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Biomedical subjects

B A Berko

Publications and source records attributed to B A Berko.

3 recordsLinked to original sources

Gender-related differences in cardiomyopathy.

As with other cardiovascular diseases, there are sufficient data to suggest significant gender-related differences in the prevalence and presentation of congestive heart failure and myocardial diseases. From animal studies, it is apparent that there are sex-related differences in intrinsic ventricular function and in the cardiovascular response to various stimuli, which are at least partly modulated through direct effects of sex hormones on the heart. Although similar data are not available in humans, it seems likely that similar gender-related differences in cardiac function exist and may in part account for the observed differences in myocardial diseases in men and women. Additionally, genetic factors may contribute to these differences, as X-linked disorders may present differently in males and females. An awareness of the impact of sex-related factors is clearly important in the evaluation of any patient presenting with heart failure or cardiomyopathy and may alter both diagnostic and therapeutic considerations, as well as broaden our basic knowledge and understanding of the pathogenetic mechanisms involved in myocardial dysfunction.

Cardiomyopathies↗

Variable responses of mitral valve motion and flow in systemic hypertension and in idiopathic dilated cardiomyopathy.

The relation between transmitral flow and diastolic mitral valve motion were examined in 17 normal persons, 14 patients with hypertension and 12 patients with idiopathic dilated cardiomyopathy. M-mode echograms were analyzed for early and late diastolic mitral leaflet separations, their ratio and E-F slope. Pulsed Doppler transmitral flow was analyzed for early and late velocities, their ratio and early flow deceleration. Early diastolic mitral valve leaflet separation was reduced in patients with hypertension (at 28 +/- 5 mm [p less than 0.05] ) and in patients with cardiomyopathy (at 22 +/- 3 mm [p less than 0.01] ). Flow velocity was also reduced in patients with hypertension (at 52 +/- 11 cm/s [p less than 0.05] ) and in patients with cardiomyopathy (at 48 +/- 15 cm/s [p less than 0.01] ). However, early leaflet separation and flow velocity were not related (r = 0.26). Late diastolic leaflet separation was similar (at 25 +/- 5 mm) in normal subjects and in those with hypertension (at 23 +/- 6 mm), but was reduced in patients with cardiomyopathy (at 18 +/- 3 mm [p less than 0.01] ). In contrast, late flow velocity was increased in patients with hypertension (at 52 +/- 12 cm/s [p less than 0.05] ) but unchanged in patients with cardiomyopathy (at 42 +/- 16 cm/s). The ratio of early to late leaflet separation was similar in all groups, whereas the ratio of flow velocities was reduced in hypertensive patients. Neither the E-F slope not early flow deceleration was altered in either pathologic group. Thus, hypertension and cardiomyopathy had similar effects in early rather than late diastole.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

X-linked dilated cardiomyopathy.

To study the inheritance of idiopathic dilated cardiomyopathy, we investigated a large kindred in which 11 young male members had definite or possible evidence of the disorder. The five affected males for whom we had complete clinical data survived for 5 to 12 months after the onset of symptoms, which occurred early in life (ages 15 to 21 years). In six other males, clinical data were incomplete but suggested possible cardiomyopathy. Three mothers of affected males were given a diagnosis of definite, and two of possible, late-onset dilated cardiomyopathy. These women presented in their 40s with atypical chest pain, and progressive congestive heart failure developed gradually over a period of 10 or more years. X-linked inheritance of dilated cardiomyopathy is suggested in this family by the early onset in males, late onset in females, and no evidence of male-to-male transmission. The late onset of the disease in females, in contrast to the early onset in hemizygous males, is compatible with heterozygosity for the mutant allele. Since most cases of genetically lethal X-linked syndromes appear to be sporadic, for every case of "idiopathic" dilated cardiomyopathy in which X-linked inheritance can be confirmed from family information, it is possible that there are several nonfamilial cases due to a mutation at the same locus.

Adult↗