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At least 433 records · Page 24Linked to original sources
PubMed1983

Ambulatory electrocardiography in squash players.

Ambulatory electrocardiography was carried out in 21 healthy, fit, male squash players (aged 23-43 years) before, during, and after match play. Resulting electrocardiograms were analysed with respect to heart rate and changes in rhythm. The results indicate that squash increases the heart rate to 80% of an individual's predicted maximum heart rate for the duration of a game. Ventricular arrhythmias were detected in seven of the subjects during play and in seven in the immediate post-exercise period, an incidence which was not reproduced on subsequent maximal treadmill exercise testing. This study indicates that squash is a physiologically demanding sport which places a severe strain on the myocardium for considerable periods of time and is capable of generating cardiac arrhythmias. These findings are particularly important for an individual already at risk of sudden death from coronary artery disease or structural cardiovascular abnormalities. Medical advice before participation in the game will identify those at high risk of cardiovascular disease. Subjects in this study who developed arrhythmias were not, however, identified by history, examination, or exercise electrocardiography. Thus, it seems unwise to begin playing squash after the age of 40 years. Whether subjects in this age group already participating in the game should continue to play remains a matter for individual judgment.

Adult↗
PubMed2003

Parathyroid adenomas and cardiovascular risk.

In recent decades, primary hyperparathyroidism (pHPT) has changed its clinical presentation from a disease with bone and renal involvement to a frequently asymptomatic disorder detected on routine biochemistry. Nevertheless, it remains unclear whether patients with untreated mild asymptomatic hyperparathyroidism are at risk for other complications such as increased morbidity and mortality from cardiovascular diseases. There are limited data on the incidence of cardiovascular abnormalities in mild pHPT. However, pHPT has been associated with increased risk of death from cardiovascular disease, hypertension, left ventricular hypertrophy (LVH), valvular and myocardial calcifications, impaired vascular reactivity, alterations in cardiac conduction, impaired glucose metabolism, dyslipidaemia, and alterations in body composition. The nature of some of these associations is in question, because cure of pHPT does not lead to improvement of the cardiovascular disorder e.g. hypertension. In contrast, currently available data suggest that LVH, impaired glucose metabolism and dyslipidaemia may improve after surgery and that successful parathyroidectomy could decrease the excess mortality in patients with pHPT due to cardiovascular disease.

Adenoma↗
PubMed1995

Effect of having a functioning cadaveric renal transplant on cardiovascular mortality risk in patients on renal replacement therapy.

Our aim was to estimate the effect of having a functioning cadaveric renal transplant on the risk of cardiovascular and total mortality in patients on renal replacement therapy (RRT). We retrospectively studied (by the Cox proportional hazards regression model) 195 subjects who began RRT with maintenance dialysis in our centre from 1 January 1978 to 31 December 1991. Out of this number, 76 patients received a cadaveric kidney transplant. Cardiovascular abnormalities at the onset of RRT were the principal independent determinant of both total and cardiovascular mortality risk. As compared to patients on dialysis with the same duration of RRT, patients with a functioning renal transplant for more than 1 year had a significantly lower total mortality risk (mean relative risk (RR): 0.48 (0.25-0.91) (95% confidence limits in parentheses), P = 0.03), an effect whose significance disappeared after adjustment for pretreatment conditions (RR = 0.62 (0.30-1.30), P > 0.3). However, the beneficial effect of a functioning renal transplant for more than 1 year on cardiovascular mortality risk was significant, both before (RR = 0.21 (0.06-0.74), P = 0.02) and after the adjustment for pretreatment conditions (RR = 0.32 (0.11-0.90), P = 0.035). During the first year after a successful transplantation the beneficial effect of having a functioning transplant on cardiovascular mortality risk was only weakly attenuated. During RRT a functioning cadaveric renal transplant decreases cardiovascular mortality risk partially independently of the better pretreatment status of the patients selected for transplantation.

Adult↗
PubMedDate not supplied

[Shift-work and cardiovascular diseases among chemical industry workers].

In order to assess the prevalence of cardiovascular abnormalities among shift workers, who were free from such abnormalities at the time of hiring, compared to day workers and ex-shift workers, we studied the QTc interval and several cardiovascular risk factors in 61 chemical workers, including 40 shift workers, 11 day workers, and 10 ex-shift workers. We found a high prevalence rate of ischemic heart disease and conduction abnormalities among ex-shift workers (5/10, 50%). We did not observe variations in the QTc interval among the three groups. The occurrence of cardiovascular disease is a reason for moving workers to day work. Therefore, the shift workers group in our study might have been selected among subjects with a healthier lifestyle preventing side effects on their cardiovascular system.

Cardiovascular Diseases↗
PubMed1995

Calcium accumulation in experimental hypertension.

At present, the significance of calcium accumulation in the aetiology of coronary artery disease (CAD) in humans is not known, except only to exacerbate the condition. In an attempt to understand ionic disturbances in vasculature derived from cardiovascular abnormalities, soft tissues from hypertensive models were examined. The study hypothesis was to see if basic cardiovascular regulatory sites in hypertensive models accumulated greater amounts of Ca2+. Calcium levels were measured by flame atomic absorption spectrophotometry in tissue derived from two types of hypertensive rabbits. Both models of hypertension developed mean arterial pressures of at least 50 mm Hg greater than those of controls over a 5-wk period. Significant increases in calcium levels were found in left ventricle and aorta derived from both hypertensive groups compared with controls. Renal cortex and medulla were not significantly different among any of the groups. These levels corroborate the findings of others which show increased calcium levels in cardiovascular tissues in experimental hypertension in rabbits. Although there have been several studies that have shown the relationship between calcium, hypertension and CAD, this is the first study to look at calcium accumulation rather that the effects of calcium channel blockers. The link between hypertension and calcium accumulation in a number of tissues may be important in the development of CAD and other cardiac dysfunction.

Acetates↗
PubMed1994

Long-term cardiovascular morbidity and mortality in autosomal dominant polycystic kidney disease patients after renal transplantation.

Patients with autosomal dominant polycystic kidney disease (ADPKD) have an increased incidence of hypertension and cardiovascular abnormalities. In this long-term follow-up study (5.88 years on average), we evaluated cardiovascular disease and patient and graft survival in 101 ADPKD patients and 692 nondiabetic control patients receiving cadaveric renal transplants between March 1967 and April 1991 at the Leiden University Hospital. Graft and patient survival was not different between patient groups, using the same immunosuppressive therapy. However, death with functioning graft, mainly due to cardiovascular disease, was significantly more frequent in the ADPKD patients than in controls using AZA (P < 0.01). Multivariate analysis of pretransplant data showed that ADPKD patients on AZA therapy demonstrated an elevated age-adjusted relative risk of 2.07 (95% confidence interval [95% CI]: 1.12-3.80) for cardiovascular events and 2.88 (95% CI: 1.41-5.90) for cardiovascular mortality alone. After adjustment for age, gender, and other cardiovascular risk factors, a relative risk of 2.39 (95% CI: 1.06-5.40) was found. This was 2.87 (95% CI: 1.04-7.93) when cardiovascular mortality was the dependent variable. With posttransplant data, the age-adjusted relative risk for cardiovascular morbidity and mortality in ADPKD patients using AZA was 2.16 (95% CI: 1.12-4.15) and 2.97 (95% CI: 1.40-6.27), with only cardiovascular mortality as the dependent variable. After adjustment for age, gender, and other cardiovascular risk factors, this was 1.59 (95% CI: 0.64-3.91) and 2.28 (95% CI: 0.79-6.53), respectively. With CsA treatment, an elevated risk for cardiovascular morbidity and mortality in ADPKD patients was present, but the corresponding 95% CI were wide and include unity, due to the shorter period of follow-up (CsA: 3.81 +/- 2.50 years vs. AZA: 7.28 +/- 6.74 years). Survival of ADPKD patients using AZA was less in those patients without pretransplant nephrectomy as compared with control patients, but the morbidity and mortality of pretransplant nephrectomies should be taken into account. We conclude that ADPKD patients show a similar graft and patient survival after renal transplantation as control patients, but they are especially at risk for cardiovascular disease after renal transplantation.

Adult↗
PubMed1988

[Flow imaging of the cardiovascular system using magnetic resonance imaging].

Blood flow images by magnetic resonance imaging (MRI) using a 0.25 T unit were evaluated for nine normal volunteers and 108 subjects with a variety of cardiovascular abnormalities. Using the non-gated short-spin echo (SE) technique, blood flow in the cardiovascular systems was not imaged in the normal volunteers. Using end-systolic and end-diastolic SE techniques for the normal subjects, blood flow in the cardiac chambers was not clearly imaged. Blood flow in the ascending aorta and aotric arch often did not appear in the gated SE images of the normal subjects. However, blood flow in the descending aorta was often observed in the gated SE images. Blood flow imaging was demonstrated by both non-gated and gated SE techniques in regions where blood flow was relatively slow; for example, in the left atrium of mitral stenosis, in an aortic aneurysm, in a false lumen of an aortic dissection, and in the left ventricle having old myocardial infarction. Using the non-gated inversion recovery (IR) technique, no blood flow was imaged in the cardiovascular system except in the left atrium of one case with mitral stenosis. Using the non-gated short SE technique, there was good correlation between the thrombus formation and the presence of blood flow images in the left atria of 17 patients with mitral stenosis, and in the aneurysmal portions of the aorta or in the false lumens of aortic dissection of 18 patients. It was suggested that mural thrombi in such diseases were related to the relatively slow blood flow. Blood flow imaging easily distinguished stagnant blood flow from mural thrombi using non-gated short SE, end-systolic SE, and IR techniques. Thus, blood flow imaging using MRI should become an important means of evaluating the cardiovascular system.

Adult↗
PubMed1995

Cardiac malformation in two infants with hypochondrogenesis.

Autopsy records from the Women and Infants' Hospital from January 1974 through January 1994 were reviewed to identify cardiac malformations in the presence of skeletal dysplasia. Of 24 cases of lethal fetal or neonatal osteochondrodysplasias, 4 were given diagnoses in which disorders of type II collagen are regarded as causative. These 4 were categorized in the spondyloepiphyseal dysplasia (SED) spectrum of disorders; specifically two patients with hypochondrogenesis and two with spondyloepiphyseal dysplasia congenita were identified. Defects in cardiac septation were noted in the 2 patients with hypochondrogenesis. No cardiovascular abnormalities were present in the remaining cases, which included thanatophoric dysplasia, osteogenesis imperfecta, and asphyxiating thoracic dystrophy. Although cardiovascular malformations have been described in other types of osteochondrodysplasias, e.g., short rib polydactyly syndrome type II and chondroectodermal (Ellis-van Creveld) dysplasia, congenital heart disease has not been described in hypochondrogenesis. Type II collagen, which has been found to be abnormal in some patients with hypochondrogenesis, is considered to have a limited tissue distribution, and has not been detected as yet in human myocardium. The findings presented here suggest that type II collagen may function in human cardiogenesis.

Abnormalities, Multiple↗
PubMed1995

Multiple system atrophy presenting as parkinsonism: clinical features and diagnostic criteria.

To evaluate the possibility that parkinsonian signs may be the only presenting feature of multiple system atrophy (MSA), parkinsonian patients were studied who had no atypical clinical signs and had no symptoms of autonomic dysfunction, but who reported that they had not experienced the anticipated good response to dopaminergic treatment. These stringent criteria identified 20 patients from a series of 298 consecutive parkinsonian outpatients. The following clinical pointers were analysed: (a) rate of disease progression; (b) symmetry of parkinsonian symptoms and signs; (c) occurrence of resting tremor during the first three years from onset. In addition, all patients underwent (d) acute and chronic challenge with dopaminergic drugs; (e) cardiovascular reflex autonomic function tests; (f) high field MRI. Rapid progression of disease was seen in 45% of patients, onset was symmetric in 25%, tremor was absent at onset in 70%, response to dopaminergic drug challenges was inadequate in 40%, abnormal cardiovascular reflexes occurred in 50%, and some abnormal MRI finding occurred in 35% of cases. Each of these features was equally weighted by giving to each patient a 0 to 6 point score corresponding to the number of abnormal findings. Fifteen patients scoring higher than 1 were considered at risk for having MSA: five of them were classified as clinically possible (score 2), six as clinically probable (score 3-4), and four patients were classified as clinically definite multiple system atrophy (score 5). The six pointers considered were variably combined in each patient, none of them being universally abnormal in patients with high scores. The patients were followed up for a mean 2.1 (SEM 0.65) years. All but one of the 10 patients prospectively classified as probable or definite MSA developed unequivocal clinical signs of fully symptomatic MSA. A receiver operator characteristic cure was plotted for the prospective score based on follow up diagnosis. The best compromise for trade off between sensitivity and specificity was a cut off value at a score of 3. The sensitivity and specificity of the individual pointers considered to predict fully symptomatic MSA varied considerably, and no single item could predict whether patients presenting with just parkinsonian signs went on during the two year follow up period to develop fully symptomatic MSA. Instead, the number of abnormalities offered a predictive value for the clinical prognosis of these parkinsonian patients.

Adult↗
PubMed1979

Clinical implications of the convex supradiaphragmatic inferior vena cava.

The configuration of the supradiaphragmatic segment of the inferior vena cava (SIVC) was evaluated on lateral chest radiographs to determine the clinical situations in which a posterior convex contour occurred. Of 34 patients with a convex SIVC, 31 had cardiovascular abnormalities. Left ventricular enlargement was present in 17 of 34 (50%), and right ventricular failure in 13 (38%). Valvular regurgitation, left-to-right shunts, narrow anteroposterior chest diameter, and chronic obstructive lung disease were also present. In 102 consecutive normal patients, the SIVC was visible in 97%; only 1 patient had a convex SIVC (p = 10(-7)). The results show that detection of a convex SIVC suggests associated abnormalities.

Adolescent↗
PubMed1990

Assessment of pupillary light reflex latency and darkness adapted pupil size in control subjects and in diabetic patients with and without cardiovascular autonomic neuropathy.

Increased pupillary light reflex latencies were found more often than a reduced darkness pupil size in diabetic patients with and without abnormal cardiovascular reflexes. This finding suggests that parasympathetic pupillary dysfunction precedes sympathetic pupillary denervation in diabetic autonomic neuropathy.

Adolescent↗
PubMed1984

Severe aortic-valve stenosis unmasked by amateur running.

Three men aged 35, 55, and 60 years had asymptomatic underlying aortic-valve stenosis unmasked by amateur running or jogging. All three men underwent aortic-valve replacement and two of the three have resumed mild exercise programs. Congenitally abnormal aortic valves were found in two of the three patients. Amateur exercise may uncover an underlying cardiovascular abnormality perhaps sooner than might be apparent without exercise.

Adult↗
PubMed1976

Phenformin and lactic acidosis.

Thirty-eight patients who presented with diabetes and a changed state of consciousness satisfied the criteria for lactic acidosis. Sixteen patients were non-ketotic, and 15 of these were receiving phenformin on admission. In all but one of these 15 patients, however, additional renal or cardiovascular abnormalities, or both, could be identified, which supported a multifactorial aetiology for lactic acidosis. Advanced age and cardiovascular and renal disease are absolute contraindications to the use of phenformin in diabetics.

Adolescent↗
PubMed2001

[Effects of adaptive changes of vestibular system on cardiovascular regulation and orthostatic tolerance].

Astronauts may experience Space Adaptation Syndrome at the primary period in spaceflight. It is widely accepted that it is mainly caused by vestibular adaptive changes. The reverse changes of adaptation present after the return from weightlessness to normal 1 G. It may cause astronauts' postural instability and orthostatic intolerance. Evidences from animal model and some data from humans suggest that the vestibular system have influences on the sympathetic nervous system and cardiovascular control. The inputs that appear to be critical in producing these responses come from otolith receptors. The important medical problem--orthostatic intolerance in space medicine is mainly caused by cardiovascular abnormal control. It is possible that vestibular adaptive changes under microgravity may have its influence on the cardiovascular function and orthostatic intolerance.

Adaptation, Physiological↗