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PubMed1975

Metabolic and cardiovascular abnormalities in patients with peripheral arterial disease.

Twenty-eight consecutive patients of an average age of 63 years with intermittent claudication secondary to underlying peripheral arterial disease were studied for evidence of metabolic or other cardiovascular abnormalities and the results obtained were compared with those of 28 matched control subjects free of vascular disease. Patients with peripheral arterial disease had significantly higher levels of systolic and diastolic blood pressure, a greater incidence of ECG abnormalities, lipoprotein abnormalities, elevated serum triglycerides, and serum copper. The incidence of smoking and abnormal glucose tolerance, while higher in peripheral arterial disease patients, was not statistically significant. Hematocrit and serum cholesterol levels were nearly indentical in both groups of patients. Twenty-six of the 28 patiens with peripheral arterial disease had either a cardiovascular or a metabolic abnormality, indicating the high incidence of multisystem illness in this disorder. The epidemiologic data in peripheral arterial disease are similar to those in coronary artery disease but some measurements contrast sharply, such as the apparent normal level of serum cholesterol in patients with peripheral arterial diseases.

Adult↗
PubMed1977

Cardiovascular abnormalities in the Beckwith-Wiedemann syndrome.

Twelve of 13 patients with Beckwith-Wiedemann syndrome were found to have cardiovascular abnormalities: congenital heart disease in 7 of the 12 and isolated cardiomegaly in the others. No specific type of cardiac abnormality predominated.

Abnormalities, Multiple↗
PubMed1995

Aortobronchial fistula after correction of congenital cardiovascular abnormalities.

Aortobronchial fistula (ABF) is a rare but highly lethal condition. Four patients with ABF, 10-25 years after surgical repair of a congenital cardiovascular abnormality are reported. All patients presented with haemoptysis. Computed tomographic (CT) scan and aortography were inconclusive in two, diagnostic in one and not performed in another. Three patients underwent operation: all survived and are free of symptoms with a follow-up of 2-8 yrs. The fourth patient died before operation due to massive haemorrhage into the lung. In all patients, the fistula was secondary to aortic interposition of patch grafts.

Adult↗
PubMedDate not supplied

Evaluation of gastrin secretion in diabetic subjects with normal or abnormal cardiovascular autonomic function tests.

The serum gastrin response to a meat extract drink was measured in 16 non-diabetic subjects, in 40 diabetic subjects and 9 patients with positive tests for gastric parietal cell antibodies. Standard cardiovascular autonomic function tests were also performed in diabetic subjects. The test drink produced a highly significant rise in the serum gastrin concentration (p less than 0.001). Diabetic subjects with normal cardiovascular autonomic function tests had slightly lower stimulated gastrin concentrations than non-diabetic subjects. In diabetic subjects with abnormal cardiovascular autonomic function tests the distribution of gastrin concentrations after the test drink was bimodal. Eleven out of 20 had 45-min gastrin concentrations greater than 120 pg/ml, compared with 2 out of 20 diabetics with normal cardiovascular autonomic function tests and 1 out of 16 non-diabetic subjects (p less than 0.001). Much higher gastrin responses were found in 5 out of 9 patients with positive tests for gastric parietal cell antibodies. An increased gastrin response may be found in patients with abnormal autonomic function but its value as a marker is limited by the small amplitude of the change and by the significant prevalence of atrophic gastritis, in which much higher gastrin responses may be found.

Adult↗
PubMed1985

Hepatic dysfunction and cardiovascular abnormalities. Occurrence in infants, children, and young adults.

In infants and children, the effect of heart failure and/or cyanotic heart disease on the liver has not been well documented, nor has there been any comparison between the degree of liver dysfunction and hemodynamic factors. Sixty-five patients with cardiovascular abnormalities were examined. Hepatic function, as indicated by laboratory data and histologic liver studies, was compared with the following categories of cardiovascular dysfunction: hypoxemia, systemic venous congestion, and low cardiac output. If any one of these factors was present, or any combination, abnormalities of liver function were usually noted. Patients with both hypoxemia and systemic venous congestion had marked hepatic dysfunction. Those with low cardiac output had the most severe abnormalities. Serial studies indicated that liver function correlated with cardiac status.

Adolescent↗
PubMed1997

Retinoic acid reverses ethanol-induced cardiovascular abnormalities in quail embryos.

The effect of ethanol on early avian cardiovascular development was investigated in stage 8 quail embryos grown in culture for 24 hr. When the culture medium contained 1% ethanol, 50% of the embryos developed abnormalities of the cardiovascular system, some of which resembled vitamin A deficiency. Only 15% of the embryos grown in control media developed abnormalities attributed to the manipulation of the embryo. When all-trans-retinoic acid, the active form of vitamin A, was added at 10(-8) M to the ethanol-containing medium, the cardiovascular development was similar to that of untreated controls. Inclusion of 4-methylpyrazole and citral, enzyme inhibitors for the conversion of retinol to retinoic acid, produced cardiovascular abnormalities in embryos similar to those observed in vitamin A deficiency. These abnormalities were partially prevented by the presence of 10(-8) M all-trans-retinoic acid in the medium. Immunohistochemical studies using antibodies specific for the heart muscle myosin heavy chain (MF-20) and quail endothelial cells (QH-1) revealed that looping of the heart of ethanol-treated embryos was prevented, and the embryonal circulation had no or minimal vascular connections to the extraembryonic circulation. Our studies provide indirect evidence that ethanol is producing vitamin A deficiency during embryonic cardiovascular development and that these effects are specifically prevented by the presence of retinoic acid. These findings may explain some of the symptoms of fetal alcohol syndrome.

Animals↗
PubMedDate not supplied

Fluid status, blood pressure, and cardiovascular abnormalities in patients on peritoneal dialysis.

OBJECTIVE: Hypertension, reduced arterial distensibility, and left ventricular hypertrophy (LVH) are risk factors for mortality in hemodialysis patients. However, few studies have focused on the relation between fluid status, blood pressure (BP), and cardiovascular abnormalities in peritoneal dialysis (PD) patients. This study was designed, first, to assess, using tracer dilution techniques, fluid status in PD patients compared to a control population of stable renal transplant (RTx) patients; second, to study the relation between fluid status, BP, and arterial wall abnormalities; third, to assess the determinants of cardiac structure; and last, to compare office and ambulatory BP measurements with respect to cardiac abnormalities. DESIGN: Cross-sectional study. SETTING: Multicenter study. PATIENTS: 41 stable PD patients with a mean Kt/V urea of 2.4 +/- 0.7, and 77 stable RTx patients. INTERVENTION: Fluid status was assessed by tracer dilution techniques: extracellular volume (ECV) with bromide dilution; total body water (TBW) with deuterium oxide; and plasma volume (PV) with dextran 70. Echocardiography was performed to assess left ventricular mass (LVM), left ventricular end diastolic diameter (LVEDD), and relative wall thickness as indicators of LVH. Echography of the common carotid artery was performed to assess arterial distensibility. Both office and 24-hour ambulatory BP measurements were performed. RESULTS: Fluid status, as assessed by ECV corrected for body surface area (BSA) (ECV:BSA), was significantly different between PD and RTx patients (9.4 +/- 2.6 vs 8.6 +/- 1.2 L/m2, p < 0.05). In 36.6% of the PD patients, ECV:BSA was above the 90th percentile of the RTx patients. Fluid status corrected for BSA, assessed by TBW (TBW:BSA), ECV (ECV:BSA), or plasma volume (PV:BSA), was significantly related to diastolic BP (DBP) (r = 0.35, r = 0.37, r = 0.53; p < 0.05). Arterial distensibility of the common carotid artery was related to systolic BP (SBP) (r = -0.36, p < 0.05). ECV was significantly related to LVEDD (r = 0.41, p < 0.05) as a marker of eccentric LVH, whereas arterial distensibility was related to relative wall thickness (r = -0.53, p < 0.001) as a marker of concentric LVH. An abnormal day-night BP rhythm, which was not related to fluid status, was observed in 68.4% of patients. Ambulatory DBP and SBP but not office DBP and SBP were related to LVM (r = 0.43, r = 0.46; p < 0.01). CONCLUSIONS: A large proportion of PD patients whose treatment prescriptions are in accordance with the Dialysis Outcomes Quality Initiative guidelines were found to be overhydrated compared with a population of stable RTx patients. Fluid status was significantly related to DBP and eccentric LVH, whereas arterial distensibility of the common carotid artery was significantly related to SBP and concentric LVH. In contrast to ambulatory BP, office BP was not related to LVM.

Adult↗
PubMed1989

The cardiovascular abnormalities associated with duplicated segments of chromosome 7.

Congenital heart disease is an integral part of many genetic syndromes such as the major trisomies 13, 18, and 21. Little information, however, is available with reference to the incidence of cardiac anomalies in the trisomy 7 syndromes. Two patients with partial trisomy 7q, one of whom had congenital heart disease, are presented. A review of the literature reveals incomplete description of the cardiovascular abnormalities in the majority of case reports of patients with this syndrome, however, when described it appears that there are no specific defects associated with trisomy 7p and 7q, but only an increased frequency of occurrence. Further clinical and postmortem data regarding details of the congenital heart defects associated with trisomy 7 is required to confirm this preliminary observation.

Chromosomes, Human, Pair 7↗
PubMed1998

Cardiovascular abnormalities in never-treated hypertensives according to nondipper status.

Ambulatory blood pressure monitoring allows a better understanding of blood pressure fluctuations over 24 h than simple clinic measurements. In this way the diagnosis of "white coat" versus "sustained" hypertension and that of "dipper" (patient with blood pressure fall during nighttime > 10% of daytime levels) versus "nondipper" status were made possible. This pilot study has been undertaken to investigate whether patients with recently discovered, never-treated, mild, sustained hypertension have cardiovascular abnormalities according to their dipper/nondipper status. Patients with long-standing (n = 123) and newly discovered (n = 56) sustained hypertension were classified according to their nighttime blood pressure fall, and compared with normotensive controls. Ambulatory blood pressure monitoring was performed noninvasively. Parameters of left ventricular structure, cardiac systolic and diastolic function, and carotid anatomy were determined noninvasively by echographic methods. Significant increases in parameters of cardiac structure as well as abnormalities in diastolic function were observed in patients with long-standing hypertension, regardless of their dipper status. In the group with newly discovered hypertension, left atrium (3.4+/-0.3, 3.7+/-0.5, 3.2+/-0.4 cm in dippers, nondippers, and controls, respectively), end-diastolic diameter index (2.9+/-0.3, 3.0+/-0.2, 2.8+/-0.2 cm/m), and atrial filling fraction (0.50+/-0.07, 0.52+/-0.05, 0.42+/-0.04) were significantly altered only in the nondipper subgroup, in comparison with controls. Significant changes in cardiac structure and diastolic function were observed in nondipper patients with recently discovered hypertension, who, at variance with dippers, show changes similar to those in patients with long-standing hypertension. Hypertensives with the observed abnormalities may benefit from active antihypertensive treatment, which appears, therefore, justified even in an early phase of mild hypertension, in terms of potential reduction of end-organ complications as well as cost-effectiveness.

Adult↗
PubMed2001

Extreme hydrops fetalis and cardiovascular abnormalities in mice lacking a functional Adrenomedullin gene.

Adrenomedullin, a recently identified potent vasodilator, is expressed widely and has been suggested to have functions ranging from reproduction to blood pressure regulation. To elucidate these functions and define more precisely sites of Adm expression, we replaced the coding region of the Adm gene in mice with a sequence encoding enhanced green fluorescent protein while leaving the Adm promoter intact. We find that Adm(-/-) embryos die at midgestation with extreme hydrops fetalis and cardiovascular abnormalities, including overdeveloped ventricular trabeculae and underdeveloped arterial walls. These data suggest that genetically determined absence of Adm may be one cause of nonimmune hydrops fetalis in humans.

Abnormalities, Multiple↗
PubMed1994

Abnormal cardiovascular reflexes in patients with achalasia.

Using 3 non-invasive tests, abnormalities of cardiovascular reflex function were found in 7 of 15 patients with achalasia. Abnormalities of heart rate responses to the Valsalva maneuver, deep breathing, and standing were noted in patients with autonomic neuropathy defect. The findings are consistent with the hypothesis that an abnormality of vagal function may contribute to the pathogenesis of achalasia.

Adult↗
PubMed2003

Prenatal diagnosis of mosaic ring chromosome 22 associated with cardiovascular abnormalities and intrauterine growth restriction.

OBJECTIVES: To present the prenatal diagnosis and perinatal findings of mosaic ring chromosome 22. CASE: Amniocentesis was performed at 18 gestational weeks because of an advanced maternal age. Cytogenetic analysis of the cultured amniotic fluid cells revealed mosaicism for ring chromosome 22, 45,XX,-22[6]/46,XX,r(22)(p13q13.31)[15]. Abnormal fetal sonographic findings included small for gestational age, a ventricular septal defect, and truncus arteriosus. The pregnancy was terminated. Additional phenotypic findings included hypertelorism, epicanthal folds, and abnormal ears. Cytogenetic analysis of the cord blood lymphocytes revealed a complex mosaic karyotype, 45,XX,-22[7]/46,XX,r(22)(p13q13.31)[82]/46,XX,idic r(22)(p13q13.31;p13q13.31)[11]. Cytogenetic analysis of the hepatocytes also revealed mosaic r(22) with mosaicism for idic r(22) and monosomy 22. The deletion of distal 22q and the duplication of 22q11.2 on idic r(22), and the distal 22q deletion on r(22) were demonstrated by fluorescent in situ hybridization (FISH) analysis using 22q terminal probes at 22q13 and a DiGeorge syndrome critical region probe at 22q11.2. The breakpoint on distal 22q13 and the extent of the duplication of 22q on idic r(22) was determined by examining polymorphic markers specific for chromosome 22 using quantitative fluorescent polymerase chain reaction assays. The chromosomal aberration was of maternal origin. CONCLUSION: Molecular and FISH studies allow a better delineation of some prenatally detected aneuploidy syndromes and help elucidate the genetic pathogenesis. Fetuses having mosaic r(22) with a low level mosaicism for r(22) duplication/deletion may present cardiovascular abnormalities and intrauterine growth restriction on prenatal ultrasound.

Abnormalities, Multiple↗
PubMed1981

Abnormal cardiovascular reflexes in juvenile diabetics as preclinical signs of autonomic neuropathy.

The prevalence of abnormalities of cardiovascular reflexes as a marker of autonomic neuropathy was studied in a group of juvenile diabetics with long-standing disease, aged 20-58 years (mean 36). No patient had clinical evidence of autonomic failure. The study was carried out employing the most simple techniques and routine equipment. Resting heart rate, beta-to-beat variation, Valsalva ratio, systolic blood pressure in supine position and immediately after standing were measured. The results were compared with those determined in an age and sex-matched population. Beat-to-beat variation test appeared to be the most sensitive technique in detecting an impaired autonomic function (12/54 = 22.2%). Resting tachycardia was found in 10 patients and postural hypotension in 6. Only 1 patient had an abnormal Valsalva ratio associated with postural hypotension and reduced beta-to-beat variation. In agreement with previous studies our data confirm that autonomic dysfunction is frequent in asymptomatic diabetics. The methods to detect these abnormalities are easy to perform. Therefore they may be routinely used as screening tests in the diabetic population.

Adult↗