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At least 235 records · Page 13Linked to original sources
PubMed1993

A patient with cardiac amyloidosis presenting a rapid increase in technetium-99m-hydroxymethylene diphosphonate accumulation.

We assessed the changes in cardiac condition in a patient with cardiac amyloidosis, by means of dual nuclei single photon emission computed tomographic (SPECT) images with technetium-99m-hydroxymethylene diphosphonate (99mTc-HMDP) and thallium-201 (201Tl). Dual SPECT showed a marked increase in myocardial 99mTc-HMDP accumulation along with deterioration of symptoms and signs, while 201Tl scintigraphy remained almost unchanged.

Aged↗
PubMed2004

Hypertrophic cardiomyopathy: from "heart tumour" to a complex molecular genetic disorder.

Hypertrophic cardiomyopathy (HCM) is a disorder which has fascinated clinicians for many years. The remarkable diversity in clinical presentations, ranging from no symptoms to severe heart failure and sudden cardiac death, illustrates the complexity of this disorder. Over the last decade, major advances have been made in our understanding of the molecular basis of several cardiac conditions. HCM was the first cardiac disorder in which a genetic basis was identified and as such, has acted as a paradigm for the study of an inherited cardiac disorder. At least eleven genes have now been identified, defects in which cause HCM. Most of these genes encode proteins which comprise the basic contractile unit of the heart, i.e. the sarcomere. Genetic studies are now beginning to have a major impact on diagnosis in HCM, as well as in guiding treatment and preventative strategies. While much is known about which genes cause disease, relatively little is known about the molecular steps leading from the gene defect to the clinical phenotype, and what factors modify the expression of the mutant genes. Concurrent studies in cell culture and animal models of HCM are now beginning to shed light on the signalling pathways involved in HCM, and the role of both environmental and genetic modifying factors. Understanding these basic molecular mechanisms will ultimately improve our knowledge of the basic biology of heart muscle function, and will therefore provide new avenues for diagnosis and treatment not only for HCM, but for a range of cardiovascular diseases in man.

Journal Article↗
PubMed1994

Effects of insertion depth and use of the sidearm of the introducer sheath of pulmonary artery catheters in cardiac output measurement.

OBJECTIVE: To investigate the effects of various insertion depths and sidearm functions of the introducer sheath of pulmonary artery flotation catheters on cardiac output measurement. DESIGN: Prospective, randomized, crossover study. SETTING: A general intensive care unit. PATIENTS: Ten patients who had a pulmonary artery flotation catheter placed in the right internal jugular vein as part of their clinical management. INTERVENTIONS: Cardiac output was measured at three insertion depths of the pulmonary artery catheter, each with a different rate of flow into the introducer sheath. MEASUREMENTS AND MAIN RESULTS: Significant differences of up to 23% occurred in the measurement of cardiac output under the various conditions. Cardiac output measurement is greater, the closer the injection port lies to the introducer sheath and the more open the introducer sheath sidearm. CONCLUSIONS: All users of pulmonary artery catheters should be alert to this problem. For reliable measurements of cardiac output by thermodilution, the cold saline injection port of the pulmonary artery catheter must be downstream of the introducer sheath, and the introducer sidearm must be closed.

Adult↗
PubMedDate not supplied

Delayed enhancement MR imaging: utility in myocardial assessment.

Use of magnetic resonance (MR) imaging for diagnosis of cardiac diseases and treatment monitoring is expanding. Delayed myocardial enhancement MR imaging is performed after administration of paramagnetic contrast agents and is used for a growing number of clinical applications. This technique was developed primarily for characterization of myocardial scarring after myocardial infarction. On delayed enhancement MR images, scarring or fibrosis appears as an area of high signal intensity that is typically subendocardial or transmural in a coronary artery distribution. However, delayed myocardial enhancement is not specific for myocardial infarction and can occur in a variety of other disorders, such as inflammatory or infectious diseases of the myocardium, cardiomyopathy, cardiac neoplasms, and congenital or genetic cardiac conditions, as well as after cardiac interventions. In nonischemic myocardial disease, the delayed enhancement usually does not occur in a coronary artery distribution and is often midwall rather than subendocardial or transmural. Therefore, the patient's clinical history is critical in the evaluation of delayed myocardial enhancement MR images.

Cardiomyopathies↗
PubMed1994

Cytoprotective effects of nicorandil on hypothermic injury to immature cardiac myocytes--comparison with nitroglycerin, diltiazem and prostaglandin E1.

The purpose of this study was to evaluate the functional and biochemical effects of nicorandil (NRD), nitroglycerin (NTG), diltiazem (DTZ) and prostaglandin E1 (PGE) on cardiac myocytes incubated under hypothermic conditions. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for 4 days with MCDB 107 medium. Myocytes (12.5 x 10(5) myocytes/flask) were then incubated at 4 degrees C for 24 h in media containing various concentrations of NRD, NTG, DTZ or PGE. After hypothermic incubation, creatine kinase (CK) and lactate dehydrogenase (LDH) were measured. The myocytes were cultured for an additional 24 h at 37 degrees C to evaluate the recovery of myocyte beating rate. In the nicorandil groups, 10(-4) M NRD showed a significantly increased beating rate recovery compared to the control (44% vs 25% respectively, as a percentage of the baseline values; i.e., beating rate prior to hypothermic incubation). Although treatment with 10(-6) M diltiazem showed no beneficial effects (10(-6) M; 25%, control; 30%), beating was not observed at all with 10(-4) M or 10(-5) M DTZ. There were no significant changes among the NTG and PGE groups. The release of CK and LDH was significantly suppressed with 10(-4) M NRD (10(-4) M: 24.1 mIU/flask, 257.2; control: 125.4, 459.5, respectively). In contrast, 10(-4) M DTZ showed significantly increased CK and LDH levels compared to its respective control (10(-4) M: 203.3 mIU/flask, 883.4; control: 112.3, 457.4, respectively). There were no significant differences in CK and LDH levels among the NTG and PGE groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Alprostadil↗
PubMed1993

[Experimental procedure for evaluation of myocardial protection using cultured cardiac myocyte--functional and biochemical effects of hypothermic preservation].

The purpose of the present study was to evaluate the functional and biochemical effects on cardiac myocytes cultured under hypothermic conditions. Cardiac myocytes were isolated from neonatal rat ventricles by collagenase dispersion and cultured for 4 days with MCDB 107 medium containing 2% FCS. Thereafter, the myocytes (12.5 x 10(5) myocytes/culture flask) were incubated at 4 degrees C for 6, 12, 18, 24, 36 or 48 hours. After each incubation, CPK and LDH were measured. The myocytes were then cultured for additional 24 hours at 37 degrees C to evaluate the recovery of myocyte beating rate. The recovery ratio of myocyte beating rate was well maintained at 6 and 12 hours (94.5, 103.4 percent of control: ie, beating rate prior to hypothermic incubation, respectively). Thereafter, the recovery ratio significantly decreased at 18 hours (58.4 percent, p < 0.05), and reached null levels at 48 hours. Release of CPK and LDH increased significantly at 18 hours (CPK: 131.8 mIU/flask, p < 0.05; LDH: 356.0 mIU/flask, p < 0.05), and showed a marked increase at 48 hours (CPK: 961.3, LDH: 1729.5). In addition, the CPK and LDH levels did not significantly increased at 37 degrees C for 48 hours compared to those for 6 hours (6 hours: 7.95, 193.7; 48 hours: 13.5, 199.4, respectively). In summery, 4 degrees C hypothermia induced the myocyte injury both functionally and biochemically, which increased with an increasing incubation time. In addition, it was suggested that an optimal temperature in hypothermic preservation might be 10 degrees C. Thus, this cell-culture system may provide a useful and simple method for in vitro evaluation of hypothermic preservation.

Animals↗
PubMed2004

Comparative lipid profile studies in cardiac and diabetic conditions.

Lipid profile in cardiac patients (myocardial infarction, angina pectoris, coronary heart disease, ischaemic heart disease), diabetic patients and normal humans was investigated. Total serum cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides, blood glucose, calcium, potassium and sodium were determined, employing established methods and procedures. Higher level of total cholesterol, LDL-C and triglyceride were found in both cardiac and diabetic patients, however, cardiac patients had much lower level of HDL-C as compared to normal humans. Age wise comparison revealed that level of total cholesterol; triglyceride and LDL-C were elevating while the level of HDL-C were decreasing with the age in cardiac and diabetic patients. Sex wise comparison showed that females had higher HDL-C level than males and therefore had fewer incidences of heart diseases. The level of Ca++, K+ and Na+ were similar in all age groups and sexes. No significant elevation in the level of these electrolytes was discovered.

Journal Article↗
PubMed1993

Heart disease in patients with stroke: incidence, impact, and implications for rehabilitation. Part 1: Classification and prevalence.

Heart disease is found in about 75% of patients who have suffered a stroke. Cardiovascular diseases can be risk factors, etiologic mechanisms, associated conditions, or direct consequences of stroke. Cardiac comorbidity may delay initiation of rehabilitation, complicate the course and care of the patient with stroke, inhibit participation in a therapeutic exercise program, limit functional outcomes, and contribute to early mortality in the individual with cerebrovascular disease. Part 1 of this two-part article describes the various forms of heart disease that may be seen in stroke patients, and reviews the incidence figures for each type of associated cardiac condition.

Cerebrovascular Disorders↗
PubMed2006

Are mental health problems associated with use of Accident and Emergency and health-related harm?

BACKGROUND: Previous findings indicate that mental health problems are common in Emergency departments; however, there are few studies of the extent of health-related problems and emergency service use in mental health populations as a whole. METHODS: Record linkage methods were used to map the association between mental health, age, gender, and health-related harm across total health and mental health care populations in one geographical area, over three years. By examining patterns of health-related harm, an accurate profile of mentally ill Emergency patients was generated enabling identification of factors that increased vulnerability to harm. RESULTS: Of the total population of 625 964 individuals, 10.7% contacted Accident and Emergency (A&E) over three years, this proportion rose to 28.6% among the total secondary care mental health population. Young men and older women were more likely to contact A&E, both overall and within mental health populations and were also more likely to be frequent attendees at A&E. Four distinct groups (typologies) of mental health patients attending A&E emerged: young, male frequent attendees with self-inflicted and other traumatic injuries; young females also presenting with self-harm; older patients with multiple medical conditions; and very old patients with cardiac conditions and fractures. CONCLUSION: The study indicates increased A+E service use and unmet health-related need within a total mental health population. It identifies specific 'care populations' particularly vulnerable to accidents and self-harm and highlights the need for targeted services for mentally ill groups who may not access traditional health and social care services effectively.

Adolescent↗
PubMed2005

[Recognition of cardiorespiratory distress and failure in children].

Every pediatrician and general practitioner can face children with life-threatening conditions in their private practice. Recognition of symptoms of respiratory failure and shock is essential to initiate therapy promptly in order to prevent the development of cardiopulmonary failure. This article provides clinical information on detecting critical respiratory and cardiac conditions, anticipating cardiac arrest in children, establishing priorities in care, and transferring to an emergency center.

Child↗
PubMed1997

Vagal activity predicts eyeblink conditioning in human subjects.

A group of old (mean age 73 years) and young (mean age 19.8 years) human subjects received concomitant eyeblink and heart rate classical conditioning, in which a 1000 Hz tone was the conditioning stimulus and a corneal airpuff was the unconditioned stimulus. Fewer old than young subjects showed eyeblink conditioning and age greatly attenuated the magnitude of the brady-cardiac conditioned heart rate response. The heart rate conditioned response was also significantly smaller in the subjects who failed to show eyeblink conditioning regardless of age, suggesting a relationship between parasympathetic cardiac control and somatomotor learning. The power associated with the respiratory peak in the heart rate spectrum, which is vagal in origin, was also smaller in subjects that failed to show eyeblink conditioning, again suggesting a relationship between parasympathetic cardiac activity and motor learning.

Adolescent↗
PubMed1998

Response intensity in content-specific fear conditioning comparing 20% versus 13% CO2-enriched air as unconditioned stimuli.

This study examined the relation between the intensity of CO2-induced psychophysiological responses and content-specific fear conditioning. Sex-balanced groups of undergraduates (N = 96) were assigned to 1 of 3 conditioned stimuli (CSs) differing in fear-relevance, and within each CS, to either 20% or 13% CO2-enriched air (unconditioned stimuli [UCS]). Several psychophysiological measures were assessed before, during, and following conditioning phases. Consistent with expectation, electrodermal and cardiac conditioned responses were larger and more resistant to extinction when associated with fear-relevant compared with fear-irrelevant stimuli, and this overall effect of fear-relevance was more robust to the more intense UCS. Severity and frequency of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) panic symptoms also varied reliably with UCS intensity, and women reported more distress and symptoms than men. Overall, the findings suggest that content-specific fear conditioning is mediated, in part, by the intensity of the bodily response. The authors discuss clinical and theoretical implications for understanding fear onset in the absence of obvious environmental pain or trauma.

Adolescent↗
PubMed2003

Hypertrophic cardiomyopathy: from gene defect to clinical disease.

Major advances have been made over the last decade in our understanding of the molecular basis of several cardiac conditions. Hypertrophic cardiomyopathy (HCM) was the first cardiac disorder in which a genetic basis was identified and as such, has acted as a paradigm for the study of an inherited cardiac disorder. HCM can result in clinical symptoms ranging from no symptoms to severe heart failure and premature sudden death. HCM is the commonest cause of sudden death in those aged less than 35 years, including competitive athletes. At least ten genes have now been identified, defects in which cause HCM. All of these genes encode proteins which comprise the basic contractile unit of the heart, i.e. the sarcomere. While much is now known about which genes cause disease and the various clinical presentations, very little is known about how these gene defects cause disease, and what factors modify the expression of the mutant genes. Studies in both cell culture and animal models of HCM are now beginning to shed light on the signalling pathways involved in HCM, and the role of both environmental and genetic modifying factors. Understanding these mechanisms will ultimately improve our knowledge of the basic biology of heart muscle function, and will therefore provide new avenues for treating cardiovascular disease in man.

Animals↗
PubMed1997

[Löffler's parietal fibroplastic endocarditis. Echocardiographic course over 5 years].

HISTORY AND CLINICAL FINDINGS: A 28-year-old man, who had sustained a traumatic displaced fracture of the left lateral clavicle requiring operative realignment, was admitted to hospital because of the incidental finding of pathological electrocardiographic findings (suggestive of past anterior myocardial infarction). He had dyspnoea on effort and episodes of irregular tachycardia without other cardiac symptoms, as well as regular tachycardia (120/min) without pulse deficit. Body temperature was 37.3 degrees C, blood pressure 110/70 mm Hg. INVESTIGATIONS: Transoesophageal echocardiography showed regular myocardial contractility but a 3.27 cm cap-like area of echo-poor and echo-dense layers at the left ventricular apex. There was leucocytosis (25,400/microliter) with 45% eosinophilia (11,430/microliter). IgE was raised to 134.6 kU/l. Bone marrow smear showed marked eosinophilic but little neutrophilic hyperplasia. Parasitic infection was excluded. TREATMENT AND COURSE: The clinical and echocardiographic findings suggested the diagnosis of Löffler's eosinophilic endocarditis (endomyocardial fibrosis), later confirmed histologically. After initial treatment, first only with cortisone then also hydroxyurea, the eosinophilia finally responded to combined cortisone and interferon alpha 2. The dosage schedule was governed by the clinical and echocardiographic findings. In the further course of the disease there occurred progressive heart failure with severe tricuspid and mitral regurgitation, secondary pulmonary hypertension and severe fibrosis of both ventricles, 41 months after diagnosis the patient underwent tricuspid and mitral valve reconstruction with removal of the endocardial fibrotic layers. Follow-up examinations found the cardiac condition to be adequately controlled without further cardiac infiltration since 20 months. CONCLUSIONS: Echocardiography, in conjunction with the clinical findings, provides a firm foundation for successfully treating Löffler's endocarditis. In selected cases cardiac surgery can markedly improve the course.

Adult↗
PubMed1988

Cardiovascular effects of antidepressants. Avoiding cardiotoxicity in the elderly.

Elderly patients are at high risk for both depression and cardiovascular disease. Withholding antidepressant therapy from an elderly patient who has a stable cardiac condition is usually unjustified. Knowledge of the cardiac side effects of commonly used antidepressants enables the primary care physician to prescribe these agents safely for depressed elderly patients.

Aged↗
PubMedDate not supplied

The effects of music therapy in cardiac healthcare.

Music therapy has been applied with patients who present with acute myocardial infarction, coronary artery bypass graft, and other cardiac conditions. Music therapists integrate their techniques into cardiac care units, often treating patients who require assistance in coping with stress. This article reviews the research supporting the use of music as therapy and offers case examples to illustrate a variety of clinical methods.

Coronary Artery Bypass↗
PubMed1999

Ca(2+) Sparks in Cardiac Muscle: Is There Life Without Them?

The discovery of elementary Ca(2+) signaling events, the Ca(2+) sparks, has profoundly changed our view of cardiac Ca(2+) signaling and, in particular, excitationcontraction coupling. In addition, a partial disruption of cardiac Ca(2+) signaling may be important in clinical cardiac conditions such as congestive heart failure. Understanding cardiac diseases on the cellular and molecular levels may provide a key to new pharmacological strategies in the near future.

Journal Article↗
PubMed1978

[The heart and drug poisoning, excluding cardiologic treatments].

When considered strictly from the viewpoint of actions on the myocardium, the number of drugs falling into this category is limited, but the resulting conditions may be serious. The prototype for cardiac toxicity is the group of antimitotic drugs (adriamycin or daunomycin). If these drugs are used; frequent and careful follow-up is necessary, the dosage at which the drug becomes cumulative must be known; and patients with a pre-existing cardiac condition must be exluded from treatment. Above all, it is essential not to wait until asystole occurs, but to try to prevent such occurrences by monitoring the patient electrocardiographically. A part from these drugs, recent articles in the literature suggest that similar care should be taken when prescribing emetine and lithium salts. There is insufficient information about other drugs which may have a certain degree of cardiotoxicity. For this reason, it is most important to gather information on accidents and reaction during treatment.

Daunorubicin↗