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At least 685 records · Page 38Linked to original sources
PubMed1984

A prospective study of platelet metabolism in rheumatic heart disease. Effect of prosthetic heart valve.

The metabolic activity of platelets in patients with advanced rheumatic heart disease (RHD) was estimated by measurement of heat production in a microcalorimeter. Twenty-nine patients were randomly selected and prospectively followed before and after valve replacement with Björk-Shiley prosthesis. Before the operation a significantly (P less than 0.02) elevated platelet heat production was found compared with normal subjects, 63 +/- 5 fW/cell and 59 +/- 4 fW/cell, respectively, probably due to the presence of a younger and metabolically more active platelet population. Platelet count before the operation was significantly lower than normal (P less than 0.001). Platelet heat production did not correlate with either type of valvular disease, the presence of valvular calcification or atrial fibrillation. After valve replacement the platelet heat production significantly decreased (P less than 0.001) to 58 +/- 5 fW/cell and the platelet count normalized. The highest incidence of thromboembolic manifestations was in the immediate postoperative period. The greatest reductions in platelet heat production. 19% and 27% were observed in two patients with thromboembolic events, as compared with an average of 4% for the rest of the operated patients without complications. The possible relationship between changes in platelet heat production and thromboembolism in patients with RHD is discussed.

Adult↗
PubMed1989

The Rochester Coronary Heart Disease Project: effect of cigarette smoking, hypertension, diabetes, and steroidal estrogen use on coronary heart disease among 40- to 59-year-old women, 1960 through 1982.

A population-based case-control study of coronary heart disease (CHD) risk in young women attributable to cigarette smoking, hypertension, diabetes, and steroidal estrogen use was conducted among residents of Rochester, Minnesota. All newly diagnosed cases of CHD (sudden unexpected death [SUD], N = 18; myocardial infarction [MI], N = 90; and angina, N = 133) among female Rochester residents 40 to 59 years of age during the years 1960 through 1982 were identified, and two community control subjects were matched for age and duration of community medical record. The overall adjusted odds ratio (OR) for the association between steroidal estrogen use and definite CHD (MI and SUD) was 0.6 (95% confidence interval [CI] = 0.2 to 1.3). Smoking (OR = 5.1; 95% CI = 2.3 to 11.6), hypertension (OR = 4.8; 95% CI = 2.3 to 10.2), and diabetes (OR = 8.4; 95% CI = 1.6 to 44.5) were strong risk factors for CHD events. If considered causal, cigarette smoking accounted for 64% of all MIs and SUDs in the community, hypertension accounted for 45%, and diabetes accounted for 13%. Although steroidal estrogen exposure reduced CHD among these women by 14%, giving steroidal estrogens to all women in this age group might reduce the population rates of MI by as much as 45%.

Adult↗
PubMed1999

[Observation of preventing and treating effect of Salvia miltiorrhiza composita on patients with ischemic coronary heart disease undergoing non-heart surgery].

OBJECTIVE: To observe the preventing and treating effect of Salvia miltiorrhiza composita (SMC) on patients with ischemic coronary heart disease (CHD) undergoing non-heart surgery. METHODS: The 108 patients were randomly divided into the control group and treatment group. In the treatment group, each patient of 54 were administered SMC intravenously during the operation. ECG, HR, MAP and SpO2 were observed and bleeding quantity was measured perioperatively. RESULTS: Effective rate of ECG in treatment group was 90.7% (49/54 cases) and the control group was 35.2% (19/54 cases). There was significant difference between the two groups (P < 0.01). HR of the treatment group was no great flutter but control group became faster (P < 0.05). MAP and SpO2 of the two groups were no significant difference perioperatively. There was no significant difference to bleeding quantity between the two groups. CONCLUSIONS: SMC could effectively improve and protect myocardial ischemia in patients with CHD undergoing non-heart surgery, and no side effect was found.

Aged↗
PubMed1980

Incidence of coronary artery disease in patients with valvular heart disease.

The case notes, cardiac catheterisation data, and coronary arteriograms of 239 patients investigated for valvular heart disease during a five year period were reviewed. Angina present in 13 of 95 patients with isolated mitral valve disease, 43 of 90 patients with isolated aortic valve disease, and 18 of 54 patients with combined mitral and aortic valve disease. Significant coronary artery disease was present in 85 per cent of patients with mitral valve disease and angina, but in only 33 per cent of patients with aortic valve disease and angina. Patients with no chest pain still had a high incidence of coronary artery disease, significant coronary obstruction being present in 22 per cent with mitral valve disease, 22 per cent with aortic valve disease, and 11 per cent with combine mitral and aortic valve disease. Several possible clinical markers of coronary artery disease were examined but none was found to be of practical help. There was, however, a significant inverse relation between severity of coronary artery disease and severity of valve disease in patients with aortic valve disease. Asymptomatic coronary artery disease is not uncommon in patients with valvular heart disease and if it is policy to perform coronary artery bypass grafting in such patients, routine coronary arteriography must be part of the preoperative investigation.

Adult↗
PubMedDate not supplied

Morphometric analysis of fossa ovalis in rheumatic heart disease.

BACKGROUND: Rheumatic heart disease is an important cause of valvular disease in India, with resultant alterations in the interatrial septum and fossa ovalis. Morphometric details of fossa ovalis may help in its localization during transseptal catheterization so as to prevent complications. METHODS AND RESULTS: Autopsy heart specimens of rheumatic heart disease (n=30) and non-cardiac death (n=30) patients between 15-45 years of age were studied as case and control group, respectively. The dimensions of fossa ovalis and interatrial septum were measured. The ratio of area of fossa ovalis to septum was calculated. Case group showed a significant increase in surface area of septum and fossa as compared to control group. The septal area was significantly increased in 15-30 years and 31-45 years groups, specially females in the former group. The fossa area was increased only in 31-45 years age group. The ratio of area of fossa to septum was not statistically altered in cases versus controls. Case group, specially females of 15-30 years, showed a significant horizontal orientation of fossa as compared to controls. Cases having both mitral and aortic stenosis showed highest increase in the areas of fossa and septum, as also the most horizontal orientation of fossa. CONCLUSIONS: The enlargement of the septal area begins at an early age in rheumatic heart disease along with initial hemodynamic and valvular alterations. There is a categorical horizontal orientation of fossa ovalis in these cases. Varying dynamics in stenotic and regurgitant valves leads to varying morphological changes in dimensions of fossa ovalis and septum.

Adolescent↗
PubMed1975

The functional defect in amyloid heart disease. The "stiff heart" syndrome.

Left ventricular performance was studied in three patients with heart failure due to amyloid deposits. The diagnosis of amyloidosis was proved by cardiac biopsy in two patients and by rectal biopsy in the third. One patient had myelomatosis, but the other two had no other identifiable disease. The investigative technique allowed simultaneous measurements of pressure and volume in the left ventricle. The functional defect with slow cardiac filling at high pressure and greatly reduced left ventricular contraction differed from that of constrictive pericarditis and other heart muscle disease. These features of a "stiff heart" are probably unique to amyloidosis and should make possible positive recognition of the condition on the basis of echocardiographic, angiographic and hemodynamic findings.

Adult↗
PubMed1993

Relation of fibrinogen to presence and severity of coronary artery disease is independent of other coexisting heart disease. The ECAT Angina Pectoris Study Group.

Six hundred fifty seven patients with angina pectoris underwent coronary angiography after measurement of plasma fibrinogen levels. Coronary artery disease (CAD) was angiographically confirmed in 75% of the patients. Other cardiac disease, either alone or in combination with CAD, was diagnosed in 8% and 11% of cases, respectively; 17% of the patients had no evidence of overt heart disease. Fibrinogen concentrations showed a graded increase according to the severity of coronary stenosis (p = 0.02) but were not significantly associated with any other cardiac heart disease. However, patients with valvular heart diseases had on average a 5.9% elevation of fibrinogen levels as compared to patients without proven cardiac disease (p = 0.08), similar to the observed 6.9% increase for CAD (p = 0.005). On average, patients with cardiomyopathies or pulmonary hypertension had only a 1.6% or 1.2% increase, respectively. The increase in fibrinogen levels associated with CAD was similar in patients with and without coexisting heart diseases. The results demonstrate a significant positive relation of fibrinogen to the presence and severity of CAD irrespective of a possible confounding influence from other cardiac diseases. The results therefore lend support to the hypothesis of a pathogenetic role for fibrinogen as a cardiovascular risk factor.

Coronary Angiography↗
PubMed1998

Relative weight, weight change, and risk of coronary heart disease in the Honolulu Heart Program.

Risk of coronary heart disease (CHD) among the Honolulu Heart Program participants was examined in relation to body mass index (BMI) at age 25 and two subsequent periods of weight change: age 25 to examination I (1965-1968) and examination I to examination III (1971-1974). During a maximum follow-up period of 17 years after examination III, there were 479 incident cases of CHD among the study sample of 6,176 Japanese-American men. Levels of BMI at age 25 were positively related to CHD incidence after statistical control for age, smoking, and subsequent weight change. Relative risk between the lowest and highest BMI categories was 2.44 (95% confidence interval (CI) 1.61-3.69). Compared with a weight change of less than 2.5 kg between age 25 and examination I, relative risks were 1.41 (95% CI 1.00-1.97) for a weight gain between 2.6 and 5 kg, 1.60 (95% CI 1.22-2.11) for a weight gain between 5.1 and 10 kg, and 1.75 (95% CI 1.32-2.33) for a weight gain of more than 10 kg. During the examination I-III period, in contrast, the highest risk of CHD was found in men who lost the greatest amount of weight; the relative risk of CHD for men who lost more than 2.5 kg was 1.25 (95% CI 0.98-1.60). The authors conclude that levels of relative weight in early adulthood were positively related to risk of CHD occurring much later in the lives of these men. The association between CHD incidence and weight change appeared to be modified by age, with higher risks for earlier weight gain and later weight loss in the lives of these men.

Adult↗
PubMed1975

Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: prevalence of coronary and hypertensive heart disease and associated risk factors.

A study of coronary heart disease (CHD) among Japanese migrants compared with Japanese living in Japan provided the opportunity to study factors possibly responsible for the high rates of CHD in America as compared with Japan. Comparable methods were employed in examining 11,900 men of Japanese ancestry aged 45--69 living in Japan, Hawaii and California. The age-adjusted prevalence rates for definite CHD as determined by ECG were: Japan 5.3, Hawaii 5.2 and California 10.8/1000. For definite plus possible CHD the rates were 25.4, 34.7 and 44.6. The prevalence of angina pectoris and pain of possible myocardial infarction, determined by questionnaire, showed a similar gradient. Elevated serum cholesterol showed a Japan-Hawaii-California gradient, but the prevalence of hypertension in Japan was intermediate between the prevalence in Hawaii and the higher prevalence in California. The three geographic locations were compared as to prevalence of CHD at comparable levels of blood pressure and cholesterol. At each blood pressure level and at each cholesterol level, the greater prevalence of CHD in California persisted. These facts, plus the near universality of smoking in Japan, suggest that conventional risk factors only partly explain the observed gradient in CHD.

Age Factors↗
PubMed2002

Single-nucleotide polymorphisms in the lipoprotein lipase gene associated with coronary heart disease in Chinese.

Coronary heart disease is a complex disease reflecting the interaction of multiple genes with the environment (e.g. diet, life style). Lipoprotein lipase (LPL) plays an important role in lipid metabolism and the pathogenesis of coronary atherosclerosis. Recent associations between single-nucleotide polymorphisms in the LPL gene and heart disease have been reported, but little is known in Chinese. The LPL gene spans >26 kb, with an mRNA of 3549 bp. In the present study, we screened 5155 bp (565 bp of 5' flanking region, nine exons and donor- and acceptor-splice sites, and some intronic bases) in 160 Chinese patients with confirmed coronary heart disease and 150 age- and gender-matched controls. Thirteen of the sixteen single-nucleotide polymorphisms that we found have not been previously reported. In males, significant (P<0.05) differences between the coronary heart disease patients and controls were found for five single-nucleotide polymorphisms: -421G>A (5' flanking region); +13,577C>A (intron 2); +16,052G>A, R192Q (exon 5); +16,173C>G and +16,177T>C (intron 5). In females, significant differences between the patients with coronary heart disease and controls were found for only the -421G>A and +16,052G>A (R192Q) mutations. Among the coronary heart disease males, significant (P<0.05) associations were found between the low-HDL high-triglyceride (LHDL/HTG) phenotype and the non-LHDL/HTG trait for the 5' flanking-421G, the intron 2+13,577C, and the exon 5+16,052G mutations, with odds-ratios (ORs)[confidence intervals] of 3.90[1.12-13.66], 3.38[1.22-9.40], and 3.22[1.04-10.01], respectively; no corresponding associations were found in females. There were 69, 51, 57 and 41 unphased haplotype patterns in male coronary heart disease, male control, female coronary heart disease and female control groups, respectively; the computer program PM-Plus found the heterogeneity model by far the best fit (P<0.0001 in males, >0.01 in females). These data show that some single-nucleotide polymorphisms in the LPL gene among Chinese are associated with abnormal lipid and lipoprotein profiles and predisposition to coronary heart disease, a genetically heterogeneous complex disease, and that they are gender-specific.

Adult↗
PubMed1992

Apolipoprotein(a) phenotypes, Lp(a) concentration and plasma lipid levels in relation to coronary heart disease in a Chinese population: evidence for the role of the apo(a) gene in coronary heart disease.

Elevated lipoprotein(a) (Lp[a]) concentrations are associated with premature coronary heart disease (CHD). In the general population, Lp(a) levels are largely determined by alleles at the hypervariable apolipoprotein(a) (apo[a]) gene locus, but other genetic and environmental factors also affect plasma Lp(a) levels. In addition, Lp(a) has been hypothesized to be an acute phase protein. It is therefore unclear whether the association of Lp(a) concentrations with CHD is primary in nature. We have analyzed apo(a) phenotypes, Lp(a) levels, total cholesterol, and HDL-cholesterol in patients with CHD, and in controls from the general population. Both samples were Chinese individuals residing in Singapore. Lp(a) concentrations were significantly higher in the patients than in the population (mean 20.7 +/- 23.9 mg/dl vs 8.9 +/- 12.9 mg/dl). Apo(a) isoforms associated with high Lp(a) levels (B, S1, S2) were significantly more frequent in the CHD patients than in the population sample (15.9% vs 8.5%, P less than 0.01). Higher Lp(a) concentrations in the patients were in part explained by this difference in apo(a) allele frequencies. Results from stepwise logistic regression analysis indicate that apo(a) type was a significant predictor of CHD, independent of total cholesterol and HDL cholesterol, but not independent of Lp(a) levels. The data demonstrate that alleles at the apo(a) locus determine the risk for CHD through their effects on Lp(a) levels, and firmly establish the role of Lp(a) as a primary genetic risk factor for CHD.

Adolescent↗
PubMed2000

Benefits of lipid-lowering agents in stroke and coronary heart disease: pharmacoeconomics.

Coronary heart disease remains the leading cause of death in the United States. Although coronary heart disease and stroke entail very expensive therapies and extensive hospital utilization, the cost of preventive measures is also quite expensive. In this review, the factors that determine the cost-effectiveness of statin therapy for the primary and secondary prevention of coronary heart disease are discussed. A risk-based strategy for the selection of patients seems to provide cost-effective utilization of this potent treatment strategy. Appropriate patient selection should be accompanied by aggressive measures to improve utilization and compliance through improved physician and patient education.

Coronary Disease↗