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Invasion of the cardiovascular system in childhood malignant hepatic tumors.

PURPOSE: To evaluate the utility of transthoracic echocardiography for the early detection of subclinical cardiac metastasis in childhood malignant hepatic tumors. PATIENTS AND METHODS: From April 1995 until February 2000, 12 consecutive children with malignant hepatic tumor were enrolled in this study. To determine the degree of invasion of the cardiovascular system, transthoracic echocardiography was performed for all patients at the time of initial diagnosis and also at subsequent follow-up investigations every 6 months until the patient was deemed to be disease-free, or until the patient died. RESULTS: There were seven patients diagnosed with hepatocellular carcinoma (six boys, one girl) and five patients diagnosed with hepatoblastoma (three boys, two girls). Most tumors were multiple (7/12) and involved both lobes of the liver (7/12). Inferior vena cava thrombi were observed in four patients. Three patients exhibited intracardiac tumor metastasis, and lung metastasis was noted in four patients. Lung metastasis was significantly more common in children with cardiovascular involvement (4/4) compared with those without (0/8). The ages of the patient, levels of alpha-fetoprotein, and types of tumor did not differ between the two groups. CONCLUSIONS: Echocardiography may be useful for the early detection of cardiovascular metastases of malignant hepatic tumors in children; this was the case for 33% of the patients in this series. The frequent occurrence of cardiovascular tumor involvement and the high degree of association between lung metastasis and cardiovascular involvement observed in this small series suggest that transthoracic echocardiography should be studied prospectively in a large series of children with hepatic tumors.

Adolescent↗

[Pathophysiological roles of the prostanoids in the cardiovascular system: studies using mice deficient in prostanoid receptors].

Prostanoids, consisting of the prostaglandins (PGs) and thromboxanes (TXs), exert various actions through activation of their specific receptors. They include the DP, EP, FP, IP, and TP receptors for PGD2, PGE2, PGF2alpha, PGI2, and TXA2, respectively. Moreover, EP receptors are classified into four subtypes, the EP1, EP2, EP3 and EP4 receptors. Using mice lacking prostanoid receptors, we intended to clarify in vivo roles of prostanoids under pathophysiological conditions of the cardiovascular system, which include ischemia-induced cardiac injury, pressure overload-induced cardiac hypertrophy, renovascular hypertension, tachycardia during systemic inflammation and thromboembolism. The results demonstrated that 1) PGI2 plays an important role in attenuating the ischemic injury and the pressure overload-induced hypertrophy of the hearts, and also contributes to the development of renovascular hypertension; 2) PGE2 plays a cardioprotective role against the ischemic injury via both the EP3 and EP4, and also participates in acute thromboembolism via the EP3; and 3) both PGF2alpha and TXA2, which have been produced during systemic inflammation, are responsible for tachycardia.

Cardiovascular Diseases↗

[An echocardiographic study of the cardiovascular system in patients with kyphoscoliotic deformation of the spine in Marfan's syndrome].

In the work are presented the results of echocardiographic investigation of 19 patients (aged 11-15) with kyphoscoliotic spine deformities at the Marfan's syndrome. The analysis of the obtained data has shown that the most common type of the cardiovascular system pathology in 78.9% of the examined children and adolescents was the II and III stage prolapse of the mitral valve. The changes of the heart cavity dimensions and the signs of the ventricle overloading have not been detected. Prolapse of the mitral valve cusps to the III stage was the most often accompanied by the root and aorta ascending section dilatation. The presence of the heart affection should be considered as one of the indications to carry out the corrective operations at the spine, allowing to reduce the heart overloading and decrease the probability and rate of progression of the cardiac disturbances, specific for this syndrome.

Adolescent↗

Cardiovascular systemic regulation by plantar surface stimulation.

UNLABELLED: The decreased blood pressure and flow rates associated with orthostasis have been implicated in the etiology of numerous clinical conditions, including deep vein thrombosis, chronic fatigue syndrome, and more recently osteoporosis. Here, we investigate the potential of low-magnitude vibration, applied at the plantar surface, to inhibit the cardiovascular responses of adult women to the orthostatic stress associated with quiet sitting. METHODS: Thirty healthy women, aged 22-82 years, were exposed to a plantar-based vibration immediately after taking a seated position. Seven stimulus frequencies (0, 15, 22, 44, 60, 90, and 120 Hz, all at 0.2g) were tested on each subject, and cardiovascular responses were followed for 20 minutes. Each subject experienced only a single test frequency on any day. Pre- and poststimulus blood pressures and continuous electrocardiogram results were obtained, from which mean arterial pressure (MAP) and heart rate variability (HRV) were calculated. RESULTS: In the per-protocol study population (n = 25), 20 minutes of quiet sitting was associated with an average depression of 8.95 mm Hg in systolic pressure and of 1.9 mm Hg in diastolic blood pressure, corresponding to an average decrease in MAP of 5.15 mm Hg. These orthostasis-based changes in blood pressure were significantly reduced by exposure to plantar vibration, in a frequency-dependent manner, with essentially complete suppression of the drop in MAP achieved with plantar stimulation at 44 Hz (P < or = . 01). In the orthostatically hypotensive subpopulation (n = 15), both the 9.3-mm Hg depression in MAP and the decline in HRV were eliminated by exposure to plantar vibrations in the 40- to 60-Hz range (P = .01 and P = .03, respectively). These results are consistent with the hypothesis that the plantar vibration may be stimulating type IIA muscle fiber activity in the leg, which is critical for effective skeletal muscle pumping in the absence of locomotion. CONCLUSIONS: Our findings lead us to suggest that noninvasive, low-level, plantar-based vibration in the regime of 30-60 Hz can significantly inhibit the effects of the orthostatic stress of quiet sitting on the cardiovascular system.

Adult↗