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At least 793 records · Page 44Linked to original sources
PubMed1999

[New cardiovascular drugs: expanded therapeutic possibilities in coronary heart disease and in heart failure].

Important novel developments in the pharmacotherapy of cardiovascular diseases are briefly summarized. New results with lipid lowering statins in secondary prevention of atherosclerosis are mentionned. Atorvastatin, introduced recently, is compared to the other statins. The extended possibilities for inhibition of platelet-aggregation in coronary disease and after interventional coronary therapy with ticlopidine, clopidogrel and specific antagonists of platelet integrin IIb/IIIa receptors (abciximab, tirofibrane) as well as fibrinolysis with reteplase are covered. Among modern trends in pharmacotherapy of heart failure studies with angiotensin-II-receptor inhibition (losartane and related compounds) or betablockers (carvedilol) are worth mentioning.

Cardiovascular Agents↗
PubMed2004

Mechanisms and management of hypertensive heart disease: from left ventricular hypertrophy to heart failure.

Hypertensive heart disease (HHD) is a spectrum of abnormalities that represents the accumulation of a lifetime of functional and structural adaptations to increased blood pressure load. Left ventricular hypertrophy (LVH), increasing vascular and ventricular stiffness,and diastolic dysfunction are prominent intermediate features of this syndrome that operate in parallel with ischemic heart disease and ultimately cause heart failure (HF) if inadequately treated. Outcomes in HHD and HF are improved by antihypertensive drugs at any stage of the condition. This review describes an integrated model of the natural history, pathogenesis, and drug treatment of hypertensive heart disease that is consistent with the recommendations of the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, including an important modification to the HF guideline published by the American College of Cardiology and the American Heart Association that includes LVH and diastolic dysfunction as treatable conditions within the HHD-HF continuum.

Adrenergic beta-Antagonists↗
PubMed1987

Dynamic exercise echocardiography in children with congenital heart disease affecting the left heart.

Thirty-five children (male 22, female 13) with congenital heart disease resulting in volume and pressure overload of the left ventricle were investigated echocardiographically during supine bicycle exercise. The children had to follow a test-protocol with increasing workload. Left ventricular function parameters were measured from M-mode-echocardiography, electrocardiography and phonocardiograms before, during and after exercise and were expressed as fractional shortening (FS), velocity of circumferential fiber shortening (VcF) and the frequency corrected parameters: FScorr. = FS X 100/HR and VcFcorr. = VcF X 100/HR (HR = heart rate). The data of this group of children under study were compared to those obtained from 140 healthy children examined under similar conditions. In children with pressure overload, values for fractional shortening, velocity of circumferential fiber shortening and the frequency corrected parameters were significantly higher than in normals throughout exercise testing. In some children with moderate to severe aortic stenosis or coarctation the frequency corrected parameters showed a decrease at higher exercise levels instead of an increase as seen in the majority of cases. In these cases cardiac output was increased by an abnormal rise in heart rate. This was considered as a diminished left ventricular reserve. After aortic valve replacement in two cases with aortic stenosis, parameters of left ventricular function were still elevated at rest and during exercise testing. In two children with hypertrophic cardiomyopathy the almost maximally elevated rest values did not change during exercise. In children with mild volume overload (small ventricular septal defect or aortic incompetence) the left ventricular function parameters were within the normal range or slightly below.

Adolescent↗
PubMed2001

[Anesthesia for a patient with alcoholic heart disease and transient complete heart block].

A 70-year-old man who had been drinking a bottle of whisky each day was scheduled for laser resection of a tongue tumor. His electrocardiogram showed sinus bradycardia (heart rate was 35-40 bpm), and transient complete heart block was observed. Echocardiography showed hypertrophic cardiomyopathy. After a temporary transvenous pacemaker had been inserted, anesthesia was induced with thiopental and vecuronium bromide, and maintained with sevoflurane and fentanyl. Heart rate was 45.min-1 before the induction of anesthesia, and after the induction increased to 70-80.min-1. Analysis of heart rate variability suggested that the increase in heart rate was due to augmentation of sympathetic nervous activity after intubation and operation stress. After the operation his bradycardia improved gradually, and after 3 months heart rate settled at about 55.min-1. Cadiomyopathy is known to be one of the complications of alcoholism. It was reported that alcoholic heart disease was improved promptly by abstinence from alcohol. During his long hospitalization, abstinence might have improved his severe bradycardia. Thiopental is useful for induction of anesthesia in a patient with severe bradycardia from alcoholic cadiomyopathy.

Aged↗
PubMed1984

Ten-year incidence of coronary heart disease in the Honolulu Heart Program. Relationship to biologic and lifestyle characteristics.

In 10 years of follow-up of 7705 Japanese men living in Hawaii, aged 45-68 years and judged free of coronary heart disease (CHD) at the initial examination during 1965-1968, a total of 511 new CHD cases were identified: fatal CHD, 139; nonfatal myocardial infarction (MI), 216; acute coronary insufficiency, 55; and uncomplicated angina pectoris (AP), 101. The incidence rate of fatal CHD and nonfatal MI for this cohort is less than half the rate for US whites and approximately twice the rate for Japanese men in Japan. The relationships of 14 biologic and lifestyle characteristics measured at baseline examination to the incidence of total CHD and specific manifestations of CHD were examined in bivariate and multivariate analyses. In bivariate analyses, all variables except heart rate were significantly related to the risk of total CHD after adjustment for age. However, when an independent contribution of each variable to CHD risk was evaluated in multiple logistic analyses in which all other variables were taken into account, the numbers of risk factors retaining significant associations varied by clinical subgroup of CHD. Among the characteristics studied, systolic blood pressure was the most powerful and consistent risk factor for all manifestations except AP. Cigarette smoking showed a similar pattern. Serum cholesterol was significantly associated with fatal CHD and nonfatal MI, but its contribution to CHD risk was less potent than systolic blood pressure or cigarette smoking. Glucose intolerance was strongly associated with fatal CHD, but with no other manifestations of CHD. Alcohol consumption demonstrated a strong protective effect upon fatal CHD and nonfatal MI. Uncomplicated AP was distinguished from other CHD manifestations by the lack of association with most of the known major risk factors for CHD, including blood pressure, serum cholesterol, and cigarette smoking.

Aged↗
PubMed2006

[Coronary disease risk and prevalence of heart disease in primary care patients with hypertension and renal disease].

INTRODUCTION AND OBJECTIVES: The presence of renal disease significantly alters the cardiovascular risk of patients with high blood pressure. However, few studies have examined renal parameters in primary care patients. The objectives of this study were to investigate cardiovascular risk and the factors influencing it in hypertensive patients with renal disease and to compare the findings with those in hypertensive patients without renal disease. METHODS: The CORONARIA study involved primary care patients with hypertension from all regions of Spain and included two groups with different degrees of renal disease. RESULTS: In total, 703 patients (9.8%) had renal disease. Hypertensive patients with renal disease had a worse cardiovascular risk profile than other hypertensives. The prevalence of diabetes was double in patients with renal disease. Moreover, the risk of a coronary event was significantly higher in those with renal disease. One-third of hypertensives with renal disease had another previously diagnosed cardiovascular disease. In addition, they more frequently had a history of angina, were twice as likely to have had a myocardial infarction, and were more than twice as likely to have undergone revascularization or to have peripheral vascular disease or cerebrovascular disease. Heart failure was four times more frequent in these patients with renal disease than in other hypertensives. CONCLUSIONS: Patients with hypertension and renal disease have a higher risk of cardiovascular disease, exhibit an increased prevalence of diabetes, and suffer from more extensive target organ damage.

Adult↗
PubMed2002

Heart disease and its related risk factors in Asian Indians.

Although Asian Indians represent the second fastest growing Asian immigrant group in the United States, we know little about their increased risk for coronary artery disease (CAD). A key word search of Medline (using key words Asian Indian, South Asian Indian, coronary artery disease, and heart disease), from 1980-2001, was used to develop a database of articles relating to coronary artery disease for Asian Indians in the United States and abroad. We describe the prevalence and other data of CAD in Asian-Indian communities abroad and in the United States. We then outline certain risk factors for coronary artery disease, specifically diet, cholesterol, and Type 2 diabetes, which contribute to the increased risk of heart disease in Asian Indians. Finally, we describe an approach to screening and potential prevention of coronary artery disease in those of Asian-indian descent in this country.

Adult↗
PubMed1983

Ethnic differences in health knowledge and behaviors related to the prevention and treatment of coronary heart disease. The San Antonio Heart Study.

From a public health perspective, Mexican Americans are widely recognized as an understudied population. Available evidence suggests that Mexican Americans shared equally with non-Hispanic Caucasians (Anglo Americans or "Anglos") in the national decline in coronary heart disease (CHD) mortality during 1970-1976. This finding is somewhat unexpected in view of Mexican Americans' relatively lower socioeconomic status, and it suggests that studying this ethnic group may be strategic in understanding which factors have operated to produce the decline in general. Data obtained from a random sample of Mexican Americans and Anglos residing in three socioeconomically and culturally distinct neighborhoods in San Antonio, Texas, indicated that Anglos were significantly more informed than Mexican Americans about CHD prevention and generally reported engaging in more behaviors specifically aimed toward prevention than did Mexican Americans. Levels of knowledge were not particularly high in either ethnic group; moreover, reported behavior lagged considerably behind knowledge. While Mexican Americans were significantly less likely than Anglos to volunteer knowledge about major heart attack symptoms, there were negligible ethnic differences in awareness of the need for prompt utilization of medical treatment resources when a heart attack actually occurs. Awareness of the need for prompt action was notably high among both ethnic groups. Although limitations in the nature and scope of the data dictate that these findings should be interpreted with caution, the results tend to argue in the direction that prompt access to medical treatment when coronary emergencies occur may have made a relatively greater contribution to the CHD mortality decline in both Mexican Americans and Anglos than did changes in life-style. Much additional data are needed, however, before a definitive explanation of the decline will be possible.

Coronary Disease↗
PubMed2004

[Nebivolol in the treatment of ischemic heart disease patients with chronic heart failure].

AIM: To assess effectiveness of inclusion of nebivolol in complex therapy of patients with chronic heart failure (CHF) due to ischemic heart disease (IHD). MATERIAL: Patients (n=62, age 47-73 years) with NYHA class II-III CHF and left ventricular (LV) ejection fraction (EF) less than 45% receiving standard therapy +/- nebivolol (5 mg/day). The patients were followed up for 4 months. RESULTS: After 4 months improvement of clinical state, exercise tolerance, parameters of central hemodynamics and LV remodeling, lipid spectrum, rheological properties of blood and platelets haemostasis was more pronounced in a group of nebivolol treated patients. CONCLUSION: Inclusion of nebivolol in complex therapy increases efficacy of treatment of patients with CHF due to IHD.

Adrenergic beta-Antagonists↗
PubMed1988

Antimitochondrial autoantibodies in myocardial hypertrophy: comparison between hypertrophic cardiomyopathy, hypertensive heart disease, and athlete's heart.

Antimitochondrial autoantibodies (AMA) were tested by indirect immunofluorescence in three groups of subjects with different types of myocardial hypertrophy: 35 patients affected with hypertrophic cardiomyopathy (HC), 20 patients with cardiac hypertrophy secondary to essential hypertension, and 35 active endurance athletes with exercise-induced left ventricular hypertrophy. Forty-two healthy subjects served as a control group. Left ventricular hypertrophy was considered a left ventricular mass (LVM) echocardiographically calculated (Devereux formula), exceeding 244 gm or a LVM index exceeding 122 gm/m2 (greater than 2 SD from a previously studied normal population). AMA were found in 15 of 35 (43%) patients with HC and in 6 of 20 (30%) patients with hypertensive heart disease (p less than 0.01); in contrast, AMA were not present in the sera of athletes or in the sera of controls. Although the significance of AMA in subjects with pathologic myocardial hypertrophy has not yet been established, their absence in the sera of athletes strengthens the opinion that cellular changes, as a compensatory response of the myocardium to a work overload, have a physiologic fashion in these cases. Moreover, identification of AMA in the sera of athletes with disproportionate severe left ventricular hypertrophy of uncertain origin may be helpful to ensure a single diagnosis.

Adolescent↗
PubMedDate not supplied

Utility of N-terminal brain natriuretic peptide plasma concentrations in comparison to lactate and troponin in children with congenital heart disease following open-heart surgery.

We conducted a prospective study in a pediatric cardiac intensive care unit in order to determine the diagnostic value of N-terminal brain natriuretic peptide (N-BNP) plasma concentration in the perioperative care of children with congenital heart disease (CHD). N-BNP plasma concentrations were determined by using a validated enzyme immunoassay. We measured N-BNP the day before surgery and up to 15 days postoperatively in 23 children (age range, 0.25-11 years) undergoing cardiac surgery due to various CHDs. Supply and duration of catecholamines, vasodilators, and respiratory therapy were determined and correlated to N-BNP. In addition, troponin T (TnT) and arterial Lactat (aL) concentrations were measured simultaneously. We found a significant correlation between preoperative and maximal N-BNP levels and dosage of vasodilators (r = 0.41, p < 0.02 and r = 0.83, p < 0.01, respectively). Maximal TnT and aL levels were not correlated to dosage of vasodilators. The dosage and duration of catecholamines, the duration of respiratory therapy, and the plasma concentration of TnT and aL were not correlated to pre- or perioperative N-BNP. Maximal TnT and aL levels were correlated to duration (r = 0.53, p < 0.01 and r = 0.48, p < 0.02) and dosage (r = 0.52, p < 0.02 and r = 0.60, p < 0.01) of catecholamines and duration of respiratory therapy (r = 0.57, p < 0.01 and r = 0.50, p < 0.02). As recent studies show, N-BNP appears to be a powerful neurohumoral indicator of ventricular function and prognosis for guiding therapy in the outpatient department or for discriminating cardiac from noncardiac symptoms. In contrast, the value of N-BNP for guiding perioperative therapy in pediatric cardiac intensive care units is limited.

Child↗
PubMed2005

Depression and medication adherence in outpatients with coronary heart disease: findings from the Heart and Soul Study.

BACKGROUND: Depression leads to adverse outcomes in patients with coronary heart disease (CHD). Medication nonadherence is a potential mechanism for the increased risk of CHD events associated with depression, but it is not known whether depression is associated with medication nonadherence in outpatients with stable CHD. METHODS: We examined the association between current major depression (assessed using the Diagnostic Interview Schedule) and self-reported medication adherence in a cross-sectional study of 940 outpatients with stable CHD. RESULTS: A total of 204 participants (22%) had major depression. Twenty-eight (14%) of 204 depressed participants reported not taking their medications as prescribed compared with 40 (5%) of 736 nondepressed participants (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.7-4.7; P<.001). Twice as many depressed participants as nondepressed participants (18% vs 9%) reported forgetting to take their medications (OR, 2.4; 95% CI, 1.6-3.8; P<.001). Nine percent of depressed participants and 4% of nondepressed participants reported deciding to skip their medications (OR, 2.2; 95% CI, 1.2-4.2; P = .01). The relationship between depression and nonadherence persisted after adjustment for potential confounding variables, including age, ethnicity, education, social support, and measures of cardiac disease severity (OR, 2.2; 95% CI, 1.2-3.9; P = .009 for not taking medications as prescribed). CONCLUSIONS: Depression is associated with medication nonadherence in outpatients with CHD. Medication nonadherence may contribute to adverse cardiovascular outcomes in depressed patients.

Aged↗
PubMedDate not supplied

Evolution of heart disease in utero.

Cardiac embyogenesis occurs in the first 6 to 7 weeks of human development. Although it is during this time that many of the major cardiovascular defects develop, many of these lesions continue to evolve and others develop in the latter half of gestation. There may be development or progression of ventricular inflow or outflow tract and arch obstruction, and ventricular or great artery hypoplasia. There may be progressive antrioventricular or semi-lunar valve regurgitation which can compromise the fetal circulation. There may be development of dysrhythmias, primary myocardial disease and heart failure. The fetal shunts, the foramen ovale and ductus arteriosus, may change in form and function. Finally, cardiac tumors may develop, grow, or regress. Knowledge of the mechanisms of and potential for progression in fetal heart disease is critical for counseling regarding prognosis and for planning of prenatal and neonatal management.

Disease Progression↗
PubMed1989

The effects of diagnostic criteria on trends in coronary heart disease morbidity: the Minnesota Heart Survey.

The Minnesota Heart Survey assessed attack rates of MI in Twin Cities residents ages 30-74 years in 1970 and 1980. The age-adjusted attack rate per 100,000 of definite MI was similar in 1970 (174.2) and 1980 (179.9) p greater than 0.05, using ECG, chest pain, and blood enzyme concentrations of aspartate transaminase and/or lactic dehydrogenase as criteria. The attack rate of definite MI also remained constant when autopsy findings were included in the algorithm, 197.0 in 1970 and 191.4 in 1980 (p greater than 0.05). Adding creatine phosphokinase (CPK) and CPK-MB isoenzyme to the algorithm increased the rate of definite MIs from 209.0 in 1970 to 277.0 in 1980 (p less than 0.001). Interpretation of long-term trends in coronary heart disease morbidity is highly dependent upon variables used to validate cases. Care must be taken to maintain consistent criteria to avoid bias due to improvements in diagnostic techniques over time which increase sensitivity for detection of cardiac ischemia.

Adult↗
PubMed2005

Zinc Finger Protein 202: a new candidate gene for ischemic heart disease: The Copenhagen City Heart Study.

OBJECTIVE: Zinc Finger Protein 202 (ZNF202) is a transcriptional repressor of genes affecting the vascular endothelium as well as lipid metabolism. A phenotype associated with genetic variation in ZNF202 is presently unknown. We tested the hypothesis that a common variant in ZNF202, A154V, predicts risk of ischemic heart disease (IHD), myocardial infarction (MI), and ischemic cerebrovascular disease (ICVD). METHODS AND RESULTS: We conducted a prospective study of more than 9000 individuals from the general population with 24 years follow-up. In women, age-adjusted hazard ratios in heterozygotes and homozygotes versus non-carriers were 1.2 (95% CI: 1.0-1.5, P = 0.04) and 1.5 (1.1-2.1, P = 0.007) for IHD, 1.5 (1.1-2.1; P = 0.01) and 1.7 (1.1-2.8, P = 0.02) for MI, and 1.3 (1.0-1.8, P = 0.07) and 1.3 (0.8-2.1; P = 0.33) for ICVD. Adjustments for lipids and lipoproteins did not alter these hazard ratios substantially. Genotype did not predict risk in men. Finally, results for IHD were borderline significant (P = 0.06) in an independent case-control study including 933 patients and 8068 controls. CONCLUSION: This is the first study to suggest that ZNF202 could be a new candidate gene for IHD and MI in the general population.

Carrier Proteins↗
PubMed1998

Hostility, social support, and coronary heart disease in the National Heart, Lung, and Blood Institute Family Heart Study.

This cross-sectional study investigated the association of hostility and social support to coronary heart disease (CHD) in 2 groups of men and women: those with a familial predisposition for CHD (high-risk sample) and a randomly selected group. The hypothesis was that hostility and low social support would be associated with CHD, and would have a greater effect in the high-risk group. The random sample contained 2,447 individuals (47.1% male) from 576 families, and the high-risk sample consisted of 2,300 people (45.5% male) from 542 families. Odds ratios (OR) and their 95% confidence intervals were calculated using generalized estimating equations (GEE) for logistic regression. Family was specified as the clustering variable, and robust SEEs were obtained to account for dependence of the data within families. After controlling for age, education, body mass index, exercise, smoking history, drinking history, and drinking >5 drinks a day, hostility was associated with a history of coronary bypass surgery or coronary angioplasty in high-risk men (OR 1.21) and a history of myocardial infarction in high-risk women (OR 1.39). High-risk women with high social support had reduced odds of a previous myocardial infarction (OR 0.76), whereas women with high network adequacy in the random sample had reduced risk of myocardial infarction (OR 0.41) and angina (OR 0.49). A ratio of high hostility to low social support was associated with past myocardial infarction in high-risk women (OR 2.47) and a history of angina (OR 2.02) in the random sample men. These results suggest that high hostility and low social support are associated with some manifestations of CHD after controlling for adverse health behaviors.

Adult↗