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At least 577 records · Page 32Linked to original sources
PubMed1975

Applications of diagnostic ultrasound and radionuclides to cardiovascular diagnosis. Part II. Cardiovascular disease in the young.

Echocardiography (ECHO) and radionuclide cardiography have had a significant impact on pediatric cardiology because they have proved to be sensitive enough to permit early diagnosis of many forms of heart disease and in some cases to estimate its severity and to provide information concerning ventricular performance. An overview of the anatomic and functional information that can be obtained from these two methods will be presented first, followed by details concerning the indications for their use and their relative clinical value in various acquired and congenital heart diseases. We have stressed particularly those facets of pediatric cardiac disease that differ most from those in the adult.

Aortic Coarctation↗
PubMed1987

Cardiovascular disease in the elderly. Hypertensive cardiovascular disease.

Hypertension is a common problem with advancing age, approaching or exceeding a 50% prevalence in the aging population. When blood pressure consistently exceeds 140/90 mm Hg, it should be treated. Patients with borderline isolated systolic hypertension should have their blood pressure measured at 6 month intervals. Risk of isolated systolic hypertension is sufficient to justify cautiously administering drug therapy if nonpharmacologic therapy fails to bring the systolic pressure less than 160 mm Hg, even though controlled studies have not been completed to prove efficacy. Both nonpharmacologic and pharmacologic therapy are recommended for those with sustained pressure elevation. Adverse effects of antihypertensive drugs may be minimized by starting with lower doses and by checking blood pressure in the upright position.

Aged↗
PubMed2002

Cardiovascular ageing in health sets the stage for cardiovascular disease.

The incidence and prevalence of coronary disease, hypertension, heart failure and stroke increase exponentially with advancing age. While epidemiologic studies have discovered that aspects of lifestyle and genetics are risk factors for these diseases, age, per se, confers the major risk. Thus, it is reasonable to hypothesise that specific pathophysiological mechanisms that underlie these diseases become superimposed on cardiac and vascular substrates that have been modified by an 'ageing process', and that the latter modulates disease occurrence and severity. In order to unravel this age-disease interaction, the nature of the ageing process in the heart and vasculature requires elucidation. Some aspects of the current understanding of ageing of the heart and blood vessels in the absence of apparent disease are the focus of this review.

Journal Article↗
PubMed2004

The relationship of cardiovascular risk factors to microalbuminuria in older adults with or without diabetes mellitus or hypertension: the cardiovascular health study.

BACKGROUND: Microalbuminuria is a risk factor for coronary heart disease (CHD). It occurs most commonly in the settings of diabetes and hypertension. The mechanisms by which it increases CHD risk are uncertain. METHODS: We examined the cross-sectional association of microalbuminuria with a broad range of CHD risk factors in 3 groups of adults aged 65 years or older with and without microalbuminuria: those with (1) no diabetes or hypertension (n = 1,098), (2) hypertension only (n = 1,450), and (3) diabetes with or without hypertension (n = 465). RESULTS: Three factors were related to microalbuminuria in all 3 groups: age, elevated systolic blood pressure, and markers of systemic inflammation. In patients with neither diabetes nor hypertension, increasing C-reactive protein levels were associated with microalbuminuria (odds ratio per 1-mg/L increase, 1.46; 95% confidence interval [CI], 1.15 to 1.84). Among those with diabetes, an increase in white blood cell (WBC) count was associated with microalbuminuria (odds ratio per 1,000-cell/mL increase, 2.57; 95% CI, 1.12 to 5.89). Among those with hypertension, an increase in WBC count (odds ratio per 1,000-cell/mL increase, 1.83; 95% CI, 1.04 to 3.23) and fibrinogen level (odds ratio per 10-mg/dL increase, 1.02; 95% CI, 1.00 to 1.05) were significantly associated with microalbuminuria. In all 3 groups, prevalent CHD was related to an elevated WBC count. In none of the 3 groups was brachial artery reactivity to ischemia, an in vivo marker of endothelial function, related to microalbuminuria. CONCLUSION: Microalbuminuria is associated with age, systolic blood pressure, and markers of inflammation. These associations reflect potential mechanisms by which microalbuminuria is related to CHD risk.

Age Distribution↗
PubMedDate not supplied

AHA scientific statement: practice standards for electrocardiographic monitoring in hospital settings: an American Heart Association Scientific Statement from the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young: endorsed by the International Society of Computerized electrocardiology and the American Association of Critical-Care Nurses.

The goals of electrocardiographic (ECG) monitoring in hospital settings have expanded from simple heart rate and basic rhythm determination to the diagnosis of complex arrhythmias, myocardial ischemia, and prolonged QT interval. Whereas Computerized arrhythmia analysis is automatic in cardiac monitoring systems, computerized ST-segment ischemia analysis is available only in newer-generation monitors, and computerized QT-interval monitoring is currently unavailable. Even in hospitals with ST-monitoring capability, ischemia monitoring is vastly underutilized by healthcare professionals. Moreover, because no computerized analysis is available for QT monitoring, healthcare professionals must determine when it is appropriate to manually measure QT intervals (eg, when a patient is started on a potentially proarrhythmic drug). The purpose of the present review is to provide "best practices" for hospital ECG monitoring. Randomized clinical trials in this area are almost nonexistent; therefore, expert opinions are based upon clinical experience and related research in the field of electrocardiography. This consensus document encompasses all areas of hospital cardiac monitoring in both children and adults. The emphasis is on information clinicians need to know to monitor patients safely and effectively. Recommendations are made with regard to indications, time frames, and strategies to improve the diagnostic accuracy of cardiac arrhythmia, ischemia, and QT-interval monitoring. Currently available ECG lead systems are described, and recommendations related to staffing, training, and methods to improve quality are provided.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Acute and chronic cardiovascular effects of doxorubicin in the dog: the cardiovascular pharmacology of drug-induced histamine release.

We evaluated the acute hemodynamic effects of doxorubicin in the open-chest dog. Doxorubicin at doses of 1-4 mg/kg administered over 2 min produced profound hemodynamic changes that were similar to those produced by histamine. These changes persisted despite administering the drug as a slow infusion. Histamine release in peripheral tissues was documented by a marked increase in venous histamine levels following doxorubicin administration. The heart extracted histamine during a period when arterial levels were increased, as indicated by consistently low coronary sinus/aortic ratios. Secondary catecholamine release occurred in response to histamine and histamine-mediated hemodynamic effects. Immunoreactive prostaglandins E and F were increased in coronary sinus blood beginning 30 min after the initiation of a continuous infusion of doxorubicin, and increased slowly thereafter. H1- and H2-receptor blockade with diphenhydramine and cimetidine prevented the early (2-30 min postinfusion) effects of doxorubicin, and combined histaminergic and adrenergic blockade prevented the late effects. A dose of doxorubicin (1 mg/kg) that released histamine and catecholamines produced primary cardiac effects acutely and a cardiomyopathy when administered chronically. The release of vasoactive substances could be part of the pathogenetic mechanism of anthracycline cardiomyopathy.

Animals↗
PubMed1996

Cardiovascular reactivity of mitral valve prolapse patients during experimental stress exposure: evidence for a functional nature of cardiovascular symptoms.

We studied a group of 18 patients with mitral valve prolapse (MVP) and a group of 20 healthy controls. Subjects in both groups were subjected to a 1-h experimental stress exposure during which Holter-ECG monitoring was performed and was then continued for the following 24 h. MVP patients complained of significant cardiac palpitation during the stress session, but ECG examination did not reveal significant inter-group differences. However, the two groups did show statistically significant differences in some psychometric measurements (Toronto Alexithymia Scale, Anxiety Sensitivity Index, Fear Questionnaire, Beck Depression Inventory, and Harm Avoidance subscale of Tridimensional Personality Questionnaire) that underlie personality traits known to be important in the process fostering functional somatic symptoms, according to the somatosensory amplification model. As no objective signs of cardiac rhythm modification were found in MVP patients under stress, we postulate that the symptoms for which these patients were referred have a functional nature, and that there is no pathogenetic link with the underlying valvular defect.

Adult↗
PubMed1976

Respiratory and cardiovascular interactions in ducks: the effect of lung denervation on the initation of and recovery from some cardiovascular responses to submergence.

Lung denervation in ducks, by sectioning all vagal branches to one lung following mid-cervical vagotomy on the other side, resulted in immediate bradycardia and fall in breathing frequency. Some 3-5 weeks after lung denervation breathing frequency was within the normal range but the lung inflation reflex, present in unilaterally vagotomized sham-operated ducks, was abolished. During 2 min dives there were no significant differences between sham-operated and denervated ducks in heart rate, arterial blood pressure, blood gas tensions and pH(a). However, during recovery from diving heart rate increased more slowly in denervates and breathing rate was significantly below that attained by shams, although tidal volume rose to a maximum increase of 139% to a maximum of 225% of the pre-dive value in denervates in contrast to a maximum increase of 139% of pre-dive in sham-operated ducks. Both sham-operated and denervated ducks exhibited a significant fall in diastolic blood pressure 60 sec after emergence...

Action Potentials↗