Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cardiovascular Abnormalities”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMed2003

Epidemiology of cardiovascular risk in patients with chronic kidney disease.

BACKGROUND: Chronic kidney disease (CKD) patients are highly prone to cardiovascular disease for a number of reasons. At the time of starting renal replacement treatment, their cardiovascular condition is already severely compromised, suggesting that cardiovascular risk factors begin to operate very early in the progression of CKD. Moreover, those patients reaching end-stage renal disease without cardiovascular abnormalities have a high probability of developing de novo cardiovascular disease. METHODS: In this review, we analyse the prevalence of the major cardiovascular risk factors in CKD patients and their importance as contributors to the excess cardiovascular disease in this population. We also describe and discuss the main results obtained in the management of these risk factors in terms of preventing cardiovascular morbidity and mortality. RESULTS: Hypertension plays a major role in determining cardiac damage at all stages of CKD, including the dialytic phase. Anaemia is a major determinant of the development of left ventricular hypertrophy and therefore its correction can be expected to improve cardiovascular status and long-term survival, but this needs to be done before changes in cardiac structure become well established. Calcium-phosphate disorders are increasingly acknowledged to be cardiovascular risk factors in CKD, yet their medical control is still far from being satisfactory. Dyslipidaemia is particularly frequent in CKD patients, but the benefit of lipid-lowering treatments still has to be proven. Finally, CKD is associated with newly recognized risk factors for atherosclerosis, although their importance as cardiovascular risk factors is still controversial. CONCLUSIONS: Nephrologists should attempt to give optimal treatment for well-established cardiovascular risk factors, even if this generally fails to prevent the excess cardiovascular disease of CKD patients. Increasing attention is now being paid to newly recognized CKD-related risk factors for atherosclerosis, although their real importance is still under debate and, before therapeutic prescriptions can be applied to CKD patients, further studies in these new fields are needed.

Cardiovascular Diseases↗
PubMed1990

Hypotension due to unexpected cardiac tamponade.

We report a case of profound hypotension, after induction of general anaesthesia, that resulted from unexpected cardiac tamponade. The differential diagnosis was complicated by the absence of any evidence to indicate that there was significant direct chest injury. Many of the recognised clinical signs of cardiac tamponade were absent, in particular, there was no compensatory tachycardia, and heart rate remained stable despite severe hypotension before surgical drainage of the pericardium. The possible aetiology and pathophysiology is discussed. It is suggested that after major trauma, cardiac tamponade should be considered as a possibility even in the absence of significantly abnormal cardiovascular signs, evidence of direct chest injury, or an abnormal chest X ray.

Adult↗
PubMed2005

The PPAR genes, cardiovascular disease and the emergence of PPAR pharmacogenetics.

The peroxisome proliferator-activated receptors (PPARs) comprise a group of related transcription factors that serve to regulate a number of cellular processes that are central to cardiovascular health and disease. Two large bodies of work strongly implicate the PPARs as key factors in normal cardiovascular physiology and in cardiovascular pathophysiology: i) studies demonstrating associations between PPAR and abnormal cardiovascular phenotypes; and ii) pharmacological studies assessing the effects of specific PPAR agonists in clinical trials. With the abundance of data available from these studies as a background, PPAR pharmacogenetics has become a promising and rapidly-advancing field. This review summarises the current state of understanding of PPAR pharmacogenetics and its profound implications for the individualisation of therapy for patients with a diverse group of cardiovascular diseases.

Animals↗
PubMed1993

[The neuropathy of the autonomic nervous system. An additional anesthetic risk in diabetes mellitus].

Some 20-40% of diabetics suffer from an autonomic neuropathy. This complication of diabetes mellitus impairs the regulation and the reflexes of the cardiovascular system. This study compares the cardiovascular characteristics of diabetics and nondiabetic control patients. METHODS. 21 patients (11 diabetics, 10 nondiabetics) undergoing ophthalmic surgery were investigated. They were tested preoperatively for autonomic cardiovascular dysfunction by application of four established tests. These were: heart rate responses to the Valsalva maneuver, deep breathing and standing up (30/15 test) and the Schellong test. The anaesthesia was induced with fentanyl (0.1 mg), etomidate (2.5 mg/kg) and succinyl choline (1.5 mg) and maintained with oxygen/nitrous oxide (1.4:3 l/min) and isoflurane (0.2-0.8 vol%). Blood pressure and heart rate were automatically measured every minute during induction of anaesthesia and every 3 min during anaesthesia. Additionally the heart rate response to 0.5 mg atropine i.v. was evaluated. RESULTS. The autonomic function tests revealed pathologic reactions in all diabetics (two early, six definitive, three severe) and none in controls. Remarkable cardiovascular events occurred exclusively in the diabetic group, especially during induction of anaesthesia. The systolic blood pressure (SAP) increased in diabetics from a preinduction value of 150 mmHg (median, range 105-205 mmHg) to a maximum of 200 mmHg (160-250 mmHg) after intubation, in controls from 130 (100-150 mmHg) to 170 (110-190 mmHg). Following this peak, SAP fell in diabetics to 120 mmHg (80-160 mmHg), in controls to 110 (100-140 mmHg). Two diabetics had to be treated because of an SAP exceeding 220 mmHg, two other diabetics because of an SAP below 80 mmHg. After atropine administration the heart rate of diabetics showed a median increase of 15% (range 0-40%). In four diabetics, however, the increase was less than 10%. In control patients the increase was 50% (40-80%). All patients with severe cardiovascular reactions during induction of anaesthesia and with heart rate elevation following atropine of less than 10% had a definite or severe neuropathy of the autonomic nervous system revealed by the tests. DISCUSSION. In the only slightly stressful ophthalmic surgery, remarkable events were noted particularly during the induction of anaesthesia. The critical decreases and increases of SAP might be related to the autonomic dysfunction, because of the hypersensitivity of a partly damaged autonomic nervous system or its impaired function. This led to a loss of heart rate variation and adequate blood vessel tone. The severe cardiovascular reactions always went along with clearly pathologic findings in the tests performed. Normal test results in diabetics implied normal cardiovascular reactions, as could be observed in nondiabetics. CONCLUSION. Abnormal cardiovascular reactions in diabetics must be kept in mind. The simple tests specified here can identify such predisposed patients.

Adult↗
PubMed2005

Flow mediated dilatation and cardiac function in type 1 diabetes mellitus.

The present study sought to examine the occurrence of subclinical markers of cardiovascular risk and cardiac dysfunction with increasing disease duration in type 1 diabetes mellitus (DM). There are few data on subclinical cardiovascular abnormalities in type 1 DM. The study included 100 patients without any cardiovascular complaints (mean age 46.6 years, range 22 to 63), with a history of type 1 DM ranging from 2 to 36 years, and 75 age-matched controls. Standard 2-dimensional and Doppler echocardiography and pulse-wave tissue Doppler (tD) mapping of systolic (Sm) and diastolic (Em, Am) velocities (12 left ventricular [LV] segments and right-sided cardiac) were performed. An Em/Am ratio of <1 was considered to represent abnormal segmental diastolic function. Flow-mediated dilation (FMD) of the brachial artery, carotid intima media thickness (IMT) measurement, and extensive laboratory analysis were performed. The FMD was reduced, and IMT increased in patients (p < 0.01). Regional tD-derived diastolic and systolic functional abnormalities were observed within the first decade of the disease. Significant correlations were found between FMD and LV segments with tD-derived dysfunction, the duration of DM, and fibrinogen (p < 0.0001 for all). Stepwise regression analysis showed that FMD was the strongest predictor of abnormal segmental function (p < 0.0001). Data further presented as an analysis of tertiles by DM duration show an increasing occurrence of subclinical cardiac dysfunction and cardiovascular risk markers compared with age-matched controls. In conclusion, FMD is associated with abnormal segmental cardiac function in type 1 DM.

Adult↗
PubMed1987

Anaesthetic-related recovery room complications.

A prospective survey was conducted over a one-month period in all surgical patients admitted to the recovery room of a university-affiliated teaching hospital. Complications arising in the recovery room were documented by the nursing staff according to predefined criteria and were critically evaluated. A total of 443 patients were admitted to the recovery room and in 133 (30%) of these, some form of complication was noted. There were 86 patients with complications referable to the central nervous system, 68 with abnormal cardiovascular parameters, 24 with nausea and/or vomiting and 10 with abnormalities referable to the respiratory system. Many patients had more than one complication. The results are discussed, with emphasis on their relevance to current anaesthetic practice. It is concluded that many patients exhibit recovery room complications when they are specifically sought. The recovery period remains a time of great potential danger to patients.

Adult↗
PubMed1983

Contrast-medium-induced electrocardiographic abnormalities: comparison of bolus and infusion of methylglucamine iodamide and methylglucamine/sodium diatrizoate.

A double-blind study comparing electrocardiographic (ECG) abnormalities induced by methyglucamine iodamide and methylglucamine/sodium diatrizoate was conducted in 189 patients. The media were each administered by both bolus and infusion. Iodamide caused fewer ECG changes both by injection and infusion. This contrast medium also resulted in fewer ECG changes in the patient groups with known prior ECG abnormalities, cardiovascular disease, arrhythmias, ischemia, or renal impairment and in those over 50 years of age. Digitalis did not increase the frequency of ECG abnormalities with either medium. With diatrizoate, the lower bolus dose produced as many major ECG changes in the presence of preexisting ECG abnormalities (arrhythmias, ischemia) or prior cardiovascular disease as the three-times-larger infusion dose more slowly administered; conversely, the opposite was found when renal insufficiency or older age existed. The conclusion is that iodamide media caused fewer ECG abnormalities and may be less hazardous.

Arrhythmias, Cardiac↗
PubMed2004

Hungarian cohort-controlled trial of periconceptional multivitamin supplementation shows a reduction in certain congenital abnormalities.

BACKGROUND: The 1984-1991 Hungarian randomized controlled trial (RCT) of periconceptional multivitamin supplementation containing folic acid (0.8 mg) showed a significant reduction in the first occurrence of neural tube defects (NTDs), and of urinary tract and cardiovascular abnormalities, but no reduction in orofacial clefts. A controlled cohort trial was designed to confirm or deny these results. METHODS: Supplemented women were recruited from the Hungarian Periconceptional Service using the same multivitamin as the Hungarian RCT. Unsupplemented pregnant women were recruited in the standard regional antenatal care clinics and were matched to each supplemented pregnant woman on the basis of age, socioeconomic status, place of residence, and year of pregnancy. RESULTS: A total of 3056 informative offspring were evaluated in each cohort. The occurrence of congenital cardiovascular malformations (31 vs. 50) was reduced (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.38-0.96) in the supplemented cohort, accounted for mainly by ventricular septal defects (5 vs. 19; OR, 0.26; 95% CI, 0.09-0.72). There was no significant difference (14 vs. 19) in the occurrence of urinary tract defects between the two cohorts, but stenosis/atresia of pelvic-ureteric junction (2 vs. 13) showed a significant reduction (OR, 0.19; 95% CI, 0.04-0.86). The protective effect of the folic acid-containing multivitamin for NTDs (one offspring in the supplemented vs. nine in the unsupplemented cohort) was confirmed (OR, 0.11; 95% CI, 0.01-0.91). There was, however, no protective effect on orofacial clefts or on multiple congenital abnormalities. CONCLUSIONS: The results of this cohort-controlled trial support the findings of the previous Hungarian RCT. The primary prevention of some major structural birth defects by multivitamins containing folic acid or by folic acid has great public health importance.

Adult↗
PubMed2004

Orthotopic liver transplantation for portosystemic encephalopathy in an adult with congenital absence of the portal vein.

Congenital absence of the portal vein (CAPV) is a very rare venous malformation in which mesenteric venous blood drains directly into the systemic circulation. There is no portal perfusion of the liver and no portal hypertension. This abnormality is usually coincidentally discovered in children, the majority of whom have no signs of encephalopathy and only slightly abnormal liver function tests. Additional anomalies common in CAPV are cardiovascular abnormalities and hepatic tumors. To date, only 5 adult patients (>18 years) with CAPV have been described, none of whom underwent liver transplantation. We describe a 45-year-old man with CAPV and end-stage renal insufficiency due to focal segmental glomerulopathy, who developed therapy-resistant encephalopathy with intermittently high ammonia levels. The patient underwent a combined liver and kidney transplantation and is doing well at 2.5 years of follow-up. Histopathological examination of the native liver showed no portal vein branches in the portal tracts. In conclusion, our experience suggests that, although children with CAPV usually have no symptoms of encephalopathy, this may still develop at a later stage in adult life. When encephalopathy becomes refractory to medical therapy, orthotopic liver transplantation (OLT) can be successfully performed with restoration of normal cerebral function.

Comorbidity↗
PubMed1995

Noonan syndrome.

The Noonan syndrome is a rare disease characterized by dysmorphic facies, short stature, ear abnormalities, cryptorchidism, ocular abnormalities, cardiovascular anomalies, cubitus valgus, webbed neck, and cutaneous and hair abnormalities. Some 25% to 40% of patients have dermatologic abnormalities. Diagnosis is purely clinical, and intrauterine diagnosis is very important based on the presence of cystic hygroma and evidence of myocardial abnormalities. Treatment is symptomatic. Genetic counseling is necessary.

Diagnosis, Differential↗
PubMed2000

Cutis marmorata telangiectatica congenita: report of 18 cases.

We report 18 patients with cutis marmorata telangiectatica congenita (CMTC) who visited the University Hospital Nijmegen between 1982 and 1999. In 11 patients (61%), associated abnormalities of varying severity were observed. Three of these patients had a previously described distinct syndrome comprising CMTC, a naevus flammeus at the upper lip/philtrum, macrocephaly and syndactyly, among other abnormalities. Findings in the other eight patients with associated abnormalities included hydrocephalus, hyperplasia/hypoplasia (body asymmetry), anal atresia, hearing loss, cardiovascular abnormalities, strabismus hypothyroidism, haemangioma, naevus anaemicus, café-au-lait spot, lipoma and an elevation of the right diaphragm. All cases were sporadic.

Abnormalities, Multiple↗
PubMedDate not supplied

Late somatic and psycho-social consequences of renal insufficiency in children.

The aim of the project was to establish the somatic and psycho-social consequences in adulthood of paediatric end-stage renal disease (ESRD). A long term follow up study of all Dutch patients who started renal replacement therapy at age 0-15 years between 1972 and 1992 and who were born before 1979 was undertaken. The study was performed between 1998 and 2000. About 25% of patients had died at time of investigation. Cardiovascular abnormalities were prominent in both transplanted and dialysis patients and cardiovascular disease was also found to be the most prominent cause of death. Skeletal disorders as a result of metabolic bone disease accounted for most frequent occurring disabilities. The risk for malignancies was 10-fold that of the normal population. Mean IQ and educational attainment were low as compared to the normal population. The overall quality of life was good, despite the co-morbidity and disabilities. Adverse outcomes were in nearly all cases related to a prolonged period of dialysis in the past and to (current) hypertension, not to the state of dialysis at time of investigation.

Adolescent↗
PubMed2006

Regulation of eNOS expression in HCAEC cell line treated with opioids and proinflammatory cytokines.

BACKGROUND: Nitric oxide (NO) generated by endothelial nitric oxide synthase (eNOS) plays a crucial role in vascular function and homeostasis. eNOS activity maintains normal vascular tone, regulates leukocyte-endothelial cell interactions, inhibits platelet aggregation, limits smooth muscle cell proliferation and influences cardiac myocyte contractility. The loss of endothelium-derived NO has been shown to result in serious cardiovascular abnormalities, which may indicate eNOS involvement in the origin/development of cardiovascular disorders. AIM: Evaluation of eNOS mRNA level in the endothelium of human coronary arteries upon opioids treatment (mediators of ischaemic preconditioning) and after incubation with proinflammatory cytokines (stress stimuli). METHODS: Different concentrations of beta-endorphin, endomorphin-1 and endomorphin-2 (alone or in combination with the opioid receptor blocker naloxone) as well as different concentrations of cytokines alone (IL-1beta, TNF-alpha) or in combination were applied to in vitro cultured human coronary artery endothelial cells (HCAEC). After 24 hrs incubation, the cells were harvested, mRNA extracted and relative quantification of eNOS mRNA was conducted using real-time PCR. RESULTS: Opioid treatment altered eNOS expression; however, none of the changes reached a statistically significant level. As for proinflammatory cytokines, both TNF-alpha and IL-1beta substantially down-regulated the eNOS mRNA level (p <0.05). When applied in combination, these cytokines lowered eNOS mRNA even further (p <0.05). The effect was independent of the cytokine combination used. CONCLUSIONS: It was demonstrated that proinflammatory cytokines exert a substantial and statistically significant negative effect on eNOS mRNA level in human coronary artery endothelial cells in in vitro culture. Unfortunately, we were unable to demonstrate significant changes within the eNOS mRNA pool upon opioid treatment. These results indicate that opioids (basal release) do not affect eNOS expression in normal in vitro culture conditions but might do so upon stress stimuli.

Cardiovascular Diseases↗
PubMed1984

Cardiovascular shunts and oxygen transport in lower vertebrates.

O2 transport in animals with normal or abnormal cardiovascular shunts is analyzed using a two-compartment model. This analysis reveals that the O2 affinity of blood is a key factor determining the arterial, venous, and tissue O2 partial pressure (PO2) levels. Depending on the value of "critical" PO2, factors that decrease O2 affinity (e.g., increased temperature and reduced pH) should increase tissue PO2 and favor increased tissue oxygenation. Species comparisons suggest that O2 affinity is closely linked to critical PO2. In contrast to the model for environmental hypoxia, hypoxia due to shunting a right-shifted O2 dissociation curve is, at sea level, always adaptive. When hypoxia due to shunting is combined with external hypoxia, a decreasing O2 affinity causes increased blood and tissue PO2 values up to a "breaking point," which varies with shunt fraction, inspired PO2, lung PCO2, and respiratory properties of the blood. External hypoxia would cause ectotherms with high preferred body temperatures (e.g., lizards) to have blood and tissue PO2 values beyond the breaking point. This led to the hypothesis, now confirmed in several species, that external hypoxia would result in a reduction of preferred body temperature.

Acid-Base Equilibrium↗
PubMed1987

Loss of vision due to central serous chorioretinopathy following psychological stress.

The authors studied 33 patients with central serous chorioretinopathy and found that a very disturbing psychological event had preceded the loss of vision in 91% of the cases. The acute disturbance preceded the first visual symptoms by an average of 7 days. When relapses occurred, the psychological disturbances were often less severe and preceded the visual symptoms by minutes or hours. In some cases vision improved 1 to 2 weeks after the patient learned of the amelioration of the original distressing situation. The majority of the patients were found to be tension ridden, and 48% had cardiovascular abnormalities.

Adult↗
PubMed2003

[Morphologic and functional abnormalities of the cardiovascular system in patients with hepatic cirrhosis].

During liver cirrhosis many important changes occur in the cardiovascular system and these abnormalities appear more evident as portal hypertension and liver dysfunction progress. The cirrhotic heart develops a series of structural and functional abnormalities consisting in diastolic dysfunction and reduced myocardial reactivity during exercise, likely due to a diminished myocardial beta-adrenergic receptor function. Nevertheless, the peculiarity of the cardiovascular involvement during liver cirrhosis is represented by a progressive development of a hyperdynamic circulation that seems to be due to portal hypertension rather than to liver insufficiency. In fact, it has been hypothesized that this syndrome raise from the venous portal bed and is primarily determined by an increase in blood volume that leads to an enhanced cardiac output. Later, as liver cirrhosis progresses, new important pathogenetic elements occur and lead to a reduction in peripheral vascular resistances and to the full clinical expression of hyperdynamic circulation. The pathogenesis of hyperdynamic circulation is very interesting for scientific research because of the complex and still in part unknown origin. In addition, this syndrome has an important clinical meaning for its severely adverse prognostic value and it represents the pathogenetic background for a number of severe complications of advanced liver cirrhosis.

Blood Circulation↗