) 164 +/- 4 and diastolic BP (DBP) 103 +/- 4 mm Hg: men and women, blacks and whites, mean age 48.6 years] received 240-480 mg slow-release verapamil (Calan-SR) a day. BP, left ventricle (LV) wall thickness and mass, and mitral flow characteristics on echocardiography, and plasma catechols and renin were determined at 0, 5, 10, and 15 months. Patients were compared with 10 normotensive controls, of similar group composition (SBP 130 +/- 3 and DBP 82 +/- 1 mm Hg; age 47.2 years). In the hypertensive patients, SBP and DBP decreased significantly (p < 0.05), by 14 and 12 mm Hg, respectively, but remained well above that of controls and > 140/90 mm Hg. Diastolic LV septal thickness decreased from 15.3 +/- 0.6 to 14.5 +/- 1.1 mm (not significant), while diastolic LV posterior wall thickness (PWTd) decreased significantly (p < 0.05) from 15.7 +/- 0.6 to 14.1 +/- 0.7 mm after 8 months, but not to the value of the controls. LV diastolic and systolic and left atrial dimensions remained constant. Normalized LV mass, initially 60% greater than the controls, decreased slightly (11%) but nonsignificantly and remained above that of controls. Neither LV mass nor LV posterior wall thinning was correlated with reduction in BP. Patient peak systolic wall stress was initially significantly lower than that of controls.(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Pharmacol 1993 Oct
PMID:Structural and functional myocardial responses to chronic treatment with the Ca2+ blocker verapamil (Calan-SR) in hypertensive patients. 750 68

Manufacturing factors have seldom been implicated as a direct cause of structural deterioration of valvular bioprostheses; this phenomenon has generally been considered to be of a host-dependent origin. We analyzed the clinical and pathologic data from 12 Carpentier-Edwards mitral bioprostheses removed from 12 patients because of severe dysfunction and showing detachment of the porcine aortic wall from the stent in one commissure or more. These 12 prostheses were part of a group of 92 such valves that were explanted and displayed structural deterioration. They belong to a population of 405 Carpentier-Edwards bioprostheses implanted in the mitral position in our institution between May 1978 and November 1988. The patients included three men and nine women with a mean age of 54 +/- 13 years. One patient had a history of chronic renal failure, and two had systemic hypertension. Prosthesis sizes were 29, 31, and 33 mm (n = 4 for each size). The models of the valves were 6625 (n = 8) and 6650 (n = 4). Mean duration of implantation of the prostheses was 99 +/- 27 months (52 to 136 months) and did not differ depending on the model. There was no significant clustering of commissural detachments depending on valve size, year of implantation, or gender of the patient. No similar phenomenon was observed among 76 explanted aortic Carpentier-Edwards bioprostheses with structural deterioration from a population of 441 valves implanted during the same time frame. Native porcine aortic roots (n = 5) and aortic Carpentier-Edwards bioprostheses explanted because of structural deterioration (n = 4) were used as controls for comparison. Macroscopic examination showed single commissural dehiscence in 10 patients and double in two. Radiology disclosed no or mild mineralization in eight valves and no calcium in the area of aortic wall dehiscence, except for heavily calcified valves. Light microscopy evidenced a significant thinning of the aortic wall at the paracommissural level of mitral bioprostheses (351 +/- 68 microns) compared with either aortic bioprostheses (526 +/- 59 microns; p < 0.01) or control native porcine aortic roots (419 +/- 50 microns; p < 0.01). No difference was found in terms of aortic wall thickness between detached (322 +/- 42 microns) and intact (366 +/- 74 microns) commissures in mitral bioprostheses.(ABSTRACT TRUNCATED AT 400 WORDS)
J Thorac Cardiovasc Surg 1995 Sep
PMID:Commissural dehiscence of Carpentier-Edwards mitral bioprostheses. Explant analysis and pathogenesis. 756 35

Ventricular remodeling is a pathologic change in the size and shape of the heart after myocardial infarction. Human and animal studies have described the mechanisms responsible for the thinning and enlargement that progresses for years beyond the initial infarction. As a result of elevations in preload and afterload, ventricular pressures increase, and changes occur in both the infarcted and uninfarcted regions of the ventricle, increasing overall heart size. Recent investigation has demonstrated that the initiation of angiotensin-converting enzyme (ACE) inhibitor drugs after myocardial infarction reduces both systolic and diastolic wall stresses, thereby averting changes in heart size. These findings are significant, as increases in heart size and ventricular volumes have proved to be powerful predictors of early mortality after myocardial infarction.
J Cardiovasc Nurs 1993 Oct
PMID:The role of angiotensin-converting enzyme inhibitors in reducing ventricular remodeling after myocardial infarction. 810 96

We assessed the therapeutic efficacy of a low-dose combination of metoprolol and captopril given orally to C3H/Hej mice that developed dilated and hypertrophied hearts after being inoculated with the encephalomyocarditis virus. Mice were randomly assigned to one of six 8-week oral regimens: 1 mg/kg/day of metoprolol (group 1); 10 mg/kg/day of metoprolol (group 2); 1.2 mg/kg/day of captopril (group 3); 12 mg/kg/day of captopril (group 4); 1 mg/kg/day of metoprolol plus 1.2 mg/kg/day of captopril (group 5); or distilled water (control group). Group 4 exhibited a significantly lower survival rate and body weight than the control group (p < 0.01). Survival rates and body weights were similar in groups 1, 2, 3, 5, and the control group. Low-dose metoprolol plus captopril is superior to low-dose metoprolol, high-dose metoprolol, and low-dose captopril with regard to heart weight and the heart weight/body weight ratio. The left and right ventricular cavity dimensions as well as myocardial necrosis, calcification, and fibrosis were less severe in groups 4 and 5 than in the control group. The left ventricular free wall showed significantly more thinning in group 4 than in the control group (p < 0.01). Our results show that the administration of low-doses of metoprolol and captopril given in combination was effective in this animal model of congestive heart failure and was associated with a reduction in biventricular cavity dimensions and myocardial necrosis.
Cardiovasc Drugs Ther 1993 Nov
PMID:Low-dose combination therapy with metoprolol and captopril for congestive heart failure in mice. 811 Jun 23

Recurrent significant aortic valvular stenosis or regurgitation, or both, after balloon or open valvotomy in pediatric patients often necessitates aortic valve replacement. In an attempt to preserve the aortic valve, we performed extended aortic valvuloplasty in 21 children with recurrent aortic valve stenosis or regurgitation from January 1989 to March 1993. Previous related procedures were one open aortic valvotomy or more (n = 15), balloon valvotomy (n = 4), balloon valvotomy after surgical valvotomy (n = 1), and repair of iatrogenic valve tear (n = 1). Mean age at the time of the extended aortic valvuloplasty was 6 +/- 3.4 years. Mean pressure gradient across the aortic valve was 56 +/- 12 torr. Regurgitation was moderate (grade 2 to 3) in nine and severe (grade 4) in 12 patients. Extended aortic valvuloplasty techniques consisted of thinning of valve leaflets (n = 15), augmentation of scarred and retracted leaflets with autologous pericardium (n = 11), resuspension of the augmented leaflet (n = 14), release of the rudimentary commissure from the aortic wall (n = 5), extension of the valvotomy incision into the aortic wall on both sides of the commissure (n = 20), patch repair of the sinus of Valsalva perforation (n = 1), reapproximation of tears (n = 5), and narrowing of the ventriculoaortic junction (n = 2). No operative deaths occurred. The postoperative mean pressure gradient, assessed by most recent Doppler echocardiography or cardiac catheterization at a follow-up of 18 +/- 6 months, was 19 +/- 6 torr (p < 0.01 versus the preoperative gradient). Aortic regurgitation was absent in 13, mild in 6, and moderate-to-severe, necessitating subsequent aortic valve replacement, in 2. This short-term experience indicates that extended aortic valvuloplasty is a safe and effective surgical approach that minimizes the need for aortic valve replacement in children with significant recurrent aortic valve stenosis or regurgitation.
J Thorac Cardiovasc Surg 1994 Apr
PMID:Extended aortic valvuloplasty for recurrent valvular stenosis and regurgitation in children. 815 34

The prolonged regional contractile failure of reperfused myocardium has usually been characterized in terms of systolic function, while only few reports on its diastolic function are available. None of these studies considered changes in the isovolumic diastole and the subsequent filling phase separately. Therefore, in the present study, the velocities of wall excursion during systole (Vsys), isovolumic diastole (Viso) and filling phase (Vfill) were determined in 12 anesthetized dogs. Additionally, post-ejection thickening (Pejt), a marker of left ventricular asynchrony, was determined. Measurements were performed under control conditions, during a 15 minute left circumflex (LCX) coronary artery occlusion (CAO) and at 10 minutes, 4 and 8 hours reperfusion. Heart rate, left ventricular pressure, and Vsys, Viso, Vfill, and Pejt of the anterior myocardium remained unchanged throughout the experiments. During CAO, systolic wall-thickening of the posterior wall was reversed to systolic wall-thinning. Upon reperfusion, Vsys started to recover (2.5 +/- 3.2 mm/s at 10 minutes) and gradually improved over 8 hours of reperfusion (4.6 +/- 3.2 mm/s at 4 hours, 6.4 +/- 1.5 mm/s at 8 hours). Viso became positive during CAO (9.4 +/- 7.1 mm/s vs. -5.6 +/- 3.9 mm/s under control conditions) and was unchanged at 10 minutes reperfusion (7.9 +/- 5.2 mm/s). After 4 hours and 8 hours of reperfusion, Viso recovered to 1.2 +/- 9.2 mm/s and -0.3 +/- 10.7 mm/s, respectively. Vfill also became positive during CAO (1.5 +/- 6.2 mm/s vs. -18 +/- 8.7 mm/s under control conditions). There was a quick recovery of Vfill (-9.4 +/- 7.5 mm/s) with the onset of reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
Am J Cardiovasc Pathol 1993
PMID:Diastolic dysfunction of stunned myocardium. 830 99

In recent years, the right gastroepiploic artery has been attracting attention as a second reliable arterial graft for clinical application. In this study we measured the postoperative graft diameter of the right gastroepiploic artery and demonstrated the postoperative "thinning down" phenomenon of the right gastroepiploic artery graft. We report on coronary revascularization with the right gastroepiploic artery in 55 cases from December 1989 to July 1991. The properties of right gastroepiploic artery grafts were comparatively examined with the use of postoperative angiographic findings when possible. The results revealed that the patency ratio of right gastroepiploic artery grafts was satisfactory, with an average diameter of 2.1 mm (range 1.2 to 3.5 mm). "String sign" was not observed in these cases, but thinning down was noted in four cases. The thinning down phenomenon of the right gastroepiploic artery had previously been defined as a graft diameter no greater than that of a 5F catheter, with ineffective graft flow; it was termed slender sign. The development of slender sign is caused by good native coronary flow, narrowing of the perfused region, and poor runoff. Three cases of slender sign caused by good native flow had no signs of ischemia in the perfused regions, which was indicative of sufficient blood supply to the myocardium. The long-term patency ratio of right gastroepiploic artery grafts should be evaluated further.
J Thorac Cardiovasc Surg 1993 Jul
PMID:Effect of coronary revascularization with the right gastroepiploic artery. Comparative examination of angiographic findings in the early postoperative period. 832 Sep 93

Suboptimal luminal widening or acute closure secondary to arterial dissection remain significant risks of percutaneous transluminal balloon angioplasty. Non surgical techniques are often employed in an attempt to repair dissections either as temporary or definitive treatment. The aim of this study was to test the hypothesis that radiofrequency thermal balloon angioplasty at an operating temperature of 70 degrees C and low inflation pressure could seal dissections and perforations in a model of severe arterial wall damage. Dissections and perforations were created in renal (n = 4) and carotid (n = 4) arteries in four mongrel dogs. Endoluminal sealing was then attempted with conventional balloon angioplasty or radiofrequency thermal balloon angioplasty (2 atm at 70 degrees C). Contrast dye extravasation persisted in all cases following conventional balloon angioplasty but completely resolved with radiofrequency balloon angioplasty in all but one artery. Histologic examination of the arteries treated with radiofrequency balloon angioplasty showed extensive thermal injury, including transmural coagulation necrosis, flattening of the internal elastic lamina, and medial thinning. On the basis of these results, the utility of thermal balloon angioplasty for endoluminal sealing of dissections and perforations complicating angioplasty deserves further evaluation.
Cathet Cardiovasc Diagn 1993 Jun
PMID:Endoluminal sealing of vascular wall disruptions with radiofrequency-heated balloon angioplasty. 834 5

Pulmonary vascular disease was morphometrically analyzed in 67 patients (mean age, 19 months) with isolated complete atrioventricular canal defect. Complete obstruction of the small pulmonary arterial lumen resulting from acute fibrous proliferation and atrophy of the peripheral arterial media, which were considered absolute operative contraindications, were characteristic in six patients with Down's syndrome. Morphometric analysis of medial thickness revealed that thinning of the media of the small pulmonary arteries is generally observed at around 6 months of age in patients with complete atrioventricular canal defect and that the media in patients who have complete atrioventricular canal defect and Down's syndrome was thinner than that in such patients without Down's syndrome. These results suggest that thinning of the media as a result of two factors--Down's syndrome and aging--facilitates the rapid occurrence of fibrous intimal proliferation. Therefore intracardiac repair is desirable within 6 months of life, before medial thinning, in patients with complete atrioventricular canal defect and Down's syndrome. Excluding patients with absolute operative contraindications, the scores of the index of pulmonary vascular disease in operative survivors were below 2.0 and death occurred when scores were more than 2.2. The pulmonary vascular resistances measured in room air and by the oxygen inhalation and tolazoline tests in patients with operative contraindications were more than 7.3, 3.8, and 6.6 units.m2, respectively. We thus conclude that lung biopsy should be undertaken for patients in whom pulmonary vascular resistance is beyond these values to determine the appropriateness of surgical intervention.
J Thorac Cardiovasc Surg 1993 Sep
PMID:Pulmonary vascular disease and operative indications in complete atrioventricular canal defect in early infancy. 836 Nov 79


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