WorldWideScience

Sample records for chronic heart disease

  1. Ivabradine, heart failure and chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Luca Di Lullo

    2015-12-01

    Full Text Available The incidence and prevalence of congestive heart failure are actually increasing worldwide, especially in Western countries. In Europe and the United States, congestive heart failure represents a disabling clinical disease, accountable for increased hospitalization and health care costs. European guidelines have underlined the importance of pharmacological treatment to improve both patients’ outcomes and quality of life. The latest clinical trials to evaluate ivabradine’s efficacy have underlined its usefulness as a stand-alone medication and in combination with conventional congestive heart failure therapy, including in chronic kidney disease patients.

  2. Heart Failure Update: Chronic Disease Management Programs.

    Science.gov (United States)

    Fountain, Lorna B

    2016-03-01

    With high mortality and readmission rates among patients with heart failure (HF), multiple disease management models have been and continue to be tested, with mixed results. Early postdischarge care improves outcomes for patients. Telemonitoring also can assist in reducing mortality and HF-related hospitalizations. Office-based team care improves patient outcomes, with important components including rapid access to physicians, partnerships with clinical pharmacists, education, monitoring, and support. Pay-for-performance measures developed for HF, primarily use of angiotensin-converting enzyme inhibitors and beta blockers, also improve patient outcomes, but the influence of adherence to other measures has been minimal. Evaluating comorbid conditions, including diabetes and hypertension, and making drug adjustments for patients with HF to include blood pressure control and use of metformin, when possible, can reduce mortality and morbidity.

  3. Anemic syndrome in patients with ischemic heart disease and chronic heart failure (review

    Directory of Open Access Journals (Sweden)

    Shvarts Y.G.

    2011-12-01

    Full Text Available Anemic syndrome of different severity often accompanies ischemic heart disease (IHD and chronic heart failure (CHF. Anemia has association with unfavorable prognosis in patients with all forms of CVD — acute and chronic. In this article the authors summarize a literature review of English articles dedicated to the problem of anemia and ischemic heart disease (IHD and the results of original research on the relationship between anemic syndrome and prognosis in the hospitalized patients with IHD and chronic heart failure (CHF. Anemia is frequently observed in patients with CHF, and evidence suggests that anemia might be associated with an increased mortality in both systolic and diastolic chronic heart failure (CHF, morbidity and rate of hospitalization in CHF patients. Moreover, CHF itself could be involved in the pathogenesis of anemia. Early studies suggested a pathogenic role of inflammation mediators. The normalization of hemoglobin concentration by EPO and iron supply in patients with CHF and chronic renal insufficiency results in improved exercise capacity by increasing oxygen delivery and improving cardiac function. However, there is limited information concerning the association of hemoglobin concentration and new onset of clinically recognized coronary artery disease, and lack of information about the effect of anemia treatment on prognosis of acute forms of IHD

  4. Understanding chronic heart failure

    OpenAIRE

    Fenton, Matthew; Burch, Michael

    2007-01-01

    The key principles of chronic heart failure and the development of clinical management strategies are described. The physiological changes in chronic heart failure and the clinical management of children with heart failure are considered, but the treatment of heart failure related to congenital heart disease or the intensive care management of heart failure are not mentioned as both topics require consideration in their own right. A greater understanding of the maladaptive responses to chroni...

  5. Chronic oral pathology and ischemic heart disease and its complications

    Directory of Open Access Journals (Sweden)

    Ivaschenko Y.Y.

    2013-09-01

    Full Text Available Objective: to establish the relationship of chronic generalized periodontitis, multiple cavities and dentofacial anomalies with various forms of coronary heart disease and its complications. Material and methods. The study included 294 patients with coronary heart disease and its complications. The patients were divided into two groups. Group I included 89 patients with acute Q-myocardial infarction, which was placed in the presence of at least 2 of the following criteria identified on the basis of a comprehensive clinical and instrumental examination: clinical, laboratory confirmation (CK-MB, electrocardiographic signs of damage or myocardial necrosis. The following statistical methods were used: multi-variate and univariate analysis of variance, non-parametric tests, crosstabulation, chi-square test, Fisher»s exact test. As a measure of variability of the normal distribution standard deviation was used. Results. It is noted that in patients with myocardial infarction more likely than in patients without coronary heart attack in history severe generalized periodontitis, dentofacial anomalies and multiple dental caries have appeared. In patients with acute myocardial infarction, severe periodontal disease has been associated with increased fibrinogen levels in the blood and an increase in the dispersion of the interval QT, which are known to be indicators of poor prognosis in acute coronary disease.

  6. Pulmonary Hypertension and Right Heart Dysfunction in Chronic Lung Disease

    Directory of Open Access Journals (Sweden)

    Amirmasoud Zangiabadi

    2014-01-01

    Full Text Available Group 3 pulmonary hypertension (PH is a common complication of chronic lung disease (CLD, including chronic obstructive pulmonary disease (COPD, interstitial lung disease, and sleep-disordered breathing. Development of PH is associated with poor prognosis and may progress to right heart failure, however, in the majority of the patients with CLD, PH is mild to moderate and only a small number of patients develop severe PH. The pathophysiology of PH in CLD is multifactorial and includes hypoxic pulmonary vasoconstriction, pulmonary vascular remodeling, small vessel destruction, and fibrosis. The effects of PH on the right ventricle (RV range between early RV remodeling, hypertrophy, dilatation, and eventual failure with associated increased mortality. The golden standard for diagnosis of PH is right heart catheterization, however, evidence of PH can be appreciated on clinical examination, serology, radiological imaging, and Doppler echocardiography. Treatment of PH in CLD focuses on management of the underlying lung disorder and hypoxia. There is, however, limited evidence to suggest that PH-specific vasodilators such as phosphodiesterase-type 5 inhibitors, endothelin receptor antagonists, and prostanoids may have a role in the treatment of patients with CLD and moderate-to-severe PH.

  7. Chronic obstructive pulmonary disease in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Iversen, K K; Kjaergaard, J; Akkan, D;

    2008-01-01

    OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study...... a possible relationship between right and left ventricular function and pulmonary function. DESIGN: Prospective substudy. SETTING: Systematic screening at 11 centres. SUBJECTS: Consecutive patients (n = 532) admitted with HF requiring medical treatment with diuretics and an episode with symptoms...... corresponding to New York Heart Association class III-IV within a month prior to admission. INTERVENTIONS: Forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC) were measured by spirometry and ventricular function by echocardiography. The diagnosis of COPD and HF were made according...

  8. [Heart rhythm disturbances in patients with chronic obstructive pulmonary disease in aggregate with coronary heart disease].

    Science.gov (United States)

    Shoĭkhet, Ia N; Klester, E B; Golovin, V A

    2008-01-01

    The purpose of the research was to study kinds, frequencies and features of heart rhythm disturbances (HRD) in patients with chronic obstructive pulmonary disease (COPD) subject to degree of severity, including presence of coronary heart disease (CHD). 1189 of patients with registered HRD were examined. 315 of them had COPD (group 1), 531--combination of COPD and CHD (group 2), 343 were CHD patients (group 3). The extent of examinations included electrocardiogram (ECG), Halter monitoring (HM), bicycle ergometry (BEM), external respiration function estimation. Supraventricular HRD were registered statistically more frequently in group 1: according to ECG data in rest - in 37.2% patients, by BEM results--in 18.8%, by HM--in 50%. Combined (supraventricular and ventricular) HRD were registered most frequently in group 2: 41.2 24.4, and 45.5% respectively. Ventricular HRD dominated in group 3: 47.6, 29.3 and 48.6% respectively. The results of the study indicate that supraventricular HRDprevaile in patients with COPD, combined HRD - in patients with COPD and CHD. Ventricular HRD, which most informatively reflect changes in intracardiac geometry and left ventricle hemodynamics, dominate in CHD patients. The optimization of therapy correction consists in early diagnostics of HRD subject to features of cardiorespiratory system functional state.

  9. Congestive heart failure in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Poskurica Mileta

    2014-01-01

    Full Text Available Cardiovascular disorders are the most frequent cause of death (46-60% among patients with advanced chronic renal failure (CRF, and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF. Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, β-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°. In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable.

  10. Overlap and distinctiveness of psychological risk factors in patients with ischemic heart disease and chronic heart failure

    DEFF Research Database (Denmark)

    Pelle, Aline J; Denollet, Johan; Zwisler, Ann-Dorthe

    2009-01-01

    Growing evidence supports the importance of psychological factors in the etiology and progression of cardiovascular disease (CVD). However, this research has been criticized due to overlap between psychological constructs. We examined whether psychological questionnaires frequently used...... in cardiovascular research assess distinct constructs in a mixed group of ischemic heart disease (IHD) and chronic heart failure (CHF) patients....

  11. [CHARACTERISTIC OF ALTERATIONS OF ARTERIES IN PATIENTS WITH ISCHEMIC HEART DISEASE AND CHRONIC HEPATITIS C].

    Science.gov (United States)

    Guliaev, N I; Kuznetsov, V V; Poltareĭko, D S; Qleksiuk, I B; Gordienko, A V; Barsukov, A V

    2015-01-01

    The article presents an assessment of degree and type of atherosclerosis of coronary and non-coronary vessels in old patients with ischemic heart disease associated with chronic viral hepatitis C (VHC), the incidence of myocardial infarction and the possibility of participation chronic VHC in atherogenesis. Patients with ischemic heart disease have correlation of atherosclerosis of arteries with age, hypercholesterinemia. Patients without chronic VHC more often give a higher risk of myocardial infarction, especially in early period (1-1,5 years) of onset of ischemic heart disease clinical implications. Patients with ischemic heart disease associated with chronic viral hepatitis C more often have generalized alterations in vessels, multifocal type of alteration. So, participation of VHC in atherogenesis is most probably connected with maintenance of chronic immune inflammation in vascular endothelium.

  12. Association of chronic mucus hypersecretion with FEV1 decline and chronic obstructive pulmonary disease morbidity. Copenhagen City Heart Study Group

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E; Lange, P

    1996-01-01

    The aim of this study was to examine the association between chronic mucus hypersecretion, and FEV1 decline, and subsequent hospitalization from chronic obstructive pulmonary disease (COPD). We used data from The Copenhagen City Heart Study on 5,354 women and 4,081 men 30 to 79 yr of age with ass......The aim of this study was to examine the association between chronic mucus hypersecretion, and FEV1 decline, and subsequent hospitalization from chronic obstructive pulmonary disease (COPD). We used data from The Copenhagen City Heart Study on 5,354 women and 4,081 men 30 to 79 yr of age...

  13. Evaluation of proinflammatory cytokines and brain natriuretic peptide in patients with rheumatic heart diseases and coronary heart disease complicated by chronic heart insufficiency

    OpenAIRE

    2005-01-01

    Objective. To study proinflammatory cytokines and brain natriuretic peptide (BNP) in patients with rheumatic heart diseases (RHD) and coronary heart disease (CHD) complicated by chronic heart insufficiency (CHI). Material and methods. 54 pts with CHI (among them 16 with RHD and 38 with CHD with signs of CHI ofll-IV functional class according to NYHA that correspond to 11A-III stage according to N.D. Strazesko-V.H. \\frsilenko classification) and 30 healthy persons of control group were examine...

  14. Shifts in the age distribution and from acute to chronic coronary heart disease hospitalizations

    NARCIS (Netherlands)

    Koopman, Carla; Bots, Michiel L.; Van Dis, Ineke; Vaartjes, Ilonca

    2016-01-01

    Background Shifts in the burden of coronary heart disease (CHD) from an acute to chronic illness have important public health consequences. Objective To assess age-sex-specific time trends in rates and characteristics of acute and chronic forms of CHD hospital admissions in the Netherlands. Methods

  15. Heart Disease

    Science.gov (United States)

    ... daily aspirin to prevent heart attack? Does taking birth control pills increase my risk for heart disease? Does using ... tells you to. Return to top Does taking birth control pills increase my risk for heart disease? Taking birth ...

  16. Heart Diseases

    Science.gov (United States)

    ... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the U.S. ... of disability. There are many different forms of heart disease. The most common cause of heart disease is ...

  17. Haptoglobin Phenotype Predicts a Low Heart Rate Variability in Patients with Chronic Kidney Disease

    DEFF Research Database (Denmark)

    Svensson, My; Strandhave, Charlotte; Krarup, H.B.;

    F-PO1096 Haptoglobin Phenotype Predicts a Low Heart Rate Variability in Patients with Chronic Kidney Disease My Svensson,1 Charlotte Strandhave,1 Henrik My Svensson,1 Charlotte Strandhave,1 HenrikKrarup,2 Jeppe H. Christensen.1 1Department of Nephrology, Aalborg Hospital, Aalborg, Denmark; 2...... to a phenotype-dependent antioxidant capacity where Hp 2-2 exhibits a low antioxidant ability, increasing the risk of cardiovascular disease. An attenuated heart rate variability (HRV) may be an important predictor of mortality in patients with chronic kidney disease (CKD). In the present study, we examined...

  18. The relationship of H-type hypertension and renal insufficiency in coronary heart disease patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    郑卫峰

    2014-01-01

    Objective To discuss the relationship between Htype hypertension and renal insufficiency in patients with coronary atherosclerotic heart disease(CHD)and chronic heart failure(CHF).Methods 100 CHD patients with both hypertension and CHF were chosen in our hospital from January 2011 to July 2013.Left ventricular ejection fraction(LVEF)was measured with echocardiography and estimated glomerular filtration rate(e GFR)was calculated with the simplified modification of diet in renal

  19. [Parenteral iron therapy in chronic kidney disease or chronic heart failure].

    Science.gov (United States)

    Eisenga, Michele F; Diepenbroek, Adry; Swinkels, Dorine W; Bakker, Stephan J L; van der Meer, Peter; Gaillard, Carlo A J M

    2015-01-01

    Iron deficiency and anaemia occur frequently in patients with chronic kidney disease (CKD) or chronic heart failure (CHF) and are associated with lower quality of life and higher mortality. Treating anaemia with erythropoietic growth factors produces no improvement. In recent years, the focus has therefore shifted to correction of iron deficiency. Chronic inflammation in CKD increases the production of hepcidin, which blocks iron absorption from the intestine and leads to less efficient re-use of iron from the macrophages. In absolute iron deficiency the body's iron stores are depleted, whereas in functional iron deficiency the supply of iron is not sufficient to meet demand from the bone marrow. Normal or high ferritin levels do not exclude iron deficiency at tissue level. The iron saturation fraction is a more useful indicator. Parenteral iron therapy ameliorates in CHF the symptoms of iron deficiency, irrespective of the effect on haemoglobin levels. The long-term effects of intravenous iron on mortality and morbidity are still unknown.

  20. Clinical utility of biomarkers in chronic kidney disease and chronic heart failure.

    Science.gov (United States)

    Zachariah, Donah; Olechowski, Bartosz; Kalra, Paul R

    2013-09-01

    Biomarkers have an increasingly important clinical role in managing patients with heart failure as well as those with kidney disease, both common conditions with generally poor prognostic outcomes and huge impacts on healthcare economics. For patients with chronic heart failure, biomarkers have become centre place in streamlining diagnostic pathways as well as identifying those with worse prognosis. There is much interest in the role for biomarkers in identifying patients at risk of acute kidney injury, although a number of these currently remain as research tools or are in the early stages of evaluation in clinical practice. Patients with cardiorenal syndrome represent a particular challenge to the clinician, and recent studies have suggested a valuable clinical role for certain biomarkers in this setting, either on their own or in combination. This paper will focus on biomarkers with a current clinical role in patients with cardiorenal disease (natriuretic peptides and neutrophil gelatinase-associated lipocalin), although brief reference will be made to other biomarkers with potential future application.

  1. Lysophospholipids in coronary artery and chronic ischemic heart disease

    Science.gov (United States)

    Abdel-Latif, Ahmed; Heron, Paula M.; Morris, Andrew J.; Smyth, Susan S.

    2015-01-01

    Purpose of review The bioactive lysophospholipids, lysophosphatidic acid (LPA) and sphingosine 1 phosphate (S1P) have potent effects on blood and vascular cells. This review focuses their potential contributions to the development of atherosclerosis, acute complications, such as acute myocardial infarction, and chronic ischemic cardiac damage. Recent findings Exciting recent developments have provided insight into the molecular underpinnings of LPA and S1P receptor signaling. New lines of evidence suggest roles for these pathways in the development of atherosclerosis. In experimental animal models, the production, signaling and metabolism of LPA may be influenced by environmental factors in the diet that synergize to promote the progression of atherosclerotic vascular disease. This is supported by observations of human polymorphisms in the lysophospholipid metabolizing enzyme, PPAP2B, that are associated with risk of coronary artery disease and myocardial infarction. S1P signaling protects from myocardial damage that follows acute and chronic ischemia both by direct effects on cardiomyocytes and through stem cell recruitment to ischemic tissue. Summary This review will suggest novel strategies to prevent the complications of coronary artery disease by targeting LPA production and signaling. Additionally, ways in which S1P signaling pathways may be harnessed to attenuate ischemia-induced cardiac dysfunction will be explored. PMID:26270808

  2. Chronic obstructive pulmonary disease

    Science.gov (United States)

    ... and oxygen therapy Right-sided heart failure or cor pulmonale (heart swelling and heart failure due to chronic ... PA: Elsevier Saunders; 2016:chap 44. Read More Cor pulmonale Dilated cardiomyopathy Heart failure - overview Lung disease Patient ...

  3. Plasma calprotectin levels reflect disease severity in patients with chronic heart failure

    DEFF Research Database (Denmark)

    Jensen, Louise Jn; Kistorp, Caroline Michaela Nervil; Bjerre, Mette

    2011-01-01

    Background: Low-grade inflammation has been associated with cardiovascular disease (CVD) and chronic heart failure (CHF). The aim of the present study was to investigate the potential usefulness of the inflammatory protein calprotectin as a biomarker in CHF. Methods: Plasma calprotectin...

  4. Readmission patterns in patients with chronic obstructive pulmonary disease, chronic heart failure and diabetes mellitus: an administrative dataset analysis.

    Science.gov (United States)

    Brand, C; Sundararajan, V; Jones, C; Hutchinson, A; Campbell, D

    2005-05-01

    Comprehensive disease management programmes for chronic disease aim to improve patient outcomes and reduce health-care utilization. Readmission rates are often used as an outcome measure of effectiveness. This study aimed to document readmission rates, and risk for early and late readmission, for patients discharged from the Royal Melbourne Hospital with a disease diagnosis of chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD) or diabetes mellitus compared to those with other general medical conditions. Eighty five (8.6%) of patients were readmitted within 28 days and 183 (20.8%) were readmitted between 29 and 180 days. No risk factors for early readmission were identified. Patients with a primary disease diagnosis of CHF and COPD are at increased risk of late readmissions (29-180 days).

  5. [Body composition and heart rate variability in patients with chronic obstructive pulmonary disease pulmonary rehabilitation candidates].

    Science.gov (United States)

    Curilem Gatica, Cristian; Almagià Flores, Atilio; Yuing Farías, Tuillang; Rodríguez Rodríguez, Fernando

    2014-07-01

    Body composition is a non-invasive method, which gives us information about the distribution of tissues in the body structure, it is also an indicator of the risk of mortality in patients with chronic obstructive pulmonary disease. The heart rate variability is a technique that gives us information of autonomic physiological condition, being recognized as an indicator which is decreased in a number of diseases. The purpose of this study was to assess body composition and heart rate variability. The methodology used is that of Debora Kerr (1988) endorsed by the International Society for advances in Cineantropometría for body composition and heart rate variability of the guidelines described by the American Heart Association (1996). Roscraff equipment, caliper Slimguide and watch Polar RS 800CX was used. , BMI 26.7 ± 3.9 kg / m²; Muscle Mass 26.1 ± 6.3 kg ; Bone Mass 1.3 kg ± 8.1 76 ± 9.9 years Age : 14 candidates for pulmonary rehabilitation patients were evaluated , Adipose mass 16.4 ± 3.6 kg ; FEV1 54 ± 14%. Increased waist circumference and waist hip ratio was associated with a lower overall heart rate variability. The bone component was positively related to the variability of heart rate and patients with higher forced expiratory volume in one second had lower high frequency component in heart rate variability. In these patients, the heart rate variability is reduced globally and is associated with cardiovascular risk parameters.

  6. Ivabradine Prevents Heart Rate Acceleration in Patients with Chronic Obstructive Pulmonary Disease and Coronary Heart Disease after Salbutamol Inhalation

    Directory of Open Access Journals (Sweden)

    Uta C. Hoppe

    2012-04-01

    Full Text Available Accelerated sinus rhythm is an important side effect of inhaled salbutamol which is especially harmful in patients with chronic obstructive pulmonary disease (COPD and coronary heart disease (CHD. Cross-over, randomized, open label study design. 20 patients (18 males and two females with COPD stage II–IV and comorbide CHD NYHA class I–III were included. Spirometry with 400 mg salbutamol inhalation was performed at two consecutive days of the study. Patients in group I were prescribed 5 mg ivabradine per os 3 h before salbutamol inhalation solely on the first day of the study and patients of group II received 5 mg ivabradine only on the second day of the study. Salbutamol caused a significant increase of HR by 5.5 bpm (95% CI 0.8; 10.2, p < 0.03. After ivabradine ingestion salbutamol did not change HR significantly by −2.4 bpm (−7.0; 2.3, p = 0.33. The attenuation of HR elevation by ivabradine was significant, p < 0.01. Salbutamol alone increased FEV1 by 6.0% (2.7; 9.3, p < 0.01. This effect was not impaired by ivabradine (FEV1 increase by 7.7% (2.8; 12.6, p < 0.01 versus baseline, p = 0.5 versus no ivabradine. Ivabradine 5 mg per os prevents heart rate acceleration after inhalation of 400 mg salbutamol. Ivabradine has no impact on lung function in patients with moderate-to-very-severe COPD and CHD comorbidity.

  7. Importance of chronic obstructive pulmonary disease for prognosis and diagnosis of congestive heart failure in patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Kjøller, Erik; Køber, Lars; Iversen, Kasper

    2004-01-01

    AIMS: To evaluate the importance of chronic obstructive pulmonary disease for prognosis and diagnosis of congestive heart failure in patients with acute myocardial infarction. METHOD AND RESULTS: Prospective registration of 6669 consecutive patients admitted with infarction and screened...... in patients with acute myocardial infarction without congestive heart failure, but is also a confounding factor for the diagnosis of congestive heart failure....

  8. Gas exchange during exercise in different evolutional stages of chronic Chagas' heart disease

    Directory of Open Access Journals (Sweden)

    Fátima Palha de Oliveira

    2000-12-01

    Full Text Available OBJECTIVE: To compare gas exchange at rest and during exercise in patients with chronic Chagas' heart disease grouped according to the Los Andes clinical/hemodynamic classification. METHODS: We studied 15 healthy volunteers and 52 patients grouped according to the Los Andes clinical/hemodynamic classification as follows: 17 patients in group IA (normal electrocardiogram/echocardiogram, 9 patients in group IB (normal electrocardiogram and abnormal echocardiogram, 14 patients in group II (abnormal electrocardiogram/echocardiogram, without congestive heart failure, and 12 patients in group III (abnormal electrocardiogram/echocardiogram with congestive heart failure. The following variables were analyzed: oxygen consumption (V O2, carbon dioxide production (V CO2, gas exchange rate (R, inspiratory current volume (V IC, expiratory current volume (V EC, respiratory frequency, minute volume (V E, heart rate (HR, maximum load, O2 pulse, and ventilatory anaerobic threshold (AT. RESULTS: When compared with the healthy group, patients in groups II and III showed significant changes in the following variables: V O2peak, V CO2peak, V ICpeak, V ECpeak, E, HR, and maximum load. Group IA showed significantly better results for these same variables as compared with group III. CONCLUSION: The functional capacity of patients in the initial phase of chronic Chagas' heart disease is higher than that of patients in an advanced phase and shows a decrease that follows the loss in cardiac-hemodynamic performance.

  9. Efficacy and safety of ivabradine as an add-on to atenolol in patients with chronic stable ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Elavarasi Pichai

    2016-12-01

    Conclusions: Ivabradine is safe and effective in preventing and treating further anginal attacks in patients with chronic stable ischemic heart disease already on atenolol therapy. [Int J Basic Clin Pharmacol 2016; 5(6.000: 2546-2551

  10. Periodontitis in Chronic Heart Failure.

    Science.gov (United States)

    Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A; Zugck, Christian; Frankenstein, Lutz

    2016-08-01

    Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P <0.00001). The severity of periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases.

  11. Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease

    Energy Technology Data Exchange (ETDEWEB)

    Bestetti, Reinaldo B., E-mail: rbestetti44@gmail.com; Restini, Carolina Baraldi A.; Couto, Lucélio B. [Universidade de Ribeirão Preto, Ribeirão Preto, São Paulo, SP (Brazil)

    2016-07-15

    The scientific construction of chronic Chagas heart disease (CCHD) started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas.

  12. Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease

    Directory of Open Access Journals (Sweden)

    Reinaldo B. Bestetti

    2016-01-01

    Full Text Available Abstract The scientific construction of chronic Chagas heart disease (CCHD started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas.

  13. Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease

    Science.gov (United States)

    Bestetti, Reinaldo B.; Restini, Carolina Baraldi A.; Couto, Lucélio B.

    2016-01-01

    The scientific construction of chronic Chagas heart disease (CCHD) started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas. PMID:27223644

  14. Heart Disease

    Science.gov (United States)

    ... Atherosclerosis is also the most common cause of cardiovascular disease. It can be caused by correctable problems, such as an unhealthy diet, lack of exercise, being overweight and smoking. Causes of heart arrhythmia ...

  15. Diagnostic Utility of ANG in Coronary Heart Disease Complicating Chronic Heart Failure: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Peng Yu

    2016-01-01

    Full Text Available Angiogenin (ANG has been shown to be elevated in several cardiovascular diseases. To detect its levels and diagnostic capacity in coronary heart disease (CHD patients complicating chronic heart failure (CHF, we performed this cross-sectional study and enrolled 616 CHD patients and 53 healthy controls. According to complicating CHF or not, the patients were divided into CHF group (n=203 and CHD disease controls (n=413, in which the CHF group was subdivided as heart failure with reduced ejection fraction (HFrEF group or heart failure with preserved ejection fraction (HFpEF group on the basis of left ventricular ejection fraction (LVEF, or as different NYHA class group. Their plasma ANG levels were detected using enzyme-linked immunosorbent assay (ELISA. Plasma ANG was 342.8 (IQR [273.9,432.9], 304.5 (IQR [254.0,370.5], and 279.7 (IQR [214.4,344.0] ng/mL in the CHF group, CHD disease controls, and healthy controls, respectively, significantly higher in the CHF group compared with the others. Furthermore, among CHF group, ANG is dramatically higher in the HFrEF patients compared with the HFpEF patients. As for the diagnostic capacity of ANG, the area under the receiver operating characteristic curve was 0.71 (95% CI 0.63–0.78. We concluded that plasma ANG is elevated in CHD complicating CHF patients and may be a moderate discriminator of CHF from CHD or the healthy.

  16. Diagnostic Utility of ANG in Coronary Heart Disease Complicating Chronic Heart Failure: A Cross-Sectional Study

    Science.gov (United States)

    Liu, Ming; Yang, Xue; Yu, Ying; Zhao, Ji; Zhang, Lei; Tong, Rui; Zou, Yunzeng; Ge, Junbo

    2016-01-01

    Angiogenin (ANG) has been shown to be elevated in several cardiovascular diseases. To detect its levels and diagnostic capacity in coronary heart disease (CHD) patients complicating chronic heart failure (CHF), we performed this cross-sectional study and enrolled 616 CHD patients and 53 healthy controls. According to complicating CHF or not, the patients were divided into CHF group (n = 203) and CHD disease controls (n = 413), in which the CHF group was subdivided as heart failure with reduced ejection fraction (HFrEF) group or heart failure with preserved ejection fraction (HFpEF) group on the basis of left ventricular ejection fraction (LVEF), or as different NYHA class group. Their plasma ANG levels were detected using enzyme-linked immunosorbent assay (ELISA). Plasma ANG was 342.8 (IQR [273.9,432.9]), 304.5 (IQR [254.0,370.5]), and 279.7 (IQR [214.4,344.0]) ng/mL in the CHF group, CHD disease controls, and healthy controls, respectively, significantly higher in the CHF group compared with the others. Furthermore, among CHF group, ANG is dramatically higher in the HFrEF patients compared with the HFpEF patients. As for the diagnostic capacity of ANG, the area under the receiver operating characteristic curve was 0.71 (95% CI 0.63–0.78). We concluded that plasma ANG is elevated in CHD complicating CHF patients and may be a moderate discriminator of CHF from CHD or the healthy. PMID:27872509

  17. Resting heart rate is a risk factor for mortality in chronic obstructive pulmonary disease, but not for exacerbations or pneumonia

    NARCIS (Netherlands)

    Warnier, Miriam J.; Rutten, Frans H.; De Boer, Anthonius; Hoes, Arno W.; De Bruin, Marie L.

    2014-01-01

    Background: Although it is known that patients with chronic obstructive pulmonary disease (COPD) generally do have an increased heart rate, the effects on both mortality and non-fatal pulmonary complications are unclear. We assessed whether heart rate is associated with all-cause mortality, and non-

  18. EFFECT OF BRONCHODILATORS ON HEART RATE VARIABILITY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    Directory of Open Access Journals (Sweden)

    H. H. Shugushev

    2015-12-01

    Full Text Available Aim. To study effect of long-acting theophylline (Theotard, KRKA and combination of salmeterol and fluticasone (Seretide, GlaxoSmithKline on heart rhythm variability (HRV and number of arrhythmic episodes in patients with chronic obstructive pulmonary disease (COPD.Material and methods. 144 patients with COPD and 35 patients of control group were examined. The analysis of HRV and Holter monitoring were made f on 2th and 14th days.Results. Treatment with both drugs led to increase in power of low- and high frequencies and their ratio (LF/HF, decrease in rate of supraventricular and ventricular arrhythmias. Theophylline therapy raised in a number of single and pair supraventricular extrasystoles. Treatment with combination of salmeterol and fluticasone did not change a number of extrasystoles.Conclusion. Combination of salmeterol and fluticasone is more preferable as a broncholytic therapy for patients with COPD and heart rhythm disorders.

  19. Chronic obstructive pulmonary disease and heart failure: research and clinical practice in primary care

    Directory of Open Access Journals (Sweden)

    Francesco Chiumeo

    2015-12-01

    Full Text Available The treatment of chronic obstructive pulmonary disease (COPD and comorbidities, increasing with age, is the challenge that nowadays health care systems are facing to better care treat these patients. For this reason a clinical trial was conducted in the province of Trento by a group of 30 volunteer general practitioners members of SNAMID (Scientific Society for Continuing Medical Education of General Practitioners. The objectives were to identify: i prevalence of COPD in patients (65-98 years in the province of Trento; ii presence and incidence of heart failure (HF in COPD patients; iii early detection of other chronic diseases; and iv improving electronic medical records (EMR as an innovation way of professional care management. From May 2011 to October 2013, 17 doctors completed the two-year work using the EMR. The studied patients were men and women (65-98 years, suffering from COPD; the considered data included: anthropometric information, smoking status, International Classification of Diseases (ICD-9 diagnosis of COPD, HF and chronic diseases, specific blood and instrumental tests. The extracted results were then linked with data of sentinel therapies, collected by the EMR. The database obtained identified patients with COPD or HF not previously recognized with ICD-9 diagnosis. The study identified the sentinel drugs chosen for COPD and HF, excluding other drugs not selective for the study or confusing for a proper statistical evaluation.

  20. Men and Heart Disease

    Science.gov (United States)

    ... Pressure Salt Cholesterol Million Hearts® WISEWOMAN Men and Heart Disease Fact Sheet Recommend on Facebook Tweet Share Compartir ... Source: Interactive Atlas of Heart Disease and Stroke Heart Disease Facts in Men Heart disease is the leading ...

  1. Platelet function and activation in Cavalier King Charles Spaniels with subclinical chronic valvular heart disease.

    Science.gov (United States)

    Tong, Linda J; Hosgood, Giselle L; French, Anne T; Irwin, Peter J; Shiel, Robert E

    2016-08-01

    OBJECTIVE To assess platelet closure time (CT), mean platelet component (MPC) concentration, and platelet component distribution width (PCDW) in dogs with subclinical chronic valvular heart disease. ANIMALS 89 Cavalier King Charles Spaniels (CKCSs) and 39 control dogs (not CKCSs). PROCEDURES Platelet count, MPC concentration, PCDW, and Hct were measured by use of a hematology analyzer, and CT was measured by use of a platelet function analyzer. Murmur grade and echocardiographic variables (mitral valve regurgitant jet size relative to left atrial area, left atrial-to-aortic diameter ratio, and left ventricular internal dimensions) were recorded. Associations between explanatory variables (sex, age, murmur grade, echocardiographic variables, platelet count, and Hct) and outcomes (CT, MPC concentration, and PCDW) were examined by use of multivariate regression models. RESULTS A model with 5 variables best explained variation in CT (R(2), 0.74), with > 60% of the variance of CT explained by mitral valve regurgitant jet size. The model of best fit to explain variation in MPC concentration included only platelet count (R(2), 0.24). The model of best fit to explain variation in PCDW included platelet count and sex (R(2), 0.25). CONCLUSIONS AND CLINICAL RELEVANCE In this study, a significant effect of mitral valve regurgitant jet size on CT was consistent with platelet dysfunction. However, platelet activation, as assessed on the basis of the MPC concentration and PCDW, was not a feature of subclinical chronic valvular heart disease in CKCSs.

  2. Neutrophil proteolytic activation cascades: a possible mechanistic link between chronic periodontitis and coronary heart disease.

    Science.gov (United States)

    Alfakry, Hatem; Malle, Ernst; Koyani, Chintan N; Pussinen, Pirkko J; Sorsa, Timo

    2016-01-01

    Cardiovascular diseases are chronic inflammatory diseases that affect a large segment of society. Coronary heart disease (CHD), the most common cardiovascular disease, progresses over several years and affects millions of people worldwide. Chronic infections may contribute to the systemic inflammation and enhance the risk for CHD. Periodontitis is one of the most common chronic infections that affects up to 50% of the adult population. Under inflammatory conditions the activation of endogenous degradation pathways mediated by immune responses leads to the release of destructive cellular molecules from both resident and immigrant cells. Matrix metalloproteinases (MMPs) and their regulators can activate each other and play an important role in immune response via degrading extracellular matrix components and modulating cytokines and chemokines. The action of MMPs is required for immigrant cell recruitment at the site of inflammation. Stimulated neutrophils represent the major pathogen-fighting immune cells that upregulate expression of several proteinases and oxidative enzymes, which can degrade extracellular matrix components (e.g. MMP-8, MMP-9 and neutrophil elastase). The activity of MMPs is regulated by endogenous inhibitors and/or candidate MMPs (e.g. MMP-7). The balance between MMPs and their inhibitors is thought to mirror the proteolytic burden. Thus, neutrophil-derived biomarkers, including myeloperoxidase, may activate proteolytic destructive cascades that are involved in subsequent immune-pathological events associated with both periodontitis and CHD. Here, we review the existing studies on the contribution of MMPs and their regulators to the infection-related pathology. Also, we discuss the possible proteolytic involvement and role of neutrophil-derived enzymes as an etiological link between chronic periodontitis and CHD.

  3. Researching of cardos activity for chronic heart failure treatment in case of concomitant chronic kidney disease (stage V, conventional hemodialysis

    Directory of Open Access Journals (Sweden)

    Chepurina N.G.

    2011-06-01

    Full Text Available Aim: comparative investigation of cardos (antibodies to angiotensin II receptor subtype 1 (AT., C-terminal fragment, diovan (Valsartan or both drug combination effects (changing of clinical picture, physical exertion tolerance and quality of life for treatment chronic heart failure (CHF patients. Methods. 12-month open-label randomized research was performed. CHF patients (NYHA Class l-ll, n=30 with concomitant chronic kidney disease (stage V, conventional hemodialysis were randomized (10 patients in each group for 6-month treatment by cardos (group I, average dose 1,8g/day, diovan (group II, average dose 80mg/dayorboth drug combination (group III, cardos 1,8g/day and diovan 80mg/day. CHD basic treatment was prescribed for all patients. In a 6-month drug crossover between groups I and I was performed, group III was divided into 2 subgroups (subgroup IIIA— cardos, subgroup NIB — diovan followed by next 6-month treatment. Results. Long-term treatment by cardos has improved functional class (NYHA of CHF patients with concomitant chronic kidney disease (stage V, conventional hemodialysis. cardos, diovan and both drug combination have demonstrated improvement of physical exertion tolerance, quality of life and patient clinical status during 6-min walking test. Conclusion. Cardos and diovan have shown the same efficacy. Cardos can be used as real alternative in case of ARA administration necessity

  4. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... slow down or stop. A risk factor for heart disease is something that increases your chance of getting ...

  5. Socioeconomic inequalities in mobility decline in chronic disease groups (asthma/COPD, heart disease, diabetes mellitus, low back pain): only a minor role for disease severity and comorbidity

    OpenAIRE

    2004-01-01

    Objective: This study examined the association between socioeconomic status and mobility decline and whether this could be explained by disease severity and comorbidity in four different chronic disease groups (asthma/COPD, heart disease, diabetes mellitus, and low back pain). It is not clear, whether the adverse course of physical functioning in persons with a low socioeconomic status can be explained by a higher prevalence of more severe disease or comorbidity in these persons.

  6. Carvedilol Enhances the Antioxidant Effect of Vitamins E and C in Chronic Chagas Heart Disease

    Energy Technology Data Exchange (ETDEWEB)

    Budni, Patrícia, E-mail: budnip@gmail.com [Universidade Federal de Santa Catarina, Florianópolis, SC (Brazil); Pedrosa, Roberto Coury [Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil); Dalmarco, Eduardo Monguilhott; Dalmarco, Juliana Bastos; Frode, Tânia Sílvia; Wilhelm, Danilo Filho [Universidade Federal de Santa Catarina, Florianópolis, SC (Brazil)

    2013-10-15

    Chagas disease is still an important endemic disease in Brazil, and the cardiac involvement is its more severe manifestation. To verify whether the concomitant use of carvedilol will enhance the antioxidant effect of vitamins E and C in reducing the systemic oxidative stress in chronic Chagas heart disease. A total of 42 patients with Chagas heart disease were studied. They were divided into four groups according to the modified Los Andes classification: 10 patients in group IA (normal electrocardiogram and echocardiogram; no cardiac involvement); 20 patients in group IB (normal electrocardiogram and abnormal echocardiogram; mild cardiac involvement); eight patients in group II (abnormal electrocardiogram and echocardiogram; no heart failure; moderate cardiac involvement); and four patients in group III (abnormal electrocardiogram and echocardiogram with heart failure; severe cardiac involvement). Blood levels of markers of oxidative stress were determined before and after a six-month period of treatment with carvedilol, and six months after combined therapy of carvedilol with vitamins E and C. The markers analyzed were as follows: activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase and reductase, myeloperoxidade and adenosine deaminase; and the levels of reduced glutathione, thiobarbituric-acid reactive substances, protein carbonyls, vitamin E, and nitric oxide. After treatment with carvedilol, all groups showed significant decrease in protein carbonyls and reduced glutathione levels, whereas nitric oxide levels and adenosine activity increased significantly only in the less severely affected group (IA). In addition, the activity of most of the antioxidant enzymes was decreased in the less severely affected groups (IA and IB). By combining the vitamins with carvedilol, a reduction in protein damage, in glutathione levels, and in the activity of most of the antioxidant enzymes were observed. The decrease in oxidative

  7. Women's Heart Disease: Heart Disease Risk Factors

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table of ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk factors. ...

  8. Heart Disease and Stroke

    Centers for Disease Control (CDC) Podcasts

    2013-09-03

    In this podcast, Dr. Tom Frieden, CDC Director, discusses the number one killer in the United States - heart disease and stroke.  Created: 9/3/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/6/2014.

  9. Abnormal heart rate recovery and chronotropic incompetence on exercise in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Gupta, Mansi; Bansal, Vishal; Chhabra, Sunil K

    2013-08-01

    Chronotropic incompetence (CI; failure to reach the targeted heart rate (HR) on exercise) and a delayed HR recovery (HRR; ≤12 beats decline within the first minute after cessation) reflect autonomic dysfunction (AD) and predict adverse cardiac prognosis. As chronic obstructive pulmonary disease (COPD) is known to be associated with AD, we hypothesized that these patients may manifest these responses on exercise. The prevalence and predictors of these responses in COPD and their association with its severity have not been evaluated. Normoxemic, stable male patients with COPD (n = 39) and 11 healthy controls underwent lung function testing and incremental leg ergometry. HR responses were monitored during exercise and recovery to compute the HRR and CI. Of all the patients, 33 (84.6%) had at least one of the two exercise responses as abnormal, with the majority (23, 58.9%) having both an abnormal HRR and CI. The frequency of abnormal responses increased with increasing Global Initiative for Chronic Obstructive Lung Disease stage and body mass index, airflow obstruction, dyspnoea and exercise capacity index. After adjusting for smoking history and post-bronchodilator forced expiratory volume in 1 second, only a reduced diffusion capacity for carbon monoxide predicted abnormal HRR, though weakly. We concluded that abnormal HRR and CI are common in patients with COPD. These responses are observed with increasing frequency as the severity of disease increases.

  10. Chronic kidney disease: an independent risk factor of all-cause mortality for elderly Chinese patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    Shi-Hui Fu; Ping Ye; Lei-Ming Luo; Bing Zhu; Yu-Xiao Zhang; Shuang-Yan Yi; Yuan Liu; Tie-Hui Xiao; Liang Wang; Yong-Yi Bai; Cai-Yi Lu

    2012-01-01

    Objective To evaluate the prognostic value of chronic kidney disease (CKD) in elderly Chinese patients with chronic heart failure (CHF). Methods The study consisted of 327 elderly patients with CHF. All-cause mortality was chosen as an endpoint over the median follow-up period of 345 days. Cox regression analysis was used to identify the risk factors of mortality. Results The median age of the entire cohort was 85 years (60-100 years). The mortality for 168 elderly patients with CHF and CKD (51.4% of entire cohort) was 39.9%(67 deaths), which was higher than the mortality for CHF patients without CKD [25.2% (40/159 deaths)] and the mortality for entire cohort with CHF [32.7% (107/327 deaths)]. The Cox regression analysis showed that old age [hazard ratio (HR): 1.033; 95% confidence interval (95% CI): 1.004-1.064], CKD (HR: 1.705; 95% CI: 1.132-2.567), CHF New York Heart Association (NYHA) class IV (HR: 1.913; 95% CI:1.284-2.851), acute myocardial infarction (AMI) (HR: 1.696; 95% CI: 1.036-2.777), elevated resting heart rate (HR: 1.021; 95% CI:1.009-1.033), and decreased plasma albumin (HR: 0.883; 95% CI: 0.843-0.925) were independent risk factors of mortality for elderly patients with CHF. Conclusions CKD was an independent risk factor of mortality for elderly Chinese patients with CHF.

  11. Heart failure in a cohort of patients with chronic kidney disease: the GCKD study.

    Directory of Open Access Journals (Sweden)

    Hanna Beck

    Full Text Available Chronic kidney disease (CKD is a risk factor for development and progression of heart failure (HF. CKD and HF share common risk factors, but few data exist on the prevalence, signs and symptoms as well as correlates of HF in populations with CKD of moderate severity. We therefore aimed to examine the prevalence and correlates of HF in the German Chronic Kidney Disease (GCKD study, a large observational prospective study.We analyzed data from 5,015 GCKD patients aged 18-74 years with an estimated glomerular filtration rate (eGFR of 500 mg/d. We evaluated a definition of HF based on the Gothenburg score, a clinical HF score used in epidemiological studies (Gothenburg HF, and self-reported HF. Factors associated with HF were identified using multivariable adjusted logistic regression. The prevalence of Gothenburg HF was 43% (ranging from 24% in those with eGFR >90 to 59% in those with eGFR<30 ml/min/1.73m2. The corresponding estimate for self-reported HF was 18% (range 5%-24%. Lower eGFR was significantly and independently associated with the Gothenburg definition of HF (p-trend <0.001. Additional significantly associated correlates included older age, female gender, higher BMI, hypertension, diabetes mellitus, valvular heart disease, anemia, sleep apnea, and lower educational status.The burden of self-reported and Gothenburg HF among patients with CKD is high. The proportion of patients who meet the criteria for Gothenburg HF in a European cohort of patients with moderate CKD is more than twice as high as the prevalence of self-reported HF. However, because of the shared signs, symptoms and medications of HF and CKD, the Gothenburg score cannot be used to reliably define HF in CKD patients. Our results emphasize the need for early screening for HF in patients with CKD.

  12. Sex differences in the hypertensive population with chronic ischemic heart disease.

    Science.gov (United States)

    Barrios, Vivencio; Escobar, Carlos; Bertomeu, Vicente; Murga, Nekane; de Pablo, Carmen; Calderón, Alberto

    2008-10-01

    Cardiopatía Isquémica Crónica e Hipertensión Arterial en la Práctica Clínica en España (CINHTIA) was a survey designed to assess the clinical management of hypertensive outpatients with chronic ischemic heart disease. Sex differences were examined. Blood pressures (BP) was considered controlled at levels of <140/90 or <130/80 mm Hg in diabetics (European Society of Hypertension/European Society of Cardiology 2003); low-density lipoprotein cholesterol (LDL-C) was considered controlled at levels <100 mg/dL (National Cholesterol Education Program Adult Treatment Panel III). In total, 2024 patients were included in the study. Women were older, with a higher body mass index and an increased prevalence of atrial fibrillation. Dyslipidemia, smoking, sedentary lifestyle, and peripheral arterial disease were more frequent in men. In contrast, diabetes, left ventricular hypertrophy, and heart failure were more common in women. BP and LDL-C control rates, although poor in both groups, were better in men (44.9% vs 30.5%, P<.001 and 33.0% vs 25.0%, P<.001, respectively). Stress testing and coronary angiography were more frequently performed in men.

  13. Short-term effects of ivabradine in patients with chronic stable ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Hosam Zaky

    2013-01-01

    Full Text Available Introduction: Ivabradine is a novel selective If current inhibitor with anti-ischemic and antianginal activity. Objectives: To assess the effect of the selective If current inhibitor ivabradine on heart rate, angina pectoris, and functional capacity in stable patients with chronic coronary artery disease on maximally tolerated medical therapy. Materials and Methods: Consecutive patients from the out-patient cardiology clinic with stable coronary artery disease documented by coronary angiography were included. Patients had to be on maximally tolerated medical therapy with β-blockers, angiotensin-converting enzyme inhibitors or receptor blockers (ACE-I or ARB, antiplatelets, statins, nitrates, and anti-metabolics with a baseline heart rate of at least 70 beats per minute. All patients underwent assessment of angina (Canadian Cardiovascular Society Angina Class: CCS I to IV and functional capacity (using a validated self-administered questionnaire, at baseline and after 4 months of ivabradine therapy. Results: Twenty patients were enrolled (mean age 47 ± 7 years, all male, 60% with hypertension, 30% with diabetes mellitus. Patients were on optimal medical regimen of aspirin (100%, β-blocker (100%, statins (100%, clopidogrel (90%, nitrates (35%, anti-metabolics (90%, and ACE-I or ARB (95%. At baseline, the majority of patients (90% were in CCS class II-IV. All patients were started on ivabradine 5 mg twice daily, and in 12 patients the dose was increased to 7.5 mg twice daily. After 4 months of treatment, the heart rate was significantly reduced from an average of 82 ± 8 to 68 ± 6 bpm ( P < 0.001. The reduction in heart rate was accompanied by a significant improvement in functional capacity (score 3.5 ± 0.9 to 4.7 ± 0.7, P < 0.001 and angina classification; at baseline 10% of the patients were in CCS class I compared to 50% after 4 months of therapy ( P = 0.01. No symptomatic bradycardia was reported with ivabradine. Conclusion: The addition

  14. Effect of tolvaptan in patients with chronic kidney disease due to diabetic nephropathy with heart failure.

    Science.gov (United States)

    Sato, Eiichi; Nakamura, Tsukasa; Amaha, Mayuko; Nomura, Mayumi; Matsumura, Daisuke; Yamagishi, Hidetsugu; Ono, Yuko; Ueda, Yoshihiko

    2014-01-01

    The efficacy of tolvaptan for treating heart failure has already been shown. Adequate data relating to the effect of tolvaptan on the correlation of water balance in renal disease are not available. A retrospective study was conducted on the efficacy and adverse reactions of tolvaptan for treating nephrotic syndrome.The subjects were 26 patients with chronic kidney failure due to diabetic nephropathy with heart failure who were administered tolvaptan and seen between December 2011 and October 2013. The endpoints were urinary output, physical findings, and blood analyses. The expression of aquaporin-2 in the collecting duct, which is related to the action of tolvaptan, was investigated by immunohistochemistry using the kidney tissue obtained for the diagnosis.Responses were seen in 19 of the patients. In the histopathological investigation there was severe glomerulosclerosis in patients with diabetic nephropathy, but the responders were noticeable in that they only had mild tubulointerstitial damage. Non-responders exhibited profound tubulointerstitial damage. The expression of aquaporin-2 was determined in 8 patients, of which 7 were responders who tested positive for aquaporin-2. The remaining case was a non-responder who showed no expression of aquaporin-2.Tolvaptan is considered effective for some cases of nephrotic syndrome. There are no clear parameters for predicting an effect, but the present study showed that aquaporin-2 was expressed in the epithelial cells of the collecting ducts of tolvaptan responders.

  15. Diabetic Heart Disease

    Science.gov (United States)

    ... be coronary heart disease (CHD), heart failure, and diabetic cardiomyopathy. Diabetes by itself puts you at risk for heart disease. Other risk factors include Family history of heart disease Carrying extra ...

  16. MAGNESIUM METABOLISM AND CLINICAL CHARACTERISTICS OF PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    A. V. Yezhov

    2010-01-01

    Full Text Available Aim. To study relationship of the clinical state and cardiac functional parameters with magnesium metabolism indices in patients with chronic ischemic heart disease (IHD.Material and methods. Patients with stable angina pectoris, II-III class (n=480 were involved into the study. Evaluation of the following items was performed: disease course, anxiodepressive syndrome intensity, exercise tolerance, blood and urine electrolyte profile, systolic and diastolic left ventricle function, endothelium-dependent and endotheliumnondependent vasodilatation, i/v magnesium load test, Holter electrocardiogram monitoring.Results. High prevalence of systemic magnesium deficiency (17.9 and 37.5% according to serum and erythrocyte levels, respectively was found in IHD patients. Severity of magnesium deficiency in IHD patients depended on duration of disease, experience of myocardial infarction, myocardial ischemia seriousness, disorders of endothelium vasodilating function and left ventricle diastolic function, severity of concomitant anxiety. Exercise tests were changed in IHD patients with magnesium deficiency.Conclusion. The study data let to consider that magnesium deficiency involves into the IHD pathogenesis.

  17. The effectiveness of telemedicine in the management of chronic heart disease – a systematic review

    Science.gov (United States)

    Soma, Mounica; Pulluri, Deepthi; Nemali, Naga T; Brooks, Matthew

    2017-01-01

    Objective The primary objective of this systematic review is to assess the effectiveness of telemedicine in managing chronic heart disease patients concerning improvement in varied health attributes. Design This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. Setting We adopted a logical search process used in two main research databases, the Cumulative Index to Nursing and Allied Health Literature and PubMed (MEDLINE). Four reviewers meticulously screened 151 abstracts to determine relevancy and significance to our research objectives. The final sample in the literature review consisted of 20 articles. Main outcome measures We looked for improved medical outcomes as the main outcome measure. Results Our results indicated that telemedicine is highly associated with the reduction in hospitalisations and readmissions (9 of 20 articles, 45%). The other significant attributes most commonly encountered were improved mortality and cost-effectiveness (both 40%) and improved health outcomes (35%). Patient satisfaction occurred the least in the literature, mentioned in only 2 of 20 articles (10%). There was no significant mention of an increase in patient satisfaction because of telemedicine. Conclusions We concluded that telemedicine is considered to be effective in quality measures such as readmissions, moderately effective in health outcomes, only marginally effective in customer satisfaction. Telemedicine shows promise on an alternative modality of care for cardiovascular disease, but additional exploration should continue to quantify the quality measures. PMID:28321319

  18. A randomized controlled study of finerenone vs. eplerenone in patients with worsening chronic heart failure and diabetes mellitus and/or chronic kidney disease

    DEFF Research Database (Denmark)

    Filippatos, Gerasimos; Anker, Stefan D; Böhm, Michael;

    2016-01-01

    AIMS: To evaluate oral doses of the non-steroidal mineralocorticoid receptor antagonist finerenone given for 90 days in patients with worsening heart failure and reduced ejection fraction and chronic kidney disease and/or diabetes mellitus. METHODS AND RESULTS: Miner Alocorticoid Receptor antagon...

  19. Challenges in personalised management of chronic diseases-heart failure as prominent example to advance the care process.

    Science.gov (United States)

    Brunner-La Rocca, Hans-Peter; Fleischhacker, Lutz; Golubnitschaja, Olga; Heemskerk, Frank; Helms, Thomas; Hoedemakers, Thom; Allianses, Sandra Huygen; Jaarsma, Tiny; Kinkorova, Judita; Ramaekers, Jan; Ruff, Peter; Schnur, Ivana; Vanoli, Emilio; Verdu, Jose; Zippel-Schultz, Bettina

    2015-01-01

    Chronic diseases are the leading causes of morbidity and mortality in Europe, accounting for more than 2/3 of all death causes and 75 % of the healthcare costs. Heart failure is one of the most prominent, prevalent and complex chronic conditions and is accompanied with multiple other chronic diseases. The current approach to care has important shortcomings with respect to diagnosis, treatment and care processes. A critical aspect of this situation is that interaction between stakeholders is limited and chronic diseases are usually addressed in isolation. Health care in Western countries requires an innovative approach to address chronic diseases to provide sustainability of care and to limit the excessive costs that may threaten the current systems. The increasing prevalence of chronic diseases combined with their enormous economic impact and the increasing shortage of healthcare providers are among the most critical threats. Attempts to solve these problems have failed, and future limitations in financial resources will result in much lower quality of care. Thus, changing the approach to care for chronic diseases is of utmost social importance.

  20. Deep breathing heart rate variability is associated with respiratory muscle weakness in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Michel Silva Reis

    2010-01-01

    Full Text Available BACKGROUND: A synchronism exists between the respiratory and cardiac cycles. However, the influence of the inspiratory muscle weakness in chronic obstructive pulmonary disease (COPD on cardiac autonomic control is unknown. The purpose of the present investigation was to evaluate the influence of respiratory muscle strength on autonomic control in these patients. METHODS: Ten chronic obstructive pulmonary disease patients (69±9 years; FEV1/FVC 59±12% and FEV1 41±11% predicted and nine age-matched healthy volunteers (64±5 years participated in this study. Heart-rate variability (HRV was obtained at rest and during respiratory sinusal arrhythmia maneuver (RSA-M by electrocardiograph. RESULTS: Chronic obstructive pulmonary disease patients demonstrated impaired cardiac autonomic modulation at rest and during RSA-M when compared with healthy subjects (p<0.05. Moreover, significant and positive correlations between maximal inspiratory pressure (MIP and the inspiratory-expiratory difference (ΔIE (r = 0.60, p<0.01 were found. CONCLUSION: Patients with chronic obstructive pulmonary disease presented impaired sympathetic-vagal balance at rest. In addition, cardiac autonomic control of heart rate was associated with inspiratory muscle weakness in chronic obstructive pulmonary disease. Based on this evidence, future research applications of respiratory muscle training may bring to light a potentially valuable target for rehabilitation.

  1. Prognostic impact of atrial fibrillation on clinical outcomes of acute coronary syndromes,heart failure and chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    Nileshkumar; J; Patel; Aashay; Patel; Kanishk; Agnihotri; Dhaval; Pau; Samir; Patel; Badal; Thakkar; Nikhil; Nalluri; Deepak; Asti; Ritesh; Kanotra; Sabeeda; Kadavath; Shilpkumar; Arora; Nilay; Patel; Achint; Patel; Azfar; Sheikh; Neil; Patel; Apurva; O; Badheka; Abhishek; Deshmukh; Hakan; Paydak; Juan; Viles-Gonzalez

    2015-01-01

    Atrial fibrillation(AF) is the most common type of sustained arrhythmia,which is now on course to reach epidemic proportions in the elderly population. AF is a commonly encountered comorbidity in patients with cardiac and major non-cardiac diseases. Morbidity and mortality associated with AF makes it a major healthcare burden. The objective of our article is to determine the prognostic impact of AF on acute coronary syndromes,heart failure and chronic kidney disease. Multiple studies have been conducted to determine if AF has an independent role in the overall mortality of such patients. Our review suggests that AF has an independent adverse prognostic impact on the clinical outcomes of acute coronary syndromes,heart failure and chronic kidney disease.

  2. Combined heart rate variability and pulse oximetry biofeedback for chronic obstructive pulmonary disease: preliminary findings.

    Science.gov (United States)

    Giardino, Nicholas D; Chan, Leighton; Borson, Soo

    2004-06-01

    The purpose of this study was to examine the feasibility of an intervention that included heart rate variability (HRV) biofeedback and walking with pulse oximetry feedback to improve functioning and quality of life for patients with chronic obstructive pulmonary disease (COPD). Twenty patients with COPD participated in 5 weekly sessions of HRV biofeedback and 4 weekly sessions of walking practice with oximetry feedback, with instructions for daily home practice. Primary outcomes measures were the distance walked in 6 min (6MWD) and overall quality of life, as measured by the St. George's Respiratory Questionnaire (SGRQ). Secondary outcomes included measures of self-efficacy, self-reported disability, anxiety, depression, dyspnea before and after the 6MWD, and HRV at the frequency of respiration during spontaneous and paced breathing. After 10 weeks of training, participants showed statistically and clinically significant improvements in 6MWD and quality of life. Significant changes were also seen in self-efficacy, disability, dyspnea before and after the 6MWD, and HRV amplitude during spontaneous breathing. We conclude that our intervention is feasible for patients with COPD and that further research using a randomized controlled design is warranted.

  3. Anthropometry, lipid profile and dietary pattern of patients with chronic ischaemic heart disease.

    Directory of Open Access Journals (Sweden)

    Vajifdar B

    1999-10-01

    Full Text Available The anthropometry, lipid profile and dietary characteristics of 114 patients with chronic ischaemic heart disease (IHD were evaluated. There were 91 (80% men and the mean age was 56 +/- 9 years. The body mass index was near normal (24.4 +/- 3.4, but the waist: hip ratio was high (0.94 +/- 0.06 suggesting central obesity. This was well in accordance of the step II recommendations of the NCEP guidelines as regards their caloric intake and its break-up in terms of carbohydrate, protein and fat (including saturated, mono-unsaturated and poly-unsaturated fatty acids content. Their daily cholesterol intake (31 +/- 32 mg/day, range 4-180 was very low. The total cholesterol (212 +/- 37 mg% was marginally elevated, HDL cholesterol (33 +/- 7.5 mg% was low, LDL cholesterol (148 +/- 39 mg% was high and the total: HDL ratio (6.8 +/- 2.0 was significantly abnormal. The serum triglyceride level (154 +/- 68 mg% was on the higher side of normal. These observations give further credence to the recently evolving view that there are different and hitherto unrecognised risk factors of IHD in Indians, who seem to have the highest incidence of IHD amongst all ethnic groups of the world despite consuming a diet low in fat and cholesterol content.

  4. Clinical and morphologic features of acute, subacute and chronic cor pulmonale (pulmonary heart disease).

    Science.gov (United States)

    Roberts, William Clifford; Shafii, Alexis E; Grayburn, Paul A; Ko, Jong Mi; Weissenborn, Matthew R; Rosenblatt, Randall L; Guileyardo, Joseph M

    2015-03-01

    Described are certain clinical and morphologic features of one patient with acute, another with subacute, and one with chronic cor pulmonale. All 3 had evidence of severe pulmonary hypertension. The patient with acute cor pulmonale 4 days after coronary bypass for unstable angina pectoris suddenly developed severe breathlessness with cyanosis and had fatal cardiac arrest and necropsy disclosed massive pulmonary embolism. The patient with subacute cor pulmonale had severe right-sided heart failure for 5 weeks and necropsy disclosed microscopic-sized neoplastic pulmonary emboli from a gastric carcinoma without parenchymal pulmonary metastases. The patient with chronic cor pulmonale had evidence of right-sided heart failure for years, the result of primary or idiopathic pulmonary hypertension almost certainly present from birth because the pattern of elastic fibers in the pulmonary trunk was that seen in newborns where the pressure in the pulmonary trunk and ascending aorta are similar. The patient with chronic cor pulmonale had plexiform pulmonary lesions indicative of irreversible pulmonary hypertension. Neither the acute nor the subacute patient had chronic pulmonary vascular changes. All 3 patients had dilated right ventricular cavities and non-dilated left ventricular cavities and only the patient with chronic cor pulmonale had right ventricular hypertrophy.

  5. Abnormal nocturnal heart rate variability response among chronic kidney disease and dialysis patients during wakefulness and sleep

    OpenAIRE

    Roumelioti, Maria-Eleni; Ranpuria, Reena; Hall, Martica; Hotchkiss, John R.; Chan, Chris T.; Mark L Unruh; Argyropoulos, Christos

    2010-01-01

    Background. Dialysis patients and patients with chronic kidney disease (CKD) experience a substantial risk for abnormal autonomic function and abnormal heart rate variability (HRV). It remains unknown whether HRV changes across sleep stages in patients with different severity of CKD or dialysis dependency. We hypothesized that high-frequency (HF) HRV (vagal tone) will be attenuated from wakefulness to non-rapid eye movement (NREM) and then to rapid eye movement (REM) sleep in dialysis patient...

  6. Hypertensive heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000163.htm Hypertensive heart disease To use the sharing features on this page, please enable JavaScript. Hypertensive heart disease refers to heart problems that occur because of ...

  7. Congenital heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001114.htm Congenital heart disease To use the sharing features on this page, please enable JavaScript. Congenital heart disease (CHD) is a problem with the heart's structure ...

  8. Cyanotic heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001104.htm Cyanotic heart disease To use the sharing features on this page, please enable JavaScript. Cyanotic heart disease refers to a group of many different heart ...

  9. Inflammation and Heart Disease

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Inflammation and Heart Disease Updated:Oct 12,2016 Understand the risks of ... inflammation causes cardiovascular disease, inflammation is common for heart disease and stroke patients and is thought to be ...

  10. Heart disease and women

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007188.htm Heart disease and women To use the sharing features on ... please enable JavaScript. People often DO NOT consider heart disease a woman's disease. Yet cardiovascular disease is the ...

  11. DETERMINANTS OF PREVENTIVE BEHAVIOR REGARDING CARDIOVASCULAR DISEASES AND RISK FACTORS IN PATIENTS WITH ESSENTIAL HYPERTENSION AND CHRONIC ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    D. Yu. Platonov

    2011-01-01

    Full Text Available Aim. To analyze potential determinants of preventive behavior (PB in patients with essential hypertension (HT and chronic ischemic heart disease (CIHD, and to establish their significance and hierarchy. Material and methods. Patients with HT (n=285 and CIHD (n=223 were studied. Questioning of all patients was performed to assess the characteristics of their PB. Differentiated multivariate analysis of activity and efficacy of PB determinants was performed in HT and CIHD patients by the method of step-by-step backward logistic regression. Results. Awareness of the cardiovascular diseases (CVD and its prevention (odds ratio [OR] 6.08 as well as high level of general education (OR=2.29 were the most significant determinants of active PB in HT patients. Sufficient social support (OR=3.77, awareness of CVD and its prevention (OR=3.16 were the most significant determinants of active PB in patients with CIHD. Efficacy of PB in patients with HT and CIHD mostly depends on satisfaction of medical service (OR=10.2 and 6.63, respectively, social support (OR=6.25 and 10.5, respectively, adequate awareness of CVD and its prevention (OR, 6.92 and 6.64, respectively. Conclusion. PB activity and efficacy in patients with HT and CIHD depends on many contributing and impeding factors. Disregarding these factors can result in failure in preventive efforts at both individual and population levels.

  12. What Causes Heart Disease?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Causes Heart Disease? Research suggests that coronary heart disease (CHD) begins with damage to the lining and ... causing coronary microvascular disease (MVD). Coronary MVD is heart disease that affects the heart's tiny arteries. The cause ...

  13. Resting heart rate is a risk factor for mortality in chronic obstructive pulmonary disease, but not for exacerbations or pneumonia

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Rutten, Frans H; de Boer, Anthonius

    2014-01-01

    BACKGROUND: Although it is known that patients with chronic obstructive pulmonary disease (COPD) generally do have an increased heart rate, the effects on both mortality and non-fatal pulmonary complications are unclear. We assessed whether heart rate is associated with all-cause mortality, and non...... and information on complications (exacerbation of COPD or pneumonia) by scrutinizing patient files of general practitioners. Multivariable cox regression analysis was performed. RESULTS: During the follow-up 132 (33%) patients died. The overall mortality rate was 50/1000 py (42-59). The major causes of death were...... did not result in an increased risk of exacerbations or pneumonia. This may indicate that the increased mortality risk of COPD is related to non-pulmonary causes. Future randomized controlled trials are needed to investigate whether heart-rate lowering agents are worthwhile for COPD patients....

  14. Remodeling of intrinsic cardiac neurons: effects of β-adrenergic receptor blockade in guinea pig models of chronic heart disease.

    Science.gov (United States)

    Hardwick, Jean C; Southerland, E Marie; Girasole, Allison E; Ryan, Shannon E; Negrotto, Sara; Ardell, Jeffrey L

    2012-11-01

    Chronic heart disease induces remodeling of cardiac tissue and associated neuronal components. Treatment of chronic heart disease often involves pharmacological blockade of adrenergic receptors. This study examined the specific changes in neuronal sensitivity of guinea pig intrinsic cardiac neurons to autonomic modulators in animals with chronic cardiac disease, in the presence or absence of adrenergic blockage. Myocardial infarction (MI) was produced by ligature of the coronary artery and associated vein on the dorsal surface of the heart. Pressure overload (PO) was induced by a banding of the descending dorsal aorta (∼20% constriction). Animals were allowed to recover for 2 wk and then implanted with an osmotic pump (Alzet) containing either timolol (2 mg·kg(-1)·day(-1)) or vehicle, for a total of 6-7 wk of drug treatment. At termination, intracellular recordings from individual neurons in whole mounts of the cardiac plexus were used to assess changes in physiological responses. Timolol treatment did not inhibit the increased sensitivity to norepinephrine seen in both MI and PO animals, but it did inhibit the stimulatory effects of angiotensin II on the norepinephrine-induced increases in neuronal excitability. Timolol treatment also inhibited the increase in synaptically evoked action potentials observed in PO animals with stimulation of fiber tract bundles. These results demonstrate that β-adrenergic blockade can inhibit specific aspects of remodeling within the intrinsic cardiac plexus. In addition, this effect was preferentially observed with active cardiac disease states, indicating that the β-receptors were more influential on remodeling during dynamic disease progression.

  15. Chronic Kidney Disease

    Science.gov (United States)

    ... of the feet and ankles Causes & Risk FactorsWhat causes CKD?The most common causes of CKD are high blood pressure, diabetes and heart disease. ... caused by CKD.How else is CKD treated?Chronic kidney disease can cause other problems. Talk with your doctor about how ...

  16. The Envy of Scholars: Applying the Lessons of the Framingham Heart Study to the Prevention of Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Walter G. Wasser

    2015-07-01

    Full Text Available During the past 50 years, a dramatic reduction in the mortality rate associated with cardiovascular disease has occurred in the US and other countries. Statistical modeling has revealed that approximately half of this reduction is the result of risk factor mitigation. The successful identification of such risk factors was pioneered and has continued with the Framingham Heart Study, which began in 1949 as a project of the US National Heart Institute (now part of the National Heart, Lung, and Blood Institute. Decreases in total cholesterol, blood pressure, smoking, and physical inactivity account for 24%, 20%, 12%, and 5% reductions in the mortality rate, respectively. Nephrology was designated as a recognized medical professional specialty a few years later. Hemodialysis was first performed in 1943. The US Medicare End-Stage Renal Disease (ESRD Program was established in 1972. The number of patients in the program increased from 5,000 in the first year to more than 500,000 in recent years. Only recently have efforts for risk factor identification, early diagnosis, and prevention of chronic kidney disease (CKD been undertaken. By applying the approach of the Framingham Heart Study to address CKD risk factors, we hope to mirror the success of cardiology; we aim to prevent progression to ESRD and to avoid the cardiovascular complications associated with CKD. In this paper, we present conceptual examples of risk factor modification for CKD, in the setting of this historical framework.

  17. The Envy of Scholars: Applying the Lessons of the Framingham Heart Study to the Prevention of Chronic Kidney Disease.

    Science.gov (United States)

    Wasser, Walter G; Gil, Amnon; Skorecki, Karl L

    2015-07-30

    During the past 50 years, a dramatic reduction in the mortality rate associated with cardiovascular disease has occurred in the US and other countries. Statistical modeling has revealed that approximately half of this reduction is the result of risk factor mitigation. The successful identification of such risk factors was pioneered and has continued with the Framingham Heart Study, which began in 1949 as a project of the US National Heart Institute (now part of the National Heart, Lung, and Blood Institute). Decreases in total cholesterol, blood pressure, smoking, and physical inactivity account for 24%, 20%, 12%, and 5% reductions in the mortality rate, respectively. Nephrology was designated as a recognized medical professional specialty a few years later. Hemodialysis was first performed in 1943. The US Medicare End-Stage Renal Disease (ESRD) Program was established in 1972. The number of patients in the program increased from 5,000 in the first year to more than 500,000 in recent years. Only recently have efforts for risk factor identification, early diagnosis, and prevention of chronic kidney disease (CKD) been undertaken. By applying the approach of the Framingham Heart Study to address CKD risk factors, we hope to mirror the success of cardiology; we aim to prevent progression to ESRD and to avoid the cardiovascular complications associated with CKD. In this paper, we present conceptual examples of risk factor modification for CKD, in the setting of this historical framework.

  18. Heart Disease in Women

    Science.gov (United States)

    ... United States, 1 in 4 women dies from heart disease. The most common cause of heart disease in both men and women is narrowing or ... It's the major reason people have heart attacks. Heart diseases that affect women more than men include Coronary ...

  19. Menopause and Heart Disease

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Menopause and Heart Disease Updated:Aug 30,2016 Heart ... can become more evident after the onset of menopause. Menopause does not cause cardiovascular diseases . However, certain ...

  20. Heart disease and depression

    Science.gov (United States)

    ... gov/ency/patientinstructions/000790.htm Heart disease and depression To use the sharing features on this page, ... a heart attack or heart surgery Signs of Depression It is pretty common to feel down or ...

  1. Diabetes and ischemic heart disease

    DEFF Research Database (Denmark)

    Bergmann, Natasha; Ballegaard, Søren; Holmager, Pernille

    2014-01-01

    The aim of this study was to test i) whether patients having diabetes and ischemic heart disease (IHD), i.e., patients suffering from two chronic diseases, demonstrate a higher degree of chronic stress when compared with patients suffering from IHD alone, and ii) whether suffering from the two...... chronic diseases results in an elevation in specific elements of the chronic stress concept. A total of 361 participants with IHD were included, of whom 47 suffered from concomitant diabetes. Stress was measured by pressure pain sensitivity (PPS) and by the following questionnaires: the Major Depression...

  2. Incidence of acute rheumatic fever and chronic rheumatic heart disease, trends in deaths in the Tula region (1991—2011

    Directory of Open Access Journals (Sweden)

    Valentina Nikolayevna Sorotskaya

    2013-01-01

    Full Text Available The paper analyzes the incidence of acute rheumatic fever (ARF and chronic rheumatic heart disease (CRHD and theirs outcomes in the Tula Region in 1991 to 2011. In this period, the incidence of ARF decreased to 0.002, which was much lower than Russia's rates. That of CRHD in 2011 accounted for 1.6 per 1,000 adult population, which was comparable to the values in Russia. CRHD mortality rates showed a 2.5-fold decrease. The main causes of fatal outcomes were cardiovascular disorders.

  3. [Inter-sectoral coordination of rehabilitation can reduce the number of dropouts from chronic heart disease courses].

    Science.gov (United States)

    Hansen, Vibeke Brogaard; Haslev, Vibeke Pind; Kring, Anette; Buch, Martin Sandberg

    2014-03-03

    The Department of Cardiology, Lillebælt Hospital, Vejle, has implemented a development and implementation project on the gradient of the inter-sectoral coordination of rehabilitation for patients in chronic heart disease courses conducted in cooperation with the Municipal Health Centre, Denmark. The project was financed by the Region of South Denmark through the Danish Health and Medicines Authority. Implementation of a nurse hospital-based case manager is shown through the project to reduce dropout and opt-outs under the sectoral transition significantly.

  4. Aspirin and heart disease

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000092.htm Aspirin and heart disease To use the sharing features on this page, ... healthy people who are at low risk for heart disease. You provider will consider your overall medical condition ...

  5. Caffeine and Heart Disease

    Science.gov (United States)

    ... Healthy Workplace Food and Beverage Toolkit Caffeine and Heart Disease Updated:Aug 17,2015 Caffeine has many metabolic ... high caffeine intake increases the risk of coronary heart disease is still under study. Many studies have been ...

  6. Valvular heart disease

    OpenAIRE

    Gelson, E; Gatzoulis, M; Johnson, M.

    2007-01-01

    Valvular disease may be unmasked in pregnancy when physiological changes increase demands on the heart. Women with valvular heart disease require close follow-up during pregnancy, delivery, and postpartum

  7. Hypothyroidism and Heart Disease

    Science.gov (United States)

    ... in Balance › Hypothyroidism and Heart Disease Fact Sheet Hypothyroidism and Heart Disease January 2014 Download PDFs English ... nervous system, body temperature, and weight. What is hypothyroidism and what are its symptoms? Hypothyroidism, also called ...

  8. Heart Diseases--Prevention

    Science.gov (United States)

    ... you have a close family member who had heart disease at an early age. Fortunately, there are many things you can do reduce your chances of getting heart disease. You should Know your blood pressure and keep ...

  9. Cordyceps sinensis protects against liver and heart injuries in a rat model of chronic kidney disease: a metabolomic analysis

    Science.gov (United States)

    Liu, Xia; Zhong, Fang; Tang, Xu-long; Lian, Fu-lin; Zhou, Qiao; Guo, Shan-mai; Liu, Jia-fu; Sun, Peng; Hao, Xu; Lu, Ying; Wang, Wei-ming; Chen, Nan; Zhang, Nai-xia

    2014-01-01

    Aim: To test the hypothesis that the traditional Chinese medicine Cordyceps sinensis could improve the metabolic function of extrarenal organs to achieve its anti-chronic kidney disease (CKD) effects. Methods: Male SD rats were divided into CKD rats (with 5/6-nephrectomy), CKD rats treated with Cordyceps sinensis (4 mg•kg-1•d-1, po), and sham-operated rats. After an 8-week treatment, metabolites were extracted from the hearts and livers of the rats, and then subjected to 1H-NMR-based metabolomic analysis. Results: Oxidative stress, energy metabolism, amino acid and protein metabolism and choline metabolism were considered as links between CKD and extrarenal organ dysfunction. Within the experimental period of 8 weeks, the metabolic disorders in the liver were more pronounced than in the heart, suggesting that CKD-related extrarenal organ dysfunctions occurred sequentially rather than simultaneously. Oral administration of Cordyceps sinensis exerted statistically significant rescue effects on the liver and heart by reversely regulating levels of those metabolites that are typically perturbed in CKD. Conclusion: Oral administration of Cordyceps sinensis significantly attenuates the liver and heart injuries in CKD rats. The 1H NMR-based metabolomic approach has provided a systematic view for understanding of CKD and the drug treatment, which can also be used to elucidate the mechanisms of action of other traditional Chinese medicines. PMID:24632844

  10. Living with Heart Disease

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Living With Heart Disease If you have coronary heart disease (CHD), you can take steps to control its ... the section of this article titled "How Is Heart Disease Treated?" You also can visit the Health Topics ...

  11. Serum neutrophil gelatinase-associated lipocalin concentration reflects severity of coronary artery disease in patients without heart failure and chronic kidney disease.

    Science.gov (United States)

    Katagiri, Mikako; Takahashi, Masao; Doi, Kent; Myojo, Masahiro; Kiyosue, Arihiro; Ando, Jiro; Hirata, Yasunobu; Komuro, Issei

    2016-10-01

    Serum neutrophil gelatinase-associated lipocalin (NGAL) is recognized as a useful biomarker for acute kidney injury. Recently, elevated NGAL levels were reported in patients with heart failure and cardiac events, but the association between serum NGAL and severity of coronary artery disease (CAD) has not been investigated adequately. This study aimed to evaluate the association between serum NGAL concentration and CAD severity in patients without heart failure and chronic kidney disease. Two-hundred thirteen patients [mean age: 66.2 ± 9.2 (SD)] without heart failure and chronic kidney disease (estimated glomerular filtration rate >60 mL/min/1.73 m(2)) who underwent coronary angiography were retrospectively analyzed using the SYNTAX score. The mean concentration of serum NGAL was 134.3 ± 111.3 ng/mL. A statistically significant correlation was observed between serum NGAL levels and the SYNTAX score (R = 0.18, P = 0.0091). Multivariable analysis also showed elevated serum NGAL as an independent risk factor for a high SYNTAX score (P 100 ng/mL) and high levels of BNP (>25 pg/mL) had a higher SYNTAX score (low-low vs. high-high: 13.8 ± 13.4 vs. 20.8 ± 18.9, P heart failure. Serum NGAL might be a biomarker for CAD severity.

  12. Anemia in Chronic Kidney Disease

    Science.gov (United States)

    ... High Blood Pressure Heart Disease Mineral & Bone Disorder Anemia in Chronic Kidney Disease What is anemia? Anemia is a condition in which the body ... function as well as they should. How is anemia related to chronic kidney disease? Anemia commonly occurs ...

  13. Differential effects of arginine methylation on diastolic dysfunction and disease progression in patients with chronic systolic heart failure

    Science.gov (United States)

    Wilson Tang, Wai Hong; Tong, Wilson; Shrestha, Kevin; Wang, Zeneng; Levison, Bruce S.; Delfraino, Brian; Hu, Bo; Troughton, Richard W.; Klein, Allan L.; Hazen, Stanley L.

    2008-01-01

    Aims To investigate the association of arginine methylation with myocardial function and prognosis in chronic systolic heart failure patients. Methods and results Asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), as well as N-mono-methylarginine (MMA) and methyl-lysine, were simultaneously measured by tandem mass spectrometry in 132 patients with chronic systolic heart failure with echocardiographic evaluation and follow-up. Increasing ADMA and SDMA levels were associated with elevated natriuretic peptide levels (both P < 0.001), and increasing SDMA levels were associated with worsening renal function (P < 0.001). Higher plasma levels of methylated arginine metabolites (but not methyl-lysine) were associated with the presence of left ventricular (LV) diastolic dysfunction (E/septal E′, Spearman's r = 0.31–0.36, P < 0.001). Patients taking beta-blockers had lower ADMA levels than those not taking beta-blockers [0.42 (0.33, 0.50) vs. 0.51 (0.40, 0.58), P < 0.001]. Only increasing ADMA levels were associated with advanced right ventricular (RV) systolic dysfunction. Elevated ADMA levels remained a consistent independent predictor of adverse clinical events (hazard ratio = 1.64, 95% CI: 1.20–2.22, P = 0.002). Conclusion In chronic systolic heart failure, accumulation of methylated arginine metabolites is associated with the presence of LV diastolic dysfunction. Among the methylated derivatives of arginine, ADMA provides the strongest independent prediction of disease progression and adverse long-term outcomes. PMID:18687662

  14. Transmission of chronic wasting disease identifies a prion strain causing cachexia and heart infection in hamsters.

    Directory of Open Access Journals (Sweden)

    Richard A Bessen

    Full Text Available Chronic wasting disease (CWD is an emerging prion disease of free-ranging and captive cervids in North America. In this study we established a rodent model for CWD in Syrian golden hamsters that resemble key features of the disease in cervids including cachexia and infection of cardiac muscle. Following one to three serial passages of CWD from white-tailed deer into transgenic mice expressing the hamster prion protein gene, CWD was subsequently passaged into Syrian golden hamsters. In one passage line there were preclinical changes in locomotor activity and a loss of body mass prior to onset of subtle neurological symptoms around 340 days. The clinical symptoms included a prominent wasting disease, similar to cachexia, with a prolonged duration. Other features of CWD in hamsters that were similar to cervid CWD included the brain distribution of the disease-specific isoform of the prion protein, PrP(Sc, prion infection of the central and peripheral neuroendocrine system, and PrP(Sc deposition in cardiac muscle. There was also prominent PrP(Sc deposition in the nasal mucosa on the edge of the olfactory sensory epithelium with the lumen of the nasal airway that could have implications for CWD shedding into nasal secretions and disease transmission. Since the mechanism of wasting disease in prion diseases is unknown this hamster CWD model could provide a means to investigate the physiological basis of cachexia, which we propose is due to a prion-induced endocrinopathy. This prion disease phenotype has not been described in hamsters and we designate it as the 'wasting' or WST strain of hamster CWD.

  15. Women's Heart Disease: Heart Attack Symptoms

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter 2014 Table ... NHLBI has uncovered some of the causes of heart diseases and conditions, as well as ways to prevent ...

  16. Congenital Heart Disease in Adults

    Science.gov (United States)

    ... and genetics may play a role. Why congenital heart disease resurfaces in adulthood Some adults may find that ... in following adults with congenital heart disease. Congenital heart disease and pregnancy Women with congenital heart disease who ...

  17. Women and Heart Disease

    Institute of Scientific and Technical Information of China (English)

    邹国如

    2005-01-01

    Heart disease is the leading killer of Americans. But it kills more women than men. The American Heart Association says heart disease and other cardiovascular (心血管的) disorders kill about five hundred thousand women a year. That is more than the next seven causes of death combined.

  18. Chronic kidney disease and worsening renal function in acute heart failure: different phenotypes with similar prognostic impact?

    Science.gov (United States)

    Palazzuoli, Alberto; Lombardi, Carlo; Ruocco, Gaetano; Padeletti, Margherita; Nuti, Ranuccio; Metra, Marco; Ronco, Claudio

    2016-12-01

    Nearly a third of patients with acute heart failure experience concomitant renal dysfunction. This condition is often associated with increased costs of care, length of hospitalisation and high mortality. Although the clinical impact of chronic kidney disease (CKD) has been well established, the exact clinical significance of worsening renal function (WRF) during the acute and post-hospitalisation phases is not completely understood. Therefore, it is still unclear which of the common laboratory markers are able to identify WRF at an early stage. Recent studies comparing CKD with WRF showed contradictory results; this could depend on a different WRF definition, clinical characteristics, haemodynamic disorders and the presence of prior renal dysfunction in the population enrolled. The current definition of acute cardiorenal syndrome focuses on both the heart and kidney but it lacks precise laboratory marker cut-offs and a specific diagnostic approach. WRF and CKD could represent different pathophysiological mechanisms in the setting of acute heart failure; the traditional view includes reduced cardiac output with systemic and renal vasoconstriction. Nevertheless, it has become a mixed model that encompasses both forward and backward haemodynamic dysfunction. Increased central venous pressure, renal congestion with tubular obliteration, tubulo-glomerular feedback and increased abdominal pressure are all potential additional contributors. The impact of WRF on patients who experience preserved renal function and individuals affected with CKD is currently unknown. Therefore it is extremely important to understand the origins, the clinical significance and the prognostic impact of WRF on CKD.

  19. Chronic Beryllium Disease

    Science.gov (United States)

    ... Science Education & Training Home Conditions Chronic Beryllium Disease Chronic Beryllium Disease Make an Appointment Find a Doctor ... MD, MSPH, FCCP (February 01, 2016) What is chronic beryllium disease (CBD)? Chronic beryllium disease (CBD) is ...

  20. Systolic and diastolic dysfunction of the right heart ventricle in patients with chronic obstructive pulmonary disease in extremely cold climate.

    Science.gov (United States)

    Sivtseva, Anna Innokentievna; Strutynsky, Andrew Vladislavovich; Krivoshapkin, Vadim Grigorievich; Sivtseva, Elena Nikolaevna; Ivanova, Marianna Adolfovna; Timofeev, Leonid Fedorovich

    2014-11-30

    The paper describes echocardiographic values of systolic and diastolic dysfunction the right heart ventricle in 229 patients with chronic obstructive pulmonary disease. In our patients the values AvPAP (?25 mmHg while resting), FDDrv and FSDrv (>26 and 20 mm respectively), the thickness of front wall the RV (>5 mm), the dimension of AD (>35 mm), as well as the reduction the vestibular-distal shortening of RV (<23%), maximum blood velocity and the blood evacuation time from reflect indirectly the progressive reduction the contractive capacity RV myocardium and the occurrence of systolic dysfunction. In patients with severe de-compensation a restrictive type diastolic function is more characteristic - acceleration of early diastolic filling and blood velocity decrease during the auricular systole.

  1. Physician-estimated disease severity in patients with chronic heart or lung disease: a cross-sectional analysis

    Directory of Open Access Journals (Sweden)

    Babu Ajit N

    2006-09-01

    Full Text Available Abstract Background We evaluated how well physicians' global estimates of disease severity correspond to more specific physician-rated disease variables as well as patients' self-rated health and other patient variables. Methods We analyzed baseline data from 1662 primary care patients with chronic cardiac or pulmonary disease who were enrolled in a longitudinal study of health-related quality of life (HRQoL. Each patient's primary physician rated overall disease severity, estimated the two-year risk of hospitalization and mortality, and reported the use of disease-specific medications, tests, and subspecialty referrals. Patient variables included sociodemographic characteristics, psychosocial factors, self-rated health, and both generic and disease-specific HRQoL. Results Physicians rated 40% of their patients "about average", 30% "worse", and 30% "better" than the typical patient seen with the specific target disorder. The physician's global estimate of disease severity was strongly associated (P Conclusion Physicians' global ratings may provide disease severity and prognostic information unique from and complementary to patient self-rated health and HRQoL measures. The elements influencing physician-rated disease severity and its predictive validity for clinical outcomes warrant prospective investigation.

  2. The influence of concomitant diseases on a long-term prognosis in patients with chronic ischemic heart disease according to the PROGNOZ IBS register

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2015-12-01

    Full Text Available Aim. To study the incidence of comorbidities and their impact on the prognosis in patients with ischemic heart disease (IHD included into the PROGNOZ IBS Register.Material and methods. Data from the PROGNOZ IBS register of patients diagnosed with IHD using coronary angiography during the reference hospitalization (n=541; 432 male and 109 female was included in the analysis. 504 (93% patients were included in the survival analysis. Risk factors of cardiovascular diseases, associated with atherosclerosis, or those that were complications of IHD were considered as comorbidities as well as not cardiovascular diseaseschronic obstructive pulmonary disease, bronchial asthma andchronic kidney disease (CKD.Results. The average duration of follow-up was 7.3±2.19 years. The average number of comorbidities in patients with IHD was 1.83. Comorbidities worsened the prognosis of life: the presence of diabetes mellitus (DM increased the relative risk (RR of primary endpoint occurrence by 1.7 times, the combination of DM with hypertension – by 2.4 times, a history of stroke – by 2.3 times (p<0.05; 2 and 3 heart diseases – respectively, by 2.3 and 3.2 times (p<0.05; a combination of chronic lung diseases and CKD stages 3-5 – by 1.4 times (p=0.06; the presence of 2, 3, 4 and 5 comorbidities – respectively, by 4, 5, 6.4 and 13 times (p<0.001. The risk of death from all causes was determined by the number of concomitant cardiovascular diseases: 2 diseases increased RR by 2.3 times, 3 diseases – by 4.6 times, a combination of any 4 diseases – by 3.5 times, of 5 diseases – by 5 times (p<0.05.Conclusion. Prognosis of life in IHD patients is worsened by the presence of several comorbidities: risk factors of cardiovascular disease (DM and hypertension, cardiovascular diseases associated with atherosclerosis or those that are complications of IHD, chronic lung diseases and CKD.

  3. The influence of concomitant diseases on a long-term prognosis in patients with chronic ischemic heart disease according to the PROGNOZ IBS register

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2015-01-01

    Full Text Available Aim. To study the incidence of comorbidities and their impact on the prognosis in patients with ischemic heart disease (IHD included into the PROGNOZ IBS Register.Material and methods. Data from the PROGNOZ IBS register of patients diagnosed with IHD using coronary angiography during the reference hospitalization (n=541; 432 male and 109 female was included in the analysis. 504 (93% patients were included in the survival analysis. Risk factors of cardiovascular diseases, associated with atherosclerosis, or those that were complications of IHD were considered as comorbidities as well as not cardiovascular diseaseschronic obstructive pulmonary disease, bronchial asthma andchronic kidney disease (CKD.Results. The average duration of follow-up was 7.3±2.19 years. The average number of comorbidities in patients with IHD was 1.83. Comorbidities worsened the prognosis of life: the presence of diabetes mellitus (DM increased the relative risk (RR of primary endpoint occurrence by 1.7 times, the combination of DM with hypertension – by 2.4 times, a history of stroke – by 2.3 times (p<0.05; 2 and 3 heart diseases – respectively, by 2.3 and 3.2 times (p<0.05; a combination of chronic lung diseases and CKD stages 3-5 – by 1.4 times (p=0.06; the presence of 2, 3, 4 and 5 comorbidities – respectively, by 4, 5, 6.4 and 13 times (p<0.001. The risk of death from all causes was determined by the number of concomitant cardiovascular diseases: 2 diseases increased RR by 2.3 times, 3 diseases – by 4.6 times, a combination of any 4 diseases – by 3.5 times, of 5 diseases – by 5 times (p<0.05.Conclusion. Prognosis of life in IHD patients is worsened by the presence of several comorbidities: risk factors of cardiovascular disease (DM and hypertension, cardiovascular diseases associated with atherosclerosis or those that are complications of IHD, chronic lung diseases and CKD.

  4. EFFECTS OF Β-ADRENOBLOCKERS ON MYOCARDIAL REMODELING, IMMUNO-INFLAMMATORY REACTIONS AND ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ISCHEMIC HEART DISEASE AND CHRONIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    A. N. Zakirova

    2015-12-01

    Full Text Available Aim. To assess the effect of β-adrenoblockers (BAB on myocardial remodeling, immuno-inflammatory reactions and endothelial dysfunction in patients with ischemic heart disease and chronic heart failure (CHF.Material and methods. 84 patients with ischemic CHF of II-IV functional class were involved in the study. They were randomized in two groups. The first group was presented with 43 patients receiving carvedilol in addition to standard therapy for 24 weeks; the second group was presented with 41patients receiving metoprolol. Echocardiography, 6-minute walk test were applied. Blood levels of primary and secondary lipid peroxidation (LP products, cytokines, endothelin-1 (ET-1, intercellular adhesive molecule (VCAM-1 were determined.Results. Both of BAB improved the clinical condition and physical working ability of patients with CHF. Carvedilol in comparison with metoprolol was more effective in myocardial remodeling prevention, inhibition of pro-inflammatory cytokines [tumor necrosis factor alpha (TNF-α, interleukins (IL-1β IL-6] and LP. Besides carvedilol increased in endothelium-dependent vasodilatation and reduced in ET-1 and VCAM-1 levels.Conclusion. Long-term carvedilol treatment has anti-inflammatory, antioxidant and endothelium-protective effects as well as improves haemodynamics. 

  5. Effects of Aerobic Exercise Training and Irbesartan on Blood Pressure and Heart Rate Variability in Patients with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Karine Marquis

    2008-01-01

    Full Text Available BACKGROUND AND OBJECTIVES: The present pilot study was undertaken to evaluate the efficacy of an aerobic exercise training (AET program alone or combined with an antihypertensive agent (irbesartan to reduce blood pressure (BP and enhance heart rate variability (HRV in chronic obstructive pulmonary disease patients.

  6. Long-term efficacy of empirical chronic amiodarone therapy in patients with sustained ventricular tachyarrhythmia and structural heart disease.

    Science.gov (United States)

    Aiba, Takeshi; Kurita, Takashi; Taguchi, Atsushi; Shimizu, Wataru; Suyama, Kazuhiro; Aihara, Naohiko; Kamakura, Shiro

    2002-04-01

    The efficacy of empirical chronic oral amiodarone therapy in 129 patients with sustained ventricular tachyarrhythmia (VTNVF) and structural heart disease is evaluated. Twenty-nine patients were treated with class I drugs and monitored by electrophysiological study (EPS) and Holter electrocardiogram (ECG) (class I). The remaining 100 non-responders to the class I drugs were treated with oral amiodarone, of whom 70 were tolerant (AMD+) and 30 were intolerant (AMD-). Patients were followed up to 36 months. The primary and secondary end-points were recurrence of VT/VF and hypothetical death, respectively; whereby, hypothetical death was defined as actual death and the event of rapid VT.VF (heart rate >240beats/min) in patients with an implantable cardioverter defibrillator. Class I and AMD+ patients showed a better prognosis than AMD- patients. The VT/VF event free at 36 months in class I (64.8%) and AMD+ (56.1%) patients were significantly higher than that in AMD- (27.2%) (pAMD+ (83.6%) patients were significantly higher than that in AMD- (57.0%) (pdisease.

  7. Ischaemic heart disease

    DEFF Research Database (Denmark)

    Hansen, Louise Houlberg; Mikkelsen, Søren

    2013-01-01

    Purpose. Correct prehospital diagnosis of ischaemic heart disease (IHD) may accelerate and improve the treatment. We sought to evaluate the accuracy of prehospital diagnoses of ischemic heart diseases assigned by physicians. Methods. The Mobile Emergency Care Unit (MECU) in Odense, Denmark...

  8. C-reactive protein, lung hyperinflation and heart rate variability in chronic obstructive pulmonary disease --a pilot study.

    Science.gov (United States)

    Corbo, Giuseppe Maria; Inchingolo, Riccardo; Sgueglia, Gregory Angelo; Lanza, Gaetano; Valente, Salvatore

    2013-04-01

    Chronic obstructive pulmonary disease (COPD) is associated to cardiovascular morbidity and mortality, and abnormalities of the autonomic nervous system have been described in subjects with severe disease. We studied heart rate variability (HRV) in COPD patients at rest and during the 6-minute Walk Test (6mWT) and the association with lung function impairment taking into account systemic inflammation. Thirty outpatients with stable COPD underwent lung function measurements, blood gas analysis, ECG Holter and transcutaneous pulse oximetry during 6mWT and then they were classified by BODE index. Also C-reactive protein (CRP) was measured. At rest, we observed a significant reduction of HRV for increasing BODE index. During the 6mWT, HRV tended to decrease in BODE 1 subjects whereas an increase was observed in BODE 2 and BODE 3-4 subjects. Subjects with elevated CRP values had a significant reduction in Standard Deviation of all normal RR intervals at rest (SDNN: p = 0.013), Total Power (TFA: p = 0.04) and Very Low Frequency band (VLF: p = 0.041). At rest, subjects with Inspiratory Capacity-to-Total Lung Capacity ratio (IC/TLC) hyperinflation indices. At rest and during submaximal exercise, COPD patients with moderate and severe disease had an abnormal cardiac autonomic modulation which was related to both systemic inflammation and lung function impairment.

  9. Symptoms and impact of symptoms on function and health in patients with chronic obstructive pulmonary disease and chronic heart failure in primary health care

    Directory of Open Access Journals (Sweden)

    Theander K

    2014-07-01

    Full Text Available Kersti Theander,1,2 Mikael Hasselgren,2,3 Kristina Luhr,4 Jeanette Eckerblad,5 Mitra Unosson,5 Ingela Karlsson1 1Department of Nursing, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden; 2Primary Care Research Unit, County Council of Värmland, Karlstad, Sweden; 3Department of Medicine, Örebro University, Örebro, Sweden; 4Family Medicine Research Centre, Örebro County Council, Örebro, Sweden; 5Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden Background: Patients with chronic obstructive pulmonary disease (COPD and chronic heart failure (CHF seem to have several symptoms in common that impact health. However, methodological differences make this difficult to compare. Aim: Comparisons of symptoms, impact of symptoms on function and health between patients with COPD and CHF in primary health care (PHC. Method: The study is cross sectional, including patients with COPD (n=437 and CHF (n=388, registered in the patient administrative systems of PHC. The patients received specific questionnaires – the Memorial Symptom Assessment Scale, the Medical Research Council dyspnea scale, and the Fatigue Impact Scale – by mail and additional questions about psychological and physical health. Results: The mean age was 70±10 years and 78±10 years for patients with COPD and CHF respectively (P=0.001. Patients with COPD (n=273 experienced more symptoms (11±7.5 than the CHF patients (n=211 (10±7.6. The most prevalent symptoms for patients with COPD were dyspnea, cough, and lack of energy. For patients with CHF, the most prevalent symptoms were dyspnea, lack of energy, and difficulty sleeping. Experience of dyspnea, cough, dry mouth, feeling irritable, worrying, and problems with sexual interest or activity were more common in patients with COPD while the experience of swelling of arms or legs was more common among patients with CHF. When controlling for background

  10. Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease.

    Directory of Open Access Journals (Sweden)

    Joshua Byrnes

    Full Text Available The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95% CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95% CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95% CI: -$22,843, $14,863]. This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most.

  11. The incidence of acute rheumatic fever and chronic rheumatic heart disease in the Russian population (2011–2012

    Directory of Open Access Journals (Sweden)

    Rimma Mikhailovna Balabanova

    2014-03-01

    Full Text Available The problems of acute rheumatic fever (ARF and chronic rheumatic heart disease (CRHD are discussed. Carditis, polyarthritis, erythema annulare, subcutaneous nodules, and chorea minor are the main clinical manifestations of ARF caused by β-hemolytic streptococcus A. Cardiac failures emerge in 60–65% of patients after the first ARF episode. Repeated ARF attacks promote CRHD. The aim of the study is to evaluate the prevalence of rheumatic heart disease in different age groups in the regions of Russian Federation in 2011–2012. Materials and Methods. Analysis of the Ministry of Healthcare of the Russian Federation reports on population morbidity in 2011–2012 (Form N12.Results. The highest ARF prevalence was observed in 15–17-year-old teenagers, while the lowest, in adults over 18-year-old. The lowest CRHD figures were registered in juniors, while the highest ones, in adults. No ARF cases in 0–14-year-old children were registered in 31 entities of the Russian Federation; single cases, in 17 entities; no ARF cases in 15–17-year-old teenagers was registered in 37 entities, and 1–2 ARF cases were registered in 23 entities. Only in 10 entities, no ARF cases were registered in adults, and single cases were registered in 22 entities. Extremely unfavorable situations were found in the Chechen Republic (140 ARF cases in 0–14-year-old children and in the Dagestan Republic (140 cases. High morbidity among 15–17-year-old teenagers was registered in tje Kaliningrad region (83 cases and the Chechen Republic (100. ARF cases in adults were most frequent in St. Petersburg (124 cases, the Chechen Republic (154, and the Moscow region (161.The article lists the ARF and CRHD preventive measures.

  12. The incidence of acute rheumatic fever and chronic rheumatic heart disease in the Russian population (2011–2012

    Directory of Open Access Journals (Sweden)

    Rimma Mikhailovna Balabanova

    2014-01-01

    Full Text Available The problems of acute rheumatic fever (ARF and chronic rheumatic heart disease (CRHD are discussed. Carditis, polyarthritis, erythema annulare, subcutaneous nodules, and chorea minor are the main clinical manifestations of ARF caused by β-hemolytic streptococcus A. Cardiac failures emerge in 60–65% of patients after the first ARF episode. Repeated ARF attacks promote CRHD. The aim of the study is to evaluate the prevalence of rheumatic heart disease in different age groups in the regions of Russian Federation in 2011–2012. Materials and Methods. Analysis of the Ministry of Healthcare of the Russian Federation reports on population morbidity in 2011–2012 (Form N12.Results. The highest ARF prevalence was observed in 15–17-year-old teenagers, while the lowest, in adults over 18-year-old. The lowest CRHD figures were registered in juniors, while the highest ones, in adults. No ARF cases in 0–14-year-old children were registered in 31 entities of the Russian Federation; single cases, in 17 entities; no ARF cases in 15–17-year-old teenagers was registered in 37 entities, and 1–2 ARF cases were registered in 23 entities. Only in 10 entities, no ARF cases were registered in adults, and single cases were registered in 22 entities. Extremely unfavorable situations were found in the Chechen Republic (140 ARF cases in 0–14-year-old children and in the Dagestan Republic (140 cases. High morbidity among 15–17-year-old teenagers was registered in tje Kaliningrad region (83 cases and the Chechen Republic (100. ARF cases in adults were most frequent in St. Petersburg (124 cases, the Chechen Republic (154, and the Moscow region (161.The article lists the ARF and CRHD preventive measures.

  13. Living with Coronary Heart Disease

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Coronary Heart Disease Coronary heart disease (CHD) can cause serious complications. However, if you ... changes and medicines, go to "How Is Coronary Heart Disease Treated?" Work closely with your doctor to control ...

  14. Heart Disease and African Americans

    Science.gov (United States)

    ... Minority Population Profiles > Black/African American > Heart Disease Heart Disease and African Americans Although African American adults are ... were 30 percent more likely to die from heart disease than non-Hispanic whites. African American women are ...

  15. Living with Diabetic Heart Disease

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Diabetic Heart Disease Diabetic heart disease (DHD) increases the likelihood of earlier and more ... also tend to have less success from certain heart disease treatments, such as coronary artery bypass grafting and ...

  16. 老年慢性肺心病伴发冠心病60例临床分析%Clinical Analysis of 60 Cases Chronic Pulmonary Heart Disease in Elderly Combined with Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    田茂琼

    2012-01-01

    目的:探讨慢性肺心病伴冠心病的临床特点,为临床的诊断及治疗提供依据.方法:慢性肺心病合并冠心病患者60例列入研究组,单纯肺心病患者60例列入对照组,收集和分析两组患者的临床资料,分别对两组基本资料、病史、临床表现、心电图检测进行比较.结果:两组患者性别、心律失常、肺性P波无显著差异(P>0.05),研究组有吸烟史、肥胖、夜间阵发性呼吸困难、高血压史、高血脂症史、糖尿病史、心绞痛史、心肌梗死、左束支传导阻滞、心肌梗死表现、持续性缺血、电轴左偏、持续房颤的患者比例明显高于对照组,研究组患者重度右心衰、电轴右偏比例明显低于对照组,数据经统计学比较具有显著差异(P<0.05).结论:对慢性肺心病合并冠心病的确诊,应结合患者的基本情况、临床表现、病史、心电图变化等综合判断.%Objective; To discuss the clinical features of chronic pulmonary heart disease combined with coronary heart disease, in comparing with simple pulmonary heart disease. Method; 60 cases with chronic pulmonary heart disease combined with coronary heart disease were distributed into study group and 60 cases with simple pulmonary heart disease were distributed into control group. Collected the clinical information of two groups and compared the basic information, medical history, clinical manifestations and electrocardiogram. Result; Sex, arrhythmia and pulmonary P wave had no significantly difference of two groups (P>0. 05). The patients rate of smoking history, obesity, paroxysmal nocturnal dyspnea, history of hypertension, hyperlipidemia, history, history of diabetes, history of angina, myocardial infarction, left bundle branch block, myocardial infarction, performance, persistent ischemia, electrical left axis deviation and continuous AF in study group were significantly higher than control group ( P<0. 05). The rate of severe right heart

  17. Which individuals are at increased risk of pneumococcal disease and why? Impact of COPD, asthma, smoking, diabetes, and/or chronic heart disease on community-acquired pneumonia and invasive pneumococcal disease.

    Science.gov (United States)

    Torres, Antoni; Blasi, Francesco; Dartois, Nathalie; Akova, Murat

    2015-10-01

    Pneumococcal disease (including community-acquired pneumonia and invasive pneumococcal disease) poses a burden to the community all year round, especially in those with chronic underlying conditions. Individuals with COPD, asthma or who smoke, and those with chronic heart disease or diabetes mellitus have been shown to be at increased risk of pneumococcal disease compared with those without these risk factors. These conditions, and smoking, can also adversely affect patient outcomes, including short-term and long-term mortality rates, following pneumonia. Community-acquired pneumonia, and in particular pneumococcal pneumonia, is associated with a significant economic burden, especially in those who are hospitalised, and also has an impact on a patient's quality of life. Therefore, physicians should target individuals with COPD, asthma, heart disease or diabetes mellitus, and those who smoke, for pneumococcal vaccination at the earliest opportunity at any time of the year.

  18. Chronic heart failure and micronutrients.

    Science.gov (United States)

    Witte, K K; Clark, A L; Cleland, J G

    2001-06-01

    Heart failure (HF) is associated with weight loss, and cachexia is a well-recognized complication. Patients have an increased risk of osteoporosis and lose muscle bulk early in the course of the disease. Basal metabolic rate is increased in HF, but general malnutrition may play a part in the development of cachexia, particularly in an elderly population. There is evidence for a possible role for micronutrient deficiency in HF. Selective deficiency of selenium, calcium and thiamine can directly lead to the HF syndrome. Other nutrients, particularly vitamins C and E and beta-carotene, are antioxidants and may have a protective effect on the vasculature. Vitamins B6, B12 and folate all tend to reduce levels of homocysteine, which is associated with increased oxidative stress. Carnitine, co-enzyme Q10 and creatine supplementation have resulted in improved exercise capacity in patients with HF in some studies. In this article, we review the relation between micronutrients and HF. Chronic HF is characterized by high mortality and morbidity, and research effort has centered on pharmacological management, with the successful introduction of angiotensin-converting enzyme inhibitors and beta-adrenergic antagonists into routine practice. There is sufficient evidence to support a large-scale trial of dietary micronutrient supplementation in HF.

  19. 慢性肺源性心脏病患者24小时心率变异性的研究%The study of heart rate variability in patients w ith chronic pulmonary heart disease

    Institute of Scientific and Technical Information of China (English)

    何九龙; 王永东; 等

    2001-01-01

    目的:研究男性慢性肺源性心脏病患者的心率变异 性。方法:46例健康男性,34例男性慢性肺源性心脏病患者,行24 h动态心电图记录,作时域和频域分析。结果:慢性肺源性心脏病病人的高频(HF)、低频(LF)、NN50计数占 总R-R间期的百分比(pNN50)、每5 min正常R-R间期标准差的平均值(SDANN)均下降,其中严 重的慢性肺源性心脏病患者下降更为显著。结论:男性慢性肺源性心脏病患者存在植物神经功能紊乱,病情严 重程度也与植物神经功能相关。%Objective:To study variability of heart rate in pat ients with chronic pulmonary heart disease.Method:Twenty-four hour Holter monitoring were perf ormed in 46 male healthy volunteers and 34 cases of chronic pulmonary heart dis ease who were divided into groups according to the severity of their heart failure.Results:The HF,LF,pNN50 and SDANN were decreased in the chronic pulmonary heart disease cases in comparing to the normal group.T hese values were the lowest in the severe chronic pulmonary heart disease g roup.Conclusion:The autonomic nervous function of the chronic pulmonary heart diseasemale sufferers differs from that of normal people .It is possible that the changes of autonomic nervous function of chronic pulmonary heart disease sufferers are related to the severity of chronic pulmonary heart d isease.

  20. Heart disease. Third edition

    Energy Technology Data Exchange (ETDEWEB)

    Braunwald, E.

    1988-01-01

    This book contains 62 chapters. Some of the chapter titles are: Radiological and Angiographic Examination of the Heart; Newer Cardiac Imaging Techniques: Digital Subtraction Angiography, Computerized Tomography, Magnetic Resonance Imaging; Nuclear Cardiology; and Genetics and Cardiovascular Disease.

  1. Heart Disease Kicks in Earlier for Obese People

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_164003.html Heart Disease Kicks in Earlier for Obese People Study found ... News) -- Overweight and obese people tend to develop heart disease at an earlier age, living with chronic illness ...

  2. [Ischemic heart disease].

    Science.gov (United States)

    Yamamuro, Megumi; Ogawa, Hisao

    2009-04-01

    It has been reported that antihypertensive therapy reduces the risk of ischemic heart disease. Except for the antihypertensive effects, the angiotensin converting enzyme (ACE) inhibitors are proved to be very effective in primary and secondary event onset prophylaxis by many clinical trials. The angiotensin II receptor antagonists (ARBs) used briskly in recent years inhibits angiotensin II type 1 receptor alternatively. Although ARBs protect organs, especially blood vessel, heart, brain and kidney in sites of pharmacology, ARBs are still not much as effective results as ACE inhibitors for the patients with ischemic heart disease, by many clinical trials.

  3. Heart Disease and Stroke Prevention

    Science.gov (United States)

    ... Heart Health and Stroke Heart disease and stroke prevention Related information Learn more about healthy eating and ... top More information on Heart disease and stroke prevention Read more from womenshealth.gov A Lifetime of ...

  4. Clinical therapeutic efficacy of intra-aortic balloon pump as an adjuvant treatment after percutaneous coronary intervention in patients with coronary heart disease associated with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Zi-lan JING

    2015-06-01

    Full Text Available Objective To explore the clinical efficacy of intra-aortic balloon pump (IABP as an auxiliary treatment of percutaneous coronary intervention (PCI in patients with coronary heart disease (CHD associated with chronic kidney disease. Methods One hundred and twenty CHD patients with concomitant chronic kidney disease and receiving PCI in our hospital from Jan. 2000 to Jul. 2014, and 123 simple CHD patients without renal dysfunction, who had undergone PCI with concomitant IABP for the cardiac pump failure, cardiogenic shock, acute left heart failure, unstable angina pectoris (UP which was not allayed by medical treatment, or acute myocardial infarction (AMI, were selected for observation of preoperative condition, in-hospital mortality and prognosis of patients in two groups. Results There was no statistically significant difference in general clinical data including gender, age, and concomitant hypertension and diabetes, and preoperative blood lipid, AST, D-dimer, APTT, and international normalized ratio (INR showed also no statistically significant difference before surgery between two groups of patients (P>0.05. The difference in proportion of AMI, the left main trunk and (or three-branches involvement was of no statistical significance (P>0.05, but there was significant difference in the incidence of previous myocardial infarction, TnT, CK-MB, Cr, BUN, stent number, IABP application time (P0.05 between the two groups. Logistic regression analysis revealed that diabetes and the number of stents were independent risk factors for in-hospital and long-term mortalities. Conclusions By means of the effective cardiac assistance of IABP, CHD patients with renal insufficiency have the same short and long term clinical prognosis as simple CHD patients without renal dysfunction who has undergone PCI. Diabetes and the number of stents are independent risk factors for in-hospital and 1-year mortality. DOI: 10.11855/j.issn.0577-7402.2015.04.03

  5. 慢性肺源性心脏病并冠心病80例治疗探讨%Treatment of chronic pulmonary heart disease and coronary heart disease 80 cases

    Institute of Scientific and Technical Information of China (English)

    马雪梅

    2013-01-01

    Objective To explore and examine the clinical and prevention measures of chronic pulmonary heart disease and coronary heart disease in.Methods Totally 80 cases of patients suffering from chronic pulmonary heart disease and coronary heart disease study in patients with acute exacerbation of the application on the basis of carrying out comprehensive treatment of macrolide antibiotics,according to the specific circumstances of the patients' anticoagulant,thrombolytic and invasive or noninvasive mechanical ventilation and other processing of remission in patients followed up at the same time the long-term home oxygen therapy and oral empty platelet aggregation drugs,non-invasive airway of the double -barreled such as positive pressure ventilation for treatment of patients with heart and lung function improved ; lung coronary heart disease associated with elevated blood lipids in patients with oral lipid-lowering drugs and low-fat diet intervention.Results This group of patients after treatment effective in 26 cases (32.5%),effective in 34 (42.5%),ineffective in 20 cases (25%),of which 10 died (12.5%).Conclusions The long-term prevention and followed up for chronic pulmonary heart disease and coronary heart disease are very important and adhere to the long-term home oxygen therapy can also reduce patients'readmission rates.%目的 探讨慢性肺源性心脏病并冠心病在临床上的表现及防治措施.方法 本文选择80例患有慢性肺源性心脏病并冠心病的患者进行研究,对于处在急性发作期的患者,在进行综合治疗的基础上应用大环内酯类抗生素,再根据患者的具体情况进行抗凝、溶栓以及有创或者是无创机械通气等的处理,对缓解期的患者进行随诊,同时进行长期的家庭氧疗及口服抗血小板凝集药物、无创双管气道正压通气等治疗对患者的心肺功能进行改善;对伴随血脂增高的患者应采用口服降脂药及低

  6. Is Chronic Low Back Pain Associated with the Prevalence of Coronary Heart Disease when Genetic Susceptibility Is Considered? A Co-Twin Control Study of Spanish Twins

    Science.gov (United States)

    Fernandez, Matt; Ordoñana, Juan R.; Hartvigsen, Jan; Ferreira, Manuela L.; Refshauge, Kathryn M.; Sánchez-Romera, Juan F.; Pinheiro, Marina B.; Simpson, Stephen J.; Hopper, John L.; Ferreira, Paulo H.

    2016-01-01

    Objective To investigate the chronic low back pain and coronary heart disease relationship, after adjusting for relevant confounders, including genetics. Methods In a cross-sectional design, 2148 twins were recruited from the Murcia Twin Registry, Spain. The exposure was chronic LBP and the outcomes were myocardial infarction and other coronary heart diseases—lifetime and in the last 2 years–based on standardized health-related questionnaires. First, logistic regression analysis investigated associations of the total sample followed by a matched co-twin control analyses, with all complete twin pairs discordant for chronic LBP utilised, separated for zygosity—dizygotic (DZ) and monozygotic (MZ) pairs, which adjusted for shared familial factors, including genetics. Results Chronic LBP pain is associated with lifetime myocardial infarction [odds ratio (OR) = 2.69, 95% confidence interval (CI) = 1.35–5.36], other coronary heart diseases over a lifetime (OR = 2.58, 95% CI: 1.69–3.93) and in the last two years (OR = 2.19, 95% CI: 1.33–3.60), while there was a borderline association with myocardial infarction in the last 2 years (OR = 2.64, 95% CI: 0.98–7.12). Although the magnitude of the association remained or increased in the co-twin control analyses, none reached statistical significance. Conclusion Chronic LBP is associated with a higher prevalence of myocardial infarction and coronary heart disease. It is possible that this association remains even when controlling for genetics and early shared environment, although this should be investigated with larger samples of twins discordant for LBP. PMID:27171210

  7. Children, Sports, and Chronic Disease.

    Science.gov (United States)

    Goldberg, Barry

    1990-01-01

    Discusses four chronic diseases (cystic fibrosis, congenital heart disease, rheumatoid arthritis, and asthma) that affect American children. Many have their physical activities unnecessarily restricted, though sports and exercise can actually alleviate symptoms and improve their psychosocial development. Physicians are encouraged to prescribe…

  8. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  9. The influence of genotype on vascular endothelial growth factor and regulation of myocardial collateral blood flow in patients with acute and chronic coronary heart disease

    DEFF Research Database (Denmark)

    Ripa, R.S.; Jorgensen, E.; Baldazzi, F.;

    2009-01-01

    OBJECTIVE: To test the hypothesis that mutations in the vascular endothelial growth factor (VEGF) gene are associated with plasma concentration of VEGF and subsequently the ability to influence coronary collateral arteries in patients with coronary heart disease (CHD). METHODS: Blood samples from...... patients with chronic ischemic heart disease (n=53) and acute coronary syndrome (n=61) were analysed. Coronary collaterals were scored from diagnostic biplane coronary angiograms. RESULTS: The plasma concentration of VEGF was increased in patients with acute compared to chronic CHD (p=0.01). The genotype......-1154 and coronary collateral size (p=0.03) and a significant association between the VEGF plasma concentration and the collateral size (p=0.03). CONCLUSION: VEGF plasma concentration seems related to coronary collateral function in patients with CHD. The results did not support the hypothesis...

  10. Angiotensin II vaccine promising for patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    CHEN Yang-xin; YAO You-jie; NIE Ru-qiong; ZHOU Shu-xian; WANG Jing-feng

    2009-01-01

    @@ Chronic heart failure (CHF), as the end-stage presentation of all kinds of heart diseases, is a major public health problem as well as a pressing public policy issue. There are more than 5 million patients diagnosed with CHF in USA alone and approximately 550 000 new cases appear per year. About 0.4%-2% of the European population is affected by symptomatic heart failure. Hence heart failure is the leading cause of hospitalization especially in older people around the world.

  11. Evaluation of left ventricular function by radionuclide angiography during exercise in normal subjects and in patients with chronic coronary heart disease.

    Science.gov (United States)

    Iskandrian, A S; Hakki, A H; DePace, N L; Manno, B; Segal, B L

    1983-06-01

    Radionuclide angiography permits evaluation of left ventricular performance during exercise. There are several factors that may affect the results in normal subjects and in patients with chronic coronary heart disease. Important among these are the selection criteria: age, sex, level of exercise, exercise end points, ejection fraction at rest and effects of pharmacologic agents. An abnormal ejection fraction response to exercise is not a specific marker for coronary heart disease but may be encountered in other cardiac diseases. In addition to the diagnostic considerations, important prognostic data can be obtained. Further studies are needed to determine the prognostic implications of anatomic findings versus the functional abnormalities induced by exercise in patients with coronary artery disease.

  12. Can geometric indices of heart rate variability predict improvement in autonomic modulation after resistance training in chronic obstructive pulmonary disease?

    Science.gov (United States)

    Santos, Ana Alice Soares Dos; Ricci-Vitor, Ana Laura; Bragatto, Vanessa Santa Rosa; Santos, Ana Paula Soares Dos; Ramos, Ercy Mara Cipulo; Vanderlei, Luiz Carlos Marques

    2017-03-01

    Chronic obstructive pulmonary disease (COPD) is associated with autonomic dysfunctions that can be evaluated through heart rate variability (HRV). Resistance training promotes improvement in autonomic modulation; however, studies that evaluate this scenario using geometric indices, which include nonlinear evaluation, thus providing more accurate information for physiological interpretation of HRV, are unknown. This study aimed to investigate the influence of resistance training on autonomic modulation, using geometric indices of HRV, and peripheral muscle strength in individuals with COPD. Fourteen volunteers with COPD were submitted to resistance training consisting of 24 sessions lasting 60 min each, with a frequency of three times a week. The intensity was determined as 60% of one maximum repetition and was progressively increased until 80% for the upper and lower limbs. The HRV and dynamometry were performed at two moments, the beginning and the end of the experimental protocol. Significant increases were observed in the RRtri (4·81 ± 1·60 versus 6·55 ± 2·69, P = 0·033), TINN (65·36 ± 35·49 versus 101·07 ± 63·34, P = 0·028), SD1 (7·48 ± 3·17 versus 11·04 ± 6·45, P = 0·038) and SD2 (22·30 ± 8·56 versus 32·92 ± 18·78, P = 0·022) indices after the resistance training. Visual analysis of the Poincare plot demonstrated greater dispersion beat-to-beat and in the long-term interval between consecutive heart beats. Regarding muscle strength, there was a significant increase in the shoulder abduction and knee flexion. In conclusion, geometric indices of HRV can predict improvement in autonomic modulation after resistance training in individuals with COPD; improvement in peripheral muscle strength in patients with COPD was also observed.

  13. Risks for Heart Disease & Stroke

    Science.gov (United States)

    ... for Heart Disease & Stroke Risks for Heart Disease & Stroke About 1.5 million heart attacks and strokes happen every year in the United States. You ... some of your risks for heart disease and stroke, but you can manage many of your risks ...

  14. Inhibitory receptors are expressed by Trypanosoma cruzi-specific effector T cells and in hearts of subjects with chronic Chagas disease.

    Directory of Open Access Journals (Sweden)

    Rafael J Argüello

    Full Text Available We had formerly demonstrated that subjects chronically infected with Trypanosoma cruzi show impaired T cell responses closely linked with a process of T cell exhaustion. Recently, the expression of several inhibitory receptors has been associated with T cell dysfunction and exhaustion. In this study, we have examined the expression of the cytotoxic T lymphocyte antigen 4 (CTLA-4 and the leukocyte immunoglobulin like receptor 1 (LIR-1 by peripheral T. cruzi antigen-responsive IFN-gamma (IFN-γ-producing and total T cells from chronically T. cruzi-infected subjects with different clinical forms of the disease. CTAL-4 expression was also evaluated in heart tissue sections from subjects with severe myocarditis. The majority of IFN-γ-producing CD4(+ T cells responsive to a parasite lysate preparation were found to express CTLA-4 but considerably lower frequencies express LIR-1, irrespective of the clinical status of the donor. Conversely, few IFN-γ-producing T cells responsive to tetanus and diphtheria toxoids expressed CTLA-4 and LIR-1. Polyclonal stimulation with anti-CD3 antibodies induced higher frequencies of CD4(+CTAL-4(+ T cells in patients with severe heart disease than in asymptomatic subjects. Ligation of CTLA-4 and LIR-1 with their agonistic antibodies, in vitro, reduces IFN-γ production. Conversely, CTLA-4 blockade did not improved IFN-γ production in response to T. cruzi antigens. Subjects with chronic T. cruzi infection had increased numbers of CD4(+LIR-1(+ among total peripheral blood mononuclear cells, relative to uninfected individuals and these numbers decreased after treatment with benznidazole. CTLA-4 was also expressed by CD3(+ T lymphocytes infiltrating heart tissues from chronically infected subjects with severe myocarditis. These findings support the conclusion that persistent infection with T. cruzi leads to the upregulation of inhibitory receptors which could alter parasite specific T cell responses in the chronic phase

  15. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes, Heart Disease, and Stroke Having diabetes means that ... help to stop. What is the link between diabetes, heart disease, and stroke? Over time, high blood ...

  16. Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its co-relation with the severity of disease

    Directory of Open Access Journals (Sweden)

    N K Gupta

    2011-01-01

    Full Text Available Background: Chronic obstructive pulmonary disease (COPD has considerable effects on cardiac functions, including those of the right ventricle, left ventricle, and pulmonary blood vessels. Most of the increased mortality associated with COPD is due to cardiac involvement. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes. Aims: To assess the cardiac changes secondary to COPD by echocardiography and to find out the correlation between echocardiographic findings and severity of COPD, if there is any. Materials and Methods: A total 40 of patients of COPD were selected and staged by pulmonary function test (PFT and evaluated by echocardiography. Results: On echocardiographic evaluation of COPD, 50% cases had normal echocardiographic parameters. Measurable tricuspid regurgitation (TR was observed in 27/40 cases (67.5%. Pulmonary hypertension (PH, which is defined as systolic pulmonary arterial pressure (sPAP > 30 mmHg was observed in 17/27 (63% cases in which prevalence of mild, moderate, and severe PH were 10/17 (58.82%, 4/17 (23.53%, and 3/17 (17.65%, respectively. The frequencies of PH in mild, moderate, severe, and very severe COPD were 16.67%, 54.55%, 60.00%, and 83.33%, respectively. Right atrial pressure was 10 mmHg in 82.5% cases and 15 mmHg in 17.5% cases. Cor pulmonale was observed in 7/17 (41.17% cases; 7.50% cases had left ventricle (LV systolic dysfunction and 47.5% cases had evidence of LV diastolic dysfunction defined as A ≥ E (peak mitral flow velocity of the early rapid filling wave (E, peak velocity of the late filling wave caused by atrial contraction (A on mitral valve tracing. Left ventricle hypertrophy was found in 22.5% cases. Conclusion : Prevalence of PH has a linear relationship with severity of COPD and severe PH is almost associated with cor pulmonale. Echocardiography helps in early detection of cardiac complications in COPD cases giving time for early

  17. Heart rate reduction in coronary artery disease and heart failure.

    Science.gov (United States)

    Ferrari, Roberto; Fox, Kim

    2016-08-01

    Elevated heart rate is known to induce myocardial ischaemia in patients with coronary artery disease (CAD), and heart rate reduction is a recognized strategy to prevent ischaemic episodes. In addition, clinical evidence shows that slowing the heart rate reduces the symptoms of angina by improving microcirculation and coronary flow. Elevated heart rate is an established risk factor for cardiovascular events in patients with CAD and in those with chronic heart failure (HF). Accordingly, reducing heart rate improves prognosis in patients with HF, as demonstrated in SHIFT. By contrast, data from SIGNIFY indicate that heart rate is not a modifiable risk factor in patients with CAD who do not also have HF. Heart rate is also an important determinant of cardiac arrhythmias; low heart rate can be associated with atrial fibrillation, and high heart rate after exercise can be associated with sudden cardiac death. In this Review, we critically assess these clinical findings, and propose hypotheses for the variable effect of heart rate reduction in cardiovascular disease.

  18. What Causes Heart Valve Disease?

    Science.gov (United States)

    ... a heart attack or injury to the heart. Rheumatic Fever Untreated strep throat or other infections with strep bacteria that progress to rheumatic fever can cause heart valve disease. When the body ...

  19. Heart Disease and Stroke Statistics

    Science.gov (United States)

    ... Media for Heart.org Heart and Stroke Association Statistics Banner 1 - Stats white banner Each year, the ... health and disease in the population. Heart & Stroke Statistics FAQs What is Prevalence? Prevalence is an estimate ...

  20. Data and Statistics: Women and Heart Disease

    Science.gov (United States)

    ... Pressure Salt Cholesterol Million Hearts® WISEWOMAN Women and Heart Disease Fact Sheet Recommend on Facebook Tweet Share Compartir ... Atlas of Heart Disease Facts on Women and Heart Disease Heart disease is the leading cause of death ...

  1. Arteriosclerotic changes in the myocardium, lung, and kidney in dogs with chronic congestive heart failure and myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Falk, Bo Torkel; Jönsson, Lennart; Olsen, Lisbeth Høier;

    2006-01-01

    Background: The occurrence of small vessel arteriosclerosis in the myocardium, kidney, and lung in dogs with naturally occurring myxomatous mitral valve disease has not been previously investigated systematically. Methods: Twenty-one dogs with naturally occurring congestive heart failure and 21 age...... and pulmonary artery. Results: Dogs with congestive heart failure had significantly more arterial narrowing in the left ventricle (Pkidney (p...-matched, sex-matched, and weight-matched control dogs underwent extensive pathological and histopathological examination. Morphometry and scoring of tissue sections were used to measure arterial narrowing and fibrosis in the myocardium, kidney, and lung; and intimal thickness and plaque formation in the aorta...

  2. Hypertensive Heart Disease

    DEFF Research Database (Denmark)

    Wachtell, Kristian

    2011-01-01

    Abstract Hypertensive heart disease is prevalent and during the last decade it has been determined that patients with left ventricular (LV) hypertrophy have increased cardiovascular morbidity and mortality. However, many have doubted the effectiveness of LV mass assessment because it is difficult...

  3. Congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970296 Evaluating the degree of pulmonary vascularlesions in congenital heart disease with selective pul-monary angiography. PAN Shiwei(潘世伟), et al.Fuwai Hosp, CAMS & PUMC, Beijing, 100037. Chin JCardiol 1997; 25(1): 39-41. Objective: To evaluate the degree of pulmonary vas-

  4. Increased interleukin-13 levels in patients with chronic heart failure.

    Science.gov (United States)

    Nishimura, Yuki; Inoue, Teruo; Nitto, Takeaki; Morooka, Toshifumi; Node, Koichi

    2009-01-24

    A great number of basic and clinical studies have demonstrated that inflammatory cytokines play an important role in development and progress of heart failure. However, there is limited information about allergic cytokine interleukin-13 (IL-13). The inflammatory responses mediated by allergic cytokines can cause significant morbidity and mortality when they become chronic. Therefore, we elucidated the role of IL-13 in the pathophysiology of chronic heart failure. We measured plasma IL-13 levels by enzyme-linked immunosorbent assay in 110 patients with chronic heart failure and 20 control subjects. Plasma IL-13 levels were increased in heart failure patients, compared with the controls, in association with NYHA functional class. In addition, IL-13 levels were correlated positively with plasma levels of brain natriuretic peptide and C-reactive protein, and negatively with left ventricular ejection fraction. Plasma IL-13 levels may be useful for evaluating disease severity in chronic heart failure.

  5. What Is Coronary Heart Disease?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is Coronary Heart Disease? Español Coronary heart disease (CHD) is a disease in which a waxy ... medical procedures can help prevent or treat coronary heart disease. These treatments may reduce the risk of related ...

  6. Chronic Kidney Diseases

    Science.gov (United States)

    ... Room? What Happens in the Operating Room? Chronic Kidney Diseases KidsHealth > For Kids > Chronic Kidney Diseases Print ... re talking about your kidneys. What Are the Kidneys? Your kidneys are tucked under your lower ribs ...

  7. Diet - chronic kidney disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002442.htm Diet - chronic kidney disease To use the sharing features on this page, ... make changes to your diet when you have chronic kidney disease. These changes may include limiting fluids, eating a ...

  8. Chronic granulomatous disease

    Science.gov (United States)

    CGD; Fatal granulomatosis of childhood; Chronic granulomatous disease of childhood; Progressive septic granulomatosis ... In chronic granulomatous disease (CGD), immune system cells called phagocytes are unable to kill some types of bacteria and ...

  9. Hispanics and Heart Disease, Stroke

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Hispanics and Heart Disease, Stroke Updated:Aug 30,2016 Heart disease is the No. 1 killer for all Americans and stroke is the fifth leading cause of death. Hispanics ...

  10. Bone: a new endocrine organ at the heart of chronic kidney disease and mineral and bone disorders.

    Science.gov (United States)

    Vervloet, Marc G; Massy, Ziad A; Brandenburg, Vincent M; Mazzaferro, Sandro; Cozzolino, Mario; Ureña-Torres, Pablo; Bover, Jordi; Goldsmith, David

    2014-05-01

    Recent reports of several bone-derived substances, some of which have hormonal properties, have shed new light on the bone-cardiovascular axis. Deranged concentrations of humoral factors are not only epidemiologically connected to cardiovascular morbidity and mortality, but can also be causally implicated, especially in chronic kidney disease. FGF23 rises exponentially with advancing chronic kidney disease, seems to reach maladaptive concentrations, and then induces left ventricular hypertrophy, and is possibly implicated in the process of vessel calcification. Sclerostin and DKK1, both secreted mainly by osteocytes, are important Wnt inhibitors and as such can interfere with systems for biological signalling that operate in the vessel wall. Osteocalcin, produced by osteoblasts or released from mineralised bone, interferes with insulin concentrations and sensitivity, and its metabolism is disturbed in kidney disease. These bone-derived humoral factors might place the bone at the centre of cardiovascular disease associated with chronic kidney disease. Most importantly, factors that dictate the regulation of these substances in bone and subsequent secretion into the circulation have not been researched, and could provide entirely new avenues for therapeutic intervention.

  11. How Is Heart Disease Treated?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is Heart Disease Treated? Treatment for coronary heart disease (CHD) usually is the same for both women ... had lost her mother, father, and aunt to heart disease. And she knew that her life would be ...

  12. Heart Disease and Stroke in Women

    Centers for Disease Control (CDC) Podcasts

    2009-05-11

    This women's health podcast focuses on the impact of heart disease and stroke in women and includes steps to prevent these conditions.  Created: 5/11/2009 by Office of Women’s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/11/2009.

  13. Anemia, chronic renal disease and congestive heart failure--the cardio renal anemia syndrome: the need for cooperation between cardiologists and nephrologists.

    Science.gov (United States)

    Silverberg, Donald S; Wexler, Dov; Iaina, Adrian; Steinbruch, Shoshana; Wollman, Y; Schwartz, Doron

    2006-01-01

    Many patients with congestive heart failure (CHF) fail to respond to maximal CHF therapy and progress to end stage CHF with many hospitalizations, poor quality of life (QoL), progressive chronic kidney disease (CKD) which can lead to end stage kidney disease (ESKD), or die of cardiovascular complications within a short time. One factor that has generally been ignored in many of these people is the fact that they are often anemic. The anemia in CHF is due mainly to the frequently-associated CKD but also to the inhibitory effects of cytokines on erythropoietin production and on bone marrow activity, as well as to their interference with iron absorption from the gut and their inhibiting effect on the release of iron from iron stores. Anemia itself may further worsen cardiac and renal function and make the patients resistant to standard CHF therapy. Indeed anemia in CHF has been associated with increased severity of CHF, increased hospitalization, worse cardiac function and functional class, the need for higher doses of diuretics, progressive worsening of renal function and reduced QoL. In both controlled and uncontrolled studies of CHF, the correction of the anemia with erythropoietin (EPO) and oral or intravenous (IV) iron has been associated with improvement in many cardiac and renal parameters and an increased QoL. EPO itself may also play a direct role in improving the heart unrelated to the improvement of the anemia--by reducing apoptosis of cardiac and endothelial cells, increasing the number of endothelial progenitor cells, and improving endothelial cell function and neovascularization of the heart. Anemia may also play a role in the worsening of acute myocardial infarction and chronic coronary heart disease (CHD) and in the cardiovascular complications of renal transplantation. Anemia, CHF and CKD interact as a vicious circle so as to cause or worsen each other- the so-called cardio renal anemia syndrome. Only adequate treatment of all three conditions can

  14. Travel and Heart Disease

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  15. Chronic Chagas' heart disease: a disease on its way to becoming a worldwide health problem: epidemiology, etiopathology, treatment, pathogenesis and laboratory medicine.

    Science.gov (United States)

    Muñoz-Saravia, Silvia Gilka; Haberland, Annekathrin; Wallukat, Gerd; Schimke, Ingolf

    2012-01-01

    Chagas' disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America. Nearly 30% of infected patients develop life-threatening complications, and with a latency of 10-30 years, mostly Chagas' heart disease which is currently the major cause of morbidity and mortality in Latin America, enormously burdening economic resources and dramatically affecting patients' social and labor situations. Because of increasing migration, international tourism and parasite transfer by blood contact, intrauterine transfer and organ transplantation, Chagas' heart disease could potentially become a worldwide problem. To raise awareness of this problem, we reflect on the epidemiology and etiopathology of Chagas' disease, particularly Chagas' heart disease. To counteract Chagas' heart disease, in addition to the general interruption of the infection cycle and chemotherapeutic elimination of the infection agent, early and effective causal or symptomatic therapies would be indispensable. Prerequisites for this are improved knowledge of the pathogenesis and optimized patient management. From economic and logistics viewpoints, this last prerequisite should be performed using laboratory medicine tools. Consequently, we first summarize the mechanisms that have been suggested as driving Chagas' heart disease, mainly those associated with the presence of autoantibodies against G-protein-coupled receptors; secondly, we indicate new treatment strategies involving autoantibody apheresis and in vivo autoantibody neutralization; thirdly, we present laboratory medicine tools such as autoantibody estimation and heart marker measurement, proposed for diagnosis, risk assessment and patient guidance and lastly, we critically reflect upon the increase in inflammation and oxidative stress markers in Chagas' heart disease.

  16. Heart transplantation in adult congenital heart disease.

    Science.gov (United States)

    Burchill, Luke J

    2016-12-01

    Heart failure (HF) in adult congenital heart disease (ACHD) is vastly different to that observed in acquired heart disease. Unlike acquired HF in which pharmacological strategies are the cornerstone for protecting and improving ventricular function, ACHD-related HF relies heavily upon structural and other interventions to achieve these aims. patients with ACHD constitute a small percentage of the total adult heart transplant population (∼3%), although the number of ACHD heart transplant recipients is growing rapidly with a 40% increase over the last two decades. The worldwide experience to date has confirmed heart transplantation as an effective life-extending treatment option in carefully selected patients with ACHD with end-stage cardiac disease. Opportunities for improving outcomes in patients with ACHD-related HF include (i) earlier recognition and referral to centres with combined expertise in ACHD and HF, (ii) increased awareness of arrhythmia and sudden cardiac death risk in this population, (iii) greater collaboration between HF and ACHD specialists at the time of heart transplant assessment, (iv) expert surgical planning to reduce ischaemic time and bleeding risk at the time of transplant, (v) tailored immunosuppression in the post-transplant period and (vi) development and validation of ACHD-specific risk scores to predict mortality and guide patient selection. The purpose of this article is to review current approaches to diagnosing and treating advanced HF in patients with ACHD including indications, contraindications and clinical outcomes after heart transplantation.

  17. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008277 Relationship between pulse wave velocity and the NYHA classification of coronary insufficiency.SUN Weiping(孙卫平),et al.Dept Cardiol,Tongji Hosp Tongji Univ,Shanghai 200065.Chin J Intern Med 2008;47(5):382-384.Objective To investigate the relationship between brachial-ankle pulse wave velocity(baPWV)and different stage of cardiac dysfunction.Methods 253 consecutive patients with coronary atherosclerotic heart disease

  18. Long-term prognosis of asthma, chronic obstructive pulmonary disease, and asthma-chronic obstructive pulmonary disease overlap in the Copenhagen City Heart study

    DEFF Research Database (Denmark)

    Lange, Peter; Çolak, Yunus; Ingebrigtsen, Truls Sylvan

    2016-01-01

    focus on individuals with asthma-COPD overlap. METHODS: We assigned participants from the Copenhagen City Heart Study into six subgroups: healthy never-smokers, ever-smokers without asthma and COPD, those with asthma with low cumulated smoking exposure and no airflow limitation, those with COPD, those...... mixed-effects model. FINDINGS: We included 8382 participants from the Copenhagen City Heart Study in our study: 2199 never-smokers, 5435 ever-smokers, 158 with asthma, 320 with COPD, 68 with asthma-COPD overlap with early-onset asthma, and 202 with asthma-COPD overlap with late-onset asthma...

  19. Heart Disease Affects Far More Than the Heart

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163584.html Heart Disease Affects Far More Than the Heart Blocked arteries ... 14, 2017 TUESDAY, Feb. 14, 2017 (HealthDay News) -- Heart disease affects more than just the heart. It also ...

  20. [EFFICIENCY OF COMBINATION OF ROFLUMILAST AND QUERCETIN FOR CORRECTION OXYGEN- INDEPENDENT MECHANISMS AND PHAGOCYTIC ACTIVITY OF MACROPHAGE CELLS OF PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE WHEN COMBINED WITH CORONARY HEART DISEASE].

    Science.gov (United States)

    Gerych, P; Yatsyshyn, R

    2015-01-01

    Studied oxygen independent reaction and phagocytic activity of macrophage cells of patients with chronic obstructive pulmonary disease (COPD) II-III stage when combined with coronary heart disease (CHD). The increasing oxygen independent reactions monocytes and neutrophils and a decrease of the parameters that characterize the functional state of phagocytic cells, indicating a decrease in the functional capacity of macrophage phagocytic system (MPS) in patients with acute exacerbation of COPD, which runs as its own or in combination with stable coronary heart disease angina I-II. FC. Severity immunodeficiency state in terms of cellular component of nonspecific immunity in patients with acute exacerbation of COPD II-III stage in conjunction with the accompanying CHD increases with the progression of heart failure. Inclusion of basic therapy of COPD exacerbation and standard treatment of coronary artery disease and drug combinations Roflumilastand quercetin causes normalization of phagocytic indices MFS, indicating improved immune status and improves myocardial perfusion in terms of daily ECG monitoring.

  1. [Indications for surgery for valvular heart disease].

    Science.gov (United States)

    Halbach, Marcel; Wahlers, Thorsten; Baldus, Stephan; Rudolph, Volker

    2015-11-01

    Due to the demographic change, chronic valvular heart disease becomes increasingly important - especially age-related primary diseases of the aortic and mitral valve as well as secondary diseases of the mitral and tricuspid valve caused by other age-related cardiac disorders. Medical treatment is limited to symptom relief by use of diuretics. Specific drugs or drugs with a prognostic benefit are not available. Thus, valve repair or replacement are the key options for treatment of relevant valvular heart disease. While open heart surgery was the only approach for a long time, interventional, catheter-based therapies have evolved in the last decade. This article describes up-to-date recommendations on indications for surgery for the most prevalent valvular heart diseases in adults - aortic stenosis, and aortic, mitral and tricuspid regurgitation).

  2. FastStats: Heart Disease

    Science.gov (United States)

    ... 96 [PDF - 9.8 MB] Death rates for diseases of heart, by sex, race, Hispanic origin, and age Health, United States, 2015, table 22 [ ... causes of death, by sex, race, and Hispanic origin Health, United States, 2015, table ... in Heart Disease and Cancer Mortality Recent Trends in Heart Failure- ...

  3. A Novel Closed-Chest Porcine Model of Chronic Ischemic Heart Failure Suitable for Experimental Research in Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Giuseppe Biondi-Zoccai

    2013-01-01

    Full Text Available Cardiac pathologies are among the leading causes of mortality and morbidity in industrialized countries, with myocardial infarction (MI representing one of the major conditions leading to heart failure (HF. Hitherto, the development of consistent, stable, and reproducible models of closed-chest MI in large animals, meeting the clinical realism of a patient with HF subsequent to chronic ischemic necrosis, has not been successful. We hereby report the design and ensuing application of a novel porcine experimental model of closed-chest chronic ischemia suitable for biomedical research, mimicking post-MI HF. We also emphasize the key procedural steps involved in replicating this unprecedented model, from femoral artery and vein catheterization to MI induction by permanent occlusion of the left anterior descending coronary artery through superselective deployment of platinum-nylon coils, as well as endomyocardial biopsy sampling for histologic analysis and cell harvesting. Our model could indeed represent a valuable contribution and tool for translational research, providing precious insights to understand and overcome the many hurdles concerning, and currently quenching, the preclinical steps mandatory for the clinical translation of new cardiovascular technologies for personalized HF treatments.

  4. Risk of ischaemic heart disease in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Rungoe, Christine; Basit, Saima; Ranthe, Mattis Flyvholm;

    2013-01-01

    Inflammatory bowel disease (IBD) is a chronic inflammatory disorder. Systemic inflammation increases the risk of atherosclerosis and ischaemic heart disease (IHD).......Inflammatory bowel disease (IBD) is a chronic inflammatory disorder. Systemic inflammation increases the risk of atherosclerosis and ischaemic heart disease (IHD)....

  5. 慢性肺源性心脏病合并冠心病临床研究%Clinical Study of Chronic Pulmonary Heart Disease Complicated With Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    郭睿蓉; 吴明; 张尧

    2015-01-01

    目的:探讨慢性肺源性心脏病(简称肺心病)合并冠心病的临床特点。方法选取2013年1~2014年12月于我院就诊的肺心病患者共134例作为研究对象,根据是否合并冠心病分为伴发组(n=64)和非伴发组(n=70)。比较两组患者易患因素、X线检查、治疗转归等临床特点。结果与非伴发组相比,伴发组高脂血症、高血压、糖尿病、肥胖发生率显著升高,比较有统计学差异(P均<0.05),而吸烟发生比例组间比较无统计学差异(P>0.05)。X线检查显示,伴发组左心室肥大和左右心室肥大的发生率分别为23.4%和14.06%,高于非伴发组10.0%和4.28%的发生率(P均<0.05)。治疗后,与非伴发组相比,伴发组好转比例降低,比较有统计学意义(P<0.05),治疗无效及死亡人数增加,但组间比较无统计学差异(P均>0.05)。结论肺心病合并冠心病患者病情复杂,高脂血症、高血压、糖尿病、肥胖等易患因素、左心室肥大及左右心室肥大发生率明显升高,且治疗转归效果还有待进一步改善,应综合考虑进行相关诊断及治疗。%Objective To investigate the clinical characteristic of chronic pulmonary heart disease complicated with coronary heart disease.Methods From January, 2014 to December, 2014, 134 cases were selected as research subjects to retrospectively analyze their clinical characteristics. Those cases were divided into the none concomitant coronary heart disease group (NCCHD, n=84) and the concomitant coronary heart disease group (CCHD, n=92) according to if they were complicated with coronary heart disease. Then, the susceptible factors, x-ray examination, and outcomes were compared between the two groups.ResultsCompared to NCCHD group, CCHD group has higher rates of hypertension, hyperlipemia, obesity, and diabetes and same rates of smoke. The x-ray examination indicates CCHD group has higher rates of

  6. Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 Table of Contents ... to view a larger version of the image Symptoms It is very important to learn the signs ...

  7. Metabolic remodeling in chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    Jing WANG; Tao GUO

    2013-01-01

    Although the management of chronic heart failure (CHF) has made enormous progress over the past decades,CHF is still a tremendous medical and societal burden.Metabolic remodeling might play a crucial role in the pathophysiology of CHF.The characteristics and mechanisms of metabolic remodeling remained unclear,and the main hypothesis might include the changes in the availability of metabolic substrate and the decline of metabolic capability.In the early phases of the disease,metabolism shifts toward carbohydrate utilization from fatty acids (FAs) oxidation.Along with the progress of the disease,the increasing level of the hyperadrenergic state and insulin resistance cause the changes that shift back to a greater FA uptake and oxidation.In addition,a growing body of experimental and clinical evidence suggests that the improvement in the metabolic capability is likely to be more significant than the selection of the substrate.

  8. CPAP in chronic heart failure

    Directory of Open Access Journals (Sweden)

    F. Lari

    2013-05-01

    Full Text Available BACKGROUND Chronic Heart Failure (CHF represents worldwide a clinical condition with increasing prevalence, high social, economical and epidemiological impact. Even if new pharmacological and non-pharmacological approachs have been recently used, mortality remains high in general population and quality of life is poor in these patients. DISCUSSION The association between CHF and sleep disorders is frequent but still undervalued: sleep apnoeas in CHF produce negative effects on cardiovascular system and an aggravation of prognosis. CPAP (Continuous Positive Airway Pressure is commonly used to treat sleep apnoeas in patients without cardiac involvement and it is also used in first line treatment of acute cardiogenic pulmonary oedema thanks to its hemodynamic and ventilatory effects. The addition of nightly CPAP to standard aggressive medical therapy in patients with CHF and sleep apnoeas reduces the number of apnoeas, reduces the blood pressure, and the respiratory and cardiac rate, reduces the activation of sympathetic nervous system, the left ventricular volume and the hospitalization rate; besides CPAP increases the left ventricular ejection fraction, amd the oxygenation, it improves quality of life, tolerance to exercise and seems to reduce mortality in patients with a higher apnoeas suppression. CONCLUSIONS These implications suggest to investigate sleep apnoeas in patients with CHF in order to consider a possible treatment with CPAP. Further studies need to be developed to confirm the use of CPAP in patients with CHF without sleep disorders.

  9. Rationale and Design for the Intramyocardial Injection of Autologous Bone Marrow Mononuclear Cells for Patients with Chronic Ischemic Heart Disease and Left Ventricular Dysfunction Trial (FOCUS)

    Science.gov (United States)

    Willerson, James T.; Perin, Emerson C.; Ellis, Stephen G.; Pepine, Carl J.; Henry, Timothy D.; Zhao, David X.M.; Lai, Dejian; Penn, Marc S.; Byrne, Barry J.; Silva, G; Gee, Adrian; Traverse, Jay H.; Hatzopoulos, Antonis K.; Forder, John R.; Martin, Daniel; Kronenberg, Marvin; Taylor, Doris A.; Cogle, Christopher R.; Baraniuk, Sarah; Westbrook, Lynette; Sayre, Shelly L.; Vojvodic, Rachel W.; Gordon, David J.; Skarlatos, Sonia I.; Moyé, Lemuel A.; Simari, Robert D.

    2010-01-01

    Background The increasing worldwide prevalence of coronary artery disease (CAD) continues to challenge the medical community. Management options include medical and revascularization therapy. Despite advances in these methods, CAD is a leading cause of recurrent ischemia and heart failure, posing significant morbidity and mortality risks along with increasing health costs in a large patient population worldwide. Trial Design The Cardiovascular Cell Therapy Research Network (CCTRN) was established by the National Institutes of Health to investigate the role of cell therapy in the treatment of chronic cardiovascular disease. FOCUS is a CCTRN-designed randomized Phase II, placebo-controlled clinical trial that will assess the effect of autologous bone marrow mononuclear cells delivered transendocardially to patients with left ventricular (LV) dysfunction and symptomatic heart failure or angina. All patients need to have limiting ischemia by reversible ischemia on SPECT assessment. Results After thoughtful consideration of both statistical and clinical principles, we will recruit 87 patients (58 cell treated and 29 placebo) to receive either bone marrow–derived stem cells or placebo. Myocardial perfusion, LV contractile performance, and maximal oxygen consumption are the primary outcome measures. Conclusions The designed clinical trial will provide a sound assessment of the effect of autologous bone marrow mononuclear cells in improving blood flow and contractile function of the heart. The target population is patients with CAD and LV dysfunction with limiting angina or symptomatic heat failure. Patient safety is a central concern of the CCTRN, and patients will be followed for at least 5 years. PMID:20691824

  10. Anemia associated with chronic heart failure: current concepts

    Directory of Open Access Journals (Sweden)

    Shah R

    2013-02-01

    Full Text Available Ravish Shah, Anil K AgarwalDivision of Nephrology, The Ohio State University, Columbus, Ohio, USAAbstract: Anemia is a frequent comorbidity of heart failure and is associated with poor outcomes. Anemia in heart failure is considered to develop due to a complex interaction of iron deficiency, kidney disease, and cytokine production, although micronutrient insufficiency and blood loss may contribute. Currently, treatment of anemia of heart failure lacks clear targets and specific therapy is not defined. Intravenous iron use has been shown to benefit anemic as well as nonanemic patients with heart failure. Treatment with erythropoietin-stimulating agents has been considered alone or in combination with iron, but robust evidence to dictate clear guidelines is not currently available. Available and emerging new agents in the treatment of anemia of heart failure will need to be tested in randomized, controlled studies.Keywords: anemia, heart failure, chronic kidney disease, elderly population

  11. 慢性肺心病合并冠心病的临床诊治分析%Clinical diagnosis analysis on chronic pulmonary heart disease complicated with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    李顺辉; 涂颉洪; 张卫; 刘丽赟; 熊强珍

    2010-01-01

    目的 探讨慢性肺心病合并冠心病的临床特点和诊断依据,总结分析其治疗方法,从而提高临床诊断率、降低病死率.方法 回顾性分析98例慢性肺心病合并冠心病患者的临床特点、心电图、X线摄片、超声心电图以及治疗资料.结果 肺心病出现典型心绞痛、心肌梗死,心电图左心导联动态缺血性改变、左前半或完全性左束支传导阻滞,反复出现左心衰竭伴有左心扩大者,应考虑合并冠心病.处理时要在常规治疗的基础上区别对待.结论 肺心病合并冠心病引起的心力衰竭患者,要根据诊断结果,在常规基础治疗的同时,针对病因与并发症取有效的个体化治疗措施进行处理,可获得较满意的临床效果.%Objective To discuss the chronic pulmonary heart disease merge coronary artery disease's clinical characteristic and the diagnosis basis, then summarizes and analyzes its method of treatment,to improve the clinical diagnosis rates and reduce mortality. Methods Retrospective analyzing 98 cases of chronic pulmonary heart disease merge coronary artery disease patients' clinical characteristic, the electrocardiogram, X absorb the piece, the supersonic electrocardiogram and the treatment material. Results Pulmonary heart disease patients appear typical angina pectoris, myocardial infarction, 12-lead electrocardiography ischemic dynamic changes in ST-T segment, left anterior hemi block or CLBBB (Complete Left Bundle Branch Block), recurring the left heart failure with left heart amplification, we should consider merge coronary heart disease. When dealing with the disease, we must distinguish in the conventional treatment foundation. Conclusion Pulmonary heart disease merge coronary artery disease patients with heart failure, while taking conventional foundation treatment, aim at causes and complications to take effective measures to deal with individual treatment, can get a satisfactory clinical effect.

  12. Depression and Coronary Heart Disease

    OpenAIRE

    2012-01-01

    There are exciting findings in the field of depression and coronary heart disease. Whether diagnosed or simply self-reported, depression continues to mark very high risk for a recurrent acute coronary syndrome or for death in patients with coronary heart disease. Many intriguing mechanisms have been posited to be implicated in the association between depression and heart disease, and randomized controlled trials of depression treatment are beginning to delineate the types of depression manage...

  13. [Heart disease in schizophrenia].

    Science.gov (United States)

    Wobrock, T; Sittinger, H; Kindermann, M; Behrendt, B

    2004-03-01

    A 63-year-old male patient diagnosed with chronic schizophrenia and characterized by formal disorders of thought with neologism and paranoid ideation, especially grandiose delusions and feelings of being influenced by radiation, is presented. At admission to psychiatric hospital, the patient reported attacks of weakness and dizziness, which he attributed to his feelings of alien influence. The diagnosis of cardiac disease with severe bradycardia could already be established by basic physical examination. Further diagnostic procedures (e.g., ECG) revealed symptomatic atrioventricular conduction defects (atrioventricular block III). After implantation of a cardiac pacemaker, the somatic symptoms vanished and the patient recovered completely in terms of physical condition.

  14. Women and Heart Disease: Sharing Advice from the Heart

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Women and Heart Disease Sharing Advice From The Heart Past Issues / Spring ... gowns in an effort to raise awareness that heart disease is the leading cause of death among women. ...

  15. Women's Heart Disease: Join the Heart Truth Community

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Join The Heart Truth Community Past Issues / Winter ... introduced as the national symbol for women and heart disease awareness in 2002 by the NHLBI. The Red ...

  16. Effect of dyspnea and clinical variables on the quality of life and functional capacity in patients with chronic obstructive pulmonary disease and congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Hale Karapolat; Sibel Eyigor; Alev Atasever; Mehdi Zoghi; Sanem Nalbantgil; Berrin Durmaz

    2008-01-01

    Background Chronic obstructive pulmonary disease(COPD)and congestive heart failure(CHF)are two chronic diseases that affect negatively the functional condition and quality of life of patients.We assessed the effect of symptoms and clinical variables on the functional capacity and quality of life in COPD and CHF patients.Methods The study included 42 COPD and 39 CHF patients.In both patient groups,dyspnea was assessed using Borg scale;functional capacity by shuttle-walk and cardiopulmonary exercise test and quailty of life by short fOrm-36 (SF36).Results No statistically significant difference was found in neither of the two disease groups regarding the dyspnea score,shuttle-walk test and the maiority of subgroup scores of SF36 (P>0.05).A statistically significant difference was obsewed in peak VO2 in favor of COPD group(P<0.05).No significant relationship was established between dyspnea score and forced expiratory volume in one second(FEV1)in COPD patients,and left ventricular ejection fraction(L.VEF)in CHF patients (P>0.05).A significant negative correlation was obsewed between dyspnea score and functional capacity tests in both disease groups(P<0.05).On the other hand,no relationship was found between L-VEF and FEV1 and quailty of life and functional capacity (P>0.05),Conclusions It was revealed that symptoms have an impact on functional capacity and quality of life in both disease groups,however,objective indicators of disease severity do not show a similar relationship.Therefore,in addition to the objective data related to the disease,we recommend that symptoms should also be taken into consideration to assess cardiopulmonary rehabilitation program and during following-up.

  17. Mercury Exposure and Heart Diseases

    Directory of Open Access Journals (Sweden)

    Giuseppe Genchi

    2017-01-01

    Full Text Available Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways. For many years, mercury was used in a wide variety of human activities. Nowadays, the exposure to this metal from both natural and artificial sources is significantly increasing. Recent studies suggest that chronic exposure, even to low concentration levels of mercury, can cause cardiovascular, reproductive, and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity. Possible biological effects of mercury, including the relationship between mercury toxicity and diseases of the cardiovascular system, such as hypertension, coronary heart disease, and myocardial infarction, are being studied. As heart rhythm and function are under autonomic nervous system control, it has been hypothesized that the neurotoxic effects of mercury might also impact cardiac autonomic function. Mercury exposure could have a long-lasting effect on cardiac parasympathetic activity and some evidence has shown that mercury exposure might affect heart rate variability, particularly early exposures in children. The mechanism by which mercury produces toxic effects on the cardiovascular system is not fully elucidated, but this mechanism is believed to involve an increase in oxidative stress. The exposure to mercury increases the production of free radicals, potentially because of the role of mercury in the Fenton reaction and a reduction in the activity of antioxidant enzymes, such as glutathione peroxidase. In this review we report an overview on the toxicity of mercury and focus our attention on the toxic effects on the cardiovascular system.

  18. Mercury Exposure and Heart Diseases

    Science.gov (United States)

    Genchi, Giuseppe; Sinicropi, Maria Stefania; Carocci, Alessia; Lauria, Graziantonio; Catalano, Alessia

    2017-01-01

    Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways. For many years, mercury was used in a wide variety of human activities. Nowadays, the exposure to this metal from both natural and artificial sources is significantly increasing. Recent studies suggest that chronic exposure, even to low concentration levels of mercury, can cause cardiovascular, reproductive, and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity. Possible biological effects of mercury, including the relationship between mercury toxicity and diseases of the cardiovascular system, such as hypertension, coronary heart disease, and myocardial infarction, are being studied. As heart rhythm and function are under autonomic nervous system control, it has been hypothesized that the neurotoxic effects of mercury might also impact cardiac autonomic function. Mercury exposure could have a long-lasting effect on cardiac parasympathetic activity and some evidence has shown that mercury exposure might affect heart rate variability, particularly early exposures in children. The mechanism by which mercury produces toxic effects on the cardiovascular system is not fully elucidated, but this mechanism is believed to involve an increase in oxidative stress. The exposure to mercury increases the production of free radicals, potentially because of the role of mercury in the Fenton reaction and a reduction in the activity of antioxidant enzymes, such as glutathione peroxidase. In this review we report an overview on the toxicity of mercury and focus our attention on the toxic effects on the cardiovascular system. PMID:28085104

  19. Heart Disease Affects Women of All Ages

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Heart Disease Affects Women of All Ages Past Issues / Winter ... weeks of a heart attack. For Women with Heart Disease: About 6 million American women have coronary heart ...

  20. Heart Valve Diseases

    Science.gov (United States)

    Your heart has four valves. Normally, these valves open to let blood flow through or out of your heart, and then shut to keep it from flowing ... close tightly. It's one of the most common heart valve conditions. Sometimes it causes regurgitation. Stenosis - when ...

  1. Safety and tolerability of the novel non-steroidal mineralocorticoid receptor antagonist BAY 94-8862 in patients with chronic heart failure and mild or moderate chronic kidney disease

    DEFF Research Database (Denmark)

    Pitt, Bertram; Kober, Lars; Ponikowski, Piotr;

    2013-01-01

    Mineralocorticoid receptor antagonists (MRAs) improve outcomes in patients with heart failure and reduced left ventricular ejection fraction (HFrEF), but their use is limited by hyperkalaemia and/or worsening renal function (WRF). BAY 94-8862 is a highly selective and strongly potent non-steroida......Mineralocorticoid receptor antagonists (MRAs) improve outcomes in patients with heart failure and reduced left ventricular ejection fraction (HFrEF), but their use is limited by hyperkalaemia and/or worsening renal function (WRF). BAY 94-8862 is a highly selective and strongly potent non......-steroidal MRA. We investigated its safety and tolerability in patients with HFrEF associated with mild or moderate chronic kidney disease (CKD)....

  2. THE ROLE OF LIPOTROPIC THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE BEFORE AND AFTER CORONARY REVASCULARIZATION

    Directory of Open Access Journals (Sweden)

    R. N. Adzhiev

    2015-09-01

    Full Text Available Review of large of trials that prove the positive impact of high-dose lipid-lowering therapy on the prognosis in patients with ischemic heart disease (IHD are presented. The data on the efficacy of the lipid profile correction by lipid apheresis in patients with hypercholesterolemia that is refractory to optimal medical therapy are showed. The results of the large trials (LIPS, ARMYDA, NAPLES II, ARMYDA-RECAPTURE, Post-CABG, TNT and meta-analyzes on the role of statins, prescribed before and after coronary artery bypass surgery and stenting, in reducing the risk of early and late cardiac events and the need for repeat myocardial revascularization are analyzed. The issue of therapeutic apheresis should be considered in cases of refractory hypercholesterolemia according to ESC/EAS Guidelines for the management of dyslipidaemias (2011. The tendency to reduction in the risk of stent restenosis and vein graft lesions after lipid apheresis is found in very high risk patients with IHD and refractory hypercholesterolemia that underwent coronary stenting or bypass surgery.

  3. THE ROLE OF LIPOTROPIC THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE BEFORE AND AFTER CORONARY REVASCULARIZATION

    Directory of Open Access Journals (Sweden)

    R. N. Adzhiev

    2013-01-01

    Full Text Available Review of large of trials that prove the positive impact of high-dose lipid-lowering therapy on the prognosis in patients with ischemic heart disease (IHD are presented. The data on the efficacy of the lipid profile correction by lipid apheresis in patients with hypercholesterolemia that is refractory to optimal medical therapy are showed. The results of the large trials (LIPS, ARMYDA, NAPLES II, ARMYDA-RECAPTURE, Post-CABG, TNT and meta-analyzes on the role of statins, prescribed before and after coronary artery bypass surgery and stenting, in reducing the risk of early and late cardiac events and the need for repeat myocardial revascularization are analyzed. The issue of therapeutic apheresis should be considered in cases of refractory hypercholesterolemia according to ESC/EAS Guidelines for the management of dyslipidaemias (2011. The tendency to reduction in the risk of stent restenosis and vein graft lesions after lipid apheresis is found in very high risk patients with IHD and refractory hypercholesterolemia that underwent coronary stenting or bypass surgery.

  4. Cx40 mRNA expression in crista terminalis and left atrium of patients with rheumatic heart disease associated chronic atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Zhao Feng; Li Li; Xu Zhiyun; Huang Xing; Zhou Yong

    2008-01-01

    Objectives: To explore possible mechanisms of connexin40 (Cx40) remodeling by detecting Cx40 mRNA expression of the crista terminalis and left atrium (LA) in patients with rheumatic heart disease (RHD) associated chronic atrial fibrillation (AF). Methods: Twenty patients were enrolled in this study, who underwent surgical operation for RHD-associated mitral disease, including 10 with sinus rhythms (rhythm group) and 10 with AF (AF group). Another 6 patients with non-RHD sinus rhythms were divided into the control group. A small amount of myocardial tissue was cut from the crista terminalis and the LA posterior wall during the valvular replacement operation. Cx40 mRNA expression was assayed by real-time fluorescent quantitation polymerase chain reaction (RT-PCR). Results: There was no significant difference in Cx40 mRNA expression in the crista terminalis and LA posterior wall between the 3 groups, and there was no significant difference in Cx40 mRNA expression between the crista terminalis and LA within each group. Conclusion: Based on the finding in previous studies that there existed evident remodeling of atrial Cx40 protein in patients with chronic RHD, the results of the present study suggest that the mechanism of Cx40 remodeling probably lies in the post transcriptional level.

  5. Hope in elderly adults with chronic heart failure. Concept analysis.

    Science.gov (United States)

    Caboral, Meriam F; Evangelista, Lorraine S; Whetsell, Martha V

    2012-01-01

    This topic review employed Walker and Avant's method of concept analysis to explore the construct of hope in elderly adults with chronic heart failure. The articles analyzed revealed that hope, as the belief of the occurrence of a positive result without any guarantee that it will be produced, is necessary for the survival and wellbeing of the elderly adults enduring this disease.

  6. Relationship of left heart size and left ventricular mass with exercise capacity in chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    SHEN Yu-qin; WANG Le-min; CHE Lin; SONG Hao-ming; ZHANG Qi-ping

    2011-01-01

    Background Impaired exercise capacity is one of the most common clinical manifestations in patients with chronic heart failure (CHF). The severity of reduced exercise capacity is an indicator of disease prognosis. The aim of the current study was to investigate the association between left heart size and mass with exercise capacity.Methods A total of 74 patients were enrolled in the study, with 37 having congestive heart failure (left ventricular ejection fraction (LVEF) <0.45) and the other 37 with coronary heart disease (by coronary angiography) serving as the control group (LVEF >0.55). Echocardiography and cardiopulmonary exercise test were performed. The multiply linear regression model was used to evaluate the association between echocardiogrphic indices and exercise capacities.Results The study showed that left ventricular end diastolic / systolic diameter (LVEDD/LVESD), left atrial diameter (LAD) and left ventricular mass index (LVMI) were significantly enlarged in patients with chronic heart failure compared with controls (P <0.01). The VO2AT, Peak VO2, Load AT, and Load Peak in chronic heart failure patients were also significantly reduced compared with controls (P <0.05), VE/VCO2 slope was increased in patients with chronic heart failure (P <0.01). Multivariate linear regression analysis indicated that the patients' exercise capacity was significantly associated with the left heart size and mass, however, the direction and/or strength of the associations sometimes varied in chronic heart failure patients and controls. Load AT correlated negatively with LVEDD in chronic heart failure patients (P=0.012), while Load AT correlated positively with LVEDD in control patients (P=0.006). VE/VCO2 slope correlated positively with LAD (B=0.477, P <0.0001) in chronic heart failure patients, while the VE/VCO2 slope correlated negatively with LAD in control patients (P=0.009).Conclusion The study indicates that the size of LVEDD and LAD are important

  7. Genetics of valvular heart disease.

    Science.gov (United States)

    LaHaye, Stephanie; Lincoln, Joy; Garg, Vidu

    2014-01-01

    Valvular heart disease is associated with significant morbidity and mortality and often the result of congenital malformations. However, the prevalence is increasing in adults not only because of the growing aging population, but also because of improvements in the medical and surgical care of children with congenital heart valve defects. The success of the Human Genome Project and major advances in genetic technologies, in combination with our increased understanding of heart valve development, has led to the discovery of numerous genetic contributors to heart valve disease. These have been uncovered using a variety of approaches including the examination of familial valve disease and genome-wide association studies to investigate sporadic cases. This review will discuss these findings and their implications in the treatment of valvular heart disease.

  8. Genetics Home Reference: critical congenital heart disease

    Science.gov (United States)

    ... Health Conditions critical congenital heart disease critical congenital heart disease Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Critical congenital heart disease (CCHD) is a term that refers to a ...

  9. Heart Disease and Asians and Pacific Islanders

    Science.gov (United States)

    ... Data > Minority Population Profiles > Asian American > Heart Disease Heart Disease and Asians and Pacific Islanders Overall, Asian American ... are less likely than white adults to have heart disease and they are less likely to die from ...

  10. How Is Diabetic Heart Disease Treated?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is Diabetic Heart Disease Treated? Diabetic heart disease (DHD) is treated with lifestyle changes, medicines, and ... treating DHD include: Controlling diabetes and any other heart disease risk factors you have, such as unhealthy blood ...

  11. How Does Heart Disease Affect Women?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Does Heart Disease Affect Women? Español In the United States, 1 ... about coronary MVD and broken heart syndrome. Coronary Heart Disease CHD is a disease in which plaque (plak) ...

  12. Living with heart disease and angina

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000576.htm Living with heart disease and angina To use the sharing features on ... pain and reduce your risks from heart disease. Heart Disease and Angina CHD is a narrowing of the ...

  13. Chronic Kidney Disease

    Science.gov (United States)

    You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of ... help control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged ...

  14. Chronic Kidney Disease (CKD)

    Science.gov (United States)

    ... CKD treated? Kidney-friendly diet for CKD What causes chronic kidney disease (CKD)? Anyone can get CKD. Some people are ... and high blood pressure are the most common causes of CKD. If you have diabetes or high blood pressure, ...

  15. Sleep and Chronic Disease

    Science.gov (United States)

    ... message, please visit this page: About CDC.gov . Sleep About Us About Sleep Key Sleep Disorders Sleep ... Sheets Data & Statistics Projects and Partners Resources Events Sleep and Chronic Disease Recommend on Facebook Tweet Share ...

  16. Chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008430 Effect of gas exchange at maximal intensity on exercise capacity in patients with chronic obstructive pulmonary disease. WANG Haoyan(王浩彦), et al. Dept Respir Dis, Beijing Friendship Hosp, Capital Med Sci Univ, Beijing 100050. Chin J Tuberc Respir Dis 2008;31(6):414-416. Objective To investigate the effect of gas exchange at maximal intensity on exercise capacity in patients with chronic obstructive pulmonary disease (COPD).

  17. Community-based Disease Management Model for Chronic Heart Failure%慢性心力衰竭社区疾病管理模式探索

    Institute of Scientific and Technical Information of China (English)

    单红; 练宇; 刘振芳; 范文娟; 郭莹; 彭翔; 彭建强; 冯洁; 唐铭翔; 颜素岚; 谢琼; 邹琼超; 傅庆华

    2014-01-01

    Objective To understand the characteristics of people with chronic heart failure in community,based on which to make the suitable community management of the disease,next to discuss whether patients with chronic heart failure can benefit from the community management or not,so as to provides a new way for comprehensive prevention of chronic heart fail-ure. Methods (1) Self-designed questionnaire was used to investigate 288 patients with chronic heart failure in Liufu Street community of Changsha from March to April in 2012 who volunteered to take part in the community management about the charac-teristics of heart failure population. (2) Self-designed systematic management methods of chronic heart failure disease was used to interfere another 200 patients in the community drug treatment from May 2012 to May 2013,health education,lifestyle,self-management,etc. Patients' basic indexes controlling situation,usage rate of heart failure conventional drugs,awareness rate of heart failure knowledge,self-management,MNLF scores,frequency of hospitalization and incidence of cardiovascular events were observed before and after the intervention. Results (1)288 questionnaire were sent out,receiving 279 questionnaires with a recovering rate of 96. 88% and 274 valid questionnaires with an effective rate of 98. 21%. The average age of the patients was(68. 7 ± 10. 6);MNLF score was(22. 13 ± 14. 64);68. 61%(188/274)of the patients had low salt and low fat diets;41. 97%(115/274)measured their blood pressure on a regular basis;the control rate of blood pressure was 35. 40%(97/274);the active follow-up rate was 25. 18%(69/274)and the active accepting health education was 8. 03%(22/274). (2)After intervention,blood pressure control rate and heart rate control rate were higher than before(P﹤0. 05). The differ-ence of blood sugar control rate before and after intervention was not significant(P﹥0. 05). The usage rate of ACEI/ARB andβblockers,the awareness rate of heart failure

  18. Performance measures for management of chronic heart failure patients with acute coronary syndrome in China: results from the Bridging the Gap on Coronary Heart Disease Secondary Prevention in China (BRIG)Project

    Institute of Scientific and Technical Information of China (English)

    WANG Na; ZHAO Dong; LIU Jing; LIU Jun; Cheuk-Man Yu; WANG Wei; SUN Jia-yi

    2013-01-01

    Background Chronic heart failure (CHF) is a severe clinical syndrome associated with high morbidity and mortality,and with high health care expenditures.No nationwide data are currently available regarding the quality of clinical management of CHF patients in China.The aim of this study was to assess the quality of care of CHF inpatients in China.Methods The American College of Cardiology/American Heart Association Clinical Performance Measures for Adults with Chronic Heart Failure (Inpatient Measurement Set) with slight modifications was used to measure the performance status in 612 CHF patients with acute coronary syndrome (ACS) from 65 hospitals across all regions of China.Results The implementation rates of guideline recommended strategies for CHF management were low.Only 57.5% of the CHF patients received complete discharge instructions,53.6% of the patients received evaluation of left ventricular systolic function,62.8% received an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker at discharge,and 52.7% received a β-blocker at discharge,56.3% of the smokers received smoking cessation counseling.The rate of warfarin utilization was only 9.7% in CHF patients with atrial fibrillation.Most patients (81.4%) did not receive all the first four treatments.There were marked differences in the quality of CHF management among patients with different characteristics.Conclusions Performance measures provide a standardized method of assessing quality of care,and can thus highlight problems in disease management in clinical practice.The quality of care for CHF patients with ACS in China needs to be improved.

  19. Heart Rate and Cardiovascular Disease: An Alternative to Beta Blockers

    Directory of Open Access Journals (Sweden)

    Michael Liang

    2009-01-01

    Full Text Available Ivabradine, an If inhibitor, acts primarily on the sinoatrial node and is used to reduce the heart rate with minimal effect on myocardial contractility, blood pressure, and intracardiac conduction. Heart rate reduction is an important aspect of care in patients with chronic stable angina and heart failure. Many patients with coronary artery disease have coexisting asthma or chronic obstructive airway disease, and most of them are unable to tolerate beta blockers. Ivabradine may thus be a useful medicine in therapeutic heart rate management especially in patients who are intolerant of beta-blockers.

  20. Mobile phone technology in chronic disease management

    OpenAIRE

    Blake, Holly

    2008-01-01

    Mobile phones are being used to improve nurse-patient communication and monitor health outcomes in chronic disease. Innovative applications of mobile technology are expected to increase over time in community management of cancer, heart disease, asthma and diabetes. This article focuses on mobile phone technology and its contribution to health care.

  1. Heart disease and diet

    Science.gov (United States)

    ... liver, and prepared meats such as sausage, hot dogs, and high-fat lunch meats. Adults should eat ... risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ...

  2. Vital Exhaustion and Coronary Heart Disease Risk

    DEFF Research Database (Denmark)

    Frestad, Daria; Prescott, Eva

    2017-01-01

    OBJECTIVES: The construct of vital exhaustion has been identified as a potential independent psychological risk factor for incident and recurrent coronary heart disease (CHD). Despite several decades of research, no systematic review or meta-analysis has previously attempted to collate.......22-1.85) for prospective studies, and 2.61 (95% CI = 1.66-4.10) for case-control studies using hospital controls. Risk of recurrent events in patients with CHD was 2.03 (95% CI = 1.54-2.68). The pooled adjusted risk of chronic heart failure in healthy populations was 1.37 (95% CI = 1.21-1.56), but this was based...

  3. Advanced glycation endproducts in chronic heart failure

    NARCIS (Netherlands)

    Smit, Andries J.; Hartog, Jasper W. L.; Voors, Adriaan A.; van Veldhuisen, Dirk J.; Schleicher, E; Somoza,; Shieberle, P

    2008-01-01

    Advanced glycation endproducts (AGEs) have been proposed as factors involved in the development and progression of chronic heart failure (CHF). Cross-linking by AGEs results in vascular and myocardial stiffening, which are hallmarks in the pathogenesis of CHE Additionally, stimulation of receptors b

  4. New pharmacological strategies in chronic heart failure

    NARCIS (Netherlands)

    van de Wal, RMA; Voors, AA; Plokker, HWM; van Gilst, WH; van Veldhuisen, DJ

    2004-01-01

    Diuretics, ACE inhibitors and betablockers form the cornerstone of pharmacological treatment of chronic heart failure (CHF), while angiotensin receptor blockers are gaining ground. However, despite optimal treatment CHF remains a syndrome with poor prognosis. For this reason, a large number of new a

  5. SERUM YKL-40 LEVELS IN CHRONIC HEART FAILURE.

    Directory of Open Access Journals (Sweden)

    Maria Kazakova

    2014-06-01

    Full Text Available Inflammatory processes are involved in the pathogenesis and development of chronic heart disease. The promising novel inflammatory biomarker YKL-40 is related to the degree of inflammation and pathological tissue remodeling. The aim of this study was to determine serum YKL-40 levels in patients with chronic heart failure and to evaluate the potential relationship with ultrasonography findings. Forty-three individuals were enrolled in the study – 24 patients (10 females and 14 males with chronic heart failure, aged 70±11 (mean ± standard deviation and 16 healthy people as age-matched controls (above 50 years. The serum YKL-40 levels were assessed by ELISA. Sonographic measurements such as two-dimensional, Power wave, Continuous Wave, Colour mode and M-Mode were performed using a diagnostic ultrasound system (PHILIPS Ultrasound, Washington, US with a L11-3 probe of 3-11 MHz. The six minute walk test was used to assess functional capability of patients. Our study revealed significantly higher serum YKL-40 levels in patients compared to the control group (P=0.010. No relation was found between the glycoprotein and the results from the ultrasonographic and functional examination. We suppose that increased serum YKL-40 levels in patients with chronic heart failure might reflect the inflammatory route in the development of the disease.

  6. Sleep Apnea and Heart Disease, Stroke

    Science.gov (United States)

    ... Aortic Aneurysm More Sleep Apnea and Heart Disease, Stroke Updated:Mar 14,2017 Plain old snoring can ... and is associated with high blood pressure , arrhythmia , stroke and heart failure . Heart disease is the leading ...

  7. Heart rate variability in patients with chronic cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Smyshlaeva О.М.

    2010-12-01

    Full Text Available The purpose of the work is to estimate the status of autonomic nervous system in patients with chronic cerebral ischemia by means of the analysis of heart rate variability at various stages of disease. 120 patients with chronic cerebral ischemia aged from 45 to 65 took part in the research. The comparison group included 30 patients with an arterial hypertension and without chronic cerebral ischemia. Heart rate variability analisis included time-domain and frequency-domain methods of five-minute sequence of the electrocardiographic intervals registered in at rest and in or-thostatic probe. The results of research have shown, that autonomic disorders with prevalence of sympathetic nervous system accompany initial implications of chronic cerebral ischemia. The second stage of disease is characterized by depression of activity of both autonomic, and central regulation. The expressed depression of autonomic maintenance of regulation of heart rhythm of both from sympathetic, and from parasympathetic nervous system was observed at the third stage of chronic cerebral ischemia

  8. Heart disease - risk factors

    Science.gov (United States)

    ... classes or programs, or things like meditation or yoga. Limiting how much alcohol you drink to 1 drink a day for women and 2 a day for men. Good nutrition is important to your heart health and will help control some of your risk ...

  9. HEART DISEASE IN CHILDREN WITH RESPIRATORY INFECTIONS

    Directory of Open Access Journals (Sweden)

    I. V. Babachenko

    2016-01-01

    Full Text Available The link between heart disease and infectious pathogens is well known. Despite the high frequency of cardiac pathology in infectious diseases, it is rarely diagnosed because of lack of specific clinical  and  laboratory  symptoms. It is especially  difficult to diagnose in  children. Airborne  infections in the structure of infectious morbidity of children occupy a leading place.The aim of this work was to study the nature of the lesions of the heart  in children suffering from acute infection of the respiratory tract.Materials and  methods: 341 children with acute respiratory infection of moderate severity were surveyed by a method of ECG dispersion mapping. Cardiac  pathology has not previously been determined in these children. Signs of disease of the heart was identified in 76 children (22%. Further study included instrumental (ECG, ECHO-KG,  daily monitoring of ECG, biochemical and  etiological (ELISA, PCR, immunocytochemical research  methods for determining the nature of the damage to the heart and the etiology of the disease.Results. Myocarditis was diagnosed in 2%  of children, a violation of repolarization – in 21%,  heart  rhythm disorders  – in 35%  (AV – blockade in 4%.  Most  often  signs  of heart disease were detected in children with Epstein-Barr virus (32%, streptococcal (28%, cytomegalovirus (25%, herpesvirus type  6 infection (24%. Pathogens from the  group of acute respiratory virus infections were identified in 28%, enterovirus – in  10%,  Haemophilus influenzae – in  10%, Mycoplasma pneumonia – in 10%,  Pneumococcus – in 9%, Chlamydia – in 9%, Parvovirus B19 – in 6%.Conclusion. Sensitive screening test  to  detect cardiac pathology is the method of ECG dispersion mapping. Heart damage in children with respiratory diseases in 60% of cases is associated with  mixed infections. Timely  diagnosis of lesions of the heart in infectious diseases in children allows to adjust the

  10. New auxiliary indicators for the differential diagnosis of functional cardiorespiratory limitation in patients with chronic obstructive pulmonary disease and congestive heart failure

    Directory of Open Access Journals (Sweden)

    Cesar Marcelo de Castro

    2003-01-01

    Full Text Available OBJECTIVE: To differentiate the nature of functional cardiorespiratory limitations during exercise in individuals with chronic obstructive pulmonary disease (COPD or congestive heart failure (CHF and to determine indicators that may help their classifications. METHODS: The study comprised 40 patients: 23 with COPD and 17 with CHF. All individuals underwent maximal cardiopulmonary exercise testing on a treadmill. RESULTS: The values of peak gas exchange ratio (R peak, peak carbon dioxide production (VCO2 peak, and peak oxygen ventilatory equivalent (V E O2 peak were higher in the patients with CHF than in those with COPD, and, therefore, those were the variables that characterized the differences between the groups. For group classification, the differentiating functions with the R peak, VCO2 peak (L/min, and V E O2 peak variables were used as follows: group COPD: - 44.886 + 78.832 x R peak + 5.442 x VCO2 peak + 0.336 x V E O2 peak; group CHF: - 69.251 + 89.740 x R peak + 8.461 x VCO2 peak + 0.574 x V E O2 peak. The differentiating function, whose result is greater, correctly classifies the patient's group as 90%. CONCLUSION: The R peak, VCO2 peak, and V E O2 peak values may be used to identify the cause of the functional cardiorespiratory limitations in patients with COPD and CHF.

  11. Prevalence and correlates of heart disease among adults in Singapore.

    Science.gov (United States)

    Picco, Louisa; Subramaniam, Mythily; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Chong, Siow Ann

    2016-02-01

    Heart disease is one of the leading causes of morbidity and mortality worldwide and it has been well established that it is associated with both mental and physical conditions. This paper describes the prevalence of heart disease with mental disorders and other chronic physical conditions among the Singapore resident population. Data were from the Singapore Mental Health Study which was a representative, cross-sectional epidemiological survey undertaken with 6616 Singapore residents, between December 2009 and December 2010. The Composite International Diagnostic Interview Version 3.0 was used to establish the diagnosis of mental disorders, while a chronic medical conditions checklist was used to gather information on 15 physical conditions, including various forms of heart disease. Health-related quality of life was measured using the Euro-Quality of Life Scale (EQ-5D). The lifetime prevalence of heart disease was 2.8%. Socio-demographic correlates of heart disease included older age, Indian ethnicity, secondary education (vs. tertiary) and being economically inactive. After adjusting for socio-demographic variables and other comorbid physical and mental disorders, the prevalence of major depressive disorder and bipolar disorder were significantly higher among those with heart disease, as were diabetes, arthritis, kidney failure and lung disease. These findings highlight important associations between heart disease and various socio-demographic correlates, mental disorders and physical conditions. Given the high prevalence of mood disorders among heart disease patients, timely and appropriate screening and treatment of mental disorders among this group is essential.

  12. ISCHEMIA in chronic kidney disease: improving the representation of patients with chronic kidney disease in cardiovascular trials.

    Science.gov (United States)

    Wyatt, Christina M; Shineski, Matthew; Chertow, Glenn M; Bangalore, Sripal

    2016-06-01

    Despite the high cardiovascular risk associated with chronic kidney disease, a recent systematic review confirmed that patients with kidney disease remain underrepresented in cardiovascular trials. Two ongoing trials are assessing the risk:benefit of aggressive evaluation and intervention for ischemic heart disease in patients with advanced chronic kidney disease.

  13. Relation between Red Cell Distribution Width and Fibroblast Growth Factor 23 Cleaving in Patients with Chronic Kidney Disease and Heart Failure.

    Directory of Open Access Journals (Sweden)

    Fenna van Breda

    Full Text Available In chronic kidney disease (CKD, both anemia and deregulated phosphate metabolism are common and predictive of adverse outcome. Previous studies suggest that iron status influences phosphate metabolism by modulating proteolytic cleavage of FGF23 into C-terminal fragments. Red cell distribution width (RDW was recently identified as a strong prognostic determinant for cardiovascular morbidity and mortality, independently of iron status. We assessed whether RDW is associated with FGF23 cleaving in CKD patients with heart failure.The associations between RDW and either intact FGF23 (iFGF23, C-terminal FGF23 (cFGF23, reflecting iFGF23 and C-terminal fragments together and the iFGF23/cFGF23 ratio were analyzed in 52 patients with CKD (eGFR 34,9 ± 13.9 ml/min/1.73m2 and chronic heart failure (CHF. Associations between RDW and FGF23 forms were studied by linear regression analysis adjusted for parameters of renal function, iron metabolism, phosphate metabolism and inflammation.Median cFGF23 levels were 197.5 [110-408.5] RU/ml, median iFGF23 levels were 107.3 [65.1-162.2] pg/ml and median FGF23 ratio was 0.80 [0.37-0.86]. Mean RDW was 14.1 ± 1.2%. cFGF23 and RDW were associated (β = 1.63 x 10(-3, P < 0.001, whereas iFGF23 and RDW were not (β = -1.38 x 10(-3, P = 0.336. The iFGF23/cFGF23 ratio was inversely associated with RDW. The difference between cFGF23 and iFGF23 (cFGF23- iFGF23 was positively associated with RDW (β = 1.74 x 10(-3, P < 0.001. The association between cFGF23 and RDW persisted upon multivariable linear regression analysis, adjusted for parameters of renal function, phosphate metabolism, iron metabolism and inflammation (β = 0.97 x 10(-3, P = 0.047.RDW is associated with cFGF23 but not with iFGF23 levels in patients with CKD and CHF. This suggests a connection between RDW and FGF23 catabolism, independent of iron status and inflammation. Future studies are needed to unravel underlying mechanisms and whether these pertain to the link

  14. Assessment of a primary care-based telemonitoring intervention for home care patients with heart failure and chronic lung disease. The TELBIL study

    Directory of Open Access Journals (Sweden)

    Vergara Itziar

    2011-03-01

    Full Text Available Abstract Background Telemonitoring technology offers one of the most promising alternatives for the provision of health care services at the patient's home. The primary aim of this study is to evaluate the impact of a primary care-based telemonitoring intervention on the frequency of hospital admissions. Methods/design A primary care-based randomised controlled trial will be carried out to assess the impact of a telemonitoring intervention aimed at home care patients with heart failure (HF and/or chronic lung disease (CLD. The results will be compared with those obtained with standard health care practice. The duration of the study will be of one year. Sixty patients will be recruited for the study. In-home patients, diagnosed with HF and/or CLD, aged 14 or above and with two or more hospital admissions in the previous year will be eligible. For the intervention group, telemonitoring will consist of daily patient self-measurements of respiratory-rate, heart-rate, blood pressure, oxygen saturation, weight and body temperature. Additionally, the patients will complete a qualitative symptom questionnaire daily using the telemonitoring system. Routine telephone contacts will be conducted every fortnight and additional telephone contacts will be carried out if the data received at the primary care centre are out of the established limits. The control group will receive usual care. The primary outcome measure is the number of hospital admissions due to any cause that occurred in a period of 12 months post-randomisation. The secondary outcome measures are: duration of hospital stay, hospital admissions due to HF or CLD, mortality rate, use of health care resources, quality of life, cost-effectiveness, compliance and patient and health care professional satisfaction with the new technology. Discussion The results of this study will shed some light on the effects of telemonitoring for the follow-up and management of chronic patients from a primary care

  15. Chronic heart failure part 2: treatment and management.

    Science.gov (United States)

    Brake, Rebecca; Jones, Ian David

    2017-01-11

    Chronic heart failure is a common and complex clinical syndrome that results from impaired cardiac relaxation or contraction. There have been considerable advances in the management of chronic heart failure; however, the mortality rate remains high. Patients with chronic heart failure may experience multiple debilitating symptoms, such as fatigue, pain, and peripheral oedema. However, breathlessness may be considered the most debilitating symptom. The management of chronic heart failure aims to improve the patient's quality of life by reducing symptoms and supporting the patient to manage their condition. Treatment of patients with chronic heart failure may involve a combination of pharmacological therapy, device implantation and cardiac rehabilitation. This is the second of two articles on chronic heart failure. Part 1 discussed the pathophysiology of chronic heart failure, its causes, assessment, signs and symptoms. Part 2 outlines the treatment and management of patients with the condition, including pharmacological strategies, device implantation, lifestyle modification, cardiac rehabilitation and palliative care.

  16. Isometric exercise and chronic heart failure

    Directory of Open Access Journals (Sweden)

    Efthimia Zerva

    2013-07-01

    Full Text Available The resistance exercise is an important part of all rehabilitation programs in patients with chronic heart failure. Among several kinds of resistance exercises, the one mainly applied is isotonic exercise, whereas, in the contrary, isometric is not heavily used although it affects the daily lives of patients who, trying to look after themselves (moving, walking, lifting objects, twitch in an isometric way their peripheral muscles due to reduced cardiovascular endurance. Purpose: The purpose of the present review was to present the data available so far for isometric exercise in cardiovascular patients and to examine the importance of applying this kind of exercise in rehabilitation programs in the context of, firstly, evaluation, and secondly therapeutic intervention. Material - Methods: The methodology followed included searching inquiries and reviews from international databases (Pubmed, Medline, Scopus on the effects of isometric exercise in patients with chronic heart failure. The progress and development of the studies are of particular importance to this work and, to this end, the literature refers to the entire range of time in the last three decades, from 1985 to 2012 according the key words noted. Results: In rehabilitation programs for patients with chronic heart failure, resistance exercise if applied in an isotonic way helps improve hemodynamic and functional parameters. In contrast, resistance exercise applied in an isometric way requires further investigation because most findings are related to hemodynamic disturbances. The data which is encouraging for isometric exercise programs are few and, therefore, it cannot be directly recommended as a proper way to exercise. Conclusions: Isometric exercise has an important place in the evaluation of patients with chronic heart failure, and limits should be "placed" in its application as a therapeutic tool to prevent complications.

  17. Valvular heart disease in pregnancy.

    Science.gov (United States)

    Windram, Jonathan D; Colman, Jack M; Wald, Rachel M; Udell, Jacob A; Siu, Samuel C; Silversides, Candice K

    2014-05-01

    In women with valvular heart disease, pregnancy-associated cardiovascular changes can contribute to maternal, foetal and neonatal complications. Ideally, a woman with valvular heart disease should receive preconception assessment and counselling from a cardiologist with expertise in pregnancy. For women with moderate- and high-risk valve lesions, appropriate risk stratification and management during pregnancy will optimise outcomes. Pregnancy in women with high-risk lesions, such as severe aortic stenosis, severe mitral stenosis and those with mechanical valves, requires careful planning and coordination of antenatal care by a multidisciplinary team. The purpose of this overview is to describe the expected haemodynamic changes in pregnancy, review pregnancy risks for women with valvular heart disease and discuss strategies for management.

  18. Effect of milrinone in treating chronic pulmonary heart disease complicated with severe heart failure%米力农治疗慢性肺源性心脏病严重心力衰竭效果观察

    Institute of Scientific and Technical Information of China (English)

    葛慷艳; 徐海虹; 蒋鸽

    2016-01-01

    目的 探讨米力农治疗慢性肺源性心脏病严重心力衰竭的疗效.方法 选择2012年10月至2014年12月于浙江省临海市中医院住院的慢性肺源性心脏病严重心力衰竭患者68例,按入院先后顺序随机分为观察组和对照组,各34例.2组患者入院后均采用持续低流量吸氧、控制感染、纠正电解质紊乱及酸碱平衡、解痉平喘、止咳祛痰等基础治疗,根据病情适量利尿,积极治疗并发症;观察组在此基础上给予米力农0.5μg/(kg·min)静脉微量泵持续给药,7d为1个疗程.观察并比较2组患者治疗1个疗程后疗效、心功能指标[左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、每搏输出量(SV)、肺动脉压]、N末端B型脑钠肽(NT-proBNP)水平以及不良反应发生情况.结果 观察组总有效率明显高于对照组[94.1% (32/34)比76.5% (26/34)],差异有统计学意义(P<0.05).治疗后,观察组和对照组LVEF、SV均明显高于治疗前[LVEF:(68±7)%比(45±6)%、(53±5)%比(47±6)%;SV:(70±6)ml比(51±5)ml、(57 ±6)ml比(51±5)ml],且观察组明显高于对照组;肺动脉压、NT-proBNP均明显低于治疗前[肺动脉压:(42±9)mmHg(1mmHg=0.133kPa)比(80±9)mmHg、(54±8)mmHg比(78±10)mmHg;NT-proBNP:(206±72)ng/L比(689±198) ng/L、(337±102) ng/L比(674 ±204) ng/L],且观察组明显低于对照组,差异均有统计学意义(均P<0.05).2组LVEDD治疗前后差异无统计学意义(P>0.05).2组患者治疗过程中均未出现严重不良反应.结论 米力农能有效改善慢性肺源性心脏病严重心力衰竭患者的心功能.%Objective To observe the therapeutic effect of milrinone in treating chronic pulmonary heart disease complicated with severe heart failure.Methods Totally 68 cases with chronic pulmonary heart disease complicated with severe heart failure were enrolled and randomly divided into observation group and control group (34 cases in each group).After admission,both groups

  19. Ischemic heart disease in women

    Directory of Open Access Journals (Sweden)

    Stella Iraklianou

    2009-10-01

    Full Text Available Coronary heart disease has long been recognized as the leading cause of death among middle-aged men and an equally important cause of death and disability among older women. Women with acute ischemic syndromes tend to be older than men with such syndromes. This is considered to be attributed to the protective effects of female ovarian sex hormones. Estrogen express an antiatherogenic profile via mechanisms that cause favorable modifications of lipoprotein levels, coagulation and fibrolytic system and alterations in the wall of vessels that cause vasodilation. Women are susceptible to coronary heart disease because of differences in the anatomy and physiology of their vessels. Women's coronary arteries are smaller and have more diffuse disease than men's. Ischemia can be induced in women without flow limiting stenosis because of endothelial dysfunction or coronary spasm. Usually, the way of manifestation of the disease and ECG abnormalities are not typical in women. Female patients usually delay to seek treatment for their symptoms .The way of evaluation and treatment is usually conservative in women than male counterparts. The diagnosis of the disease is overestimated in men and the treatment is more often invasive, even in the category of low risk. Reversely, women of high risk are less likely to undergo a full assessment and invasive diagnostic and therapeutic interventions are seldom. Recommendations of the American Heart Association for ischemic heart disease in women are in accordance to alterations in the way of life interventions in major risk factors such as arterial hypertension, dyslipidemia and diabetes mellitus, preventive use of medications and drugs that are not recommended. In this category of medications belong hormone replacement therapy (HRT.The last is not recommended for primary and secondary prevention of coronary heart disease in women.

  20. [Chronic systolic heart failure - dosing recommendations at beginning and end of treatment].

    Science.gov (United States)

    Zugck, Christian; Remppis, Andrew; Katus, Hugo A; Frankenstein, Lutz

    2008-10-01

    As a multi-system disease, chronic heart failure requires a complex, multimodal therapy. Achieving maximum guideline adherence in (advanced) chronic heart failure can therefore become a challenge. The important decrease in morbidity and mortality seen lately largely depends on consequent and sometime tedious implementation of guideline targets. The present paper provides a comprehensive overview on medical therapeutic strategies with a particular focus of onset and discontinuation of drugs in patients with chronic systolic dysfunction.

  1. Screening for Chronic Kidney Disease

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Chronic Kidney Disease The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation on Screening for Chronic Kidney Disease (CKD) . This recommendation ...

  2. Heart Disease (For Kids)

    Science.gov (United States)

    ... brain. previous continue Surgeries If a patient has cardiovascular disease, the doctor will talk about how stopping smoking, losing weight, eating a healthy diet, and getting exercise can help. The person also may need to ...

  3. Quantification of late gadolinium enhanced CMR in viability assessment in chronic ischemic heart disease: a comparison to functional outcome

    Directory of Open Access Journals (Sweden)

    Afsharzada Farshid

    2009-03-01

    Full Text Available Abstract Background Quantification of late gadolinium enhanced cardiovascular magnetic resonance (LGE CMR by objective window setting increases reproducibility and facilitates multicenter comparison and cooperation. So far, quantification methods or models have only been validated to postmortem animal studies. This study was undertaken to evaluate quantification of LGE in relation to the clinical standard of viability, i.e. functional outcome after revascularization. Thirty-eight patients with chronic ischemic myocardial dysfunction underwent cine and LGE 1 month before and cine CMR 6 months after coronary revascularization. Enhancement was quantified by thresholding window setting at: 2-8SD above mean signal intensity of a remote normal region, and according to the full width at half maximum method (FWHM. Dysfunctional segments were divided in 5 groups according to segmental extent of enhancement (SEE: SEE 1 – no enhancement to SEE 5 – 76–100% with each quantification method. Results Quantification methods had a strong influence on SEE and total infarct size. Multilevel analysis showed that thresholding contrast images at 6SD best predicted segmental functional outcome after revascularization, but the difference with other methods was small and non-significant. Conclusion Simple thresholding techniques strongly influence global and segmental extent of LGE, but have relatively little influence on the accuracy to predict segmental functional improvement after revascularization.

  4. [Stress, mental disorders and coronary heart disease].

    Science.gov (United States)

    Lederbogen, F; Ströhle, A

    2012-11-01

    There are numerous associations between stress, mental disorders and coronary heart disease (CHD). Exposure to an acute stressor leads to activation of the hypothalamus-pituitary-adrenal and sympathoadrenal systems and chronic stressors are associated with sustained functional changes of these systems. Experiencing acute and chronic stress is paralleled by an increased incidence of mental disorders with the most consistent evidence on the triggering of major depressive episodes. Various mental disorders, including depression, anxiety and schizophrenia, are associated with an increased risk of CHD. Furthermore, acute and chronic stressors have been identified as risk factors or triggers of acute coronary syndromes. Thus therapeutic strategies aim at reducing subjective stress experience, therapy of mental disorders and treatment of cardiac risk factors known to be more prevalent in increased stress states and mental disorders.

  5. Homocysteine and coronary heart disease

    DEFF Research Database (Denmark)

    Clarke, Robert; Bennett, Derrick A; Parish, Sarah

    2012-01-01

    Moderately elevated blood levels of homocysteine are weakly correlated with coronary heart disease (CHD) risk, but causality remains uncertain. When folate levels are low, the TT genotype of the common C677T polymorphism (rs1801133) of the methylene tetrahydrofolate reductase gene (MTHFR...

  6. Predicting coronary heart disease

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Fuster, Valentin

    2012-01-01

    Atherosclerosis is the leading cause of death and disabling disease. Whereas risk factors are well known and constitute therapeutic targets, they are not useful for prediction of risk of future myocardial infarction, stroke, or death. Therefore, methods to identify atherosclerosis itself have been...

  7. Towards defining heart failure in adults with congenital heart disease.

    Science.gov (United States)

    Bolger, Aidan P; Gatzoulis, Michael A

    2004-12-01

    Injury to the myocardium disrupts geometric integrity and results in changes to intracardiac pressure, wall stress and tension, and the pattern of blood flow through the heart. Significant disruption to pump function results in heart failure which is defined in terms of symptoms: breathlessness and fatigue, signs of salt and water retention, and neurohormonal activation. This syndrome most commonly occurs in the context of injury due to ischaemic heart disease and dilated cardiomyopathy but because patients with congenital heart disease (CHD) are born with sometimes gross distortions of cardiac anatomy they too are subject to the forces that drive heart failure. This paper explores the available data relating to the clinical and neurohormonal manifestations of heart failure in patients with congenital heart disease and describes how, by additionally exploring events at a cellular level, we may be able to arrive at a definition of heart failure relevant to this population.

  8. ST2 and patient prognosis in chronic heart failure.

    Science.gov (United States)

    Bayes-Genis, Antoni; Zhang, Yuhui; Ky, Bonnie

    2015-04-02

    Biomarkers of cardiovascular diseases are indispensable tools for diagnosis and prognosis, and the use of several biomarkers is now considered the standard of care. New markers continue to be developed, but few prove to be substantially better than established markers. Suppression of tumorigenicity 2 (ST2) is a marker of cardiomyocyte stress and fibrosis that provides incremental value to natriuretic peptides for risk stratification of patients with a wide spectrum of cardiovascular diseases. On the basis of all available data, the 2013 American College of Cardiology and American Heart Association guidelines now recommend measurement of ST2 for additive risk stratification in patients with acute or chronic ambulatory heart failure (HF). This report provides an up-to-date overview of the clinical studies that led to the endorsement of ST2 as a cardiovascular prognostic marker in chronic HF. The presented data suggest that the addition of ST2 to a model that includes established mortality risk factors, including natriuretic peptides, substantially improves the risk stratification for death and HF hospitalization in patients with HF. ST2's prognostic value remains strong even in the subset of patients with renal insufficiency and is superior to other remodeling-fibrosis biomarkers currently being evaluated. In conclusion, these results have been repeatedly validated; thus, ST2 could be rapidly incorporated into clinical practice for risk prediction. Indeed, the body of evidence supporting the use of ST2 in chronic HF stratification continues to grow, with consistent data from cohorts around the world in single-center (Barcelona, Brussels, and San Diego cohorts) and multicenter (Penn Heart Failure Study [PHFS] and Muerte Subita en Insuficiencia Cardiac [MUSIC]) studies and in post hoc studies from clinical trials (Prospective Randomized Amlodipine Survival Evaluation 2 [PRAISE-2], Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training [HF

  9. Clinical Characteristics, Response to Exercise Training and Outcomes in Heart Failure Patients with Chronic Obstructive Pulmonary Disease: Findings from HF-ACTION

    Science.gov (United States)

    Mentz, Robert J.; Schulte, Phillip J.; Fleg, Jerome L.; Fiuzat, Mona; Kraus, William E.; Piña, Ileana L.; Keteyian, Steven J.; Kitzman, Dalane W.; Whellan, David J.; Ellis, Stephen J.; O’Connor, Christopher M.

    2013-01-01

    Background To investigate the clinical characteristics, exercise training response, beta-blocker selectivity and outcomes in heart failure (HF) patients with chronic obstructive pulmonary disease (COPD). Methods We performed an analysis of HF-ACTION, which randomized 2,331 HF patients with ejection fraction ≤35% to usual care with or without aerobic exercise training. We examined clinical characteristics and outcomes [mortality/hospitalization, mortality, cardiovascular (CV) mortality/CV hospitalization, and CV mortality/HF hospitalization] by physician-reported COPD status using adjusted Cox models and explored an interaction with exercise training. The interaction between beta-blocker cardioselectivity and outcomes was investigated. Results Of patients with COPD status documented (N=2311), 11% (N=249) had COPD. COPD patients were older, had more comorbidities, and lower use of beta-blockers compared to those without COPD. At baseline, COPD patients had lower peak VO2 and higher VE/VCO2 slope. During a median follow-up of 2.5 years, COPD was associated with increased mortality/hospitalization, mortality, and CV mortality/HF hospitalization. After multivariable adjustment, the risk of CV mortality/HF hospitalization remained increased (Hazard Ratio [HR] 1.46, 95% Confidence Interval [CI]: 1.14–1.87), while mortality/hospitalization (HR 1.15, 95% CI: 0.96–1.37) and mortality (HR 1.33, 95% CI: 0.99–1.76) were not significantly increased. There was no interaction between COPD and exercise training on outcomes or between COPD and beta-blocker selectivity on mortality/hospitalization (all P>0.1). Conclusions COPD in HF patients was associated with older age, more comorbidities, reduced exercise capacity, and increased CV mortality/HF hospitalization, but not a differential response to exercise training. Beta-blocker selectivity was not associated with differences in outcome for patients with versus without COPD. PMID:23351822

  10. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950286 Percutaneous transluminal coronary angio-plasty for unstable angina.LIU Meilin(刘梅林),et.al.1st Teach Hosp,Beijing Med Univ,Beijing,100034.Chin J Intern Med 1995;34(3):169-172.Percutaneous transluminal coronary angioplasty(PTCA) was performed in 190 patients with 250 dis-eased vessels and 278 lesions from Dec.1987 to Feb.1994.All the patients had unstable angina (UA).There were 52(18.7%) type A lesions,175(62.9%)type B lesions and 51(18.3%) type C lesions.Of the

  11. [Valvular heart disease in women].

    Science.gov (United States)

    Tornos, Pilar

    2006-08-01

    Very few studies of valvular heart disease have been specifically carried out in women. It is well known that the prevalence of some types of valve disease is influenced by sex: rheumatic mitral stenosis is very common in women but degenerative valve disease affects both sexes similarly. A number of sex differences in the physiopathology of degenerative aortic stenosis have been reported: the degree of calcification is less in women than men and women's ventricles respond to equivalent reductions in valve area with a greater increase in gradient and greater contractility. With regard to prognosis, it is generally accepted that mortality associated with heart surgery is higher in women than men, for both coronary artery and valve surgery. The underlying reasons for the increase in mortality are not clear. Pregnancy presents particular difficulties for women with valvular heart disease. In those with significant valve lesions, it is advisable to correct the valve disease before pregnancy is considered. Anticoagulant treatment involves serious problems for pregnant women with a mechanical prosthesis. They suffer increased risks of prosthetic valve thrombosis and of fetal embryopathy if they take oral anticoagulants during the first trimester.

  12. Heart Disease Linked to Anxiety, Negative Feelings

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163702.html Heart Disease Linked to Anxiety, Negative Feelings And that's especially ... Feb. 21, 2017 (HealthDay News) -- People with mild heart disease are more likely to say they have poorer ...

  13. How Can Heart Disease be Prevented?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Can Heart Disease Be Prevented? Taking action to control your risk factors can help prevent or delay coronary heart disease (CHD). Your risk for CHD increases with the ...

  14. Brisk Walk May Help Sidestep Heart Disease

    Science.gov (United States)

    ... fullstory_162978.html Brisk Walk May Help Sidestep Heart Disease In just 10 weeks, cholesterol, blood pressure and ... at moderate intensity may lower the risk of heart disease, a small study suggests. "We know walking is ...

  15. Preventing Heart Disease - At Any Age

    Science.gov (United States)

    ... of your heart. Preventing heart disease (and all cardiovascular diseases ) means making smart choices now that will pay off the rest of your life. Lack of exercise, a poor diet and other unhealthy habits can ...

  16. Exercise echocardiography for structural heart disease.

    Science.gov (United States)

    Izumo, Masaki; Akashi, Yoshihiro J

    2016-03-01

    Since the introduction of transcatheter structural heart intervention, the term "structural heart disease" has been widely used in the field of cardiology. Structural heart disease refers to congenital heart disease, valvular heart disease, and cardiomyopathy. In structural heart disease, valvular heart disease is frequently identified in the elderly. Of note, the number of patients who suffer from aortic stenosis (AS) and mitral regurgitation (MR) is increasing in developed countries because of the aging of the populations. Transcatheter aortic valve replacement and percutaneous mitral valve repair has been widely used for AS and MR, individually. Echocardiography is the gold standard modality for initial diagnosis and subsequent evaluation of AS and MR, although the difficulties in assessing patients with these diseases still remain. Here, we review the clinical usefulness and prognostic impact of exercise echocardiography on structural heart disease, particularly on AS and MR.

  17. Gallstones Linked to Higher Heart Disease Risk

    Science.gov (United States)

    ... news/fullstory_160497.html Gallstones Linked to Higher Heart Disease Risk Researcher says study highlights a connection between ... may have a slightly increased risk of developing heart disease down the road, a large new study suggests. ...

  18. Heart Disease Prevention: Does Oral Health Matter?

    Science.gov (United States)

    ... oral health isn't a key to heart disease prevention, it's important to take care of your teeth ... and cleanings. If you're concerned about heart disease prevention, ask your doctor about proven ways to reduce ...

  19. Warning signs and symptoms of heart disease

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  20. Flu and Heart Disease and Stroke

    Science.gov (United States)

    ... Submit Button Past Newsletters Flu and Heart Disease & Stroke Language: English Español Recommend on Facebook Tweet ... Heart Disease* and Those Who Have Had a Stroke Are at High Risk of Developing Complications from ...

  1. Screening Tests for Women Who Have Heart Disease

    Science.gov (United States)

    ... Heart Handbook for Women FOR WOMEN WHO HAVE HEART DISEASE If you have heart disease, it is extremely ... flow and any blockages. COULD YOU HAVE HIDDEN HEART DISEASE? Many women have undiagnosed heart disease—even after ...

  2. Heart transplantation in adults with congenital heart disease.

    Science.gov (United States)

    Houyel, Lucile; To-Dumortier, Ngoc-Tram; Lepers, Yannick; Petit, Jérôme; Roussin, Régine; Ly, Mohamed; Lebret, Emmanuel; Fadel, Elie; Hörer, Jürgen; Hascoët, Sébastien

    2017-02-22

    With the advances in congenital cardiac surgery and postoperative care, an increasing number of children with complex congenital heart disease now reach adulthood. There are already more adults than children living with a congenital heart defect, including patients with complex congenital heart defects. Among these adults with congenital heart disease, a significant number will develop ventricular dysfunction over time. Heart failure accounts for 26-42% of deaths in adults with congenital heart defects. Heart transplantation, or heart-lung transplantation in Eisenmenger syndrome, then becomes the ultimate therapeutic possibility for these patients. This population is deemed to be at high risk of mortality after heart transplantation, although their long-term survival is similar to that of patients transplanted for other reasons. Indeed, heart transplantation in adults with congenital heart disease is often challenging, because of several potential problems: complex cardiac and vascular anatomy, multiple previous palliative and corrective surgeries, and effects on other organs (kidney, liver, lungs) of long-standing cardiac dysfunction or cyanosis, with frequent elevation of pulmonary vascular resistance. In this review, we focus on the specific problems relating to heart and heart-lung transplantation in this population, revisit the indications/contraindications, and update the long-term outcomes.

  3. Chronic thyroiditis (Hashimoto disease)

    Science.gov (United States)

    Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis; Chronic autoimmune thyroiditis; Lymphadenoid goiter - Hashimoto; Hypothyroidism - Hashimoto; Type 2 polyglandular autoimmune ...

  4. Effect of Yiqifumai capsule on chronic pulmonary heart disease with heart failure%益气复脉胶囊治疗慢性肺源性心脏病心力衰竭疗效观察

    Institute of Scientific and Technical Information of China (English)

    代国军

    2014-01-01

    Objective It is to observe the clinical efficacy of Yiqifumai capsule on chronic pulmonary heart disease (CPHD) with heart failure.Methods 97 CPHD patients were randomly divided into 2 groups:Yiqifumai treatment group (n=54) and conventional treatment group ( n=43).All patients received the conventional treatments , including: expectorant, antiasthmatic , anti-inflammatory and heart failure treatment .In addition, Yanhuning treatment group also received Yanhun-ing capsule.The clinical curative effects were observed and several indics including :heart function, blood-gas analysis, lev-els of serum inflammation and oxidative stress before and after treatment in both groups were compared .Results The total ef-fective rate in Yiqifumai group was significantly higher than that in control group (P0.05).Adverse drug reaction was not found in the study .Conclusion Yiqifumai capsule could improve heart and lung function , reduce the levels of serum inflam-mation and oxidative stress in the patients with CPHD , the clinical curative effect is satisfied .%目的:观察益气复脉胶囊治疗慢性肺源性心脏病心力衰竭(肺心病心衰)的临床疗效。方法将97例肺心病心衰患者随机分为益气复脉组( n=54)与对照组( n=43)。所有患者均接受化痰、平喘、抗感染、抗心衰等常规治疗,益气复脉组在此治疗基础上加用益气复脉胶囊治疗。观察2组临床疗效,比较治疗前后心功能、血气分析、血清炎症因子与氧化应激水平。结果益气复脉组总有效率明显高于对照组( P<0.05)。治疗后,2组患者心功能好转,低氧血症及酸中毒得到纠正,机体炎症因子及氧化应激水平显著下降(P均<0.05),且益气复脉组改善更明显(P均<0.05),但不能进一步减缓心率(P>0.05)。整个研究中未发现药物不良反应。结论益气复脉胶囊可以明显改善慢性肺心病心衰患者的心肺功能

  5. Mortality by Heart Failure and Ischemic Heart Disease in Brazil from 1996 to 2011

    Energy Technology Data Exchange (ETDEWEB)

    Gaui, Eduardo Nagib, E-mail: engaui@cardiol.br; Oliveira, Gláucia Maria Moraes de [Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Klein, Carlos Henrique [Escola Nacional de Saúde Pública Sérgio Arouca da Fundação Oswaldo Cruz, Rio de Janeiro, RJ (Brazil)

    2014-06-15

    Circulatory system diseases are the first cause of death in Brazil. To analyze the evolution of mortality caused by heart failure, by ischemic heart diseases and by ill-defined causes, as well as their possible relations, in Brazil and in the geoeconomic regions of the country (North, Northeast, Center-West, South and Southeast), from 1996 to 2011. Data were obtained from DATASUS and death declaration records with codes I20 and I24 for acute ischemic diseases, I25 for chronic ischemic diseases, and I50 for heart failure, and codes in chapter XIII for ill-defined causes, according to geoeconomic regions of Brazil, from 1996 to 2011. Mortality rates due to heart failure declined in Brazil and its regions, except for the North and the Northeast. Mortality rates due to acute ischemic heart diseases increased in the North and Northeast regions, especially from 2005 on; they remained stable in the Center-West region; and decreased in the South and in the Southeast. Mortality due to chronic ischemic heart diseases decreased in Brazil and in the Center-West, South and Southeast regions, and had little variation in the North and in the Northeast. The highest mortality rates due to ill-defined causes occurred in the Northeast until 2005. Mortality due to heart failure is decreasing in Brazil and in all of its geoeconomic regions. The temporal evolution of mortality caused by ischemic heart diseases was similar to that of heart failure. The decreasing number of deaths due to ill-defined causes may represent the improvement in the quality of information about mortality in Brazil. The evolution of acute ischemic heart diseases ranged according to regions, being possibly confused with the differential evolution of ill-defined causes.

  6. Mortality by Heart Failure and Ischemic Heart Disease in Brazil from 1996 to 2011

    Directory of Open Access Journals (Sweden)

    Eduardo Nagib Gaui

    2014-06-01

    Full Text Available Background: Circulatory system diseases are the first cause of death in Brazil. Objective: To analyze the evolution of mortality caused by heart failure, by ischemic heart diseases and by ill-defined causes, as well as their possible relations, in Brazil and in the geoeconomic regions of the country (North, Northeast, Center-West, South and Southeast, from 1996 to 2011. Methods: Data were obtained from DATASUS and death declaration records with codes I20 and I24 for acute ischemic diseases, I25 for chronic ischemic diseases, and I50 for heart failure, and codes in chapter XIII for ill-defined causes, according to geoeconomic regions of Brazil, from 1996 to 2011. Results: Mortality rates due to heart failure declined in Brazil and its regions, except for the North and the Northeast. Mortality rates due to acute ischemic heart diseases increased in the North and Northeast regions, especially from 2005 on; they remained stable in the Center-West region; and decreased in the South and in the Southeast. Mortality due to chronic ischemic heart diseases decreased in Brazil and in the Center-West, South and Southeast regions, and had little variation in the North and in the Northeast. The highest mortality rates due to ill-defined causes occurred in the Northeast until 2005. Conclusions: Mortality due to heart failure is decreasing in Brazil and in all of its geoeconomic regions. The temporal evolution of mortality caused by ischemic heart diseases was similar to that of heart failure. The decreasing number of deaths due to ill-defined causes may represent the improvement in the quality of information about mortality in Brazil. The evolution of acute ischemic heart diseases ranged according to regions, being possibly confused with the differential evolution of ill-defined causes.

  7. PREVALENCE OF HEART DISEASE IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Sumathi Natarajan

    2016-07-01

    Full Text Available BACKGROUND Previously, the high maternal mortality in cardiac patients who became pregnant prompted the assertion: Women with an abnormal heart should not become pregnant. This long-standing notion needs to be revised today. AIM To study the prevalence of heart disease in antenatal admissions at Government Rajaji Hospital, Madurai. METHODOLOGY An observational study of 3669 antenatal patients being admitted in GRH, Madurai, from March 2016 to April 2016. Both primigravida and multi-gravida with no age restrictions were included in the study. Screening ECHOs were done. Among 3669 admissions, 46 patients were diagnosed to have heart disease. The cardiac diseases include multivalvular heart disease, congenital heart disease, peripartum cardiomyopathy, coronary heart disease, hypertrophic obstructive cardiomyopathy. RESULTS The study showed that the prevalence of heart disease in Government Rajaji Hospital is 1.25% and it is more common in 20-30 years of age (p value <0.001, which is significant. DISCUSSION Pregnancy and puerperium are important risk factors for heart disease. Heart disease also significantly affects the course of pregnancy. So it is important to diagnose heart disease early in pregnancy. This study emphasizes that heart disease complicating pregnancy forms an important proportion of antenatal mother and needs early diagnosis and management. CONCLUSION Though considered rare previously, heart disease contributes to a significant proportion of antenatal mothers (1.25% and early referral to proper tertiary care centre helps in reducing the mortality and morbidity

  8. Honolulu Heart Program

    Science.gov (United States)

    2016-04-13

    Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Heart Diseases; Heart Failure, Congestive; Myocardial Infarction; Asthma; Emphysema; Lung Diseases, Obstructive; Aortic Aneurysm, Abdominal; Bronchitis; Dementia; Hypertension; Chronic Obstructive Pulmonary Disease; Heart Failure

  9. The chronic gastrointestinal manifestations of Chagas disease

    Directory of Open Access Journals (Sweden)

    Nilce Mitiko Matsuda

    2009-01-01

    Full Text Available Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart. The objective of this review is to revise the literature and summarize the main chronic gastrointestinal manifestations of Chagas disease. The chronic gastrointestinal manifestations of Chagas disease are mainly a result of enteric nervous system impairment caused by T. cruzi infection. The anatomical locations most commonly described to be affected by Chagas disease are salivary glands, esophagus, lower esophageal sphincter, stomach, small intestine, colon, gallbladder and biliary tree. Chagas disease has also been studied in association with Helicobacter pylori infection, interstitial cells of Cajal and the incidence of gastrointestinal cancer.

  10. Coronary collaterals improve prognosis in patients with ischemic heart disease

    NARCIS (Netherlands)

    J.J. Regieli; J.W. Jukema; H.M. Nathoe; A.H. Zwinderman; S. ng; D.E. Grobbee; Y. van der Graaf; P.A. Doevendans

    2009-01-01

    BACKGROUND: The recruitment of coronary collateral vessels results from an endogenous adaptation to ischemic heart disease (IHD). Presence of collaterals may exert protection at the time of acute or chronic obstructive coronary disease. The protective role of collaterals in patients with extensive c

  11. Late and chronic Lyme disease.

    Science.gov (United States)

    Donta, Sam T

    2002-03-01

    This article reviews the late and chronic manifestations of Lyme disease. Special attention is given to the chronic manifestations of the disease, detailing its pathogenesis, clinical spectrum, and laboratory criteria for the diagnosis. Based on experimental evidence and experience, approaches to the successful treatment of the late and chronic disease are outlined. Much additional work is needed to improve the understanding of the underlying pathophysiology of the disease, its diagnosis and treatment.

  12. Illegal Drugs and Heart Disease

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  13. Heart Disease, Stroke, or Other Cardiovascular Disease and Adult Vaccination

    Science.gov (United States)

    ... Adult Vaccination Resources for Healthcare Professionals Heart Disease, Stroke, or Other Cardiovascular Disease and Adult Vaccination Language: ... with heart disease and those who have suffered stroke are at higher risk for serious problems from ...

  14. Moderate alcohol consumption and chronic disease

    DEFF Research Database (Denmark)

    Mukamal, Kenneth J; Clowry, Catherine M; Murray, Margaret M

    2016-01-01

    Drinking within recommended limits is highly prevalent in much of the world, and strong epidemiological associations exist between moderate alcohol consumption and risk of several major chronic diseases, including coronary heart disease, diabetes, and breast cancer. In many cases, plausible...... biological mediators for these associations have been identified in randomized trials, but gold standard evidence that moderate drinking causes or prevents any chronic disease remains elusive and important concerns about available evidence have been raised. Although long-term randomized trials to test...... suggests that objections to the execution of a full-scale, long-term clinical trial of moderate drinking on chronic disease are increasingly untenable. We present potential lessons learned for such a trial and discuss key features to maximize its feasibility and value....

  15. Analysis of the Relationship between Anemia and Heart Function in Patients with Chronic Heart Failure Caused by Coronary Heart Disease%冠心病慢性心力衰竭患者贫血与心功能关系的研究

    Institute of Scientific and Technical Information of China (English)

    赵媛媛; 王林; 宋芳; 郭慧卿

    2011-01-01

    Objective: To investigate the relationship between anemia and heart function in hospitalized patients with chronic heart failure caused by coronary heart disease. Methods: Patients with chronic heart failure caused by coronary heart disease, who were hospitalized in the Second Hospital of Tianjin Medical University between December 2005 and January 2007, were included in this study. Based on hemoglobin (Hb) levels, patients were divided into anemia group and non-anemia group. The relationship of the incidence data and the cardiac functions was retrospectively analyzed between two groups. Results: There were 1 816 patients in this study, and the proportion of male and female patients with anemia were 16.34% (151/925) and 17.28% (154/891) respectively. The average age was higher in patients of anemia group than that of the non-anemia gronp (t = 6.823, P < 0.01). The proportion of ≥60 years of age was higher in patients of anemia group than that of non-anemia group (x2=13.312, P < 0.01 ). With the progression of the heart function classification, the value of hemoglobin had a lower gradually trend, and the proportion of anemia had a higher gradually trend. There was a negative correlation between the heart function classification and the value of hemoglobin ( r= -0.192, P <0.05). The value of left ventricular end diastolic diameter (LVEDD) was higher, but interventricular septum thickness (IVS) was lower. in patients of anemia group than that of non-anemia group. The majority proportion of left ventricular ejection fraction (LVEF)was ≤0.45 in patients of anemia group. The proportion of E/A ≤ 1 was significantly higher than E/A>1 in patients of two groups.Conclusion: The chronic heart failure should be treated with the correction of anemia at the same time. which could significantly improve the prognosis of patients with chronic heart failure.%目的:探讨冠心病慢性心力衰竭住院患者贫血与心功能之间的

  16. Chronic obstructive pulmonary disease - adults - discharge

    Science.gov (United States)

    COPD - adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; Chronic bronchitis - adults - discharge; Emphysema - adults - discharge; Bronchitis - ...

  17. Effects of Chronic Stress on Occurrence,Progress and Prognosis of Coronary Heart Disease%慢性压力对冠心病发生、进展及预后的影响

    Institute of Scientific and Technical Information of China (English)

    杨燕飞

    2013-01-01

    Coronary heart disease has become a serious threat to human life and health of chronic non-communicable diseases. In recent years, lots of research and epidemiological investigation showed that social and psychological factors of chronic pressure play an important role in the occurrence, progress and prognosis of coronary heart disease. There are complicated mechanisms why coronary heart disease caused by chronic stress. Negative emotional responses such as anxiety, depression and burnout produced by the pressure of events have effect in increasing incidence of cardiovascular diseases, exacerbations illness and poor prognosis. This paper described the clinical and epidemiological investigation in recent years progress.%冠心病已成为严重威胁人类生命和健康的慢性非传染性疾病,近年来大量研究及流行病学调查表明慢性压力等社会心理因素对冠心病的发生、进展及预后起着重要作用.慢性压力引发冠心病的机制复杂多样,因压力事件所产生的焦虑、抑郁及倦怠等负性情感反应使心血管疾病的发病率增加、病情加重、预后不佳.文章就其近几年的临床研究及流行病学调查进展进行简述.

  18. Pathophysiology of valvular heart disease.

    Science.gov (United States)

    Zeng, Y I; Sun, Rongrong; Li, Xianchi; Liu, Min; Chen, Shuang; Zhang, Peiying

    2016-04-01

    Valvular heart disease (VHD) is caused by either damage or defect in one of the four heart valves, aortic, mitral, tricuspid or pulmonary. Defects in these valves can be congenital or acquired. Age, gender, tobacco use, hypercholesterolemia, hypertension, and type II diabetes contribute to the risk of disease. VHD is an escalating health issue with a prevalence of 2.5% in the United States alone. Considering the likely increase of the aging population worldwide, the incidence of acquired VHD is expected to increase. Technological advances are instrumental in identifying congenital heart defects in infants, thereby adding to the growing VHD population. Almost one-third of elderly individuals have echocardiographic or radiological evidence of calcific aortic valve (CAV) sclerosis, an early and subclinical form of CAV disease (CAVD). Of individuals ages >60, ~2% suffer from disease progression to its most severe form, calcific aortic stenosis. Surgical intervention is therefore required in these patients as no effective pharmacotherapies exist. Valvular calcium load and valve biomineralization are orchestrated by the concerted action of diverse cell-dependent mechanisms. Signaling pathways important in skeletal morphogenesis are also involved in the regulation of cardiac valve morphogenesis, CAVD and the pathobiology of cardiovascular calcification. CAVD usually occurs without any obvious symptoms in early stages over a long period of time and symptoms are identified at advanced stages of the disease, leading to a high rate of mortality. Aortic valve replacement is the only primary treatment of choice. Biomarkers such as asymmetric dimethylarginine, fetuin-A, calcium phosphate product, natriuretic peptides and osteopontin have been useful in improving outcomes among various disease states. This review, highlights the current understanding of the biology of VHD, with particular reference to molecular and cellular aspects of its regulation. Current clinical questions

  19. What Are the Signs and Symptoms of Diabetic Heart Disease?

    Science.gov (United States)

    ... What Are the Signs and Symptoms of Diabetic Heart Disease? Some people who have diabetic heart disease (DHD) ... when it's given right after symptoms occur. Coronary Heart Disease A common symptom of coronary heart disease (CHD) ...

  20. Gene expression changes associated with myocarditis and fibrosis in hearts of mice with chronic chagasic cardiomyopathy

    DEFF Research Database (Denmark)

    Soares, Milena Botelho Pereira; de Lima, Ricardo Santana; Rocha, Leonardo Lima;

    2010-01-01

    Chronic chagasic cardiomyopathy is a leading cause of heart failure in Latin American countries. About 30% of Trypanosoma cruzi-infected individuals develop this severe symptomatic form of the disease, characterized by intense inflammatory response accompanied by fibrosis in the heart. We perform...

  1. Relation between Red Cell Distribution Width and Fibroblast Growth Factor 23 Cleaving in Patients with Chronic Kidney Disease and Heart Failure

    NARCIS (Netherlands)

    van Breda, Fenna; Emans, Mireille E.; van der Putten, Karien; Braam, Branko; van Ittersum, Frans J.; Kraaijenhagen, Rob J.; de Borst, Martin H.; Vervloet, Marc; Gaillard, Carlo A. J. M.

    2015-01-01

    Objective In chronic kidney disease (CKD), both anemia and deregulated phosphate metabolism are common and predictive of adverse outcome. Previous studies suggest that iron status influences phosphate metabolism by modulating proteolytic cleavage of FGF23 into C-terminal fragments. Red cell distribu

  2. Impact of β-blocker selectivity on long-term outcomes in congestive heart failure patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Kubota Y

    2015-03-01

    Full Text Available Yoshiaki Kubota, Kuniya Asai, Erito Furuse, Shunichi Nakamura, Koji Murai, Yayoi Tetsuou Tsukada, Wataru Shimizu Department of Medicine (Division of Cardiology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan Background: Chronic obstructive pulmonary disease (COPD is present in approximately one-third of all congestive heart failure (CHF patients, and is a key cause of underprescription and underdosing of β-blockers, largely owing to concerns about precipitating respiratory deterioration. For these reasons, the aim of this study was to evaluate the impact of β-blockers on the long-term outcomes in CHF patients with COPD. In addition, we compared the effects of two different β-blockers, carvedilol and bisoprolol. Methods: The study was a retrospective, non-randomized, single center trial. Acute decompensated HF patients with COPD were classified according to the oral drug used at discharge into β-blocker (n=86; carvedilol [n=52] or bisoprolol [n=34] and non-β-blocker groups (n=46. The primary endpoint was all-cause mortality between the β-blocker and non-β-blocker groups during a mean clinical follow-up of 33.9 months. The secondary endpoints were the differences in all-cause mortality and the hospitalization rates for CHF and/or COPD exacerbation between patients receiving carvedilol and bisoprolol. Results: The mortality rate was higher in patients without β-blockers compared with those taking β-blockers (log-rank P=0.039, and univariate analyses revealed that the use of β-blockers was the only factor significantly correlated with the mortality rate (hazard ratio: 0.41; 95% confidence interval: 0.17–0.99; P=0.047. Moreover, the rate of CHF and/or COPD exacerbation was higher in patients treated with carvedilol compared with bisoprolol (log-rank P=0.033. In the multivariate analysis, only a past history of COPD exacerbation significantly increased the risk of re-hospitalization due to CHF and/or COPD exacerbation (adjusted hazard

  3. Other Possible Heart Disease Risk Factors

    Science.gov (United States)

    ... Heart Health and Stroke Other possible heart disease risk factors Related information Depression fact sheet Stress and your health fact sheet ... Research also suggests that depression itself is a risk factor for heart disease. Depression, stress, and other negative emotions may affect the ...

  4. How Is Coronary Heart Disease Treated?

    Science.gov (United States)

    ... healthy lifestyle changes if you have coronary heart disease. Heart-healthy lifestyle changes include: Heart-healthy eating Maintaining a healthy ... CAD risk factors and prevent or delay the disease. Lifestyle changes include ... following a healthy eating plan, maintaining a healthy weight, and being ...

  5. Self-perceived symptoms and care needs of patients with severe to very severe chronic obstructive pulmonary disease, congestive heart failure or chronic renal failure and its consequences for their closest relatives: the research protocol

    Directory of Open Access Journals (Sweden)

    Schols Jos MGA

    2008-05-01

    Full Text Available Abstract Background Recent research shows that the prevalence of patients with very severe chronic obstructive pulmonary disease (COPD, congestive heart failure (CHF and chronic renal failure (CRF continues to rise over the next years. Scientific studies concerning self-perceived symptoms and care needs in patients with severe to very severe COPD, CHF and CRF are scarce. Consequently, it will be difficult to develop an optimal patient-centred palliative care program for patients with end-stage COPD, CHF or CRF. The present study has been designed to assess the symptoms, care needs, end-of-life care treatment preferences and communication needs of patients with severe to very severe COPD, CHF or CRF. Additionally, family distress and care giving burden of relatives of these patients will be assessed. Methods/design A cross-sectional comparative and prospective longitudinal study in patients with end-stage COPD, CHF or CRF has been designed. Patients will be recruited by their treating physician specialist. Patients and their closest relatives will be visited at baseline and every 4 months after baseline for a period of 12 months. The following outcomes will be assessed during home visits: self-perceived symptoms and care needs; daily physical functioning; general health status; end-of-life care treatment preferences; end-of-life care communication and care-giver burden of family caregivers. Additionally, end-of-life care communication and prognosis of survival will be assessed with the physician primarily responsible for the management of the chronic organ failure. Finally, if patients decease during the study period, the baseline preferences with regard to life-sustaining treatments will be compared with the real end-of-life care. Discussion To date, the symptoms, care needs, caregiver burden, end-of-life care treatment preferences and communication needs of patients with very severe COPD, CHF or CRF remain unknown. The present study will

  6. Home monitoring of chronic heart failure

    Directory of Open Access Journals (Sweden)

    Bockeria O. L.

    2012-06-01

    Full Text Available Being a common syndrome chronic heart failure (CHF results in high mortality among cardiosurgical patients and requires very high expenditures for the treatment. All over the world the number of patients with CHF syndrome is about 22 millions. Heart failure is difficult to treat because of high level of hospitalization due to decompensation. Care aimed at constant home observation of patients could have been more efficient and not only symptomatic and as a response to complications induced. There are methods controlling CHF patients at home. These methods vary from increase of self-care and telephone support to telemonitoring and remote monitoring of implantable devices. Self-care includes such components as maintenance of drug intake, keeping to a diet, physical exercises and active control over edemas. Telephone calls are also a source of monitoring and treatment of heart failure at home. Meta-analysis of programs for structured phone support showed that telephone support could reduce the level of readmission of HF patients approximately by 25%. Telemonitoring implies transmission of such physiological data as blood pressure, body weight, electrocardiographic signals or oxygen saturation using phone lines, broadband and satellite or wireless networks. Having cardiac pacemakers, implantable cardioverter defibrillators and cardiac resynchronization therapy devices that are placed in HF patients, it is possible to use their opportunities for the further evaluation of the patient. Some regularly controlled parameters can show the clinical state of the patient and predict the following heart failure. For example, atrial fibrillation, decrease of cardiac rhythm variability and decrease of the level of the patient`s activity (according to integrated accelerometer can predict clinical decompensation. Also, implantable hemodynamic monitors for immediate pressure measuring in the left atrium, sensor system of pressure measuring in the right atrium are

  7. Air Pollution, Climate, and Heart Disease

    Science.gov (United States)

    ... of the American Heart Association Cardiology Patient Page Air Pollution, Climate, and Heart Disease Diane R. Gold , Jonathan ... http://www.epa.gov/greenheart/ . 7 What Is Air Pollution? Air pollution is a mixture of gases and ...

  8. Serial pulmonary function tests to diagnose COPD in chronic heart failure

    NARCIS (Netherlands)

    Minasian, A.G.; Elshout, F.J.J. van den; Dekhuijzen, P.N.R.; Vos, P.J.E.; Willems, F.F.; Bergh, P.J.P.C. van den; Heijdra, Y.F.

    2014-01-01

    BACKGROUND: It is unknown whether serial pulmonary function tests are necessary for the correct diagnosis of chronic obstructive pulmonary disease (COPD) in patients with stable non-congested chronic heart failure (CHF). The aim of this study was to determine the prevalence of COPD in outpatients wi

  9. Current Evidence on Treatment of Patients With Chronic Systolic Heart Failure and Renal Insufficiency

    NARCIS (Netherlands)

    Damman, Kevin; Tang, W. H. Wilson; Felker, G. Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J. V.

    2014-01-01

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients

  10. 慢性肺源性心脏病并发心律失常68例临床诊断与治疗%Clinical Diagnosis and Treatment of 68 Cases of Chronic Pulmonary Heart Disease Complicated With Arrhythmia

    Institute of Scientific and Technical Information of China (English)

    许文华; 李志军

    2015-01-01

    Objective To investigate the clinical diagnosis and treatment of chronic pulmonary heart disease with arrhythmia. Methods The clinical data of 68 patients with chronic pulmonary heart disease with arrhythmia were retrospectively analyzed. Results Manifestation of cardiac arrhythmias with sinus bradycardia slow, sinus tachycardia, speed, atrial flutter, atrial fibrillation, paroxysmal supraventricular tachycardia tachycardia, paroxysmal atrial tachycardia, speed and other kinds of. Conclusion The clinical analysis of chronic pulmonary heart disease with arrhythmia patients, need to be based on the ECG in order to understand the use of how to diagnose and treatment.%目的:探讨慢性肺源性心脏病并发心律失常的临床诊断和治疗。方法对我院收治的68例慢性肺源性心脏病并发心律失常患者的临床资料进行回顾性分析。结果心律失常的表现类型有窦性心动过缓、窦性心动过速、心房扑动、心房颤动、阵发性室性心动过速、阵发性房性心动过速等多种。结论临床分析慢性肺源性心脏病并发心律失常患者时,需要依据心电图以便深入了解诊断和治疗的方法。

  11. Management of chronic heart failure in the older population

    Institute of Scientific and Technical Information of China (English)

    Nahid Azad; Genevieve Lemay

    2014-01-01

    Chronic heart failure (CHF) is the leading cause of hospitalization for those over the age of 65 and represents a significant clinical and economic burden. About half of hospital re-admissions are related to co-morbidities, polypharmacy and disabilities associated with CHF. Moreover, CHF also has an enormous cost in terms of poor prognosis with an average one year mortality of 33%–35%. While more than half of patients with CHF are over 75 years, most clinical trials have included younger patients with a mean age of 61 years. Inadequate data makes treatment decisions challenging for the providers. Older CHF patients are more often female, have less cardiovascular diseases and associated risk factors, but higher rates of non-cardiovascular conditions and diastolic dysfunction. The prevalence of CHF with reduced ejection fraction, ischemic heart disease, and its risk factors declines with age, whereas the prevalence of non-cardiac co-morbidities, such as chronic renal failure, dementia, anemia and malignancy increases with age. Diabetes and hypertension are among the strongest risk factors as predictors of CHF particularly among women with coronary heart disease. This review paper will focus on the specific consideration for CHF assessment in the older population. Management strategies will be reviewed, including non-pharmacologic, pharmacologic, quality care indicators, quality improvement in care transition and lastly, end-of-life issues. Palliative care should be an integral part of an interdiscipli-nary team approach for a comprehensive care plan over the whole disease trajectory. In addition, frailty contributes valuable prognostic in-sight incremental to existing risk models and assists clinicians in defining optimal care pathways for their patients.

  12. Understanding anemia of chronic disease.

    Science.gov (United States)

    Fraenkel, Paula G

    2015-01-01

    The anemia of chronic disease is an old disease concept, but contemporary research in the role of proinflammatory cytokines and iron biology has shed new light on the pathophysiology of the condition. Recent epidemiologic studies have connected the anemia of chronic disease with critical illness, obesity, aging, and kidney failure, as well as with the well-established associations of cancer, chronic infection, and autoimmune disease. Functional iron deficiency, mediated principally by the interaction of interleukin-6, the iron regulatory hormone hepcidin, and the iron exporter ferroportin, is a major contributor to the anemia of chronic disease. Although anemia is associated with adverse outcomes, experimental models suggest that iron sequestration is desirable in the setting of severe infection. Experimental therapeutic approaches targeting interleukin-6 or the ferroportin-hepcidin axis have shown efficacy in reversing anemia in either animal models or human patients, although these agents have not yet been approved for the treatment of the anemia of chronic disease.

  13. What Are the Signs and Symptoms of Coronary Heart Disease?

    Science.gov (United States)

    ... What Are the Signs and Symptoms of Coronary Heart Disease? A common symptom of coronary heart disease (CHD) ... and Symptoms of Heart Problems Related to Coronary Heart Disease Some people who have CHD have no signs ...

  14. 磷酸肌酸钠对冠心病并慢性心力衰竭患者B型利钠肽及心功能的影响%The effects of Creatine Phosphate Sodium on B-type natriuretic peptide and heart function in patients combination with coronary heart disease and chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    滕伟; 薛永亮; 何兆辉; 刘朋

    2012-01-01

    目的 探讨注射用磷酸肌酸钠对冠心病并慢性心力衰竭患者B型利钠肽及心功能的影响.方法 选择冠心病慢性心力衰竭患者80例,随机分为对照组(n=40)以及磷酸肌酸钠治疗组(n=40),应用超声心动图检测患者左心室收缩末直径( LV ESD),左心室舒张末直径(LVEDD)及左室射血分数(LVEF);实验室检测B型利钠肽水平.用药治疗2周,观察治疗前后的指标变化.结果 治疗后磷酸肌酸钠治疗组LVESD、LVEDD与对照组比较均明显下降(P<0.05),LVEF明显增加(P<0.05).治疗2周后两组患者B型利钠肽均较治疗前降低,磷酸肌酸钠治疗组与对照组比较下降更显著(P<0.05).结论 磷酸肌酸钠可以改善冠心病并慢性心力衰竭患者的心功能,提高活动耐受.%Objective To assess the effects of Creatine Phosphate Sodium on heart function and B-type natriuretic peptide in patients combination with coronary heart disease and chronic heart failure. Methods 80 cases of coronary heart disease combined with chronic heart failure patients were randomly divided into the control group (n = 40) and the Creatine Phosphate Sodium treatment group (n = 40). Echocardiography was used to detect left ventricular end -systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF); B-type natriuretic peptide was tested by laboratory of the two groups. Drug treatment for 2 weeks, the changes of the indicators before and after treatment were observed. Results After treatment, compared with the control group, LVESD, LVEDD of the Creatine Phosphate Sodium treatment significantly decreased (P < 0.05), LVEF increased significantly (P < 0.05). After two weeks of treatment, levels of B-type natriuretic peptide decreased in both two groups than before treatment, and the decrease degree of the Creatine Phosphate Sodium treatment group was more obvious than the control group (P < 0.05). Conclusion Creatine

  15. Social inequality in chronic disease outcomes.

    Science.gov (United States)

    Nordahl, Helene

    2014-11-01

    Socioeconomic differences in morbidity and mortality, particularly across educational groups, are widening. Differential exposures to behavioural risk factors have been shown to play an important mediating role on the social inequality in chronic diseases such as heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, and lung cancer. However, much less attention has been given to the potential role of interaction, where the same level of exposure to a behavioural risk factor has different effect across socioeconomic groups, creating subgroups that are more vulnerable than others. In this thesis, Paper 1 describes the unique cohort consortium which was established by pooling and harmonising prospective data from existing cohort studies in Denmark. This consortium generated a large study population with long follow-up sufficient to study power demanding questions of mechanisms underlying social inequalities in chronic disease outcomes. In Paper 2 on incidence of coronary heart disease, smoking and body mass index partially mediated the observed educational differences. This result suggested that some of the social inequality in coronary heart disease may be enhanced by differential exposure to behavioural risk factors (i.e. smoking and obesity). In Paper 3 on incidence of stroke, an observed interaction between education and smoking indicated that participants, particularly men, with low level of education may be more vulnerable to the effect of smoking than those with high level of education in terms of ischemic stroke. Finally, Paper 4 revealed that behavioural risk factors, primarily smoking, explained a considerable part of the educational differences in cause-specific mortality. Further, this paper added important knowledge about the considerable part of the mediated effect, which could be due to interaction between education and smoking. In conclusion, the research in this thesis is a practical implementation of contemporary statistical

  16. Chronic Kidney Disease and Medicines

    Science.gov (United States)

    ... from our online catalog. Alternate Language URL Español Chronic Kidney Disease and Medicines: What You Need to Know Page ... What you need to know Because you have chronic kidney disease, you should take steps to protect your kidneys. ...

  17. Aggressive therapy of congestive heart failure and associated chronic renal failure with medications and correction of anemia stops or slows the progression of both diseases.

    Science.gov (United States)

    Silverberg, D S; Wexler, D; Blum, M; Sheps, D; Schwartz, D; Yachnin, T; Baruch, R; Tchebiner, J; Zubkov, A; Shaked, M; Steinbruch, S; Keren, G; Iaina, A

    2001-01-01

    The prevalence of congestive heart failure (CHF) is increasing rapidly in the community. We and others have shown that the prevalence and severity of both anemia and chronic renal failure (CRF) increase steadily with increasing severity of CHF. We have also shown that CHF patients may be resistant to standard drug therapy for CHF as long as the associated anemia is not corrected, and that correction of the anemia with subcutaneous erythropoietin and intravenous iron sucrose (Venofer: Vifor International, St. Gallen, Switzerland) may improve both the CHF and CRF and markedly reduce hospitalizations without causing side effects. We report here our experience with correcting anemia in this manner in 126 cases of anemic-resistant CHF patients. As in our previous studies, correction of the anemia improved both CHF and CRF, and reduced hospitalizations. Our studies suggest that correction of even mild anemia in CHF may be an important addition to the treatment of patients with the combination of CHF and CRF.

  18. Chronic granulomatous disease associated with chronic glomerulonephritis

    DEFF Research Database (Denmark)

    Frifelt, J J; Schønheyder, Henrik Carl; Valerius, Niels Henrik

    1985-01-01

    A boy with chronic granulomatous disease (CGD) developed glomerulonephritis at the age of 12 years. The glomerulonephritis progressed to terminal uraemia at age 15 when maintenance haemodialysis was started. The clinical course was complicated by pulmonary aspergillosis and Pseudomonas septicaemia...... from which he eventually died. The glomerulonephritis was of unknown origin, and a possible relationship between CGD and glomerulonephritis is discussed....

  19. Effect of mibefradil on heart rate variability in patients with chronic heart failure

    NARCIS (Netherlands)

    Brouwer, J; de Kam, PJ; Haaksma, J; Crijns, HJGM; van Veldhuisen, DJ

    2000-01-01

    Background: Mibefradil was recently withdrawn from the market because of an unfavorable clinical profile in patients with chronic heart failure. Although drug interactions appear to play a role, other mechanisms such as proarrhythmia and autonomic deterioration could also be relevant. Chronic heart

  20. Heart Valve Disease among Patients with Hyperprolactinaemia

    DEFF Research Database (Denmark)

    Steffensen, Charlotte; Maegbaek, Merete Lund; Laurberg, Peter;

    2012-01-01

    Increased risk of heart valve disease during treatment with certain dopamine agonists, such as cabergoline, has been observed in patients with Parkinson's disease. The same compound is used to treat hyperprolactinemia, but it is unknown whether this also associates with heart valve disease....

  1. Ivabradine, coronary artery disease, and heart failure: beyond rhythm control

    Directory of Open Access Journals (Sweden)

    Scicchitano P

    2014-06-01

    Full Text Available Pietro Scicchitano,1 Francesca Cortese,1 Gabriella Ricci,1 Santa Carbonara,1 Michele Moncelli,1 Massimo Iacoviello,1 Annagrazia Cecere,1 Michele Gesualdo,1 Annapaola Zito,1 Pasquale Caldarola,2 Domenico Scrutinio,3 Rocco Lagioia,3 Graziano Riccioni,4 Marco Matteo Ciccone1 1Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Bari, Italy; 2Section of Cardiovascular Diseases, Policlinic, San Paolo Hospital, Bari, Italy; 3Section of Cardiovascular Diseases, Fondazione Maugeri, Cassano Murge, Italy; 4Intensive Cardiology Care Unit, San Camillo de Lellis Hospital, Manfredonia, Foggia, Italy Abstract: Elevated heart rate could negatively influence cardiovascular risk in the general population. It can induce and promote the atherosclerotic process by means of several mechanisms involving endothelial shear stress and biochemical activities. Furthermore, elevated heart rate can directly increase heart ischemic conditions because of its skill in unbalancing demand/supply of oxygen and decreasing the diastolic period. Thus, many pharmacological treatments have been proposed in order to reduce heart rate and ameliorate the cardiovascular risk profile of individuals, especially those suffering from coronary artery diseases (CAD and chronic heart failure (CHF. Ivabradine is the first pure heart rate reductive drug approved and currently used in humans, created in order to selectively reduce sinus node function and to overcome the many side effects of similar pharmacological tools (ie, β-blockers or calcium channel antagonists. The aim of our review is to evaluate the role and the safety of this molecule on CAD and CHF therapeutic strategies. Keywords: chronic heart failure, heart rate reduction, cardiac ischemic disease, heart-rate lowering drugs, funny current

  2. Heart rate awareness in patients with chronic stable heart failure. A multi-center observational study.

    LENUS (Irish Health Repository)

    Moran, D

    2014-08-23

    We assessed adherence to European Society of Cardiology heart rate guidelines (i.e. heart rates less than 70bpm) in patients with chronic stable heart failure. We also investigated the percent of patients on target doses of rate controlling drugs.

  3. Research of B-tyepe natriuretic Peptide, blood gas analysis,and Pulmonary Function in Patients with Chronic Bronchitis,Chronic Obstructive Pulmonary Disease and Pulmonary Heart Disease%慢性支气管炎、COPD及肺心病患者BNP、肺功能和血气变化的研究

    Institute of Scientific and Technical Information of China (English)

    卜凡靖; 张红; 范磊; 刘伟

    2012-01-01

    Objective To explore the change of BNP ( B-type natriuretic peptide ), pulmonary function and blood gas analysis in patients with chronic bronchitis, rhronir obstructive pulmonary disease and pulmonary heart disease. Methods Vein blood was pumped from the patients with chronic bronchitis, chronic obstructive pulmonary disease and pulmonary heart disease, then testing plama BNP and pulmonary function, and artery blood was pumped for bood gas analysis. A contrastive study was performed among two groups and control group. Results From chronic bronchitis to chronic obstructive pulmonary disease and pulmonary heart disease, BNP tended to increase ( P < 0. 05 ). From chronic bronchitis to rhronir obstructive pulmonary disease and pulmonary heart disease, FE V, /FVC, MMEF tended to decrease ( both P < 0. 05 ), PaO, , PH tended to decrease, and PaCO, tended to increase ( allP < 0. 05 ). The BNP levels were negatively related with PaO2,PH(r= -0.69, - 0. 58 ,bothP <0. 01 ), and positively related with PaCO2( r = 0. 55 ,P < 0. 01 ). The BNP levels were negatively correlated with FEV,/FVC, MMEF( r = -0. 71 , -0. 68, bothP <0. 01 ). Conclusion The BNP levels had significant correlation with the blood analysis and pulmonary junction parameter. The BNP level may be an indicator in judging the prognosis of the COPD.%目的 探讨慢性支气管炎(慢支)、COPD、慢性肺源性心脏病(肺心病)患者不同时期BNP(B型钠尿肽)、肺功能、动脉血气的变化.方法 慢支、COPD、肺心病患者均空腹抽静脉血检测BNP;另抽动脉血检测血气;并行肺功能检测.三组间对比,并与正常组对照.结果 由慢支发展到COPD、肺心病时BNP逐渐升高(P<0.05);慢支、COPD及肺心病各组FEV1/FVC、MMEF逐渐降低(P均<0.05),动脉血氧分压(PaO2)、PH值逐渐降低,二氧化碳分压(PaCO2)逐渐增高(P均<0.05).BNP与PaO2、PH呈显著负相关(r=-0.69,-0.58,P均<0.01),而与PaCO2呈正相关(r=0.55,P<0.01).BNP与FEV1/FVC

  4. Pregnancy and chronic kidney disease.

    Science.gov (United States)

    Davison, John M; Lindheimer, Marshall D

    2011-01-01

    This article reviews the association of chronic renal disease and pregnancy. Included are discussions of guidelines for counseling pregnant women with underlying chronic renal disease who are considering conceiving as well as management of those already pregnant. Specifically highlighted are recent studies that question the validity of using estimated glomerular filtration rate and other formulae and questions of whether we should strive to replace the classic counseling approaches based primarily on serum creatinine levels with guidelines based on chronic kidney disease classification. The article concludes with a review as well as a critique of recent research on the prevalence of preeclampsia in women with underlying chronic renal disease, as well as if women with preeclampsia and underlying kidney disease have accelerated courses toward end-stage renal disease.

  5. Chronic diseases in elderly men

    DEFF Research Database (Denmark)

    Nielsen, Morten Frost Munk; Wraae, Kristian; Gudex, Claire

    2012-01-01

    OBJECTIVE: prevalence estimates for chronic diseases and associated risk factors are needed for priority setting and disease prevention strategies. The aim of this cross-sectional study was to estimate the self-reported and clinical prevalence of common chronic disorders in elderly men. STUDY......-reported data on risk factors and disease prevalence were compared with data from hospital medical records. RESULTS: physical inactivity, smoking and excessive alcohol intake were reported by 27, 22 and 17% of the study population, respectively. Except for diabetes, all the chronic diseases investigated......: the study showed a high prevalence of detrimental life style factors including smoking, excessive alcohol consumption and physical inactivity in elderly Danish men. Except for diabetes and respiratory disease, chronic diseases were underreported and in particular erectile dysfunction and osteoporosis were...

  6. CLINICAL STUDY OF HEART DISEASE COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Richa

    2014-07-01

    Full Text Available Introduction-Heart disease complicating pregnancy is considered as a high risk situation. Increased cardiac demands during the course of pregnancy potentially increase morbidity and mortality in women with underlying heart disease. AIM: To determine maternal and fetal outcome in women with heart disease complicating pregnancy, To emphasize on proper protocol for managing pregnancy complicated by heart disease, To correlate the time of booking & NYHA grading with maternal & fetal outcome. Risk of adverse outcome is more in rural population as compared to its urban counterpart. METHOD: A prospective clinical study of 25 cases of pregnancy complicated by heart disease, reporting to tertiary care hospital for delivery, was carried out to find out the incidence and maternal and fetal outcome. RESULTS: The incidence of heart disease in pregnancy in the present study was 0.6%. Most of the women (91% belonged to low socioeconomic class in the rural population. Rheumatic heart lesions constituted 77% of the cases. Mitral stenosis was the commonest lesion in 40% of cases. Ten (40% women delivered spontaneously vaginally at term. Cesarean section was performed in 14 cases (56%. There were 5 maternal deaths. There were no perinatal deaths. CONCLUSION: Early diagnosis of heart disease, regular antenatal check-up, institutional delivery, limiting family size can reduce the maternal and perinatal mortality and morbidity associated with heart disease

  7. Exercise for older patients with chronic disease.

    Science.gov (United States)

    Petrella, R J

    1999-10-01

    Coronary artery disease, hypertension, congestive heart failure, type 2 diabetes mellitus, osteoarthritis, osteoporosis, and cognitive disorders become more prevalent as people age. Besides delaying the onset of many of these conditions, regular exercise may improve function and delay disability and morbidity in those who have them. Further, exercise may work synergistically with medication to combat the effects of some chronic diseases. Special adaptations for older patients include lower-intensity exercise (eg, fewer repetitions), low-impact exercise (cycling, exercise while sitting), and modified equipment (smaller weights, special shoes, loose clothing). Unresolved issues include development of optimal strategies for motivating older patients to begin and maintain exercise programs.

  8. What Are the Signs and Symptoms of Heart Disease?

    Science.gov (United States)

    ... Twitter. What Are the Signs and Symptoms of Heart Disease? The signs and symptoms of coronary heart disease ( ... will have signs and symptoms of the disease. Heart Disease Signs and Symptoms The illustration shows the major ...

  9. Epidemiology of acquired valvular heart disease.

    Science.gov (United States)

    Iung, Bernard; Vahanian, Alec

    2014-09-01

    Population-based studies including systematic echocardiographic examinations are required to assess the prevalence of valvular heart disease. In industrialized countries, the prevalence of valvular heart disease is estimated at 2.5%. Because of the predominance of degenerative etiologies, the prevalence of valvular disease increases markedly after the age of 65 years, in particular with regard to aortic stenosis and mitral regurgitation, which accounts for 3 in 4 cases of valvular disease. Rheumatic heart disease still represents 22% of valvular heart disease in Europe. The prevalence of secondary mitral regurgitation cannot be assessed reliably but it seems to be a frequent disease. The incidence of infective endocarditis is approximately 30 cases per million individiuals per year. Its stability is associated with marked changes in its presentation. Patients are getting older and staphylococcus is now becoming the microorganism most frequently responsible. Heath care-associated infections are the most likely explanation of changes in the microbiology of infective endocarditis. In developing countries, rheumatic heart disease remains the leading cause of valvular heart disease. Its prevalence is high, between 20 and 30 cases per 1000 subjects when using systematic echocardiographic screening. In conclusion, the temporal and geographical heterogeneity illustrates the effect of socioeconomic status and changes in life expectancy on the frequency and presentation of valvular heart disease. A decreased burden of valvular disease would require the elaboration of preventive strategies in industrialized countries and an improvement in the socioeconomic environment in developing countries.

  10. Air Pollution and Heart Disease, Stroke

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Air Pollution and Heart Disease, Stroke Updated:Aug 30,2016 ... or Longer-Term Acute short-term effects of air pollution tend to strike people who are elderly or ...

  11. Chronic diseases and mental disorder.

    NARCIS (Netherlands)

    Verhaak, P.F.M.; Heijmans, M.J.W.M.; Peters, L.; Rijken, M.

    2005-01-01

    The aim of this study was to achieve a better understanding of the relationship between chronic medical illness and mental distress. Therefore, the association between chronic medical illness and mental distress was analysed, taking into account the modifying effects of generic disease characteristi

  12. Chronic Obstructive Pulmonary Disease (COPD)

    Science.gov (United States)

    ... term that is used to include chronic bronchitis, emphysema, or a combination of both conditions. Asthma is also a disease where it is difficult ... with COPD to also have some degree of asthma. What is chronic ... back to their original size. In emphysema, the walls of some of the alveoli have ...

  13. [The efficacy of ivabradine in chronic heart failure (review)].

    Science.gov (United States)

    Isakadze, A; Makharadze, T; Gvishiani, M

    2015-04-01

    This review article is devoted to the treatment of chronic heart failure (HF) with a new generation drug - ivabradine. It is well known that HF is one of the most frequent reason of high mortality worldwide. HF is characterised by cardiac remodeling, which is central in the pathophysiology of HF including hemodynamic, neurohumoral and neurohormonal mechanisms during its development and established prognostic factor in patients suffered with this disease. Despite the introduction in medical practice of many drugs for the treatment of chronic HF the lethal outcome associated with HF remains high nowadays, which can be explained by complexity of remodeling mechanisms characteristic for development of HF. Ivabradine that has been introduced in medical practice in last decade is a pure heart rate-slowing agent. A large number of studies in patients with cardiovascular disease have demonstrated that heart rate (HR) is a very important and major independent risk factor for prognosis, because lowering of HR reduces cardiac work and diminished myocardial oxygen requirement. It was shown that ivabradine a selective inhibitor of the hyperpolarisation activated sodium chanel (If) is involved in pacemaker generation and responsiveness of the sino-atrial node resulting in HR reduction without negative inotropic action. Ivabradine in chronic HF improves diastolic function and attenuates cardiac tissue hypoxia. Long-term reduction of HR induced by ivabradine reduced remodeling and preserved nitric oxide (NO) bioavailability, resulting from processes triggered early after reduction of HR. The complex therapy including ivabradine promotes HR fall, leading in reduction of attacks of a stable angina and improved quality of life. Ivabradine may target the endothelial NO production via inhibition of protein tyrosine phosphatase 1B leading to endothelial protection. HR reduction by ivabradine reduces oxidative stress, improves endothelial function and prevents development of

  14. Smoking, Stress, and Coronary Heart Disease.

    Science.gov (United States)

    Epstein, Leonard H.; Perkins, Kenneth A.

    1988-01-01

    Focuses on the interrelation between stressors and smoking, and on its potential impact on coronary heart disease risk beyond that due to stressors or to smoking alone. Reviews evidence supporting the stress-smoking interrelationship, its relevance to the risk of heart disease, and mechanisms explaining why smokers smoke more during stress and why…

  15. Mortality in adult congenital heart disease

    NARCIS (Netherlands)

    Verheugt, Carianne L.; Uiterwaal, Cuno S. P. M.; van der Velde, Enno T.; Meijboom, Folkert J.; Pieper, Petronella G.; van Dijk, Arie P. J.; Vliegen, Hubert W.; Grobbee, Diederick E.; Mulder, Barbara J. M.

    2010-01-01

    Mortality in adults with congenital heart disease is known to be increased, yet its extent and the major mortality risks are unclear. The Dutch CONCOR national registry for adult congenital heart disease was linked to the national mortality registry. Cox's regression was used to assess mortality pre

  16. Mortality in adult congenital heart disease

    NARCIS (Netherlands)

    C.L. Verheugt (Carianne); C.S.P.M. Uiterwaal (Cuno); E.T. van der Velde (Enno); F.J. Meijboom (Folkert); P.G. Pieper (Petronella); A.P.J. van Dijk (Arie); H.W. Vliegen (Hubert); D.E. Grobbee (Diederick); B.J.M. Mulder (Barbara)

    2010-01-01

    textabstractAimsMortality in adults with congenital heart disease is known to be increased, yet its extent and the major mortality risks are unclear.Methods and resultsThe Dutch CONCOR national registry for adult congenital heart disease was linked to the national mortality registry. Cox's regressio

  17. Acute Kidney Disease After Liver and Heart Transplantation.

    Science.gov (United States)

    Rossi, Ana P; Vella, John P

    2016-03-01

    After transplantation of nonrenal solid organs, an acute decline in kidney function develops in the majority of patients. In addition, a significant number of nonrenal solid organ transplant recipients develop chronic kidney disease, and some develop end-stage renal disease, requiring renal replacement therapy. The incidence varies depending on the transplanted organ. Acute kidney injury after nonrenal solid organ transplantation is associated with prolonged length of stay, cost, increased risk of death, de novo chronic kidney disease, and end-stage renal disease. This overview focuses on the risk factors for posttransplant acute kidney injury after liver and heart transplantation, integrating discussion of proteinuria and chronic kidney disease with emphasis on pathogenesis, histopathology, and management including the use of mechanistic target of rapamycin inhibition and costimulatory blockade.

  18. A review of the economics of adult congenital heart disease.

    Science.gov (United States)

    Seckeler, Michael D; Thomas, Ian D; Andrews, Jennifer; Joiner, Keith; Klewer, Scott E

    2016-01-01

    Adults living with congenital heart disease (CHD) now outnumber children with the disease. Thanks to medical advances over the past 75 years, many of these fatal childhood heart problems have changed to chronic medical conditions. As the population of adults with CHD increases, they will require increasingly complex medical, surgical and catheter-based therapies. In addition, social burdens including education, employment and insurability, which increase the societal costs of adult CHD, are now being recognized for adults living with CHD. This review summarizes the available literature on the economics of adult CHD.

  19. Marital stability and congenital heart disease.

    Science.gov (United States)

    Silbert, A R; Newburger, J W; Fyler, D C

    1982-06-01

    The incidence of divorce or legal separation was studied in 438 families of children born with heart disease who entered the New England Regional Infant Cardiac Program between 1968 and 1973. The parents were interviewed when the children were 5 1/2 years old. The rate of divorce in 438 families of children with critical congenital heart disease was not significantly different from the rate in two comparison groups: (1) 25 families of children whose cardiac defect was spontaneously cured, and (2) 26 families of children catheterized in infancy for suspected cardiac defect but who were found to be free of heart disease. Rates of divorce or legal separation for the three groups were: critical congenital heart disease, 12.1%, spontaneously cured, 4.2% free of heart disease, 11.5% these rates were not significantly different. The average national divorce rate was 20.3% for the same period.

  20. Impacts of chronic kidney disease and albuminuria on associations between coronary heart disease and its traditional risk factors in type 2 diabetic patients – the Hong Kong diabetes registry

    Directory of Open Access Journals (Sweden)

    Cockram Clive S

    2007-12-01

    Full Text Available Abstract Background Glycated haemoglobin (HbA1c, blood pressure and body mass index (BMI are risk factors for albuminuria, the latter in turn can lead to hyperlipidaemia. We used novel statistical analyses to examine how albuminuria and chronic kidney disease (CKD may influence the effects of other risk factors on coronary heart disease (CHD. Methods A prospective cohort of 7067 Chinese type 2 diabetic patients without history of CHD enrolled since 1995 were censored on July 30th, 2005. Cox proportional hazard regression with restricted cubic spline was used to auto-select predictors. Hazard ratio plots were used to examine the risk of CHD. Based on these plots, non-linear risk factors were categorised and the categorised variables were refitted into various Cox models in a stepwise manner to confirm the findings. Results Age, male gender, duration of diabetes, spot urinary albumin: creatinine ratio, estimated glomerular filtration rate, total cholesterol (TC, high density lipoprotein cholesterol (HDL-C and current smoking status were risk factors of CHD. Linear association between TC and CHD was observed only in patients with albuminuria. Although in general, increased HDL-C was associated with decreased risk of CHD, full-range HDL-C was associated with CHD in an A-shaped manner with a zenith at 1.1 mmol/L. Albuminuria and CKD were the main contributors for the paradoxically positive association between HDL-C and CHD for HDL-C values less than 1.1 mmol/L. Conclusion In type 2 diabetes, albuminuria plays a linking role between conventional risk factors and CHD. The onset of CKD changes risk associations between lipids and CHD.

  1. Discrimination of the "Athlete's Heart" from real disease by electrocardiogram and echocardiogram.

    Science.gov (United States)

    Erickson, Christopher C

    2017-01-01

    Chronic physical training has been shown to produce multiple changes in the heart, resulting in the athlete's heart phenotype. Some of the changes can make it difficult to discern athlete's heart from true cardiac disease, most notably hypertrophic cardiomyopathy. Other diseases such as dilated cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy may be difficult to rule in or out. In this article, the physiological cardiac changes of chronic athletic training are reviewed. A methodological approach using electrocardiography and echocardiography to differentiate between athlete's heart and cardiac disease is proposed.

  2. Anemia of chronic disease

    Science.gov (United States)

    ... disease Long-term infections, such as bacterial endocarditis, osteomyelitis (bone infection), HIV/AIDS , hepatitis B or hepatitis ... disease Crohn disease Erythropoietin test Juvenile idiopathic arthritis Osteomyelitis Rheumatic fever Ulcerative colitis Review Date 2/1/ ...

  3. Occupational chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Omland, Oyvind; Würtz, Else Toft; Aasen, Tor Børvig

    2014-01-01

    Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures.......Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures....

  4. Anemia in chronic heart failure : etiology and treatment options

    NARCIS (Netherlands)

    Westenbrink, B. Daan; de Boer, Rudolf A.; Voors, Adriaan A.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2008-01-01

    Purpose of review Anemia is common in patients with chronic heart failure, and is related to increased morbidity and mortality. The etiology of anemia in heart failure is complex and still not fully resolved. The review will describe current advances in the understanding of the pathophysiology of an

  5. Central Mechanisms of Abnormal Sympathoexcitation in Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Takuya Kishi

    2012-01-01

    Full Text Available It has been recognized that the sympathetic nervous system is abnormally activated in chronic heart failure, and leads to further worsening chronic heart failure. In the treatment of chronic heart failure many clinical studies have already suggested that the inhibition of the abnormal sympathetic hyperactivity by beta blockers is beneficial. It has been classically considered that abnormal sympathetic hyperactivity in chronic heart failure is caused by the enhancement of excitatory inputs including changes in peripheral baroreceptor and chemoreceptor reflexes and chemical mediators that control sympathetic outflow. Recently, the abnormalities in the central regulation of sympathetic nerve activity mediated by brain renin angiotensin system-oxidative stress axis and/or proinflammatory cytokines have been focused. Central renin angiotensin system, proinflammatory cytokines, and the interaction between them have been determined as the target of the sympathoinhibitory treatment in experimental animal models with chronic heart failure. In conclusion, we must recognize that chronic heart failure is a syndrome with an abnormal sympathoexcitation, which is caused by the abnormalities in the central regulation of sympathetic nerve activity.

  6. Angiotensin II, sympathetic nerve activity and chronic heart failure.

    Science.gov (United States)

    Wang, Yutang; Seto, Sai-Wang; Golledge, Jonathan

    2014-03-01

    Sympathetic nerve activity has been reported to be increased in both humans and animals with chronic heart failure. One of the mechanisms believed to be responsible for this phenomenon is increased systemic and cerebral angiotensin II signaling. Plasma angiotensin II is increased in humans and animals with chronic heart failure. The increase in angiotensin II signaling enhances sympathetic nerve activity through actions on both central and peripheral sites during chronic heart failure. Angiotensin II signaling is enhanced in different brain sites such as the paraventricular nucleus, the rostral ventrolateral medulla and the area postrema. Blocking angiotensin II type 1 receptors decreases sympathetic nerve activity and cardiac sympathetic afferent reflex when therapy is administered to the paraventricular nucleus. Injection of an angiotensin receptor blocker into the area postrema activates the sympathoinhibitory baroreflex. In peripheral regions, angiotensin II elevates both norepinephrine release and synthesis and inhibits norepinephrine uptake at nerve endings, which may contribute to the increase in sympathetic nerve activity seen in chronic heart failure. Increased circulating angiotensin II during chronic heart failure may enhance the sympathoexcitatory chemoreflex and inhibit the sympathoinhibitory baroreflex. In addition, increased circulating angiotensin II can directly act on the central nervous system via the subfornical organ and the area postrema to increase sympathetic outflow. Inhibition of angiotensin II formation and its type 1 receptor has been shown to have beneficial effects in chronic heart failure patients.

  7. TREATMENT OF PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE IN REAL CLINICAL PRACTICE ACCORDING TO THE DATA FROM PROGNOZ IBS REGISTER. (Part 1

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2015-09-01

    Full Text Available According to the data from PROGNOZ IBS register drugs with proven efficacy in secondary prevention of cardiovascular complications (antiplatelets, β-blockers, ACE inhibitors, statins were not often prescribed in patients with stable ischemic heart disease prior to hospitalization. Significant improvement of the treatment quality was found during the cardiology hospital stay. The prescription rate of ACE inhibitors increased from 20% to 84.4%, statins - from 10% to 85.5%, β-blockers - from 20% to 91%, acetylsalicylic acid - from 74% to 96%. However, some drugs (statins have been used in inadequate doses. Low-density lipoprotein level <2.5 mmol/L was achieved at discharge only in 6.3% of patients.

  8. TREATMENT OF PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE IN REAL CLINICAL PRACTICE ACCORDING TO THE DATA FROM PROGNOZ IBS REGISTER. (Part 1

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2013-01-01

    Full Text Available According to the data from PROGNOZ IBS register drugs with proven efficacy in secondary prevention of cardiovascular complications (antiplatelets, β-blockers, ACE inhibitors, statins were not often prescribed in patients with stable ischemic heart disease prior to hospitalization. Significant improvement of the treatment quality was found during the cardiology hospital stay. The prescription rate of ACE inhibitors increased from 20% to 84.4%, statins - from 10% to 85.5%, β-blockers - from 20% to 91%, acetylsalicylic acid - from 74% to 96%. However, some drugs (statins have been used in inadequate doses. Low-density lipoprotein level <2.5 mmol/L was achieved at discharge only in 6.3% of patients.

  9. Incidence and prevalence of pregnancy-related heart disease.

    Science.gov (United States)

    Sliwa, Karen; Böhm, Michael

    2014-03-15

    Worldwide, the numbers of women who have a pre-existing cardiovascular disease or develop cardiac problems during pregnancy are increasing and, due to the lack of evidenced-based data, this provides challenges for the treating physician. Cardiovascular disease in pregnancy is a complex topic as women can present either pre- or post-partum, due to a pre-existing heart disease such as operated on or unoperated on congenital heart disease, valvular heart disease, chronic hypertension, or familial dilated cardiomyopathy. Women often present with symptoms and signs of acute heart failure. On the other hand, there are diseases which are directly related to pregnancy, such as hypertensive disorders of pregnancy and peripartum cardiomyopathy, or where pregnancy increases risk of a disease as, for example, the risk of myocardial infarction. These diseases can have long-term implications to the life of the affected women and their families. There is, in particular, a paucity of data from developing countries of this unique disease pattern and its presentations. This review summarizes the current knowledge of the incidence and prevalence of pregnancy-related cardiovascular disease in women presenting pre- or post-partum.

  10. Analysis of 36 cases of chronic pulmonary heart disease complicated with multiple organ dysfunction syndrome%慢性肺源性心脏病伴多器官功能障碍综合症36例分析

    Institute of Scientific and Technical Information of China (English)

    许丙俊; 刘志刚

    2012-01-01

    目的 探讨慢性肺源性心脏病伴发多器官功能障碍综合症的临床治疗.方法 对本院ICU诊治的36例慢性肺心病伴发多器官功能障碍综合症进行总结分析.结果 除肺、心以外,器官功能障碍发生比例由高到低依次为脑、肾、肝、胃肠.36例患者中17例死亡,死亡率为47%,其余患者好转出院或转其他相关科室继续治疗.结论 心肺功能越差,受累的脏器越多,则死亡率越高.%Objective To investigate the clinical treatment of chronir pulmonary heart disease romplirated with multiple organ dysiunction syndrome. Methods Clinical features of 36 cases of chronic pulmonary heart disease complicated with multiple organ dysfunr-tion syndrome in our hospital ICU from the 2007 ~ 2010 were retrospectively analyzed. Results Incidence of organ dysfunction from high to low was the brain, kidney, liver, gastrointestinal in addition to the lung and heart. In 36 patients, 17 patients died and the mortality rate was 47% . The other patients got better or transferred to other related departments to continue the treatment. Conclusion The Worser of heart and lung function, the number of organ involvement and the mortality is higher.

  11. Phentolamine plus Ginkgo Dipyridamole Injection for Chronic Pulmonary Heart Disease%酚妥拉明联合银杏达莫治疗慢性肺源性心脏病疗效观察

    Institute of Scientific and Technical Information of China (English)

    马继扬; 高健; 梁民勇; 陈继兴; 文启孝

    2011-01-01

    Objective: To observe the clinical effect of phentolamine combined with ginkgo dipyridamole injection in the treatment of chronic pulmonary heart disease with heart failure.Methods: A total of 90 patients were randomly divided into control group (n=45) and therapy group (n=45).Two groups were treated with medical treatment such as control infection, oxygentherapy, cardiotonic and diuresis.On the basis of the above therapy, the treatment group were added phentolamine 20 mg combined with ginkgo dipyridamole injection 25 mL with 10% Glucose 500 ml in intravenous drip, quotidie, 10 days for a course of treatment. Results: The therapeutic effect, results of blood gas analysis and blood rheology, and heart function in therapy group were better than the control group, with statistically significant difference (P<0.05). Conclusion: Phentolamine combined with ginkgo dipyridamole injection in treatment of chronic pulmonary heart disease with heart failure is effective and safe. It deserves to be popularized.%观察酚妥拉明联合银杏达莫对慢性肺源性心脏病心衰患者的疗效,为临床治疗提供依据.方法:将90例患者随机分为治疗组和对照组各45例.两组采用常规内科治疗如控制感染、氧疗、强心、利尿等,治疗组在上述治疗基础上加用酚妥拉明20mg+银杏达莫25 mL于10%葡萄糖注射液500mL中静脉滴注,1次/d,疗程均为10d.结果:治疗组的疗效、血气分析、血液流变学、功能的改善优于对照组,差异具有统计学意义(P<0.05).结论:酚妥拉明联合银杏达莫对慢性肺源性心脏病心衰患者具有良好的疗效及安全性,值得临床推广应用.

  12. [Biomarkers of iron metabolism and inflammation in patients with chronic heart failure and various types of left ventricular dysfunction].

    Science.gov (United States)

    Kazymyrko, V K; Kutovyĭ, V V; Ivanyts'ka, L M; Dubkova, A G; Silant'ieva, T S

    2013-09-01

    Study the level of some of the indicators of iron metabolism and inflammatory markers in patients with chronic heart failure due to hypertension and coronary heart disease. The results of the study in systolic and diastolic dysfunction of the left ventricle, the varying degrees of severity of heart failure. The level of the studied parameters determined by the severity of heart failure and does not depend on the nature of left ventricular dysfunction.

  13. Heart Disease Detection Using Wavelets

    Science.gov (United States)

    González S., A.; Acosta P., J. L.; Sandoval M., M.

    2004-09-01

    We develop a wavelet based method to obtain standardized gray-scale chart of both healthy hearts and of hearts suffering left ventricular hypertrophy. The hypothesis that early bad functioning of heart can be detected must be tested by comparing the wavelet analysis of the corresponding ECD with the limit cases. Several important parameters shall be taken into account such as age, sex and electrolytic changes.

  14. Vitamin B-12 and folate deficiency in chronic heart failure

    NARCIS (Netherlands)

    van der Wal, Haye H.; Comin-Colet, Josep; Klip, Ijsbrand T.; Enjuanes, Cristina; Grote Beverborg, Niels; Voors, Adriaan A.; Banasiak, Waldemar; van Veldhuisen, Dirk J.; Bruguera, Jordi; Ponikowski, Piotr; Jankowska, Ewa A.; van der Meer, Peter

    2015-01-01

    Objective To determine the prevalence, clinical correlates and the effects on outcome of vitamin B-12 and folic acid levels in patients with chronic heart failure (HF). Methods We studied an international pooled cohort comprising 610 patients with chronic HF. The main outcome measure was all-cause m

  15. Iron deficiency in chronic heart failure : An international pooled analysis

    NARCIS (Netherlands)

    Klip, IJsbrand T.; Comin-Colet, Josep; Voors, Adriaan A.; Ponikowski, Piotr; Enjuanes, Cristina; Banasiak, Waldemar; Lok, Dirk J.; Rosentryt, Piotr; Torrens, Ainhoa; Polonski, Lech; van Veldhuisen, Dirk J.; van der Meer, Peter; Jankowska, Ewa A.

    2013-01-01

    Background Iron deficiency (ID) is an emerging problem in patients with chronic heart failure (HF) and can be a potential therapeutic target. However, not much is known about the prevalence, predictors, and prognosis of ID in patients with chronic HF. Methods In an international pooled cohort compri

  16. 慢性肾脏疾病增加慢性心力衰竭患者死亡率%Chronic kidney disease is associated with increased mortality in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    程中伟; 朱孔博; 方理刚; 张抒扬; 严晓伟; 朱文玲; 方全

    2012-01-01

    Objective To study the influence of chronic kidney disease (CKD) on mortality in patients with chronic heart failure (CHF) . Methods Ischemic (at least 40 days after myocardial infarction) or non-ischemic cardiomyopathy patients (with left ventricular ejection fraction≤45% and age≥ 21 years) admitted to Pelting Union Medical College Hospital from January 1,2007 to December 31,2009 were retrospectively studied. The patients were classified into two groups according to eGFR: CKD group (eGFR <60 ml·miiT-l. 73 m-2) and control group (eGFR3≥60 ml·min-1·1. 73 m-2). Results A total of 242 patients were screened. Of those 41 patients were excluded because of disaccording with the inclusion criteria,201 patients were followed up (all-cause mortality),and 14 patients (7% ) were lost to follow-up. A total of 36 patients died from any cause during (20 ±9) months of follow up,including 21 patients (30% ) in CKD group and 15 patients (13% ) in control group (P =0.003). Conclusions CKD is associated with increased mortality in CHF patients. In CHF patients combined with CKD,the treatment for CKD is as important as the treatment for CHF.%目的 探讨慢性肾脏疾病(CKD)对慢性心力衰竭(CHF)患者死亡率的影响.方法 对2007年1月1日至2009年12月31日在北京协和医院心内科住院,年龄≥21岁,临床诊断为心力衰竭,且左心室射血分数(LVEF)≤45%的缺血性(心肌梗死后至少40d以上)或非缺血性心肌病患者进行回顾性研究,根据肾小球滤过率(eGFR)情况分为两组,一组为eGFR <60 ml·min-1 ·1.73 m-2(CKD组),另一组为eGFR≥60 ml·min-1·1.73 m-2(对照组),并进行电话随访.结果 共筛选242例患者,除外41例不符合入选标准者,对201例进行随访,14例(7%)失访,经过2 ~41个月[平均(20±9)个月]的随访,共36例(19%)发生全因死亡,包括CKD组21例(30%)和对照组15例(13%)(P=0.003).结论 CKD增加CHF患者死亡率.合并CKD的CHF患者,积极处理CHF的同时应高度重视CKD处理.

  17. Decompensated chronic pulnmnary heart disease complicated by hyponatremia analysis of 67 cases%失代偿期慢性肺源性心脏病并发低钠血症67例分析

    Institute of Scientific and Technical Information of China (English)

    钱震东

    2009-01-01

    目的 探讨肺心病失代偿期并发低钠血症的发病因素、临床特点及防治措施.方法 回顾性调查本院2004年1月至2007年12月呼吸科住院的67例肺心病失代偿期并发低钠血症患者的临床资料.结果 同期收治失代偿期肺心患者197例,其低钠血症发生率为34.01%,低钠血症常见且易被忽视易误诊为肺性脑病.结论 低钠血症在失代偿期慢性肺源性心脏病中较为常见,能否得到及时合理的治疗是影响患者预后的一个重要因素,对肺心病失代偿期低钠血症应提高认识并及时纠正.%Objective Decompensated pulmonary heart disease complicated by hyponatremia risk factots.clinical characteristics and control measures.Methods A retrospective survey in our hospital in January 2004~December 2007 of 67 cases of respiratory hospital deeompensated pulmonary heart disease complicated by hyponatremia in patients with clinical data.Results Treated in the same period the results of pulmonary decompensation period 197 cases of heart patients,the incidence of hyponatremia 34.01%,hyponatremia ignore common and easily misdiagnosed as pulmonary encephalopathy.Conclusion Hyponatremia in decompensated chronic pulmonary heart disease in the more conunon,can receive timely treatment is a reasonable impact on the prognosis of patients with an important factor,and decompensated pulmonary heart disease should raise the awareness of hyponatremia and promptly corrected.

  18. Who Is at Risk for Coronary Heart Disease?

    Science.gov (United States)

    ... on Twitter. Who Is at Risk for Coronary Heart Disease? In the United States, coronary heart disease (CHD) ... type of fat. Other Risks Related to Coronary Heart Disease Other conditions and factors also may contribute to ...

  19. American Indian and Alaska Native Heart Disease and Stroke

    Science.gov (United States)

    ... American Indian and Alaska Native Heart Disease and Stroke Fact Sheet Recommend on Facebook Tweet Share Compartir ... American Indian and Alaska Native Heart Disease and Stroke Facts Heart Disease is the first and stroke ...

  20. Rural-urban differences in the prevalence of chronic disease in northeast China.

    Science.gov (United States)

    Wang, Shibin; Kou, Changgui; Liu, Yawen; Li, Bo; Tao, Yuchun; D'Arcy, Carl; Shi, Jieping; Wu, Yanhua; Liu, Jianwei; Zhu, Yingli; Yu, Yaqin

    2015-05-01

    Rural-urban differences in the prevalence of chronic diseases in the adult population of northeast China are examined. The Jilin Provincial Chronic Disease Survey used personal interviews and physical measures to research the presence of a range of chronic diseases among a large sample of rural and urban provincial residents aged 18 to 79 years (N = 21 435). Logistic regression analyses were used. After adjusting for age and gender, rural residents had higher prevalence of hypertension, chronic ischemic heart disease, cerebrovascular disease, chronic low back pain, arthritis, chronic gastroenteritis/peptic ulcer, chronic cholecystitis/gallstones, and chronic lower respiratory disease. Low education, low income, and smoking increased the risk of chronic diseases in rural areas. Reducing rural-urban differences in chronic disease presents a formidable public health challenge for China. The solution requires focusing attention on issues endemic to rural areas such as poverty, lack of chronic disease knowledge, and the inequality in access to primary care.

  1. 酚妥拉明治疗慢性肺源性心脏病的疗效观察%Efficacy of Phentolamine Treatment of Chronic Pulmonary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    朱振清

    2013-01-01

    Objective To observe the efficacy of phentolamine on chronic pulmonary heart disease. Methods 172 patients with chronic pulmonary heart disease from January 2012 to April 2013 in cardiovascular internal medicine department of our hospital were selected and randomly divided into observation group and control group. On the basis of conventional treatment, the observation group received phentolamine. Result In control group, the total effective rate was 76.7%;the data in observation group was 90.7%, implying a better efficacy than control group, the differences have statistical significance (P<0.05). Conclusions Based on the conventional treatment, phentolamine can significantly improve the efficacy in treating chronic pulmonary heart disease.%目的:观察酚妥拉明对慢性肺源性心脏病的疗效。方法选取我院心血管内科在2012年1月至2013年4月期间的慢性肺源性心脏病患者172例,按照随机化原则分为观察和对照组。观察组则在对照组的基础上予以酚妥拉明处理,将两组的疗效对比。结果对照组的治疗总有效率76.7%;观察组的治疗总有效率90.7%,观察组优于对照组,两组差异具有统计学意义(P<0.05)。结论对于慢性肺源性心脏病患者,在常规综合治疗基础上,予以酚妥拉明处理,能显著提高疗效,值得在临床心血管内科推行。

  2. 浅析肺心病合并慢性呼吸衰竭30例临床护理%Clinical Nursing Care of 30 Cases of Pulmonary Heart Disease Complicated With Chronic Respiratory Failure

    Institute of Scientific and Technical Information of China (English)

    冯淑香

    2016-01-01

    ObjectiveStudy on clinical nursing of pulmonary heart disease complicated with chronic respiratory failure.Methods From January 2015 to January 2016,analyzed of 30 cases with chronic pulmonary heart disease respiratory failure in patients with clinical data and study effective nursing intervention.Results30 cases of patients with effective intervention to treat all patients were discharged,effective 7 cases, 21 cases,generally 2 cases,excellent recovery rate of 93.33%. This study had low incidence of adverse reactions in patients,2 patients with shock and 1 case of pulmonary cerebral hernia.Conclusion Clinic for patients with pulmonary heart disease complicated with chronic respiratory failure for targeted nursing intervention to better promote the recovery of patients, improve the excellent rate of recovery of patients, improve the prognosis of patients.%目的:研究肺心病合并慢性呼吸衰竭的临床护理措施。方法分析我院在2015年1月~2016年1月收治的30例肺心病合并慢性呼吸衰竭的患者的临床资料,研究患者的有效护理干预措施。结果30例患者经过有效的干预治疗所有患者均康复出院,所有患者当中康复显效7例,有效21例,一般2例,康复优良率为93.33%,本研究患者的不良症状发生率相对较低,出现2例休克患者和1例肺性脑病患者。结论临床上对于肺心病合并慢性呼吸衰竭的患者,配合有针对性的护理干预措施,更好地促进患者的恢复,提高患者恢复的优良率,提升患者的预后效果。

  3. Hemostatic biomarkers in dogs with chronic congestive heart failure

    DEFF Research Database (Denmark)

    Tarnow, Inge; Falk, Torkel; Tidholm, Anna

    2007-01-01

    Background: Chronic congestive heart failure (CHF) in humans is associated with abnormal hemostasis, and abnormalities in hemostatic biomarkers carry a poor prognosis. Alterations in hemostatic pathways can be involved in the pathogenesis of CHF in dogs, and microthrombosis in the myocardium could...... contribute to increased mortality. Hypothesis: That plasma concentration or activity of hemostatic biomarkers is altered in dogs with CHF and that these factors predict mortality. Animals: Thirty-four dogs with CHF caused by either dilated cardiomyopathy (DCM, n = 14) or degenerative valvular disease (CDVD......, n = 20) compared with 23 healthy age-matched control dogs were included in this study. Dogs with CHF were recruited from 2 referral cardiology clinics, and control dogs were owned by friends or colleagues of the investigators. Methods: Clinical examination and echocardiography were performed in all...

  4. The role of statins in chronic heart failure.

    Science.gov (United States)

    Szyguła-Jurkiewicz, Bożena; Szczurek, Wioletta; Król, Bogumiła; Zembala, Marian

    2014-09-01

    The efficacy of statins in reducing morbidity and mortality in patients with documented coronary artery disease is unquestionable. However, in chronic heart failure (CHF), evidence regarding the beneficial effects of statin therapy remains contradictory. Although numerous retrospective studies have demonstrated improved prognosis in CHF patients treated with statins, two randomized trials, GISSI-HF and CORONA, have not confirmed the benefit of rosuvastatin in this group of patients. The benefits of using statins in CHF probably result mostly from their pleiotropic action, including the improvement of endothelial function, the inhibition of neurohormonal activation, and the reduction of proinflammatory activation. On the other hand, it has been recognized that low cholesterol is associated with worse morbidity and mortality in patients with CHF. It appears that it is necessary to conduct further randomized clinical trials using different kinds of statins in different populations of patients with CHF.

  5. Exertional dyspnoea in chronic heart failure: the role of the lung and respiratory mechanical factors

    OpenAIRE

    Bruno-Pierre Dubé; Piergiuseppe Agostoni; Pierantonio Laveneziana

    2016-01-01

    Exertional dyspnoea is among the dominant symptoms in patients with chronic heart failure and progresses relentlessly as the disease advances, leading to reduced ability to function and engage in activities of daily living. Effective management of this disabling symptom awaits a better understanding of its underlying physiology. Cardiovascular factors are believed to play a major role in dyspnoea in heart failure patients. However, despite pharmacological interventions, such as vasodilators o...

  6. Early predictors of renal dysfunction in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Umida Kamilova

    2013-04-01

    Full Text Available Study was aimed at an early detection of subclinical disorders in renal function in patients with chronic heart failure (CHF. Fifty-two patients with ischemic heart disease (IHD with post-infarction cardiosclerosis were examined. All the patients were underwent complex clinical examination, a level of serum creatinine, residual nitrogen and urine enzymes. Determination of urine enzymes level in CHF patients may be considered as diagnostic approach for an early diagnosis of renal dysfunction.

  7. Body mass, fat-free body mass, and prognosis in patients with chronic obstructive pulmonary disease from a random population sample: findings from the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Prescott, Eva; Almdal, Thomas Peter

    2006-01-01

    Rationale: Low body mass index (BMI) is a marker of poor prognosis in chronic obstructive pulmonary disease (COPD). In the general population the harmful effect of low BMI is due to the deleterious effects of a low fat free mass index (FFMI, fat free mass/weight(2)). Objectives: We explored...... distribution of low FFMI and its association with prognosis in a population based cohort of COPD patients. Methods: We used data on 1,898 COPD patients identified in a population-based epidemiological study in Copenhagen. Fat free mass was measured using bioelectrical impedance analysis. Patients were followed...... the lowest FFMI 10(th) percentile of the general population. BMI and FFMI were significant predictors of mortality, independent of relevant covariates. Being in the lowest FFMI 10(th) percentile of the general population was associated with a hazard ratio of 1.5 (95% confidence interval 1.2-1.8) for overall...

  8. Effect of Psychosocial Work Environment on Sickness Absence Among Patients Treated for Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Biering, Karin; Lund, Thomas; Andersen, Johan Hviid;

    2015-01-01

    Introduction During the last decades mortality has declined in patients with coronary heart disease due to improvements in treatments and changes in life style, resulting in more people living with chronic heart disease. This implies that focus on rehabilitation and re-integration to the work...

  9. Implantation of total artificial heart in congenital heart disease.

    Science.gov (United States)

    Adachi, Iki; Morales, David S L

    2014-07-18

    In patients with end-stage heart failure (HF), a total artificial heart (TAH) may be implanted as a bridge to cardiac transplant. However, in congenital heart disease (CHD), the malformed heart presents a challenge to TAH implantation. In the case presented here, a 17 year-old patient with congenital transposition of the great arteries (CCTGA) experienced progressively worsening HF due to his congenital condition. He was hospitalized multiple times and received an implantable cardioverter defibrillator (ICD). However, his condition soon deteriorated to end-stage HF with multisystem organ failure. Due to the patient's grave clinical condition and the presence of complex cardiac lesions, the decision was made to proceed with a TAH. The abnormal arrangement of the patient's ventricles and great arteries required modifications to the TAH during implantation. With the TAH in place, the patient was able to return home and regain strength and physical well-being while awaiting a donor heart. He was successfully bridged to heart transplantation 5 months after receiving the device. This report highlights the TAH is feasible even in patients with structurally abnormal hearts, with technical modification.

  10. Resveratrol Reverses Functional Chagas Heart Disease in Mice

    Science.gov (United States)

    Mata-Santos, Hilton; Vicentino, Amanda R. R.; Feijó, Daniel F.; Meyer-Fernandes, José R.; Paula-Neto, Heitor A.; Medei, Emiliano; Bozza, Marcelo T.; Lannes-Vieira, Joseli; Paiva, Claudia N.

    2016-01-01

    Chronic chagasic cardiomyopathy (CCC) develops years after acute infection by Trypanosoma cruzi and does not improve after trypanocidal therapy, despite reduction of parasite burden. During disease, the heart undergoes oxidative stress, a potential causative factor for arrhythmias and contractile dysfunction. Here we tested whether antioxidants/ cardioprotective drugs could improve cardiac function in established Chagas heart disease. We chose a model that resembles B1-B2 stage of human CCC, treated mice with resveratrol and performed electrocardiography and echocardiography studies. Resveratrol reduced the prolonged PR and QTc intervals, increased heart rates and reversed sinus arrhythmia, atrial and atrioventricular conduction disorders; restored a normal left ventricular ejection fraction, improved stroke volume and cardiac output. Resveratrol activated the AMPK-pathway and reduced both ROS production and heart parasite burden, without interfering with vascularization or myocarditis intensity. Resveratrol was even capable of improving heart function of infected mice when treatment was started late after infection, while trypanocidal drug benznidazole failed. We attempted to mimic resveratrol’s actions using metformin (AMPK-activator) or tempol (SOD-mimetic). Metformin and tempol mimicked the beneficial effects of resveratrol on heart function and decreased lipid peroxidation, but did not alter parasite burden. These results indicate that AMPK activation and ROS neutralization are key strategies to induce tolerance to Chagas heart disease. Despite all tissue damage observed in established Chagas heart disease, we found that a physiological dysfunction can still be reversed by treatment with resveratrol, metformin and tempol, resulting in improved heart function and representing a starting point to develop innovative therapies in CCC. PMID:27788262

  11. Cardiac imaging in valvular heart disease.

    Science.gov (United States)

    Choo, W S; Steeds, R P

    2011-12-01

    The aim of this article is to provide a perspective on the relative importance and contribution of different imaging modalities in patients with valvular heart disease. Valvular heart disease is increasing in prevalence across Europe, at a time when the clinical ability of physicians to diagnose and assess severity is declining. Increasing reliance is placed on echocardiography, which is the mainstay of cardiac imaging in valvular heart disease. This article outlines the techniques used in this context and their limitations, identifying areas in which dynamic imaging with cardiovascular magnetic resonance and multislice CT are expanding.

  12. Diagnosis and treatment analysis of elderly chronic pulmonary heart disease combined with left heart failure in 60 cases%老年慢性肺源性心脏病合并左心衰60例诊治探析

    Institute of Scientific and Technical Information of China (English)

    王建仙

    2016-01-01

    目的:分析老年慢性肺源性心脏病合并左心衰的诊治。方法:收治慢性肺源性心脏病合并左心衰老年患者60例,对患者的超声心动图、临床特点、具体治疗资料、胸部X线以及心电图进行回顾性分析。结果:52例治疗好转出院,5例患者病情危重转上级医院治疗,3例患者放弃继续抢救主动出院,1例患者呼吸衰竭死亡。结论:对于慢性肺源性心脏病合并左心衰老年患者,临床治疗中需要高度重视血管扩张剂、利尿剂和相应胶体的使用。%Objective:To analyze the diagnosis and treatment of elderly chronic pulmonary heart disease combined with left heart failure.Methods:60 elderly patients with chronic pulmonary heart disease combined with left heart failure were selected.The echocardiography,clinical features,specific treatment data,chest X-ray and electrocardiogram of patients were retrospectively analyzed.Results:52 cases were treatment improved and discharged.5 patients were transferred to higher level hospitals for treatment due to serious illness.3 patients given up continue to rescue and actively discharged.1 patient was died due to respiratory failure.Conclusion:For the elderly patients with chronic pulmonary heart disease combined with left heart failure,the clinical treatment needs to pay great attention to the use of vascular dilation agents,diuretics and the corresponding colloid.

  13. HEART RATE-LOWERING THERAPY IN THE TREATMENT OF CHRONIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    S. V. Shalaev

    2015-01-01

    Full Text Available Aspects of heart rate-lowering therapy in patients with chronic heart failure using If-channel blocker ivabradine are discussed. The evidence-based data on ivabradine use reveal its advantages, disadvantages and place in the treatment of cardiac patients.

  14. HEART RATE-LOWERING THERAPY IN THE TREATMENT OF CHRONIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    S. V. Shalaev

    2015-09-01

    Full Text Available Aspects of heart rate-lowering therapy in patients with chronic heart failure using If-channel blocker ivabradine are discussed. The evidence-based data on ivabradine use reveal its advantages, disadvantages and place in the treatment of cardiac patients.

  15. Frailty in elderly people with chronic kidney disease.

    Science.gov (United States)

    Portilla Franco, Maria Eugenia; Tornero Molina, Fernando; Gil Gregorio, Pedro

    In recent years, the concept of frailty as a "state of pre-disability" has been widely accepted by those involved in the care of the elderly. Its importance lies not only in its high prevalence - more than 25% in people over 85 years of age - but it is also considered an independent risk factor of disability, institutionalisation and mortality amongst the elderly. The study of renal function is relevant in patients with major comorbidities. Studies have shown a significant association between chronic kidney disease and the development of adverse clinical outcomes such as heart disease, heart failure, end-stage renal disease, increased susceptibility to infections and greater functional impairment. Frailty can be reversed, which is why a study of frailty in patients with chronic kidney disease is of particular interest. This article aims to describe the association between ageing, frailty and chronic kidney disease in light of the most recent and relevant scientific publications.

  16. Deteriorated function of cutaneous microcirculation in chronic congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Marie-Louise Edvinsson; Erik Uddman; Sven E Andersson

    2011-01-01

    Background Chronic congestive heart failure is a complex condition that leads to dysfunction in the peripheral microcirculation. We have previously shown that vascular reactivity is reduced with increasing age.In this study,we examined a group of very old patients with severe chronic heart failure to test the hypothesis that vascular function is further compromised by a combination of heart failure and aging.Methods Cutaneous forearm blood flow was measured by laser Doppler flownretry and compared among three groups:Group 1 (n=20,men±SE:85.54 years),heart failure patients with New York Heart Association class Ⅳ(NYHA IV) and with a NT-proBNP level =10,mean±SE:67.6 ± 3.0 years),healthy controls with no clinical signs of heart failure.The vasodilator response to the iontophoretic administration of acetylcholine (ACh),acting via an endothelial mechanism,and sodium nitroprusside (SNP),acting via a smooth muscle cell mechanism,were studied. Results All patients with heart failure had significantly reduced vascular reactivity independent of the mode of stimulation (ACh,SNP or heat) when compared to healthy controls.However,the responses did not differ between the two groups of heart failure patients.Conclusions Cutaneous vascular reactivity is reduced in heart failure patients and does not correlate with the severity of the condition or age of patients.

  17. Acute rheumatic fever and rheumatic heart disease in indigenous populations.

    Science.gov (United States)

    Steer, Andrew C; Carapetis, Jonathan R

    2009-12-01

    Acute rheumatic fever and rheumatic heart disease are diseases of socioeconomic disadvantage. These diseases are common in developing countries and in Indigenous populations in industrialized countries. Clinicians who work with Indigenous populations need to maintain a high index of suspicion for the potential diagnosis of acute rheumatic fever, particularly in patients presenting with joint pain. Inexpensive medicines, such as aspirin, are the mainstay of symptomatic treatment of rheumatic fever; however, antiinflammatory treatment has no effect on the long-term rate of progression or severity of chronic valvular disease. The current focus of global efforts at prevention of rheumatic heart disease is on secondary prevention (regular administration of penicillin to prevent recurrent rheumatic fever), although primary prevention (timely treatment of streptococcal pharyngitis to prevent rheumatic fever) is also important in populations in which it is feasible.

  18. Chronic renal disease in pregnancy.

    Science.gov (United States)

    Ramin, Susan M; Vidaeff, Alex C; Yeomans, Edward R; Gilstrap, Larry C

    2006-12-01

    The purpose of this review was to examine the impact of varying degrees of renal insufficiency on pregnancy outcome in women with chronic renal disease. Our search of the literature did not reveal any randomized clinical trials or meta-analyses. The available information is derived from opinion, reviews, retrospective series, and limited observational series. It appears that chronic renal disease in pregnancy is uncommon, occurring in 0.03-0.12% of all pregnancies from two U.S. population-based and registry studies. Maternal complications associated with chronic renal disease include preeclampsia, worsening renal function, preterm delivery, anemia, chronic hypertension, and cesarean delivery. The live birth rate in women with chronic renal disease ranges between 64% and 98% depending on the severity of renal insufficiency and presence of hypertension. Significant proteinuria may be an indicator of underlying renal insufficiency. Management of pregnant women with underlying renal disease should ideally entail a multidisciplinary approach at a tertiary center and include a maternal-fetal medicine specialist and a nephrologist. Such women should receive counseling regarding the pregnancy outcomes in association with maternal chronic renal disease and the effect of pregnancy on renal function, especially within the ensuing 5 years postpartum. These women will require frequent visits and monitoring of renal function during pregnancy. Women whose renal disease is further complicated by hypertension should be counseled regarding the increased risk of adverse outcome and need for blood pressure control. Some antihypertensives, especially angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, should be avoided during pregnancy, if possible, because of the potential for both teratogenic (hypocalvaria) and fetal effects (renal failure, oliguria, and demise).

  19. TREATMENT OF PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE IN REAL CLINICAL PRACTICE ACCORDING TO THE DATA FROM PROGNOZ IBS REGISTER (PART 2

    Directory of Open Access Journals (Sweden)

    S. N. Tolpygina

    2013-01-01

    Full Text Available Aim. To assess the quality of drug therapy and its correspondence with current clinical guidelines in patients with proven stable ischemic heart disease (IHD before admission, during inpatient stay in hospital and after hospital discharge.Material and methods. Data on 550 patients (from PROGNOZ IBS register with detected stenosis of at least one coronary artery ≥50% were included in the analysis. Assessment of the quality of drug therapy was conducted in patients who made a follow-up visit in 3.9 years after the reference hospitalization (n=303 using a specially designed questionnaire. Adherence to treatment was studied using a phone survey.Results. According to PROGNOZ IBS register data we revealed low prescription frequency of drugs with proven effects on the cardiovascular risk in patients with stable IHD prior to hospital admission and significant pharmacotherapy improvement in specialized cardiology hospital. In specialized hospital the rate of aspirin use increased by 30%, statins - by 80%, beta-blockers - by 70%, ACE inhibitors - by 60% (p<0.0001. These medications prescription frequency decreased by 15-20% on the average in 3.9 years after discharge.Conclusion. We found significant improvement in pharmacotherapy quality of patients with stable IHD during stay in cardiology hospital, and pharmacotherapy quality reduction after discharge.

  20. Anticoagulation in adults with congenital heart disease

    DEFF Research Database (Denmark)

    Jensen, A S; Idorn, L; Nørager, B

    2015-01-01

    Adults with congenital heart disease are a growing population. One of the major challenges in the care of these patients is to prevent thromboembolic episodes. Despite relative young age and no typical cardiovascular risk factors, this cohort has a high prevalence of thrombotic events....... It is difficult to use treatment algorithms from the general adult population with acquired heart disease in this heterogeneous population due to special conditions such as myocardial scarring after previous surgery, atypical atrial flutter, prothrombotic conditions and the presence of interatrial shunts....... Furthermore, there is a lack of scientific evidence regarding how to prevent thromboembolic events with anticoagulation in adults with congenital heart disease. The aim of this paper is to review the current literature pertaining to anticoagulation in adults with congenital heart disease and hence enable...

  1. Being active when you have heart disease

    Science.gov (United States)

    ... P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 42. Thompson PD. Exercise-based, comprehensive cardiac rehabilitation. In: Mann DL, Zipes ...

  2. How Is Diabetic Heart Disease Diagnosed?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is Diabetic Heart Disease Diagnosed? Your doctor will diagnose diabetic ... have diabetes, protein in the urine is a risk factor for DHD. Other Tests and Procedures Your doctor ...

  3. Job Dissatisfaction and Coronary Heart Disease

    Science.gov (United States)

    Friis, Robert

    1976-01-01

    Based on the psychosocial factor that life dissatisfactions may be associated with physical illnesses, this research examines the relationship between job dissatisfaction and its causal link to premature death from heart disease. (Author/RK)

  4. Magnetic resonance imaging of valvular heart disease

    DEFF Research Database (Denmark)

    Søndergaard, Lise; Ståhlberg, F; Thomsen, C

    1999-01-01

    The optimum management of patients with valvular heart diseases requires accurate and reproducible assessment of the valvular lesion and its hemodynamic consequences. Magnetic resonance imaging (MRI) techniques, such as volume measurements, signal-void phenomena, and velocity mapping, can be used...... in an integrated approach to gain qualitative and quantitative information on valvular heart disease as well as ventricular dimensions and functions. Thus, MRI may be advantageous to the established diagnostic tools in assessing the severity of valvular heart disease as well as monitoring the lesion and predicting...... the optimal timing for valvular surgery. This paper reviews the validation of these MRI techniques in assessing valvular heart disease and discusses some typical pitfalls of the techniques, including suggestions for solutions.J. Magn. Reson. Imaging 1999;10:627-638....

  5. [Atrial fibrillation concomitant with valvular heart disease].

    Science.gov (United States)

    Ishii, Yosuke

    2013-01-01

    Patients with valvular heart disease frequently have atrial fibrillation(AF) due to elevated pressure and dilatation of the left and right atria and pulmonary veins. Guidelines for valvular heart disease and AF recommend that surgical treatment for the valvular heart disease should be performed concomitantly with AF surgery. The Full-Maze procedure has evolved into the gold standard of treatment for medically refractory AF. In addition to the pulmonary vein isolation, the right and left atrial incisions of the Full-Maze procedure are designed to block potential macroreentrant pathways. According to the mechanisms of AF with valvular heart disease, the Full-Maze procedure is more effective for the patients than the pulmonary vein isolation alone.

  6. Stroke Recurrence in Congenital Heart Disease

    OpenAIRE

    J Gordon Millichap

    2012-01-01

    Researchers at the Hospital for Sick Children, Toronto, Canada identified 135 patients with congenital heart disease diagnosed with arterial ischemic stroke during 1992-2008 and registered in the Canadian Pediatric Stroke Registry-Toronto site.

  7. What Are Heart Disease and Stroke?

    Science.gov (United States)

    ... Aortic Aneurysm More What Are Heart Disease and Stroke? Updated:Dec 8,2015 There are many types ... build-up in the lungs, called “pulmonary congestion”. STROKE and TIA happen when a blood vessel that ...

  8. Major Risk Factors for Heart Disease: Diabetes

    Science.gov (United States)

    ... 9 pounds are also more likely to develop type2 diabetes later in life. Symptoms of diabetes may ... glucose (blood sugar) levels will help to prevent complications. Because diabetes is so strongly linked with heart disease, managing ...

  9. Chronic kidney disease

    Science.gov (United States)

    ... 2010;362(1):56-65. PMID: 20054047 www.ncbi.nlm.nih.gov/pubmed/20054047 . Fogarty DG, Tall ... 5 Suppl 1):S1-S290. PMID: 15114537 www.ncbi.nlm.nih.gov/pubmed/15114537 . Kidney Disease: Improving ...

  10. Nebivolol: Its role in the treatment of hypertension and chronic heart failure

    NARCIS (Netherlands)

    Voors, Adriaan; Van Veldhuisen, D.J.

    2006-01-01

    (beta)-blockers are standard therapy in patients with cardiovascular disease, and have become a cornerstone in the treatment of both hypertension and chronic heart failure. However, two meta-analyses have recently raised doubts about the use of (beta)-blockers in patients with essential hypertension

  11. 10.8.Rheumatic heart disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920083 A preliminary study of cell immunefunction in rheumatic heart disease.YANG Qi(杨奇),et al.Res Lab Cardiovasc Dis,Luzhou MedColl Hosp,Sichuan.Chin Cir J 1991; 6 (5): 392-394.Cell immune function of forty one patients withrheumatic heart disease (RHD),forty four withRHD and rheumatic fever (RF) and fifty normal

  12. Magnetic resonance imaging of valvular heart disease

    DEFF Research Database (Denmark)

    Søndergaard, Lise; Ståhlberg, F; Thomsen, C

    1999-01-01

    The optimum management of patients with valvular heart diseases requires accurate and reproducible assessment of the valvular lesion and its hemodynamic consequences. Magnetic resonance imaging (MRI) techniques, such as volume measurements, signal-void phenomena, and velocity mapping, can be used...... the optimal timing for valvular surgery. This paper reviews the validation of these MRI techniques in assessing valvular heart disease and discusses some typical pitfalls of the techniques, including suggestions for solutions.J. Magn. Reson. Imaging 1999;10:627-638....

  13. Radiation-induced valvular heart disease.

    Science.gov (United States)

    Gujral, Dorothy M; Lloyd, Guy; Bhattacharyya, Sanjeev

    2016-02-15

    Radiation to the mediastinum is a key component of treatment with curative intent for a range of cancers including Hodgkin's lymphoma and breast cancer. Exposure to radiation is associated with a risk of radiation-induced heart valve damage characterised by valve fibrosis and calcification. There is a latent interval of 10-20 years between radiation exposure and development of clinically significant heart valve disease. Risk is related to radiation dose received, interval from exposure and use of concomitant chemotherapy. Long-term outlook and the risk of valve surgery are related to the effects of radiation on mediastinal structures including pulmonary fibrosis and pericardial constriction. Dose prediction models to predict the risk of heart valve disease in the future and newer radiation techniques to reduce the radiation dose to the heart are being developed. Surveillance strategies for this cohort of cancer survivors at risk of developing significant heart valve complications are required.

  14. Making sense of chromogranin A in heart disease

    DEFF Research Database (Denmark)

    Gøtze, Jens Peter; Flyvbjerg, Allan; Rehfeld, Jens F.;

    2013-01-01

    Chromogranin A is an acidic protein present in secretory granules of neuroendocrine cells. In plasma, chromogranin A is an important marker of neuroendocrine tumours. Chromogranin A measurement has gained interest in cardiovascular disease, because increased plasma concentrations are associated...... with risk of clinical deterioration and death in patients with acute coronary syndromes or chronic heart failure. Cardiac chromogranin A is stored in atrial granules with cardiac natriuretic peptides—the principal cardiac hormones associated with systemic homoeostasis of water and blood pressure. Expression...

  15. Barriers and facilitators to palliative care of patients with chronic heart failure in Germany: a study protocol

    Directory of Open Access Journals (Sweden)

    Stefan Köberich

    2015-07-01

    Full Text Available Background. Despite its high prevalence, similar symptoms and symptom burden, people suffering from chronic heart failure receive less palliative care than patients with malignant diseases. Internationally, numerous barriers to palliative care of patients with chronic heart failure are known, however, there are no credible data regarding barriers and facilitators to palliative care of people suffering from chronic heart failure available for Germany. Design and Methods. Tripartite study. First part of this study evaluates health care providers’ (physicians and nurses perceived barriers and facilitators to palliative care of patients with chronic heart failure using a qualitative approach. At least 18 persons will be interviewed. In the second part, based on the results of part one, a questionnaire about barriers and facilitators to palliative care of patients with chronic heart failure will be designed and applied to at least 150 physicians and nurses. In the last part a classic Delphi method will be used to develop specific measures to improve the palliative care for chronic heart failure patients. Expected Impact for Public Health. The results of this study will help to understand why patients with heart failure are seldom referred to palliative care and will provide solutions to overcome these barriers. Developed solutions will be the first step to improve palliative care in patients with heart failure in Germany. In addition, the results will help health care providers in other countries to take action to improve palliative care situations for heart failure patients.

  16. 肾上腺素β受体阻滞药在慢性阻塞性肺疾病合并慢性心力衰竭患者中的应用%Beta-adrenoceptor blockers in chronic obstructive pulmonary disease combined with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    周俊; 程齐俭; 李敏

    2011-01-01

    Chronic obstructive pulmonary disease (COPD) is always combined with chronic heart failure. As the cornerstones of therapy for chronic heart failure, beta-adrenoceptor blockers (beta-blockers) are contra-indicated in COPD. Recent studies showed that chronic administration of cardioselective beta-blockers could decrease mortality and improve quality of life in COPD patients. This paper reviewes the research advancement and dispute of beta-blockers on patients with COPD.%慢性阻塞性肺疾病(COPD)常合并慢性心力衰竭,虽然肾上腺素β受体(β受体)阻滞药作为治疗慢性心力衰竭的基础药物,但长期被认为是治疗COPD的禁忌证.近来有研究报道,长期使用心脏选择性β受体阻滞药可降低COPD患者的死亡率并提高生活质量.本文就COPD患者中应用β受体阻滞药的研究进展进行综述.

  17. 冠心病慢性心功能不全与慢性阻塞性肺疾病对右心功能及结构的影响%Effects of chronic heart dysfunction in patients with coronary heart disease and with chronic obstructive pulmonary disease on right ventricular function and structural changes

    Institute of Scientific and Technical Information of China (English)

    王梦义; 郑成环; 李广平

    2011-01-01

    COPD无肺心痛组及冠心痛心功能Ⅱ、Ⅲ级组,差异有统计学意义;COPD无肺心病组及冠心痛心功能Ⅱ、Ⅲ级组3组之间比较差异无统计学意义.结论 冠心痛心功能不全(心功能Ⅱ、Ⅲ级)患者右心结构(PAD、RVED、RAWT)无明显变化.冠心痛心功能不全患者在左心功能不良的同时亦存在右心功能不良.右心室Tei指数可早期评价冠心病患者及COPD患者右心收缩及舒张功能.%Objective To investigate the effects of chronic heart dysfunction in patients with coronary heart disease(CHD) and with chronic obstructive pulmonary disease(COPD) on right ventricular function and structural changes,different cardiac function class CHD patients and the COPD patients with or without cot pulmonale were studied,and the differences were compared to find the dysfunction of right heart early.Methods According to the cardiac function(NYHA) ,68 CHD patients hospitalized in Dec.2008-Feb.2010 were divided to class Ⅱ group( n =32)and class Ⅲ group( n =36).86 COPD patients hospitalized at the same time were divided to cor pulmonale group( n =40) and without cor pulmonale group ( n = 46).50 normal volunteers served as control group.Pulmonary artery dimension(PAD), right ventricular end-diastolic dimension (RVED), right ventricular anterior wall thickness (RVAWT),left ventricular ejection fraction,left and right ventircular Tei index(L, R-Tei index) and pulmonary artery pressure(PAP) were measured and compared.Results PAD, RVED and RAWT between two CHD groups were similar to control group( P >0.05).The R-Tei indexes of cardiac function in class Ⅱ group(0.62±0.19) and class Ⅲ group(0.66 ±0.13) were higher than that of control group (0.29 ± 0.09)( P < 0.05).The Tei index was not significantly different between the two CHD groups.The R-Tei index was significantly negative related to LVEF, and was significantly positive related to L-Tei index.There were 23, 10 and 6 subjects observed tricuspid valve

  18. Challenges Faced by Parents of Children with Congenital Heart Disease

    Science.gov (United States)

    ... Challenges Faced by Parents of Children with Congenital Heart Disease Page Content ​​​The first thing most parents want ... common and expected. About Congenital Heart Defects Congenital Heart Disease (CHD) is the most common type of birth ...

  19. Major Risk Factors for Heart Disease: High Blood Cholesterol

    Science.gov (United States)

    ... Major Risk Factors for Heart Disease High Blood Cholesterol High blood cholesterol is another major risk factor for heart disease ... can do something about. The higher your blood cholesterol level, the greater your risk for developing heart ...

  20. Chronic Diseases Overview

    Science.gov (United States)

    ... Web site. http://www.cdc.gov/nchs/fastats/exercise.htm . Accessed December 20, 2013. Fryar CD, Chen T, Li X. Prevalence of uncontrolled risk factors for cardiovascular disease: United States, 1999–2010. NCHS Data Brief, No. ...

  1. Grover's Disease after Heart Transplantation: A Case Report

    Directory of Open Access Journals (Sweden)

    Giovanbattista Ippoliti

    2012-01-01

    Full Text Available Grover's disease is a transient acantholytic dermatosis of unknown cause, manifesting clinically as a papular skin eruption that is usually located on the anterior chest and abdomen. Histologically characterized by an acantholytic pattern, it has been associated with numerous disorders, including hematologic malignancies, chronic renal failure, and HIV infection, as well as with chemotherapy and bone marrow and/or kidney transplant. Evaluation of followup and treatment is often complicated by spontaneous remission and the occasionally fluctuant course of the disease. Here we report the case of a patient with sudden onset of Grover's disease after heart transplantation. To the best of our knowledge, this is the first observation of Grover's disease as diagnosed after heart transplantation.

  2. Extra-aortic implantable counterpulsation pump in chronic heart failure.

    Science.gov (United States)

    Mitnovetski, Sergei; Almeida, Aubrey A; Barr, Althea; Peters, William S; Milsom, F Paget; Ho, Betty; Smith, Julian A

    2008-06-01

    Extra-aortic counterpulsation for the management of chronic heart failure is a novel approach. We report the use of an extra-aortic implantable counterpulsation pump in the management of a 73-year-old patient with severe heart failure refractory to medical therapy. The implantable counterpulsation pump prolonged his life and greatly improved its quality. The patient lived almost 7 months after the implantation of the device and died of septic complications secondary to gas line infection.

  3. Impaired mitochondrial function in chronically ischemic human heart

    DEFF Research Database (Denmark)

    Stride, Nis Ottesen; Larsen, Steen; Hey-Mogensen, Martin;

    2013-01-01

    , and finally to assess myocardial antioxidant levels. Mitochondrial respiration in biopsies from ischemic and nonischemic regions from the left ventricle of the same heart was compared in nine human subjects. Maximal oxidative phosphorylation capacity in fresh muscle fibers was lower in ischemic compared.......05), and the levels of antioxidant protein expression was lower. Diminished mitochondrial respiration capacity and excessive ROS production demonstrate an impaired mitochondrial function in ischemic human heart muscle. No chronic ischemic preconditioning effect was found....

  4. The fascial system and exercise intolerance in patients with chronic heart failure: hypothesis of osteopathic treatment

    Directory of Open Access Journals (Sweden)

    Bordoni B

    2015-10-01

    Full Text Available Bruno Bordoni,1–3 F Marelli2,3 1Don Carlo Gnocchi Foundation, Department of Cardiology, IRCCS Santa Maria Nascente, Milan, Italy; 2School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, AN, Italy; 3School CRESO, Osteopathic Centre for Research and Studies, Castellanza, VA, Italy Abstract: Chronic heart failure is a progressive, debilitating disease, resulting in a decline in the quality of life of the patient and incurring very high social economic costs. Chronic heart failure is defined as the inability of the heart to meet the demands of oxygen from the peripheral area. It is a multi-aspect complex disease which impacts negatively on all of the body systems. Presently, there are no texts in the modern literature that associate the symptoms of exercise intolerance of the patient with a dysfunction of the fascial system. In the first part of this article, we will discuss the significance of the disease, its causes, and epidemiology. The second part will explain the pathological adaptations of the myofascial system. The last section will outline a possible osteopathic treatment for patients with heart failure in order to encourage research and improve the general curative approach for the patient. Keywords: manual therapy, fatigue, chronic heart failure, osteopathic

  5. Biofeedback in the treatment of heart disease.

    Science.gov (United States)

    Moravec, Christine S; McKee, Michael G

    2011-08-01

    Biofeedback is a method of training subjects to regulate their own physiology using feedback from physiologic sensors connected to an output display. Biofeedback-assisted stress management (BFSM) incorporates the physiologic signals with instructions on stress management. The goal of BFSM training is to give subjects the tools to control their own mental and physiologic reactions, leading to improved health and wellness. In cardiovascular disease, overactivation of the sympathetic component of the autonomic nervous system and psychologic stress together negatively affect quality of life and clinical status. BFSM targets both areas. We hypothesize that this intervention can be used in cardiovascular disease to improve clinical status and quality of life, as well as interfere with disease progression. We are conducting trials of BFSM in heart failure and stable coronary artery disease. Preliminary data suggest that use of BFSM by heart failure patients may actually cause cellular and molecular remodeling of the failing heart in the direction of normal. We are comparing the effects of BFSM with usual care in patients with stable coronary artery disease, testing the hypothesis that the intervention will decrease both sympathetic hyperarousal and activation of the inflammatory cascade. Since heart rate variability is abnormal in both cardiovascular disease and depression, and since BFSM has been successfully used to change heart rate variability, we also expect this intervention to have a positive impact on the depression that often accompanies cardiovascular disease.

  6. Chronic Venous Disease under pressure

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan)

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with

  7. NAFLD and Chronic Kidney Disease.

    Science.gov (United States)

    Marcuccilli, Morgan; Chonchol, Michel

    2016-04-14

    Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in developed countries and it is now considered a risk factor for cardiovascular disease. Evidence linking NAFLD to the development and progression of chronic kidney disease (CKD) is emerging as a popular area of scientific interest. The rise in simultaneous liver-kidney transplantation as well as the significant cost associated with the presence of chronic kidney disease in the NAFLD population make this entity a worthwhile target for screening and therapeutic intervention. While several cross-sectional and case control studies have been published to substantiate these theories, very little data exists on the underlying cause of NAFLD and CKD. In this review, we will discuss the most recent publications on the diagnosis of NAFLD as well new evidence regarding the pathophysiology of NAFLD and CKD as an inflammatory disorder. These mechanisms include the role of obesity, the renin-angiotensin system, and dysregulation of fructose metabolism and lipogenesis in the development of both disorders. Further investigation of these pathways may lead to novel therapies that aim to target the NAFLD and CKD. However, more prospective studies that include information on both renal and liver histology will be necessary in order to understand the relationship between these diseases.

  8. Anemia associated with chronic heart failure: current concepts

    OpenAIRE

    Shah R; Agarwal AK

    2013-01-01

    Ravish Shah, Anil K AgarwalDivision of Nephrology, The Ohio State University, Columbus, Ohio, USAAbstract: Anemia is a frequent comorbidity of heart failure and is associated with poor outcomes. Anemia in heart failure is considered to develop due to a complex interaction of iron deficiency, kidney disease, and cytokine production, although micronutrient insufficiency and blood loss may contribute. Currently, treatment of anemia of heart failure lacks clear targets and specific therapy is not...

  9. Heart Disease in Women | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease in Women Past Issues / Winter 2014 Table of ... United States, 1 in 4 women dies from heart disease. In fact, coronary heart disease (CHD)—the most ...

  10. Improving the accuracy of heart disease diagnosis with an augmented back propagation algorithm

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    A multilayer perceptron neural network system is established to support the diagnosis for five most common heart diseases (coronary heart disease,rheumatic valvular heart disease, hypertension, chronic cor pulmonale and congenital heart disease). Momentum term, adaptive learning rate, the forgetting mechanics, and conjugate gradients method are introduced to improve the basic BP algorithm aiming to speed up the convergence of the BP algorithm and enhance the accuracy for diagnosis.A heart disease database consisting of 352 samples is applied to the training and testing courses of the system. The performance of the system is assessed by cross-validation method. It is found that as the basic BP algorithm is improved step by step, the convergence speed and the classification accuracy of the network are enhanced, and the system has great application prospect in supporting heart diseases diagnosis.

  11. Pregnancy outcomes in women with heart disease

    Institute of Scientific and Technical Information of China (English)

    LIU Hua; XU Ji-wen; ZHAO Xu-dong; YE Tai-yang; LIN Jian-hua; LIN Qi-de

    2010-01-01

    Background As the Shanghai Obstetrical Cardiology Intensive Care Center, our hospital has accumulated a large number of clinical data of pregnant women with heart disease. This paper is a retrospective analysis of 1142 pregnancies in women with heart disease so as to evaluate the maternal and fetal outcomes of these patients.Methods A retrospective analysis was carried out for pregnancies in 1142 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between 1993 and 2007.Results In this study, main heart diseases in pregnancy were arrhythmia (n=359, 31.4%), congenital heart disease (CHD; n=291,25.5%), and myocarditis and its sequelae (n=284, 24.9%); based on the functional classification criteria of New York Heart Association (NYHA), more than half (n=678, 59.4%) of patients were classified NYHA Class Ⅰ; pregnant women in NHYA Class Ⅰ-Ⅱ (n=951, 83.3%) commonly had arrhythmia, myocarditis and its sequelae, while those in NHYA Class Ⅲ-Ⅳ (n=191, 16.7%) mainly had CHD, rheumatic heart disease (RHD), cardiopathy induced by hypertensive disorders complicating pregnancy, and peripartum cardiomyopathy (PPCM). Cardiac failure occurred in 97 (8.5%)patients, and 8 (0.7%) maternal deaths and 12 (1.1%) perinatal deaths were reported in this study. Compared with those in NHYA Class Ⅰ-Ⅱ, women in NHYA Class Ⅲ-Ⅳ had a significantly lower gestational age at birth (P <0.05), lower birth weight (P <0.01), and higher incidence of preterm delivery, small for gestational age and perinatal death (P <0.01). The incidence of cardiac failure in pregnant women with cardiopathy induced by hypertensive disorders complicating pregnancy and PPCM was relatively high, with a rate of 80% and 52.2%, respectively. After cardiac operation, 131(90.3%) women were in classified NHYA Class Ⅰ-Ⅱ and 14 (9.7%) in NHYA Class Ⅲ-Ⅳ.Conclusions Arrhythmia is the type of heart disease that has a highest incidence in patients with heart

  12. Correlates of hot day air-conditioning use among middle-aged and older adults with chronic heart and lung diseases: the role of health beliefs and cues to action.

    Science.gov (United States)

    Richard, Lucie; Kosatsky, Tom; Renouf, Annie

    2011-02-01

    Extreme ambient heat is a serious public health threat, especially for the elderly and persons with pre-existing health conditions. Although much of the excess mortality and morbidity associated with extreme heat is preventable, the adoption of effective preventive strategies is limited. The study reported here tested the predictive power of selected components of the Health Belief Model for air-conditioning (AC) use among 238 non-institutionalized middle-aged and older adults with chronic heart failure and/or chronic obstructive pulmonary disease living in Montréal, Canada. Respondents were recruited through clinics (response rate 71%) and interviews were conducted in their homes or by telephone. Results showed that 73% of participants reported having a home air conditioner. The average number of hours spent per 24-hour period in air-conditioned spaces during heat waves was 14.5 hours (SD = 9.4). Exploratory structural equation modeling showed that specific beliefs about the benefits of and drawbacks to AC as well as internal cues to action were predictive of its level of use, whereas the perceived severity of the effects of heat on health was not. The findings are discussed in light of the need to adequately support effective response to extreme heat in this vulnerable population.

  13. Endothelins in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    1996-01-01

    This review describes recent progress in the accumulation of knowledge about the endothelins (ETs), a family of vasoactive 21-amino acid polypeptides, in chronic liver disease. Particular prominence is given to the dynamics of ET-1 and ET-3 and their possible relation to the disturbed circulation...... and neurohumoral dysregulation found in cirrhosis. Recent studies have shown that the ET system is highly activated in most cirrhotic patients. Circulating ET-1 and ET-3 levels have a positive relation to the severity of the disease and fluid retention, with the highest values recorded in patients with functional....... In addition, marked associations with disturbance of systemic haemodynamics and with abnormal distribution of blood volume have been reported. Although the pathophysiological importance of the ET system in chronic liver disease is not completely understood, similarities to other vasopressive...

  14. Endothelins in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    1996-01-01

    This review describes recent progress in the accumulation of knowledge about the endothelins (ETs), a family of vasoactive 21-amino acid polypeptides, in chronic liver disease. Particular prominence is given to the dynamics of ET-1 and ET-3 and their possible relation to the disturbed circulation....... In addition, marked associations with disturbance of systemic haemodynamics and with abnormal distribution of blood volume have been reported. Although the pathophysiological importance of the ET system in chronic liver disease is not completely understood, similarities to other vasopressive...... and neurohumoral dysregulation found in cirrhosis. Recent studies have shown that the ET system is highly activated in most cirrhotic patients. Circulating ET-1 and ET-3 levels have a positive relation to the severity of the disease and fluid retention, with the highest values recorded in patients with functional...

  15. Chronic Lyme disease: a review.

    Science.gov (United States)

    Marques, Adriana

    2008-06-01

    Studies have shown that most patients diagnosed with chronic Lyme disease either have no objective evidence of previous or current infection with Borrelia burgdorferi or are patients who should be classified as having post-Lyme disease syndrome, which is defined as continuing or relapsing nonspecific symptoms (such as fatigue, musculoskeletal pain, and cognitive complaints) in a patient previously treated for Lyme disease. Despite extensive study, there is currently no clear evidence that post-Lyme disease syndrome is caused by persistent infection with B burgdorferi. Four randomized placebo-controlled studies have shown that antibiotic therapy offers no sustained benefit to patients who have post-Lyme disease syndrome. These studies also showed a substantial placebo effect and a significant risk of treatment-related adverse events. Further research to elucidate the mechanisms underlying persistent symptoms after Lyme disease and controlled trials of new approaches to the treatment and management of these patients are needed.

  16. [Chronic prostatitis and Bechterew's disease].

    Science.gov (United States)

    Kohlicek, J; Svec, V

    1977-11-01

    A group of patients between 35 and 65 years old with chronic prostatitis were examined for the presence of Becherew's disease. In this connection the New York and Roman criterions for morbus Bechterew were applied. There were found one ankyosing spondylarthritis, one ankylosis of the sacroiliac joint, and 11 times a tentative sacroileitis were stated. Altogether the proved and tentative findings were only 3.68 per cent of all examinations. In our countries the morbus Bechterew is found in 0,21 per cent of the normal population. So the protion of the Bechterew's disease in patients with chronic prostatitis is indeed a little higher than average, but not so frequent as often pretended in recent times. After a second series 58 patients being treated because of Bechterew's disease of different stages and different terms were examined for the possibility of a simultaneously elapsing chronic prostatitis. A chronic prostatitis was found in 38 per cent of these patients which correspondents to the incidence published in literature for the medium-age manhood. Nobody of the test persons had complaints on the part of the urologenital tract.

  17. Carcinoid heart disease: Diagnosis and management.

    Science.gov (United States)

    Luis, Sushil A; Pellikka, Patricia A

    2016-01-01

    Hedinger syndrome refers to carcinoid valvular heart disease. The disease is believed to be triggered by vasoactive substances that result in valvular fibrosis. It classically occurs in patients with metastatic carcinoid and preferentially involves the right sided cardiac valves. Affected valves become thickened and retracted, exhibiting regurgitation and sometimes, stenosis. Echocardiography is recommended in patients with carcinoid syndrome and a follow up study is advisable in those who develop a murmur or other symptoms or signs of valvular heart disease. For appropriately selected patients, valve replacement surgery appears to improve outcomes.

  18. [Role of vaccination in chronic disease prevention and control].

    Science.gov (United States)

    Wang, Zhuoqun; Huang, Shue; Zhao, Yanfang; Zhao, Wenhua; Liang, Xiaofeng

    2015-08-01

    Chronic non-communicable disease is a major public health problem affecting the health of residents in china. Evidence shows that, in addition to four major risk factors, i.e. unreasonable dietary, lack of physical activity, smoking and drinking, epidemic and severe outcome of chronic disease is associated with many infectious diseases. Increasingly cancers have been shown to have an infectious etiology. There is also a significantly increased risk of infectious disease such as influenza, pneumonia and other infectious disease in people with pre-existing chronic non-communicable diseases like diabetes, heart disease, and lung diseases. And more than that, there is a high risk of susceptibility to death and severe outcomes among them. Epidemiological studies has confirmed, that through targeted vaccine inoculation, liver cancer, cervical cancer can be effectively prevented, while influenza or pneumonia vaccine are related to reduced risk of hospitalization or death and hospitalization expenses regarding with a variety of chronic diseases. World Health Organization and several other professional organizations have put forward recommendations on vaccine inoculation of chronic disease patients. Programs targeting infectious factors are also an important aspect of chronic diseases prevention and control, therefore, related researches need to be strengthened in the future.

  19. Perspectives on "chronic Lyme disease".

    Science.gov (United States)

    Baker, Phillip J

    2008-07-01

    There is much controversy about the treatment of Lyme disease with respect to 2 poorly defined entities: "chronic Lyme disease" and "posttreatment Lyme disease syndrome." In the absence of direct evidence that these conditions are the result of a persistent infection, some mistakenly advocate extended antibiotic therapy (>/=6 months), which can do great harm and has resulted in at least 1 death. The purpose of this brief report is to review what is known from clinical research about these conditions to assist both practicing physicians and lawmakers in making sound and safe decisions with respect to treatment.

  20. Reducing cholesterol to prevent coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Matthew J. Sorrentino

    2005-01-01

    @@ Coronary heart disease (CHD) remains the number one killer of men and women in the United States of America despite major advances in interventional technologies for the treatment of coronary artery disease. CHD is rapidly becoming a major cause of morbidity and mortality in developing nations as well and is now recognized as the leading cause of death worldwide.

  1. Design for Heart Disease Prevention Programs.

    Science.gov (United States)

    New York State Education Dept., Albany. Bureau of Continuing Education Curriculum Development.

    In this teaching and curriculum guide for community health education, a design is suggested for a course that could help prevent premature deaths due to heart disease. The course communicates facts regarding the causes of cardiovascular diseases, and outlines opportunities for attaining the degree of physical conditioning essential to prevention.…

  2. PREVALENCE OF HEART DISEASE IN PREGNANCY

    OpenAIRE

    Sumathi Natarajan; Mallika Selvaraj

    2016-01-01

    BACKGROUND Previously, the high maternal mortality in cardiac patients who became pregnant prompted the assertion: Women with an abnormal heart should not become pregnant. This long-standing notion needs to be revised today. AIM To study the prevalence of heart disease in antenatal admissions at Government Rajaji Hospital, Madurai. METHODOLOGY An observational study of 3669 antenatal patients being admitted in GRH, Madurai, from March 2016 to April 2016. Both primigravida ...

  3. 基于现代文献的慢性肺源性心脏病中医证候研究%Study on TCM Syndrome Types of Chronic Pulmonary Heart Disease Based on Modern Literatures

    Institute of Scientific and Technical Information of China (English)

    王彬; 刘惠梅; 吴蔚; 高峰

    2011-01-01

    Objective To study the TCM syndrome characteristics of chronic pulmonary heart disease and to summarize its basic law. Methods Literatures on chronic pulmonary heart disease since 1989 to 2009 were searched. The TCM syndromes involved were organized and a database was established. Then the names of those syndromes were standardized. The data of syndrome frequency before and after standardization were analyzed by statistical software. Results Totel of 120 articles were involved, including 225 kinds of TCM syndromes. The syndromes whose frequency> 1% had a proportion of 7.6% (17/225). While after the standardization, the syndromes reduced to 122 kinds. The syndromes whose frequency >1% had a proportion of 18.9% (23/122). After the standardization, there were 73 kinds during acute exacerbation period and 77 kinds for unstaged ones, and the syndromes whose frequency>l% had a proportion of 43.8% (32/73), 35.1% (27/77). The syndrome types on remission stage were relatively less. Conclusion There are various kinds of TCM syndrome types on chronic pulmonary heart disease, the use of terms is lack of standardization, the study on remission stage is not enough. So the distribution of TCM syndrome types found now can not fully reflect the syndrome law on the disease.%目的 研究慢性肺源性心脏病中医证候分布特点,总结其基本规律.方法 检索1989 - 2009年与中医证候相关的慢性肺源性心脏病文献,对中医证候分类进行整理,建立数据库,对所涉及的中医证候名称进行规范,对规范前后的中医证候进行频次统计分析.结果 纳入文献120篇,涉及中医证候类型225种,出现频率>1%的证候类型占7.6%(17/225);进行证候规范后,证候类型减至1 22种,出现频率>1%的证候类型占18.9%(23/122).规范后,急性加重期证候类型73种,不分期证候类型77种,出现频率>1%的证候类型分别占43.8% (32/73)、35.1%(27/77);缓解期证候类型相对较少.结论 目前

  4. Gut microbiota, diet, and heart disease.

    Science.gov (United States)

    Wong, Julia M W; Esfahani, Amin; Singh, Natasha; Villa, Christopher R; Mirrahimi, Arash; Jenkins, David J A; Kendall, Cyril W C

    2012-01-01

    Modulation of the gut microbiota is an area of growing interest, particularly for its link to improving and maintaining the systemic health of the host. It has been suggested to have potential to reduce risk factors associated with chronic diseases, such as elevated cholesterol levels in coronary heart disease (CHD). Diets of our evolutionary ancestors were largely based on plant foods, high in dietary fiber and fermentable substrate, and our gut microbiota has evolved against a background of such diets. Therapeutic diets that mimic plant-based diets from the early phases of human evolution may result in drug-like cholesterol reductions. In contrast, typical Western diets low in dietary fiber and fermentable substrate, and high in saturated and trans fatty acids, are likely contributors to the increased need for pharmacological agents for cholesterol reduction. The gut microbiota of those consuming a Western diet are likely underutilized and depleted of metabolic fuels, resulting in a less than optimal gut microbial profile. As a result, this diet is mismatched to our archaic gut microbiota and, therefore, to our genome, which has changed relatively little since humans first appeared. While the exact mechanism by which the gut microbiota may modulate cholesterol levels still remains uncertain, end products of bacterial fermentation, particularly the short chain fatty acids (i.e., propionate), have been suggested as potential candidates. While more research is required to clarify the potential link between gut microbiota and CHD risk reduction, consuming a therapeutic diet rich in plant foods, dietary fiber, and fermentable substrate would be a useful strategy for improving systemic health, possibly by altering the gut microbiota.

  5. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    Directory of Open Access Journals (Sweden)

    V. N. Larina

    2009-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  6. EFFECT OF MITRAL REGURGITATION ON CHRONIC HEART FAILURE COURSE AND STRUCTURE-FUNCTIONAL HEART STATE

    Directory of Open Access Journals (Sweden)

    V. N. Larina

    2016-01-01

    Full Text Available Aim. To evaluate chronic heart failure (CHF course, functional and structural heart changes in patients with functional mitral regurgitation (MR of various degrees.Material and methods. A total of 104 outpatients (60-85 y. o. with CHF of functional class II-IV by NYHA and functional MR of I-II degrees and MR of III-IV degrees were included into the study groups.Results: Patients in both groups were comparable in sex, age, CHF duration, body mass index, systolic and diastolic blood pressure, clinical state by the clinical state scale, quality of life, anxious and depressive status. The majority of patients with MR III had significant left ventricle (LV systolic dysfunction (p=0,029, severe CHF course (p=0,034, received furosemide (p=0.004 and digoxin (p=0,004. They had significant increase in end-diastolic dimension (p<0,001, end-systolic dimension (p<0,001, left atrium (p=0,004, end-diastolic volume (p<0,001, end-systolic volume (p<0,001, pulmonary artery pressure (p<0,001, decrease in LV relative wall thickness (p=0,021 and LV ejection fraction (p<0,001. Patients of this group were hospitalized because of CHF decompensation and ischemic heart disease exacerbation more often (p=0,045.Conclusion. MR can be considered as one of sensitive predictors of LV geometry and function alteration in CHF patients and play an important role in symptoms development.

  7. Chronic Kidney Disease and Kidney Failure

    Science.gov (United States)

    ... Education Visitor Information RePORT NIH Fact Sheets Home > Chronic Kidney Disease and Kidney Failure Small Text Medium Text Large Text Chronic Kidney Disease and Kidney Failure YESTERDAY One third of diabetic ...

  8. Bone marrow dysfunction in chronic heart failure patients

    NARCIS (Netherlands)

    Westenbrink, B. Daan; Voors, Adriaan A.; de Boer, Rudolf A.; Schuringa, Jan J.; Klinkenberg, Theo; van der Harst, Pim; Vellenga, Edo; van Veldhuisen, Dirk J.; van Gilst, Wiek H.

    2010-01-01

    To investigate whether chronic heart failure (CHF) is associated with a general dysfunction of the haematopoietic compartment. Bone marrow was obtained during coronary artery bypass graft surgery from 20 patients with CHF (age 67 +/- 6 years, 75% NYHA class >= III, LVEF 32 +/- 6%), and 20 age- and g

  9. TREATMENT OF CHRONIC HEART FAILURE: FOCUS ON METOPROLOL SUCCINATE

    Directory of Open Access Journals (Sweden)

    O. D. Ostroumova

    2015-12-01

    Full Text Available Advantages of metoprolol succinate in patients with chronic heart failure (CHF are covered. Results of MERIT-HF study are taken as the main evidences. Patterns of the metoprolol succinate use in the treatment of different categories of patients with CHF (women, the elderly , severe CHF forms, CHF with concomitant hypertension or diabetes are considered.

  10. High prevalence of microalbuminuria in chronic heart failure patients

    NARCIS (Netherlands)

    Van De Wal, RMA; Asselbergs, FW; Plokker, HWT; Smilde, TDJ; Lok, D; Van Veldhuisen, DJ; Van Gilst, WH; Voors, AA

    2005-01-01

    Background: Microalbuminuria is associated with increased risk for cardiovascular morbidity and mortality. However, the relation between microalbuminuria and chronic heart failure has not been well described yet. In this cross-sectional study, we aim to evaluate the prevalence of microalbuminuria an

  11. Nebivolol in chronic heart failure : current evidence and future perspectives

    NARCIS (Netherlands)

    Lipsic, Erik; van Veldhuisen, Dirk J.

    2010-01-01

    Areas covered in the review: We describe the role of the sympathetic nervous system, beta-blockers and specifically nebivolol in chronic heart failure. What the reader will gain: Nebivolol is a third-generation beta-blocker, with high beta(1)/beta(2) selectivity. Moreover, it has important vasodilat

  12. Analysis of electrocardiogram in chronic obstructive pulmonary disease patients

    Directory of Open Access Journals (Sweden)

    Lazović Biljana

    2013-01-01

    Full Text Available Introduction. Chronic obstructive pulmonary disease is the fourth leading cause of mortality worldwide. It is defined as a persistent airflow limitation usually progressive and not fully reversible to treatment. The diagnosis of chronic obstructive pulmonary disease and severity of disease is confirmed by spirometry. Chronic obstructive pulmonary disease produces electrical changes in the heart which shows characteristic electrocardiogram pattern. The aim of this study was to observe and evaluate diagnostic values of electrocardiogram changes in chronic obstructive pulmonary disease patients with no other comorbidity. Material and Methods. We analyzed 110 electrocardiogram findings in clinically stable chronic obstructive pulmonary disease patients and evaluated the forced expiratory volume in the first second, ratio of forces expiratory volume in the first second to the fixed vital capacity, chest radiographs and electrocardiogram changes such as p wave height, QRS axis and voltage, right bundle branch block, left bundle branch block, right ventricular hypertrophy, T wave inversion in leads V1-V3, S1S2S3 syndrome, transition zone in praecordial lead and QT interval. Results. We found electrocardiogram changes in 64% patients, while 36% had normal electrocardiogram. The most frequent electrocardiogram changes observed were transition zone (76.36% low QRS (50% and p pulmonale (14.54%. Left axis deviation was observed in 27.27% patients. Conclusion. Diagnostic values of electrocardiogram in patients with chronic obstructive pulmonary disease suggest that chronic obstructive pulmonary disease patients should be screened electrocardiographically in addition to other clinical investigations.

  13. Prevention Of Chronic Renal Diseases

    Directory of Open Access Journals (Sweden)

    Fejzi Alushi

    2011-10-01

    Full Text Available It is easier to prevent a disease than to cure it. This postulate is a foundation stone of the contemporary medicine, furthermore its mission. The Chronic Kidney Diseases (CKD, amongst them the Chronic Pyelonephrites (CP and the mass kidney reduction  take an important  place in human pathologies in general, and in particular in renal ones. The Chronic Pyelonephrites  are chronic renal pathologies, which on one side are of various causes and on the other side are multi systemic. At the same time they tend, earlier or later, depending on their course, to bring the patient towards the Chronic Kidney Insufficiency  in stage of uremia, consequently in need of substitution therapies e.g. dialysis, peritoneum dialysis or transplant. It is worthy to emphasize that from the prevention and correct cure of CP make profit the patients, the family, the state and in the last analyses  the entire society, because in that way the budget expense destined for the fore going substitution cures, dialysis, peritoneum dialysis or transplant, is considerably  reduced. The same should be mentioned  in relation to the CP and the mass kidney reduction, speaking about our country, which are still at the first place as the very cause of Chronic Kidney  Insufficiencies (CRI, later on advancing toward uremia and terminal uremia along with its grave consequences. In general  the very foundation of the CP is on  the  infections of urinary roads, in particular on the complicated ones, among them it should be mentioned-congenital kidney anomalies, renal calculosis  so much present in our country, and pathologies of segment or vesical-ureteral reflux, and rarely the pathologies of prostate.

  14. 2013 update on congenital heart disease, clinical cardiology, heart failure, and heart transplant.

    Science.gov (United States)

    Subirana, M Teresa; Barón-Esquivias, Gonzalo; Manito, Nicolás; Oliver, José M; Ripoll, Tomás; Lambert, Jose Luis; Zunzunegui, José L; Bover, Ramon; García-Pinilla, José Manuel

    2014-03-01

    This article presents the most relevant developments in 2013 in 3 key areas of cardiology: congenital heart disease, clinical cardiology, and heart failure and transplant. Within the area of congenital heart disease, we reviewed contributions related to sudden death in adult congenital heart disease, the importance of specific echocardiographic parameters in assessing the systemic right ventricle, problems in patients with repaired tetralogy of Fallot and indication for pulmonary valve replacement, and confirmation of the role of specific factors in the selection of candidates for Fontan surgery. The most recent publications in clinical cardiology include a study by a European working group on correct diagnostic work-up in cardiomyopathies, studies on the cost-effectiveness of percutaneous aortic valve implantation, a consensus document on the management of type B aortic dissection, and guidelines on aortic valve and ascending aortic disease. The most noteworthy developments in heart failure and transplantation include new American guidelines on heart failure, therapeutic advances in acute heart failure (serelaxin), the management of comorbidities such as iron deficiency, risk assessment using new biomarkers, and advances in ventricular assist devices.

  15. Short Telomere Length and Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Scheller Madrid, Alexander; Rode, Line; Nordestgaard, Børge Grønne

    2016-01-01

    BACKGROUND: Short telomeres are associated with aging and have been associated with a high risk of ischemic heart disease in observational studies; however, the latter association could be due to residual confounding and/or reverse causation. We wanted to test the hypothesis that short telomeres...... are associated with high risk of ischemic heart disease using a Mendelian randomization approach free of reverse causation and of most confounding. METHODS: We genotyped 3 genetic variants in OBFC1 (oligonucleotide/oligosaccharide binding fold containing 1), TERT (telomerase reverse transcriptase), and TERC...... logistic and instrumental variable analysis for genetic estimates. RESULTS: Observationally, a 200-bp-shorter telomere length was associated with a multivariable adjusted hazard ratio for ischemic heart disease of 1.02 (95% CI, 1.01-1.03). Per allele, telomeres were shorter by 67 bp (73-60). In meta...

  16. Prevalence of maternal chronic diseases during pregnancy

    DEFF Research Database (Denmark)

    Jølving, Line Riis; Nielsen, Jan; Kesmodel, Ulrik Schiøler

    2016-01-01

    chronic diseases were chronic lung diseases/asthma (1.73%), thyroid disorders (1.50%) and anxiety and personality disorders (1.33%). Taking increasing maternal age at birth into account, the relative risk for women to have a chronic disease from 2009 to 2013 was 4.14 (95% CI 4.05-4.22), compared...... pregnancy. We aimed to analyze the prevalence of chronic diseases during pregnancy. MATERIAL AND METHODS: This register-based cohort study included all women giving birth in Denmark between 1989 and 2013 based on data from Danish health registers. Maternal chronic diseases included 23 disease categories...

  17. Population attributable fraction analysis of leading chronic diseases in India

    Directory of Open Access Journals (Sweden)

    A. Choudhury

    2016-08-01

    Full Text Available Chronic diseases and their associated risk factors are increasing in India. We aim to quantify the Population Attributable Fractions (PAF of leading chronic diseases in India associated with significant modifiable risk factors. In calculating adjusted population attributable fraction, non modifiable risk factors are taken as confounders. Our findings highlight that an agenda to improve public health in India must include effective interventions to control tobacco use for cancer and heart disease prevention. There is also an urgent need to educate the general public to maintain proper BMI level thereby reducing diabetes burden in India. The analysis is based on a country wide large scale survey.

  18. Vouchers for chronic disease care.

    Science.gov (United States)

    Watts, Jennifer J; Segal, Leonie

    2008-08-01

    This paper explores the economic implications of vouchers for chronic disease management with respect to achieving objectives of equity and efficiency. Vouchers as a payment policy instrument for health care services have a set of properties that suggest they may address both demand-side and supply-side issues, and contribute to equity and efficiency. They provide a means whereby health care services can be targeted at selected groups, enabling consumer choice of provider, and encouraging competition in the supply of health services. This analysis suggests that, when structured appropriately, vouchers can support consumers to choose services that will meet their health care needs and encourage competition among providers. Although they may not be appropriate across the entire health care system, there are features of vouchers that make them a potentially attractive option, especially for the management of chronic disease.

  19. Efficacy of Lipo PGE1 on severe chronic pulmonary heart disease patients combined with pulmonary hypertension%凯时对重症肺源性心脏病合并肺动脉高压患者的疗效

    Institute of Scientific and Technical Information of China (English)

    史艳; 李雷兵; 孙彩虹

    2012-01-01

    Objective To evaluate the effects of Lipo PGE1 on severe chronic pulmonary heart disease patients combined with pulmonary hypertension.Methods Sixty-eight cases of severe chronic pulmonary heart disease combined with pulmonary hypertension were randomly divided into treatment group (34 cases) and control group(34 cases).Both groups received the conventional antibiotics,oxygen therapy and other treatments,and 10 μg Lipo PGE1 were added to the treatment group every day.Serum CNP,ADM levels and pulmonary artery pressure,arterial oxygen tension (PaO2),partial pressure of arterial blood sputum dioxide (PaCO2) were measured before and after the treatment.Results After treatment,blood CNP,ADM levels and pulmonary artery pressure,PaCO2 was significantly lower than those before treatment,PaO2 was significantly higher than that before treatment.There were significant difference between the treatment group and the control group (P < 0.05).Conclusions Lipo PGE1 can significantly reduce the serum CNP,ADM levels and pulmonary artery pressure of patients of chronic pulmonary heart disease combined with pulmonary hypertension,and improve the cardiac function,pulmonary hypertension and arterial blood gas.%目的 评价凯时(Lipo PGEl)对重症肺源性心脏病合并肺动脉高压患者的疗效.方法 将68例重症肺源性心脏病合并肺动脉高压患者,随机分为实验组和对照组各34例,实验组在常规抗感染、氧疗等治疗的基础上每日加用凯时10 μg静脉微量泵入,对照组仅给予常规治疗.治疗前后检测血C型利钠肽(CNP)、肾上腺髓质素(ADM)水平及肺动脉压、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2).结果 治疗后血CNP、ADM水平及肺动脉压、PaCO2较治疗前明显降低,PaO2较治疗前明显升高,两组比较差异有统计学意义(P<0.05).结论 凯时治疗重症肺源性心脏病合并肺动脉高压能显著降低血CNP、ADM水平及肺动脉压,改善心功能及肺动脉高压,改善动脉血气.

  20. Virtual Surgery in Congenital Heart Disease

    DEFF Research Database (Denmark)

    Sørensen, Thomas Sangild; Mosegaard, Jesper; Kislinskiy, Stefan

    2014-01-01

     Teaching, diagnosing, and planning of therapy in patients with complex structural cardiovascular heart disease require profound understanding of the three-dimensional (3D) nature of cardiovascular structures in these patients. To obtain such understanding, modern imaging modalities provide high...... et al., Cardiol Young 13:451–460, 2003). In combination with the availability of virtual models of congenital heart disease (CHD), techniques for computer- based simulation of cardiac interventions have enabled early clinical exploration of the emerging concept of virtual surgery (Sorensen et al...

  1. Genetic research in coronary heart disease.

    Science.gov (United States)

    Motulsky, A G

    1984-01-01

    Coronary heart disease research along genetic lines is difficult. Studies in molecular genetics of apolipoprotein and receptor variability appear most promising in the near future. However, unexpected discoveries and methodology may turn up that may completely change the field. Exclusive concentration on lipid research therefore should be avoided. It is likely that most advances will come from carefully designed studies that ask specific questions. Such research design is appropriate not only for laboratory studies but also for clinical and epidemiological investigations. The collaboration of clinicians, biochemists, geneticists, epidemiologists, and statisticians is likely to lead to better understanding of coronary heart disease.

  2. Myeloperoxidase in Chronic Kidney Disease

    OpenAIRE

    Madhusudhana Rao, A.; Anand, Usha; Anand, C. V.

    2010-01-01

    Numerous lines of evidence implicate a role of myeloperoxidase (MPO) in the pathogenesis of cardiovascular disease (CVD). It is a well accepted fact that patients with chronic kidney disease (CKD) are at an increased risk for CVD. MPO is a pro-oxidant enzyme which could be involved in the increased susceptibility of these patients to CVD. Hence, the levels of plasma MPO was determined in healthy controls as well as in patients with CKD [stratified with the level of their kidney failure as CKD...

  3. Chronic Venous Disease under pressure

    OpenAIRE

    Reeder, Suzan

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with regard to non-healing and recurrence rates. Annually 6% of the total healthcare costs are spent on the treatment of venous diseases. CVD results from ambulatory venous hypertension and is the conse...

  4. Chronic heart failure: Ca(2+), catabolism, and catastrophic cell death.

    Science.gov (United States)

    Cho, Geoffrey W; Altamirano, Francisco; Hill, Joseph A

    2016-04-01

    Robust successes have been achieved in recent years in conquering the acutely lethal manifestations of heart disease. Many patients who previously would have died now survive to enjoy happy and productive lives. Nevertheless, the devastating impact of heart disease continues unabated, as the spectrum of disease has evolved with new manifestations. In light of this ever-evolving challenge, insights that culminate in novel therapeutic targets are urgently needed. Here, we review fundamental mechanisms of heart failure, both with reduced (HFrEF) and preserved (HFpEF) ejection fraction. We discuss pathways that regulate cardiomyocyte remodeling and turnover, focusing on Ca(2+) signaling, autophagy, and apoptosis. In particular, we highlight recent insights pointing to novel connections among these events. We also explore mechanisms whereby potential therapeutic approaches targeting these processes may improve morbidity and mortality in the devastating syndrome of heart failure.

  5. Coronary Artery Disease - Coronary Heart Disease

    Science.gov (United States)

    ... result of coronary artery disease, or CAD, said Edward A. Fisher, M.D., Ph.D., M.P. ... Problems and Disease • High Blood Pressure (HBP) • Metabolic Syndrome • Pericarditis • Peripheral Artery Disease (PAD) • Stroke • Vascular Health • ...

  6. Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies.

    NARCIS (Netherlands)

    Detaille, S.I.; Heerkens, Y.F.; Engels, J.A.; Gulden, J.W.J. van der; Dijk, F.J. van

    2009-01-01

    OBJECTIVE: Based on prospective and retrospective disease cohort studies, the aim of this review was to determine common prognostic factors for work disability among employees with rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease (IHD

  7. Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies

    NARCIS (Netherlands)

    S.I. Detaille; Y.F. Heerkens; J.A. Engels; J.W.J. van der Gulden; F.J.H. van Dijk

    2009-01-01

    Objective Based on prospective and retrospective disease cohort studies, the aim of this review was to determine common prognostic factors for work disability among employees with rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease (IHD)

  8. Stem cells:An eventual treatment option for heart diseases

    Institute of Scientific and Technical Information of China (English)

    Joseph; C; Bilgimol; Subbareddy; Ragupathi; Lakshmanan; Vengadassalapathy; Nathan; S; Senthil; Kali-muthu; Selvakumar; M; Ganesan; Sadananda; Rao; Manjunath

    2015-01-01

    Stem cells are of global excitement for various diseases including heart diseases. It is worth to understand the mechanism or role of stem cells in the treatment of heart failure. Bone marrow derived stem cells are commonly practiced with an aim to improve the function of the heart. The majority of studies have been conducted with acute myocardial infarction and a few has been investigated with the use of stem cells for treating chronic or dilated cardiomyopathy. Heterogeneity in the treated group using stem cells has greatly emerged. Ever increasing demand for any alternative made is of at most priority for cardiomyopathy. Stem cells are of top priority with the current impact that has generated among physicians. However,meticulous selection of proper source is required since redundancy is clearly evident with the present survey. This review focuses on the methods adopted using stem cells for heart diseases and outcomes that are generated so far with an idea to determine the best therapeutic possibility in order to fulfill the present demand.

  9. Clinical significance of change of various indexes levels in patients with coronary heart disease complicating chronic chro-nic heart failure%各项指标水平变化在冠心病慢性心力衰竭患者的临床意义

    Institute of Scientific and Technical Information of China (English)

    许淑文; 李艳; 郑红云; 戴雯

    2015-01-01

    目的:探讨血清同型半胱氨酸(Hcy)、血尿酸(UA)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL‐C)、低密度脂蛋白胆固醇(LDL‐C)与脂蛋白 a[Lp(a)]联合检测在冠心病慢性心力衰竭发生、发展中的应用价值。方法分别检测319例慢性心力衰竭患者和102例健康对照者血液中 Hcy 、UA 、TC 、TG 、HDL‐C 、LDL‐C 、Lp(a)水平。结果与健康对照组比较,冠心病慢性心力衰竭组 Hcy 、UA 和 Lp(a)水平均明显升高,差异有统计学意义(P<0.05);TC 、HDL‐C 、LDL‐C 水平降低,差异有统计学意义(P <0.05);而 TG 水平差异无统计学意义(P>0.05);随着心功能分级增加,Hcy 、UA 、Lp(a)水平升高,而 TC 、HDL‐C 、LDL‐C 水平降低,差异有统计学意义(P<0.05),而 TG 水平差异无统计学意义(P>0.05);两两比较不同心功能之间 UA 水平,差异有统计学意义(P<0.05),心功能Ⅲ级、Ⅳ级比Ⅰ级、Ⅱ级的 Lp(a)水平高(P<0.05),而 TC 、HDL‐C 、LDL‐C 水平降低(P<0.05);冠心病慢性心力衰竭患者 Hcy 与 UA ,TC 与 TG 、HDL‐C 、LDL‐C 、Lp(a),TG 与 LDL‐C ,HDL‐C 与 LDL‐C ,LDL‐C 与 Lp (a)呈正相关(P<0.05)。 UA 与 HDL‐C 、LDL‐C ,TG 与 Lp(a)呈负相关(P<0.05)。结论 Hcy 、UA 、TC 、HDL‐C 、LDL‐C 、Lp(a)和冠心病慢性心力衰竭密切相关,对这些生化指标的检测有助于监测和控制冠心病慢性心力衰竭的发生和发展。%Objective To observe the application value of the combined detection of homocysteine(Hcy) ,uric acid(UA) ,plasma total cholesterol(TC) ,triglyceride(TG) ,HDL‐cholesterol(HDL‐C) ,LDL‐cholesterin(LDL‐C) and lipoprotein[Lp(a)] in the occurrence and development of coronary heart disease(CHD) complicating chronic heart failure

  10. Assessment of cardiac sympathetic nerve activity in children with chronic heart failure using quantitative iodine-123 metaiodobenzylguanidine imaging

    Energy Technology Data Exchange (ETDEWEB)

    Karasawa, Kensuke; Ayusawa, Mamoru; Noto, Nobutaka; Sumitomo, Naokata; Okada, Tomoo; Harada, Kensuke [Nihon Univ., Tokyo (Japan). School of Medicine

    2000-12-01

    Cardiac sympathetic nerve activity in children with chronic heart failure was examined by quantitative iodine-123 metaiodobenzylguanidine (MIBG) myocardial imaging in 33 patients aged 7.5{+-}6.1 years (range 0-18 years), including 8 with cardiomyopathy, 15 with congenital heart disease, 3 with anthracycrine cardiotoxicity, 3 with myocarditis, 3 with primary pulmonary hypertension and 1 with Pompe's disease. Anterior planar images were obtained 15 min and 3 hr after the injection of iodine-123 MIBG. The cardiac iodine-123 MIBG uptake was assessed as the heart to upper mediastinum uptake activity ratio of the delayed image (H/M) and the cardiac percentage washout rate (%WR). The severity of chronic heart failure was class I (no medication) in 8 patients, class II (no symptom with medication) in 9, class III (symptom even with medication) in 10 and class IV (late cardiac death) in 6. H/M was 2.33{+-}0.22 in chronic heart failure class I, 2.50{+-}0.34 in class II, 1.95{+-}0.61 in class III, and 1.39{+-}0.29 in class IV (p<0.05). %WR was 24.8{+-}12.8% in chronic heart failure class I, 23.3{+-}10.2% in class II, 49.2{+-}24.5% in class III, and 66.3{+-}26.5% in class IV (p<0.05). The low H/M and high %WR were proportionate to the severity of chronic heart failure. Cardiac iodine-123 MIBG showed cardiac adrenergic neuronal dysfunction in children with severe chronic heart failure. Quantitative iodine-123 MIBG myocardial imaging is clinically useful as a predictor of therapeutic outcome and mortality in children with chronic heart failure. (author)

  11. Bidirectional Relationship between Chronic Kidney Disease and Periodontal Disease: Structural Equation Modeling

    OpenAIRE

    Fisher, Monica A.; Taylor, George W.; West, Brady T.; McCarthy, Ellen T.

    2010-01-01

    Periodontal disease is associated with diabetes, heart disease, and chronic kidney disease (CKD), an effect postulated to be due in part to endovascular inflammation. While a bidirectional relationship between CKD and periodontal disease is plausible, it has not been previously reported in the literature. Over 11 200 adults 18 years or older were identified in the Third National Health and Nutrition Examination Survey. Analyses were conducted in two stages. First, multivariable logistic regre...

  12. Cyanotic congenital heart disease and atherosclerosis.

    Science.gov (United States)

    Tarp, Julie Bjerre; Jensen, Annette Schophuus; Engstrøm, Thomas; Holstein-Rathlou, Niels-Henrik; Søndergaard, Lars

    2017-03-04

    Improved treatment options in paediatric cardiology and congenital heart surgery have resulted in an ageing population of patients with cyanotic congenital heart disease (CCHD). The risk of acquired heart disease such as atherosclerosis increases with age.Previous studies have speculated whether patients with CCHD are protected against atherosclerosis. Results have shown that the coronary arteries of patients with CCHD are free from plaques and stenosis. Decreased carotid intima-media thickness and low total plasma cholesterol may indicate a reduced risk of later development of atherosclerosis. However, the evidence is still sparse and questionable, and a reasonable explanation for the decreased risk of developing atherosclerosis in patients with CCHD is still missing.This review provides an overview of what is known about the prevalence and potential causes of the reduced risk of atherosclerosis in patients with CCHD.

  13. Value of cardiac 320-multidetector computed tomography and cardiac magnetic resonance imaging for assessment of myocardial perfusion defects in patients with known chronic ischemic heart disease

    DEFF Research Database (Denmark)

    Qayyum, Abbas Ali; Kühl, Jørgen T; Mathiasen, Anders B;

    2013-01-01

    the modified 17-segment American Heart Association model. For the qualitative analysis, each segment was graded according to the following scoring system: 0 = no defect, 1 = hypoperfusion transmural extent 1/2, and 4 = infarct stigmata. In the semiquantitative analysis the perfusion was either scored 0 (normal...... and CMR images. The qualitative and semiquantitative MDCT against CMR analysis of rest and stress images showed high concordance to detect perfusion defects per vascular territory and on a per myocardial segment basis. 320-MDCT and CMR perfusion imaging can be used clinically to identify myocardial...

  14. Anemia associated with chronic heart failure: current concepts.

    Science.gov (United States)

    Shah, Ravish; Agarwal, Anil K

    2013-01-01

    Anemia is a frequent comorbidity of heart failure and is associated with poor outcomes. Anemia in heart failure is considered to develop due to a complex interaction of iron deficiency, kidney disease, and cytokine production, although micronutrient insufficiency and blood loss may contribute. Currently, treatment of anemia of heart failure lacks clear targets and specific therapy is not defined. Intravenous iron use has been shown to benefit anemic as well as nonanemic patients with heart failure. Treatment with erythropoietin-stimulating agents has been considered alone or in combination with iron, but robust evidence to dictate clear guidelines is not currently available. Available and emerging new agents in the treatment of anemia of heart failure will need to be tested in randomized, controlled studies.

  15. Radiation-Induced Heart Disease: Pathologic Abnormalities and Putative Mechanisms

    Directory of Open Access Journals (Sweden)

    Neil K Taunk

    2015-02-01

    Full Text Available Breast cancer is a common diagnosis in women. Breast radiation has become a critical in managing patients who receive breast conserving surgery, or have certain high-risk features after mastectomy. Most patients have an excellent prognosis, therefore understanding the late effects of radiation to the chest is important. Radiation induced heart disease (RIHD comprises a spectrum of cardiac pathology including myocardial fibrosis and cardiomyopathy, coronary artery disease, valvular disease, pericardial disease, and arrhythmias. Tissue fibrosis is a common mediator in RIHD. Multiple pathways converge with both acute and chronic cellular, molecular, and genetic changes to result in fibrosis. In this article, we review the pathophysiology of cardiac disease related to radiation therapy to the chest. Our understanding of these mechanisms has improved substantially, but much work remains to further refine radiation delivery techniques and develop therapeutics to battle late effects of radiation.

  16. Amyloid heart disease: genetics translated into disease-modifying therapy.

    Science.gov (United States)

    Sperry, Brett W; Tang, W H Wilson

    2017-03-02

    Given increased awareness and improved non-invasive diagnostic tools, cardiac amyloidosis has become an increasingly recognised aetiology of increased ventricular wall thickness and heart failure with preserved ejection fraction. Once considered a rare disease with no treatment options, translational research has harnessed novel pathways and led the way to promising treatment options. Gene variants that contribute to amyloid heart disease provide unique opportunities to explore potential disease-modifying therapeutic strategies. Amyloidosis has become the model disease through which gene therapy using small interfering RNAs and antisense oligonucleotides has evolved.

  17. Antioxidant vitamins and coronary heart disease risk

    DEFF Research Database (Denmark)

    Knekt, Paul; Ritz, John; Pereira, Mark A

    2004-01-01

    BACKGROUND: Epidemiologic studies have suggested a lower risk of coronary heart disease (CHD) at higher intakes of fruit, vegetables, and whole grain. Whether this association is due to antioxidant vitamins or some other factors remains unclear. OBJECTIVE: We studied the relation between the intake...

  18. Education and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Nordahl, Helene; Rod, Naja Hulvej; Frederiksen, Birgitte Lidegaard

    2013-01-01

    Educational-related gradients in coronary heart disease (CHD) and mediation by behavioral risk factors are plausible given previous research; however this has not been comprehensively addressed in absolute measures. Questionnaire data on health behavior of 69,513 participants, 52 % women, from...

  19. The Counselor and Coronary Heart Disease

    Science.gov (United States)

    Ottens, Allen J.

    1977-01-01

    It is clear that steps can be taken for heart disease prevention and that counselors must give thought to adapting existing ideas and techniques and to developing and experimenting with new and innovative preventive tactics. Of utmost importance is the belief that behavioral intervention is both warranted and worthwhile. (Author)

  20. Congenial Heart Disease at Adult Age

    NARCIS (Netherlands)

    J.W. Roos-Hesselink (Jolien)

    2004-01-01

    markdownabstract__Abstract__ Congenital cardiac defects are by far the most common congenital anomalies. Of all live births around the world, approximately 1% is born with congenital heart disease.1 This number is even higher if patients with a bicuspid aortic valve are included.2 Accordingly, in t

  1. Celebrities Gather to Fight Heart Disease

    Science.gov (United States)

    ... Cardiovascular disease, the leading cause of death for men and women in the United States, kills nearly 500,000 women each year. NHLBI, through The Heart Truth campaign, continued its awareness efforts by returning to New York Fashion Week the first week in February for the ...

  2. Congenital Heart Disease and General Practice

    NARCIS (Netherlands)

    W.B. de Koning (Wilfred)

    2012-01-01

    textabstractThe treatment of patients with congenital heart disease (CHD) has progressed vastly over the last five decennia. In the Netherlands, around 200,000 children are born each year, around 1,800 of whom have a CHD. This incidence – 6 – 8 per thousand live births – is reported to be similar ro

  3. EVALUATION CARDIAC RESYNCHRONIZATION THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    A. J. Fishman

    2011-01-01

    Full Text Available Objective — studying dyssynchrony characteristics and evaluation correction effectiveness in patients with chronic heart failure (CHF of ischemic origin.Materials and methods. The study included 125 patients with chronic heart failure of ischemic etiology, 28 of them — with coronary heart disease (CHD who had undergone aorto-and / or mammarokoronary bypass and / or percutaneous coronary intervention, 42 — with coronary artery disease and postinfarction cardiosclerosis, 32 — with arrhythmic variant of coronary artery disease, 23 — with stable angina without evidence of arrhythmia. Among included patients, biventricular pacemakers were implanted for 17 patients. All patients underwent echocardiography with determination of the parameters of dyssynchrony.Results and conclusion. Among patients with CHF ischemic symptoms dyssynchrony was diagnosed in 36 (28.8 % cases. Statistically significant association between patients with cardiac arrhythmias and dyssynchrony was determined. At the same time the incidence of dyssynchrony was not associated with various forms of ischemic heart disease, and did not depend on the anamnesis of cardiac surgery. Dependence of the frequency of occurrence of dyssynchrony on the severity of CHF was revealed. Patients selected for implantation of biventricular pacemakers, especially in view of echocardiographic signs of dyssynchrony had significant improvement after providing cardiac resynchronization therapy. Effect of the treatment does not depend on the atrial fibrillation rhythm presence.

  4. EVALUATION CARDIAC RESYNCHRONIZATION THERAPY IN PATIENTS WITH CHRONIC ISCHEMIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    A. J. Fishman

    2014-07-01

    Full Text Available Objective — studying dyssynchrony characteristics and evaluation correction effectiveness in patients with chronic heart failure (CHF of ischemic origin.Materials and methods. The study included 125 patients with chronic heart failure of ischemic etiology, 28 of them — with coronary heart disease (CHD who had undergone aorto-and / or mammarokoronary bypass and / or percutaneous coronary intervention, 42 — with coronary artery disease and postinfarction cardiosclerosis, 32 — with arrhythmic variant of coronary artery disease, 23 — with stable angina without evidence of arrhythmia. Among included patients, biventricular pacemakers were implanted for 17 patients. All patients underwent echocardiography with determination of the parameters of dyssynchrony.Results and conclusion. Among patients with CHF ischemic symptoms dyssynchrony was diagnosed in 36 (28.8 % cases. Statistically significant association between patients with cardiac arrhythmias and dyssynchrony was determined. At the same time the incidence of dyssynchrony was not associated with various forms of ischemic heart disease, and did not depend on the anamnesis of cardiac surgery. Dependence of the frequency of occurrence of dyssynchrony on the severity of CHF was revealed. Patients selected for implantation of biventricular pacemakers, especially in view of echocardiographic signs of dyssynchrony had significant improvement after providing cardiac resynchronization therapy. Effect of the treatment does not depend on the atrial fibrillation rhythm presence.

  5. Prevalence, correlative and statistical relationships of renal dysfunction in patients with chronic ischemic heart failure

    Directory of Open Access Journals (Sweden)

    D. A. Lashkul

    2014-02-01

    Full Text Available Chronic heart failure (CHF is one of the most common complications of cardiovascular disease. According multicenter studies conducted during recent years, coronary heart disease was the leading cause of heart failure and has been on average 64% of patients with chronic heart failure. The tight functional relationship of cardiovascular and urinary system causes a lot of interest to the functional state of kidneys in various cardiovascular diseases. Most risk factors for cardiovascular disease are common risk factors of renal failure. Causes significant differences in the prevalence of chronic kidney disease (CKD in patients with chronic heart failure, defined as coronary artery disease and hypertension remain unclear. Need clarification prevalence of CKD among patients with CHF in general and in specific groups of patients. The aim of the study was to examine the prevalence, correlation and statistical relationships of renal dysfunction with functional class, age and gender of patients with coronary heart disease and heart failure, were hospitalized. Materials and methods. Analyzed the medical cards 344 patients (286 men and 58 women with ischemic chronic heart failure, mean age 59.2±9.4 years. The etiology of heart failure in 298 (86.6% patients had a combination of coronary artery disease and essential hypertension in 46 (13.4% - CHD. Chronic heart failure 1 functional class (FC was diagnosed in 10 (2.9% patients, 2 FC - in 106 (31%, 3 FC - 207 (60.5% and 4 FC - 19 (5, 6% patients. Diabetes was 62 (18% patients. Myocardial infarction had a history of 245 (71.2% patients. Glomerular filtration rate was calculated using the formula MDRD (Modification of Diet in Renal Disease. Descriptive statistics are presented as mean±standard deviation for continuous variables and as percentages for categorical variables. Depending on the distribution of the analyzed parameters used unpaired Student's t-test or U-Mann-Whitney test. Comparisons among all

  6. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial

    DEFF Research Database (Denmark)

    Baigent, Colin; Landray, Martin J; Reith, Christina;

    2011-01-01

    Lowering LDL cholesterol with statin regimens reduces the risk of myocardial infarction, ischaemic stroke, and the need for coronary revascularisation in people without kidney disease, but its effects in people with moderate-to-severe kidney disease are uncertain. The SHARP trial aimed to assess...

  7. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection) : a randomised placebo-controlled trial

    NARCIS (Netherlands)

    Baigent, Colin; Landray, Martin J.; Reith, Christina; Emberson, Jonathan; Wheeler, David C.; Tomson, Charles; Wanner, Christoph; Krane, Vera; Cass, Alan; Craig, Jonathan; Neal, Bruce; Jiang, Lixin; Hooi, Lai Seong; Levin, Adeera; Agodoa, Lawrence; Gaziano, Mike; Kasiske, Bertram; Walker, Robert; Massy, Ziad A.; Feldt-Rasmussen, Bo; Krairittichai, Udom; Ophascharoensuk, Vuddidhej; Fellstrom, Bengt; Holdaas, Hallvard; Tesar, Vladimir; Wiecek, Andrzej; Grobbee, Diederick; de Zeeuw, Dick; Gronhagen-Riska, Carola; Dasgupta, Tanaji; Lewis, David; Herrington, William; Mafham, Marion; Majoni, William; Wallendszus, Karl; Grimm, Richard; Pedersen, Terje; Tobert, Jonathan; Armitage, Jane; Baxter, Alex; Bray, Christopher; Chen, Yiping; Chen, Zhengming; Hill, Michael; Knott, Carol; Parish, Sarah; Simpson, David; Sleight, Peter; Young, Alan; Collins, Rory

    2011-01-01

    Background Lowering LDL cholesterol with statin regimens reduces the risk of myocardial infarction, ischaemic stroke, and the need for coronary revascularisation in people without kidney disease, but its effects in people with moderate-to-severe kidney disease are uncertain. The SHARP trial aimed to

  8. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial

    DEFF Research Database (Denmark)

    Baigent, Colin; Landray, Martin J; Reith, Christina;

    2011-01-01

    Lowering LDL cholesterol with statin regimens reduces the risk of myocardial infarction, ischaemic stroke, and the need for coronary revascularisation in people without kidney disease, but its effects in people with moderate-to-severe kidney disease are uncertain. The SHARP trial aimed to assess ...

  9. Sex-linked differences in the course of chronic kidney disease and congestive heart failure: a study in 5/6 nephrectomized Ren-2 transgenic hypertensive rats with volume overload induced using aorto-caval fistula.

    Science.gov (United States)

    Červenka, Luděk; Škaroupková, Petra; Kompanowska-Jezierska, Elzbieta; Sadowski, Janusz

    2016-10-01

    The role of hypertension and the renin-angiotensin system (RAS) in sex-related differences in the course of chronic kidney disease (CKD) and congestive heart failure (CHF) remain unclear, especially when the two diseases are combined. In male and female Ren-2 transgenic rats (TGR), a model of hypertension with activation of endogenous RAS, CKD was induced by 5/6 renal mass reduction (5/6 NX) and CHF was elicited by volume overload achieved by creation of an aorto-caval fistula (ACF). The primary aim of the study was to examine long-term CKD- and CHF-related mortality, especially in animals with CKD and CHF combined, with particular interest in the potential sex-related differences. The follow-up period was 23 weeks after the first intervention (5/6 NX). We found, first, that TGR did not exhibit sexual dimorphism in the course of 5/6 NX-induced CKD. Second, in contrast, TGR exhibited important sex-related differences in the course of ACF-induced CHF-related mortality: intact female TGR showed higher survival rate than male TGR. This situation is reversed in the course of combined 5/6 NX-induced CKD and ACF-induced CHF-related mortality: intact female TGR exhibited poorer survival than male TGR. Third, the survival rate in animals with combined 5/6 NX-induced CKD and ACF-induced CHF was significantly worsened as compared with rat groups that were exposed to 'single organ disease'. Collectively, our present results clearly show that CKD aggravates long-term mortality of animals with CHF. In addition, TGR exhibit remarkable sexual dimorphism with respect to CKD- and CHF-related mortality, especially in animals with combined CKD and CHF.

  10. Congenital Heart Disease: Causes, Diagnosis, Symptoms, and Treatments.

    Science.gov (United States)

    Sun, RongRong; Liu, Min; Lu, Lei; Zheng, Yi; Zhang, Peiying

    2015-07-01

    The congenital heart disease includes abnormalities in heart structure that occur before birth. Such defects occur in the fetus while it is developing in the uterus during pregnancy. About 500,000 adults have congenital heart disease in USA (WebMD, Congenital heart defects medications, www.WebMD.com/heart-disease/tc/congenital-heart-defects-medications , 2014). 1 in every 100 children has defects in their heart due to genetic or chromosomal abnormalities, such as Down syndrome. The excessive alcohol consumption during pregnancy and use of medications, maternal viral infection, such as Rubella virus, measles (German), in the first trimester of pregnancy, all these are risk factors for congenital heart disease in children, and the risk increases if parent or sibling has a congenital heart defect. These are heart valves defects, atrial and ventricular septa defects, stenosis, the heart muscle abnormalities, and a hole inside wall of the heart which causes defect in blood circulation, heart failure, and eventual death. There are no particular symptoms of congenital heart disease, but shortness of breath and limited ability to do exercise, fatigue, abnormal sound of heart as heart murmur, which is diagnosed by a physician while listening to the heart beats. The echocardiogram or transesophageal echocardiogram, electrocardiogram, chest X-ray, cardiac catheterization, and MRI methods are used to detect congenital heart disease. Several medications are given depending on the severity of this disease, and catheter method and surgery are required for serious cases to repair heart valves or heart transplantation as in endocarditis. For genetic study, first DNA is extracted from blood followed by DNA sequence analysis and any defect in nucleotide sequence of DNA is determined. For congenital heart disease, genes in chromosome 1 show some defects in nucleotide sequence. In this review the causes, diagnosis, symptoms, and treatments of congenital heart disease are described.

  11. Neuropsychological functioning in chronic Lyme disease.

    Science.gov (United States)

    Westervelt, Holly James; McCaffrey, Robert J

    2002-09-01

    Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with chronic Lyme disease are generally consistent with the deficits that can be seen in processes with primarily frontal systems involvement. These observations are generally consistent with neuroradiologic findings. The clinical presentation in chronic Lyme disease and the nature of the neuropsychological deficits are discussed, as are several central issues in understanding neuropsychological functioning in chronic Lyme disease, such as the impact of chronic illness, response to treatment, and the relationship between neuropsychological performance and depression, fatigue, and neurological indicators of disease.

  12. Lung congestion in chronic heart failure: haemodynamic, clinical, and prognostic implications

    DEFF Research Database (Denmark)

    Melenovsky, Vojtech; Andersen, Mads Jønsson; Andress, Krystof

    2015-01-01

    AIMS:The goal of the study was to examine the prognostic impact, haemodynamic and clinical features associated with lung congestion in patients with chronic heart failure (HF). METHODS AND RESULTS:HF patients (n = 186) and HF-free controls (n = 21) underwent right heart catheterization...... and dysfunction and increased mortality in HF. These data reinforce the importance of aggressive decongestion in HF and suggest that novel agents aimed at reducing lung water may help to deter progression of pulmonary vascular disease and biventricular HF....

  13. Chronic Chagas disease: from basics to laboratory medicine.

    Science.gov (United States)

    Haberland, Annekathrin; Saravia, Silvia Gilka Munoz; Wallukat, Gerd; Ziebig, Reinhard; Schimke, Ingolf

    2013-02-01

    Chagas disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America and has huge potential to become a worldwide problem, due to increasing migration, and international tourism, as well as infectant transfer by blood contact and transfusion, intrauterine transfer, and organ transplantation. Nearly 30% of chronically-infected patients become symptomatic, often with a latency of 10-30 years, developing life-threatening complications. Of those, nearly 90% develop Chagas heart disease, while the others manifest gastrointestinal disease and neuronal disorders. Besides interrupting the infection cycle and chemo therapeutic infectant elimination, starting therapy early in symptomatic patients is important for counteracting the disease. This would be essentially supported by optimized patient management, involving risk assessment, early diagnosis and monitoring of the disease and its treatment. From economic and logistic viewpoints, the tools of laboratory medicine should be especially able to guarantee this. After summarizing the basics of chronic Chagas disease, such as the epidemiological data, the pathogenetic mechanisms thought to drive symptomatic Chagas disease and also treatment options, we present tools of laboratory medicine that address patient diagnosis, risk assessment for becoming symptomatic and guidance, focusing on autoantibody estimation for risk assessment and heart marker measurement for patient guidance. In addition, increases in levels of inflammation and oxidative stress markers in chronic Chagas disease are discussed.

  14. Multimodality Imaging of Heart Valve Disease

    Energy Technology Data Exchange (ETDEWEB)

    Rajani, Ronak, E-mail: Dr.R.Rajani@gmail.com [Department of Cardiology, St. Thomas’ Hospital, London (United Kingdom); Khattar, Rajdeep [Department of Cardiology, Royal Brompton Hospital, London (United Kingdom); Chiribiri, Amedeo [Divisions of Imaging Sciences, The Rayne Institute, St. Thomas' Hospital, London (United Kingdom); Victor, Kelly; Chambers, John [Department of Cardiology, St. Thomas’ Hospital, London (United Kingdom)

    2014-09-15

    Unidentified heart valve disease is associated with a significant morbidity and mortality. It has therefore become important to accurately identify, assess and monitor patients with this condition in order that appropriate and timely intervention can occur. Although echocardiography has emerged as the predominant imaging modality for this purpose, recent advances in cardiac magnetic resonance and cardiac computed tomography indicate that they may have an important contribution to make. The current review describes the assessment of regurgitant and stenotic heart valves by multimodality imaging (echocardiography, cardiac computed tomography and cardiac magnetic resonance) and discusses their relative strengths and weaknesses.

  15. Chronic Disease and Childhood Development: Kidney Disease and Transplantation.

    Science.gov (United States)

    Klein, Susan D.; Simmons, Roberta G.

    As part of a larger study of transplantation and chronic disease and the family, 124 children (10-18 years old) who were chronically ill with kidney disease (n=72) or were a year or more post-transplant (n=52) were included in a study focusing on the effects of chronic kidney disease and transplantation on children's psychosocial development. Ss…

  16. Successful outcome in a twin pregnancy with hereditary motor and sensory neuropathy type –II complicated with heart disease and preclampsia superimposed on chronic hypertension

    Directory of Open Access Journals (Sweden)

    Debasmita Mondal

    2008-06-01

    Full Text Available Heridetary motor and sensory neuropathy (HMSN TYPE-2 reflects reduction in the number of primary motor and sensory neurons. The occurrence of this disease is rare in pregnancy but may be exaggerated in pregnancy leading to preeclampsia / eclampsia. Here is a 28 years old 2nd gravidae with twin pregnancy at 31 weeks hospitalized with HMSN TYPE-2 disease and was managed successfully with good feto maternal outcome

  17. HIV and chronic kidney disease.

    Science.gov (United States)

    Naicker, Saraladevi; Rahmanian, Sadaf; Kopp, Jeffrey B

    2015-01-01

    Chronic kidney disease (CKD) is a frequent complication of HIV infection, occurring in 3.5 - 48.5%, and occurs as a complication of HIV infection, other co-morbid disease and infections and as a consequence of therapy of HIV infection and its complications. The classic involvement of the kidney by HIV infection is HIV-associated nephropathy (HIVAN), occurring typically in young adults of African ancestry with advanced HIV disease in association with APOL1 high-risk variants. HIV-immune complex disease is the second most common diagnosis obtained from biopsies of patients with HIV-CKD. CKD is mediated by factors related to the virus, host genetic predisposition and environmental factors. The host response to HIV infection may influence disease phenotype through activation of cytokine pathways. With the introduction of antiretroviral therapy (ART), there has been a decline in the incidence of HIVAN, with an increasing prevalence of focal segmental glomerulosclerosis. Several studies have demonstrated the overall improvement in kidney function when initiating ART for HIV CKD. Progression to end stage kidney disease has been reported to be more likely when high grade proteinuria, severely reduced eGFR, hepatitis B and/C co-infection, diabetes mellitus, extensive glomerulosclerosis, and chronic interstitial fibrosis are present. Improved renal survival is associated with use of renin angiotensin system blockers and viral suppression. Many antiretroviral medications are partially or completely eliminated by the kidney and require dose adjustment in CKD. Certain drug classes, such as the protease inhibitors and the non-nucleoside reverse transcriptase inhibitors, are metabolized by the liver and do not require dose adjustment. HIV-infected patients requiring either hemo- or peritoneal dialysis, who are stable on ART, are achieving survival rates comparable to those of dialysis patients without HIV infection. Kidney transplantation has been performed successfully in HIV

  18. Pharmacogenomics of hypertension and heart disease.

    Science.gov (United States)

    Arwood, Meghan J; Cavallari, Larisa H; Duarte, Julio D

    2015-09-01

    Heart disease is a leading cause of death in the United States, and hypertension is a predominant risk factor. Thus, effective blood pressure control is important to prevent adverse sequelae of hypertension, including heart failure, coronary artery disease, atrial fibrillation, and ischemic stroke. Over half of Americans have uncontrolled blood pressure, which may in part be explained by interpatient variability in drug response secondary to genetic polymorphism. As such, pharmacogenetic testing may be a supplementary tool to guide treatment. This review highlights the pharmacogenetics of antihypertensive response and response to drugs that treat adverse hypertension-related sequelae, particularly coronary artery disease and atrial fibrillation. While pharmacogenetic evidence may be more robust for the latter with respect to clinical implementation, there is increasing evidence of genetic variants that may help predict antihypertensive response. However, additional research and validation are needed before clinical implementation guidelines for antihypertensive therapy can become a reality.

  19. Prevalence, predictors, and survival in pulmonary hypertension related to end-stage chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Andersen, Kasper Hasseriis; Iversen, Martin; Kjaergaard, Jesper;

    2012-01-01

    The prevalence, prognostic importance, and factors that predict the presence and degree of pulmonary hypertension (PH) diagnosed with right heart catheterization (RHC) in patients with end-stage chronic obstructive pulmonary disease (COPD) remain unclear.......The prevalence, prognostic importance, and factors that predict the presence and degree of pulmonary hypertension (PH) diagnosed with right heart catheterization (RHC) in patients with end-stage chronic obstructive pulmonary disease (COPD) remain unclear....

  20. Rheumatic fever and rheumatic heart disease in Bangladesh: A review.

    Science.gov (United States)

    Islam, A K M Monwarul; Majumder, A A S

    2016-01-01

    Rheumatic fever (RF) and rheumatic heart disease (RHD) are the most-common cardiovascular disease in young people aged <25 years, globally. They are important contributors to cardiovascular morbidity and mortality in Bangladesh. Classical risk factors, i.e. poverty, overcrowding, ignorance, and insufficient health care services were responsible for the high incidence and prevalence of these diseases over the last century. In concert with the progresses in socioeconomic indicators, advances in health sectors, improved public awareness, and antibiotic prophylaxis, acute RF came into control. However, chronic RHD continues to be prevalent, and the actual disease burden may be much higher. RHD predominantly affects the young adults, seriously incapacitates them, follows a protracted course, gets complicated because of delayed diagnosis and is sometimes maltreated. The treatment is often palliative and expensive. Large-scale epidemiological and clinical researches are needed to formulate evidence-based national policy to tackle this important public health issue in future.

  1. Women's Heart Disease: Cindy Parsons and Follow the Fifty

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Cindy Parsons and Follow the Fifty Past Issues / ... Program, knowing that her personal risk factors for heart disease, including family history, were high. She watched her ...

  2. Higher Risk of Heart Disease for Blacks in Poorer Neighborhoods

    Science.gov (United States)

    ... gov/news/fullstory_163099.html Higher Risk of Heart Disease for Blacks in Poorer Neighborhoods Preventive measures must ... in poor neighborhoods are at higher risk for heart disease and stroke than those who live in wealthier ...

  3. Phase-contrast MRI and applications in congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Goldberg, A., E-mail: adgoldberg@geisinger.edu [Department of Radiology, Geisinger Health System, Danville, PA (United States); Jha, S. [Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States)

    2012-05-15

    A review of phase-contrast magnetic resonance imaging techniques, with specific application to congenital heart disease, is presented. Theory, pitfalls, advantages, and specific examples of multiple, well-described congenital heart disease presentations are discussed.

  4. New Directions in Chronic Disease Management

    Directory of Open Access Journals (Sweden)

    Hun-Sung Kim

    2015-06-01

    Full Text Available A worldwide epidemic of chronic disease, and complications thereof, is underway, with no sign of abatement. Healthcare costs have increased tremendously, principally because of the need to treat chronic complications of non-communicable diseases including cardiovascular disease, blindness, end-stage renal disease, and amputation of extremities. Current healthcare systems fail to provide an appropriate quality of care to prevent the development of chronic complications without additional healthcare costs. A new paradigm for prevention and treatment of chronic disease and the complications thereof is urgently required. Several clinical studies have clearly shown that frequent communication between physicians and patients, based on electronic data transmission from medical devices, greatly assists in the management of chronic disease. However, for various reasons, these advantages have not translated effectively into real clinical practice. In the present review, we describe current relevant studies, and trends in the use of information technology for chronic disease management. We also discuss limitations and future directions.

  5. Metformin in chronic kidney disease

    DEFF Research Database (Denmark)

    Heaf, James

    2014-01-01

    reduction, including weight loss, which are beneficial to patients. The risk of death and cardiovascular disease is reduced by about a third in non-CKD patients. Since metformin intoxication undoubtedly causes LA, and metformin is renally excreted, inappropriate dosage of metformin will increase the risk......Metformin has traditionally been regarded as contraindicated in chronic kidney disease (CKD), though guidelines in recent years have been relaxed to permit therapy if the glomerular filtration rate (GFR) is > 30 mL/min. The main problem is the perceived risk of lactic acidosis (LA). Epidemiological...... of LA. It is suggested that introduction of metformin therapy to more advanced stages of CKD may bring therapeutic benefits that outweigh the possible risks....

  6. The educational gradient in coronary heart disease

    DEFF Research Database (Denmark)

    Ariansen, Inger; Mortensen, Laust Hvas; Igland, Jannicke

    2015-01-01

    BACKGROUND: Independently of cardiovascular disease (CVD) risk factors, cognitive ability may account for some of the excess risk of coronary heart disease (CHD) associated with lower education. We aimed to assess how late adolescence cognitive ability and midlife CVD risk factors are associated...... with the educational gradient in CHD in Norway. METHODS: In a cohort of 57 279 men born during 1949-1959, health survey information was linked to military conscription records of cognitive ability, to national educational data, to hospitalisation records from the Cardiovascular Disease in Norway (CVDNOR) project...

  7. Anemia of Chronic Liver Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hyun Chung; Lee, Jhung Sang; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1971-09-15

    The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseases were studied by various methods. Only patients without previous blood loss were included : 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and T{sub 50} Cr. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

  8. Coronary artery disease in patients with chronic kidney disease: a brief literature review

    Directory of Open Access Journals (Sweden)

    Mostafa Dastani

    2015-09-01

    Full Text Available Cardiovascular is the major cause of death in chronic kidney disease and end-stage renal disease. The cardiovascular mortality rate of patients with renal impairment is evaluated to be higher than general population. Coronary artery disease seems to be an important type of cardiovascular complication among patients with chronic kidney disease and end-stage renal disease before the renal replacement therapy. Due to the strong association between chronic kidney disease and the incidence of coronary artery disease, accurate screening, diagnosis, and management of cardiovascular complications would be essential in patients at different stages of renal dysfunction. Despite the need for the comprehensive knowledge about different aspects of coronary artery disease in patients with renal failure, there is not sufficient evidence regarding the pathophysiology, ideal diagnosis, and treatment strategies for coronary heart disease in population with chronic kidney disease. In this study, we briefly reviewed the existing literatures about the possible screening, diagnosis, and the treatment approaches of risk of coronary heart disease in patients with kidney dysfunction.

  9. Radiation-associated valvular heart disease.

    Science.gov (United States)

    Ong, Daniel S; Aertker, Robert A; Clark, Alexandra N; Kiefer, Todd; Hughes, G Chad; Harrison, J Kevin; Bashore, Thomas M

    2013-11-01

    Therapeutic ionizing radiation, such as that used in the treatment of Hodgkin's lymphoma, can cause cardiac valvular damage that may take several years to manifest as radiation-associated valvular heart disease. Treatment can be complicated by comorbid radiation injury to other cardiac and mediastinal structures that lead to traditional surgical valve replacement or repair becoming high-risk. A representative case is presented that demonstrates the complexity of radiation-associated valvular heart disease and its successful treatment with percutaneous transcatheter valve replacement. The prevalence and pathophysiologic mechanism of radiation-associated valvular injury are reviewed. Anthracycline adjuvant therapy appears to increase the risk of valvular fibrosis. Left-sided heart valves are more commonly affected than right-sided heart valves. A particular pattern of calcification has been noted in some patients, and experimental data suggest that radiation induction of an osteogenic phenotype may be responsible. A renewed appreciation of the cardiac valvular effects of therapeutic ionizing radiation for mediastinal malignancies is important, and the treatment of such patients may be assisted by the development of novel, less-invasive approaches.

  10. Psychological Perspectives on the Development of Coronary Heart Disease

    Science.gov (United States)

    Matthews, Karen A.

    2005-01-01

    Psychological science has new opportunities to have major input into the understanding of the development of coronary heart disease. This article provides an overview of advances in understanding the etiology of heart disease, recently applied technologies for measuring early stages of heart disease, and an accumulating base of evidence on the…

  11. Hypertrophic osteoarthropathy of chronic inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Oppenheimer, D.A.; Jones, H.H.

    1982-12-01

    The case of a 14-year old girl with painful periostitis and ulcerative colitis is reported. The association of chronic inflammatory bowel disease with osteoarthropathy is rare and has previously been reported in eight patients. The periosteal reaction found in association with inflammatory bowel disease is apparently related to a chronic disease course and may cause extreme localized pain.

  12. Cell therapy for heart disease after 15 years: Unmet expectations.

    Science.gov (United States)

    Nigro, Patrizia; Bassetti, Beatrice; Cavallotti, Laura; Catto, Valentina; Carbucicchio, Corrado; Pompilio, Giulio

    2017-02-21

    Over the past two decades cardiac cell therapy (CCT) has emerged as a promising new strategy to cure heart diseases at high unmet need. Thousands of patients have entered clinical trials for acute or chronic heart conditions testing different cell types, including autologous or allogeneic bone marrow (BM)-derived mononuclear or selected cells, BM- or adipose tissue-derived mesenchymal cells, or cardiac resident progenitors based on their potential ability to regenerate scarred or dysfunctional myocardium. Nowadays, the original enthusiasm surrounding the regenerative medicine field has been cushioned by a cumulative body of evidence indicating an inefficient or modest efficacy of CCT in improving cardiac function, along with the continued lack of indisputable proof for long-term prognostic benefit. In this review, we have firstly comprehensively outlined the positive and negative results of cell therapy studies in patients with acute myocardial infarction, refractory angina and chronic heart failure. Next, we have discussed cell therapy- and patient-related variables (e.g. cell intrinsic and extrinsic characteristics as well as criteria of patient selection and proposed methodologies) that might have dampened the efficacy of past cell therapy trials. Finally, we have addressed critical factors to be considered before embarking on further clinical trials.

  13. Trends in Mortality from Ischemic Heart Disease, Stroke, and Stomach Cancer: from past to future

    NARCIS (Netherlands)

    M. Amiri (Masoud)

    2010-01-01

    textabstractThe common occurrence of chronic diseases – such as ischemic heart diseases (IHD, stroke, and stomach cancer in most populations and the attendant mortality, loss of independence, impaired quality of life, and social and economic costs are compelling reasons for public health concern. A

  14. Novel Risk Factors for Type II Diabetes Mellitus and Coronary Heart Disease

    NARCIS (Netherlands)

    A. Dehghan (Abbas)

    2010-01-01

    textabstractDespite the huge advances made in the understanding of type II diabetes and coronary heart disease (CHD), these diseases still constitute a major health problem. Since the 1950s, epidemiologists focused on chronic disorders, including type II diabetes and CHD. Major aims of their researc

  15. Identification of a shared genetic susceptibility locus for coronary heart disease and periodontitis

    NARCIS (Netherlands)

    Schaefer, A.S.; Richter, G.M.; Groessner-Schreiber, B.; Noack, D.; Nothnagel, M.; El Mokhtari, N.E.; Loos, B.G.; Jepsen, S.; Schreiber, S.

    2009-01-01

    Recent studies indicate a mutual epidemiological relationship between coronary heart disease (CHD) and periodontitis. Both diseases are associated with similar risk factors and are characterized by a chronic inflammatory process. In a candidate-gene association study, we identify an association of a

  16. Vitamin D deficiency and heart disease

    NARCIS (Netherlands)

    Pilz, Stefan; Tomaschitz, Andreas; Drechsler, Christiane; de Boer, Rudolf A.

    2011-01-01

    Vitamin D deficiency is present in the vast majority of patients with chronic kidney disease (CKD), and correcting a poor vitamin D status is recommended as a treatment of CKD-mineral and bone disorders. In this review, we summarize the molecular and clinical data on the role of vitamin D status for

  17. 10.7.Congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930270 Clinical analysis of rupture of aorticsinus aneurysm in 30 cases.ZHANG Yuwei (张玉威),et al.Instit Cardiovasc Dis,Dept Med,Shenyang Milit General Hosp,PLA.Chin Cir J1993;8(1):30—31.Rupture of aortic sinus aneurysm is a rarecongenital heart disease.It is sometimes misdi-agnosed and treated because of no typical symp-toms and signs.30 cases with rupture of a-neurysm of aortic sinus were studied.Clinicaldata suggested that the disease could be firstlynoticed when the healthy male aged 20~40years developed suddenly chest pain or extreme-ly uncomfortable feeling with gradually increas-ing heart dysfunction low—frequency harsh andsuperficial continuous precordial murmurs.Chest X-ray exhibited enlargement of heartand asymmetry of pulmonary plethora.ECG

  18. When a Heart Murmur Signals Valve Disease

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  19. Panorama epidemiológico y clínico de la cardiopatía chagásica crónica en México Epidemiological and clinical outlook of chronic Chagas' heart disease in Mexico

    Directory of Open Access Journals (Sweden)

    Justo Sierra-Johnson

    2005-10-01

    Full Text Available OBJECTIVO: Comparar las características epidemiológicas y clínicas de la cardiopatía chagásica crónica con otras miocardiopatías dilatadas. MÉTODOS: Se incluyeron a 128 pacientes consecutivos en un hospital de espcialidad, de 1993 a 2003 con miocardiopatías dilatadas, donde 51 (40% con anti Tripanosoma cruzi. Se recopiló información epidemiológica por entrevista directa, y datos clínicos en los servicios asistenciales. Se utilizaron la prueba de la Chi-cuadrado o prueba exacta de Fischer, prueba t de Student ó la prueba de U de Mann Whitney y análisis multivariado. RESULTADOS: Los pacientes con cardiopatía chagásica crónica, eran más viejos (55±10 años que los pacientes con miocardiopatías (42±17 años, nacieron en zonas rurales (90% vs 68%, en viviendas precarias (75% vs 16%, con hacinamiento (45% vs 20%, convivencia con animales domésticos (71% vs 61% y conocían al vector (73% vs 25%. Los trastornos del ritmo y de la conducción, así como la colocación de marcapaso definitivo fueron frecuentes en los pacientes con cardiopatía chagásica crónica (84% vs 55%, 78% vs 64% Y 24% vs 10% respectivamente. La insuficiencia cardiaca congestiva venosa fue más frecuente en los pacientes con miocardiopatía seronegativa (88% vs 71% y la perfusión miocárdic anormal con arterias epicárdicas normales fue igual en ambos grupos. Con respecto a co-morbilidad, los pacientes con cardiopatía chagásica crónica tenían sólo dos padecimientos, mientras que en el otro grupo era más amplia. CONCLUSIÓNES: La enfermedad de Chagas causa la miocardiopatía dilatada específica más común. Debido a su distribución regional en la República Mexicana, merece atención y se recomienda a nivel público adoptar medidas de prevención que ya probaron eficacia en otros países.OBJECTIVE: To compare the epidemiological and clinical characteristics of chronic Chagas' heart disease to other dilated cardiomyopathies. METHODS: A study comprising

  20. Current treatment in chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    李嘉惠

    2008-01-01

    Chronic obstructive pulmonary disease (COPD) is defined by fixed airflow limitation associated with an abnormal pulmonary and systemic inflammatory response of the lungs to cigarette smoke. COPD represents an increasing burden worldwide, reported to be the sixth leading cause of death in 1990 and the fourth in 2000. Discouragingly, it is projected to jump to third place by the year 2020.There is increasing evidence that COPD is a more complex systemic disease than an airway and lung disease. In particular, cachexia, skeletal muscle abnormalities, diabetes, coronary artery disease, heart failure, cancer and pulmonary vascular disease are the most common comorbidities. It is associated with a wide variety of systemic consequences, most notably systemic inflammation. Because COPD patients have in general ahigher cardiovascular risk than the average population, cardiovascular safety in a COPD medication is of critical importance.SINGH et al performed a systematic review and recta-analysis of 17 clinical trials enrolling 14 783 patients treated with inhaled anticholinergic drugs used for the treatment of COPD. Inhaled anticholinergics significantly increased the risk of cardiovascular death, MI, or stroke ( 1.8 % vs 1.2 % for control; RR, 1.58 (95 % CI,1.21 - 2.06); P < 0.001 ). However, UPLIIFT (Understanding the Potential Long-Term Impacts on Function with Tiotropium) , a large, 4-year, placebo controlled clinical trial with tiotropium in approximately 6 000 patients with COPD. The preliminary results of UPLIFT showed that there was no increased risk of stroke with tiotropium bromide compared to placebo.A meta-analysis is always considered less convincing than a large prospective trial designed to assess the outcome of interest. However, COPD is a systemic disease. COPD management needs to focus on four major areas: smoking cessation, pharmacologic therapy, exercise training, and pulmonary rehabilitation. Clinicians and patients should always carefully consider any

  1. Challenges for heart disease stem cell therapy

    Directory of Open Access Journals (Sweden)

    Hoover-Plow J

    2012-02-01

    Full Text Available Jane Hoover-Plow, Yanqing GongDepartments of Cardiovascular Medicine and Molecular Cardiology, Joseph J Jacobs Center for Thrombosis and Vascular Biology, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USAAbstract: Cardiovascular diseases (CVDs are the leading cause of death worldwide. The use of stem cells to improve recovery of the injured heart after myocardial infarction (MI is an important emerging therapeutic strategy. However, recent reviews of clinical trials of stem cell therapy for MI and ischemic heart disease recovery report that less than half of the trials found only small improvements in cardiac function. In clinical trials, bone marrow, peripheral blood, or umbilical cord blood cells were used as the source of stem cells delivered by intracoronary infusion. Some trials administered only a stem cell mobilizing agent that recruits endogenous sources of stem cells. Important challenges to improve the effectiveness of stem cell therapy for CVD include: (1 improved identification, recruitment, and expansion of autologous stem cells; (2 identification of mobilizing and homing agents that increase recruitment; and (3 development of strategies to improve stem cell survival and engraftment of both endogenous and exogenous sources of stem cells. This review is an overview of stem cell therapy for CVD and discusses the challenges these three areas present for maximum optimization of the efficacy of stem cell therapy for heart disease, and new strategies in progress.Keywords: mobilization, expansion, homing, survival, engraftment

  2. 酚妥拉明与多巴酚丁胺治疗慢性肺心病重度心衰的疗效观察%The observation of the curative offects on 26cases about treating the acute tert failure of the chronic pulmonary heart disease with Phentolamine and Dobutamine

    Institute of Scientific and Technical Information of China (English)

    张福财

    2001-01-01

    Objectives To study the curative effects about treating the acute heart failure of the chronic pulmonary heart disease with Phentolamine and Dobutamine.Methods Based on the integrated treatment,the treatment of the 26 patients who suffered from the acute heart failure of the chronic pulmonary heart disease was co-operatively dealt with by Phentolamine and Dobutamine.Results  After the curative courses enden,the total rate of the effect of the treatment group was 92.1%,while that of the control group was 67.0%.There was a very obvious significance(P<0.01).The former have some obvious effect on Grade IV heart function,significantly shorten the time of improving the heart function(P<0.05),resist the irregularity in the rhythem of the heart's beating and also stabilize the blood pressure and the heart rate(P>0.05).Conclusions Phentolamine and dobutamine are the safe and effective medicines which can be used to treat the acute heart failure of the chronic pulmonary heart disease with very good curative effects and without any side effects.%目的探讨酚妥拉明与多巴酚丁胺在肺心病重度心衰中的疗效。方法对26例肺心病重度心衰患者在综合治疗的基础上,应用酚妥拉明与多巴酚丁胺进行联合治疗。结果疗程结束后,治疗组总有效率为92.1%,对照组为67.0%,两组疗效有非常显著性差异(P<0.01)。前者对心功能Ⅳ级有显著疗效,心功能改善时间显著缩短(P<0.05),且有抗心律失常作用,对血压、心率有稳定(P>0.05)作用。结论酚妥拉明与多巴酚丁胺是治疗肺心病重度心衰安全有效的药物,疗效高,副作用少。

  3. Pulpal inflammation and incidence of coronary heart disease.

    Science.gov (United States)

    Joshipura, Kaumudi J; Pitiphat, Waranuch; Hung, Hsin-Chia; Willett, Walter C; Colditz, Graham A; Douglass, Chester W

    2006-02-01

    Pulpal inflammation is primarily caused by coronal caries, and leads to root canal therapy (RCT). Chronic inflammation has been associated with various cardiovascular diseases. This study evaluates the association between pulpal inflammation (using RCT as a surrogate) and incident coronary heart disease (CHD). We report results among males from the Health Professionals Follow-Up Study (HPFS), excluding participants with prior cardiovascular disease or diabetes. We obtained RCT data from the HPFS cohort (n = 34,683). Compared to men without RCT, those with >/=1 RCT had a multivariate RR of 1.21 (95% CI 1.05-1.40) for CHD. The association was limited to dentists (RR = 1.38; 95% CI 1.14-1.67). There was no association among nondentists (RR = 1.03). Dental caries was not associated with CHD. The results suggest a possible modest association between pulpal inflammation and CHD.

  4. PREGNANCY WITH HEART DISEASE - FETOMATERNAL OUTCOMEME

    Directory of Open Access Journals (Sweden)

    Mainak

    2014-01-01

    Full Text Available OBJECTIVES: To evaluate the maternal and fetal outcome of pregnancies complicated by cardiac disease in a developing country. METHODS: A prospective analysis was carried out of 40 pregnancies in women with cardiac disease who delivered at 28 weeks of gestation and beyond from June 2009 to May 2010 at a tertiary care center in the eastern part of India. RESULTS: Rheumatic heart disease (n=28 , 70% with isolated mitral stenosis (n=21 was the predominant cardiac problem. Septal defects were the most common form of congenital heart disease (n=10. In 28 (13.52% women , the diagnosis of cardiac disease was made during pregnancy. Patients in NYHA class I/II (n=29 , 72.5% had fewer maternal complications and their babies had a higher birth weight than those in NYHA class III/IV (n=11 , 27.5%. Cardiac complications were noted in 27 (67.5% patients. Commonest complication developing during pregnancy , labor and puerperium was congestive cardiac failure (n=14 , 35%. Maternal mortality was noted in 3 patients (7.5% , 2 of which were due to cardiac failure and pulmonary edema . Six patients (15% delivered preterm and thirteen patients (32.5% had low birth weight babies . There were three neonatal deaths and one stillborn. CONCLUSIONS: Rheumatic heart disease was the predominant type. Patients in NYHA class I /II had a better maternal and fetal outcome than those in NYHA class III/IV. Surgically treated women tolerate pregnancy well. Vaginal delivery was safer and caesarean section should be reserved only for obstetric indications. Maternal and perinatal outcom e can be improved by team approach at tertiary care center .

  5. Atrial fibrillation, ischaemic heart disease, and the risk of death in patients with heart failure

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Søndergaard, Peter; Nielsen, Tonny;

    2006-01-01

    AIMS: Atrial fibrillation (AF) is a risk factor for death in patients with a myocardial infarction, but highly variable results are reported in patients with heart failure. We studied the prognostic impact of AF in heart failure patients with and without ischaemic heart disease. METHODS AND RESULTS......), 1.02-1.23, P=0.018]. There was a significant interaction between the importance of AF and the presence of ischaemic heart disease (P=0.034). In patients with AF at the time of discharge and ischaemic heart disease, HR was 1.25 (95% CI: 1.09-1.42) and P... and without ischaemic heart disease, HR was 1.01 (95% CI: 0.88-1.16) and P=0.88. CONCLUSION: AF is associated with increased risk of death only in patients with ischaemic heart disease. This finding may explain the variable results of studies of the prognosis associated with AF in heart failure....

  6. Chronic Kidney Disease and Endothelium

    Directory of Open Access Journals (Sweden)

    Damir Rebić

    2015-07-01

    Full Text Available The endothelial cell layer is responsible for molecular traffic between the blood and surrounding tissue, and endothelial integrity plays a pivotal role in many aspects of vascular function. Cardiovascular disease (CVD is the main cause of death in patients with chronic kidney disease (CKD and its incidence and severity increase in direct proportion with kidney function decline. Non-traditional risk factors for CVDs, including endothelial dysfunction (ED, are highly prevalent in this population and play an important role in cardiovascular (CV events. ED is the first step in the development of atherosclerosis and its severity has prognostic value for CV events. Several risk markers have been associated with ED. Reduced bioavailability of nitric oxide plays a central role, linking kidney disease to ED, atherosclerosis, and CV events. Inflammation, loss of residual renal function, and insulin resistance are closely related to ED in CKD. ED may be followed by structural damage and remodelling that can precipitate both bleeding and thrombotic events. The endothelium plays a main role in vascular tone and metabolic pathways. ED is the first, yet potentially reversible step in the development of atherosclerosis and its severity has prognostic value for CV events.

  7. Myeloperoxidase in chronic kidney disease.

    Science.gov (United States)

    Madhusudhana Rao, A; Anand, Usha; Anand, C V

    2011-01-01

    Numerous lines of evidence implicate a role of myeloperoxidase (MPO) in the pathogenesis of cardiovascular disease (CVD). It is a well accepted fact that patients with chronic kidney disease (CKD) are at an increased risk for CVD. MPO is a pro-oxidant enzyme which could be involved in the increased susceptibility of these patients to CVD. Hence, the levels of plasma MPO was determined in healthy controls as well as in patients with CKD [stratified with the level of their kidney failure as CKD stages II-V (end stage renal disease)]. Plasma MPO was assayed by a spectrophotometric method. Serum urea and creatinine were estimated on a clinical chemistry analyzer using standard laboratory procedures. The mean plasma MPO levels were significantly lower with advancing stages of renal failure (P < 0.001). There was a positive correlation between MPO and GFR (r = +0.89, P < 0.001) and a negative correlation with urea (r = -0.85, P < 0.001) and creatinine (r = -0.82, P < 0.001). While an inverse association was observed between plasma MPO and urea in CKD patients, such an association was not observed in control subjects (P = 0.43). In conclusion, the decline in plasma MPO levels may be due to the inhibitory effect of uraemic toxins on the enzyme.

  8. Involvement of the autonomic nervous system in Chagas heart disease

    Directory of Open Access Journals (Sweden)

    Edison Reis Lopes

    1983-12-01

    Full Text Available The autonomic nervous system and especially the intracardiac autonomic nervous system is involved in Chagas' disease. Ganglionitis and periganglionitis were noted in three groups ofpatients dying with Chagas'disease: 1 Those in heart failure; 2 Those dying a sudden, non violent death and; 3 Those dying as a consequence ofaccidents or homicide. Hearts in the threegroups also revealed myocarditis and scattered involvement of intramyocardial ganglion cells as well as lesions of myelinic and unmyelinic fibers ascribable to Chagas'disease. In mice with experimentally induced Chagas' disease weobserved more intensive neuronal lesions of the cardiac ganglia in the acute phase of infection. Perhaps neuronal loss has a role in the pathogenesis of Chagas cardiomyopathy. However based on our own experience and on other data from the literature we conclude that the loss of neurones is not the main factor responsible for the manifestations exhibited by chronic chagasic patients. On the other hand the neuronal lesions may have played a role in the sudden death ofone group of patients with Chagas'disease but is difficult to explain the group of patients who did not die sudderly but instead progressed to cardiac failure.

  9. Heart Truth for Women: If You Have Heart Disease

    Science.gov (United States)

    ... of physical activity • Unhealthy diet • Diabetes and prediabetes • Metabolic syndrome Other conditions and factors also may contribute to ... The Heart Truth is a way of informing women about what they can do to prevent heart ...

  10. Blood Transfusion Therapy in Patients with Heart Disease.

    Science.gov (United States)

    1982-04-07

    good health will not require the same transfusion therapy as patients with valvular heart disease who have congestive heart failure and...normal red cell volume and normal red cell oxygen transport function. 1 ,13 When the patient has valvular heart disease or myo- cardiopathy with...cardio- pulmonary bypass patients and in patients with severe valvular heart disease . Blood 1978;52:13-23. : 81. 197. Frledenberg WR, Myers WO, Plotka

  11. 长期慢性咽炎与无症状风湿活动导致风湿性心脏瓣膜病的20年随访研究%A 20-year follow-up study on the correlation between long-term chronic pharyngitis and rheumatic heart vavular disease caused by latent chronic rheumatic activity

    Institute of Scientific and Technical Information of China (English)

    董果雄; 张社华; 李进; 李雪萍; 张泉三; 张宪明; 陈厚侠; 朱震

    2010-01-01

    Objective To observe the correlation between long-term chronic pharyngitis and rheumatic heart vavular disease (RHD) caused by to long-term latent chronic rheumatic activity and to understand the progressive course of rheumatic heart vavular disease. Methods In 1126 cases with chronic pharyngitis, 319 cases with serum antistreptolysin O (ASO) level between 400-500 U/ml were followed-up. ASO, creatine kinase enzyme MB (CK-MB) and echocardiography were measured for follow-up since 1986. Of the 319 cases, 158 were male and 161 were female with the average age of 29.4 years old. By the end of 2009, 6 cases were lost during follow up, data of 313 cases including 155 male patients and 158 female patients whose average age was 49.6 were analyzed. As the number of every kind of rheumatic heart vavular lesion was so fewer for statistical analysis that the data were only listed in tables. The student's t test was performed to compare of the ASO, CK-MB between the group with vavular lesionss and the group without vavular lesion. Results ①Of the 313 cases, 9 cases suffered from rheumatic fever at the fourth year since 1986, and 29 cases had rheumatic fever 1, 2 or 3 years after the ASOs decreased to lower than 400 U/ml and no one developed heart valvular lesion.②Two hundred and seventy-five cases whose ASO in the range of 400-500 U/ml but with normal CK-MB were found by the end of 5, 10, 15, 20 years, 9, 42, 65, 78 cases had developed heart vavular diseases respectively. ③ The levels of CK-MB in the heart valvular disease groups were significantly higher than those in the non-vavular disease group, while the levels of ASO were not. Conclusion Some of the cases suffering from long-term chronic pharyngitis can have high levels of ASO, but with normal CK-MB. These patients may have latent long-term chronic rheumatic activity and develop rheumatic heart valvular disease years later.%目的 探讨长期慢性咽炎与无症状风湿活动引起风湿性心脏病的关系,了

  12. Kidneys in chronic liver diseases

    Institute of Scientific and Technical Information of China (English)

    Marek Hartleb; Krzysztof Gutkowski

    2012-01-01

    Acute kidney injury (AKI),defined as an abrupt increase in the serum creatinine level by at least 0.3 mg/dL,occurs in about 20% of patients hospitalized for decompensating liver cirrhosis.Patients with cirrhosis are susceptible to developing AKI because of the progressive vasodilatory state,reduced effective blood volume and stimulation of vasoconstrictor hormones.The most common causes of AKI in cirrhosis are pre-renal azotemia,hepatorenal syndrome and acute tubular necrosis.Differential diagnosis is based on analysis of circumstances of AKI development,natriuresis,urine osmolality,response to withdrawal of diuretics and volume repletion,and rarely on renal biopsy.Chronic glomeruIonephritis and obstructive uropathy are rare causes of azotemia in cirrhotic patients.AKI is one of the last events in the natural history of chronic liver disease,therefore,such patients should have an expedited referral for liver transplantation.Hepatorenal syndrome (HRS) is initiated by progressive portal hypertension,and may be prematurely triggered by bacterial infections,nonbacterial systemic inflammatory reactions,excessive diuresis,gastrointestinal hemorrhage,diarrhea or nephrotoxic agents.Each type of renal disease has a specific treatment approach ranging from repletion of the vascular system to renal replacement therapy.The treatment of choice in type 1 hepatorenal syndrome is a combination of vasoconstrictor with albumin infusion,which is effective in about 50% of patients.The second-line treatment of HRS involves a transjugular intrahepatic portosystemic shunt,renal vasoprotection or systems of artificial liver support.

  13. Prevalence and burden of comorbidities in Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Corlateanu, Alexandru; Covantev, Serghei; Mathioudakis, Alexander G; Botnaru, Victor; Siafakas, Nikolaos

    2016-11-01

    The classical definition of Chronic Obstructive Pulmonary Disease (COPD) as a lung condition characterized by irreversible airway obstruction is outdated. The systemic involvement in patients with COPD, as well as the interactions between COPD and its comorbidities, justify the description of chronic systemic inflammatory syndrome. The pathogenesis of COPD is closely linked with aging, as well as with cardiovascular, endocrine, musculoskeletal, renal, and gastrointestinal pathologies, decreasing the quality of life of patients with COPD and, furthermore, complicating the management of the disease. The most frequently described comorbidities include skeletal muscle wasting, cachexia (loss of fat-free mass), lung cancer (small cell or non-small cell), pulmonary hypertension, ischemic heart disease, hyperlipidemia, congestive heart failure, normocytic anemia, diabetes, metabolic syndrome, osteoporosis, obstructive sleep apnea, depression, and arthritis. These complex interactions are based on chronic low-grade systemic inflammation, chronic hypoxia, and multiple common predisposing factors, and are currently under intense research. This review article is an overview of the comorbidities of COPD, as well as their interaction and influence on mutual disease progression, prognosis, and quality of life.

  14. The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pedersen, Susanne S.; Widdershoven, Jos W;

    2005-01-01

    Chronic heart failure (CHF) is a serious condition that is associated with impaired health status and a high prevalence of depressive symptoms. To date, little is known about the determinants of health status and depressive symptoms in CHF. Therefore, the aim of this study was to assess whether T...... Type D personality is associated with impaired health status and increased depressive symptoms in heart failure patients, independent of disease characteristics....

  15. Investigation of the Related Factors and Clinical Diagnosis and Treatment Methods of Elderly Patients with Chronic Pulmonary Heart Disease with Heart Failure%老年慢性肺源性心脏病心力衰竭的相关因素及临床诊治方法探讨

    Institute of Scientific and Technical Information of China (English)

    杨海忠

    2015-01-01

    目的:探讨老年慢性肺源性心脏病心力衰竭的相关因素及临床诊治方法。方法:采用回顾性方法,选取2012年9月-2014年10月本院收治的124例老年慢性肺源性心脏病心力衰竭患者作为观察组,同时选择同期124例老年慢性肺源性心脏病的患者作为对照组,比较分析两组患者的临床资料。结果:通过单因素分析发现,有不良嗜好、年龄≥80岁、体重指数>25、病程≥10年、有冠心病、雾霾影响较重等情况的观察组患者发病率均明显高于对照组,差异均有统计学意义(P25、有烟酒等不良嗜好、病程≥10年为老年慢性肺源性心脏病心力衰竭的独立危险因素(P25,course of disease≥10 years,with coronary heart disease and heavy effects of haze were significantly higher than the control group,the differences were statistically significant(P25,with bad habits such as alcohol and tobacco,course of disease≥10 years were independent risk factors of elderly patients with chronic pulmonary heart disease with heart failure (P<0.05).After a series of treatment,in 124 cases,116 patients were cured and 7 patients transfered to another hospital, 1 patient gave up treatment.Conclusion:According to the risk factors and patients’ individual condition,the comprehensive treatment can effectively reduce the incidence of heart failure and improve treatment.

  16. Heart disease link to fetal hypoxia and oxidative stress.

    Science.gov (United States)

    Giussani, Dino A; Niu, Youguo; Herrera, Emilio A; Richter, Hans G; Camm, Emily J; Thakor, Avnesh S; Kane, Andrew D; Hansell, Jeremy A; Brain, Kirsty L; Skeffington, Katie L; Itani, Nozomi; Wooding, F B Peter; Cross, Christine M; Allison, Beth J

    2014-01-01

    The quality of the intrauterine environment interacts with our genetic makeup to shape the risk of developing disease in later life. Fetal chronic hypoxia is a common complication of pregnancy. This chapter reviews how fetal chronic hypoxia programmes cardiac and endothelial dysfunction in the offspring in adult life and discusses the mechanisms via which this may occur. Using an integrative approach in large and small animal models at the in vivo, isolated organ, cellular and molecular levels, our programmes of work have raised the hypothesis that oxidative stress in the fetal heart and vasculature underlies the mechanism via which prenatal hypoxia programmes cardiovascular dysfunction in later life. Developmental hypoxia independent of changes in maternal nutrition promotes fetal growth restriction and induces changes in the cardiovascular, metabolic and endocrine systems of the adult offspring, which are normally associated with disease states during ageing. Treatment with antioxidants of animal pregnancies complicated with reduced oxygen delivery to the fetus prevents the alterations in fetal growth, and the cardiovascular, metabolic and endocrine dysfunction in the fetal and adult offspring. The work reviewed offers both insight into mechanisms and possible therapeutic targets for clinical intervention against the early origin of cardiometabolic disease in pregnancy complicated by fetal chronic hypoxia.

  17. 白细胞介素-1基因型与慢性牙周炎、冠心病相关性研究%Interleukin-1 genotype and its assocation with chronic periodontitis and coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    钟良军; 张琼; 张蕾; 孙大磊; 张源明

    2010-01-01

    目的:探讨白细胞介素-1A+4845(interleukin-1A+4845,IL-1A+4845)、白细胞介素-1B-31(interleukin-1B-31,IL-1B-31)基因型与慢性牙周炎(chronic periodontitis,CP)、冠心病(coronary heart disease,CHD)易感性的关系.方法:收集中重度慢性牙周炎病人127例,冠心病病人123例,慢性牙周炎合并冠心病病人87例和健康对照117例的颊黏膜拭子,提取DNA,用聚合酶链反应一限制性片段长度多态性法(poly-merase chain reaction-restriction fragment length polymorphism,PCR-RFLP)对IL-1A+4845/Fnu 4H1、IL-1B-31/Alu I位点的基因型进行检测,比较各基因型在4组间检出率的差别.结果:①IL-IA+4845基因型在4组间基因型的分布无统计学差异;②IL-1B-31等位基因T在中重度慢性牙周炎组中的检出率显著高于健康对照组,而在冠心病组与健康组、慢性牙周炎合并冠心病组与健康组间的分布无统计学意义.结论:IL-1B-31等位基因T可能是中重度慢性牙周炎的一个遗传学标志.

  18. Effect of initial periodontal therapy on chronic periodontitis patients with stable coronary heart disease%伴冠心病牙周炎患者牙周基础治疗的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    段向青; 欧阳翔英; 胡荣

    2009-01-01

    目的 观察伴有冠状动脉粥样硬化性心脏病(以下简称冠心病)的牙周炎患者牙周基础治疗后临床指标的变化,并评价其治疗效果.方法 32例伴有冠心病的牙周炎患者,在1个月内完成口腔卫生指导、洁治、刮治和根面平整术,治疗后6周复查,进行牙周维护,在治疗前和治疗后3个月时记录全口牙周情况:菌斑指数(plaque index,PLI)、探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、牙龈出血指数(bleeding index,BI),并进行血清超敏C-反应蛋白(high-sensitivity C-reactive,hs-CRP)、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(high-density lipoprotein,HDL)、低密度脂蛋白胆固醇(low-density lipoprotein,LDL)及血糖的检测.结果 牙周治疗后3个月患者的临床指标显著改善,平均PD由(3.95±0.15)mm减少至(2.93±0.21)mm,平均AL由(3.08±0.43)mm降至(2.43±0.37)mm,PD≥5 mm的位点百分比由(22.37±6.88)%降至(3.00±1.80)%,差异均有统计学意义(P<0.01).牙周治疗后3个月患者的hs-CRP水平显著降低,由(2.71±2.69)mg/L降至(1.99±2.14)mg/L,差异有统计学意义(P<0.01);总胆固醇,甘油三酯、HDL、LDL及血糖的测定值与治疗前相比差异均无统计学意义(P>0.05).结论 在本研究范围内,对于伴有冠心病的牙周炎患者,牙周基础治疗取得良好的治疗效果,患者的牙周临床指标改善,血清hs-CRP水平降低.%Objective To investigate the clinical results of initial periodontal therapy on chronic periodontitis patients with stable coronary heart disease. Methods Thirty-two chronic periodontitis patients with stable coronary heart disease were included in this prospective study. All subjects received oral hygiene instruction, scaling and root planing and clinically monitored for 3 months. The clinical parameters,including plaque index(PLI) , probing depth (PD) , attachment loss(AL) and bleeding index(BI) , were recorded at baseline and 3 months after

  19. Helicobacter Infection and Chronic Liver Diseases

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    This paper reviews the recentHelicobacter infection associated with chronic liver disease. The bacteriology, prevalence, pathogenesis and diagnosis were reviewed. Future work should be conducted on the pathogenesis and treatment of this disease.

  20. Abnormalities of skeletal muscle in patients with chronic heart failure.

    Science.gov (United States)

    Lipkin, D P; Jones, D A; Round, J M; Poole-Wilson, P A

    1988-02-01

    We have examined muscle strength, mitochondrial enzyme activity, histochemistry and fibre size in the quadriceps muscle of 9 patients with severe chronic heart failure. A needle biopsy of the quadriceps muscle was taken with patients at rest. Maximum oxygen uptake was measured during treadmill exercise. Mean maximal oxygen consumption was 11.7 ml.kg-1.min-1. Isometric maximum voluntary contraction was reduced to 55% of the predicted value for weight. Eight biopsies were abnormal. Findings included increased acid phosphatase, increased interstitial cellularity, excess intracellular lipid accumulation, atrophy of both type I and II fibres and variation in size with hypertrophy and atrophy of fibers. Muscle fibre capillary density and the activity of mitochondrial enzymes were normal. Changes in skeletal muscle strength may play a role in the limitation of exercise capacity seen in patients with congestive heart failure.

  1. Quality of life in patients with chronic congestive heart failure

    Directory of Open Access Journals (Sweden)

    Anca D. Farcaş

    2011-12-01

    Full Text Available Objective: Quality of life (QOL is severely decreased in patients with chronic heart failure (CHF. Our study aims to identify the factors affecting the evaluation of QOL. Material and Methods: Clinical, demographic, social and economic data was collected from patients with CHF in NYHA class III and IV as part of a complex workup. The Minnesota Living with Heart Failure Questionnaire (MLHFQ was used to evaluate QOL. Results: QOL decreases as the NYHA class increases. Women evaluate their QOL as more severely affected than men. Age, social and economic factors modulate the perception of QOL. Conclusion: Combining demographic, social and economic data and evaluation of QOL can provide valuable and useful information for the medical management of patients with CHF.

  2. Electrocardiographic characteristics of patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Rutten, Frans H; Numans, Mattijs E;

    2013-01-01

    Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease. Electrocardiography (ECG) carries information about cardiac disease and prognosis, but studies comparing ECG characteristics between patients with and without COPD are lacking. We related ECG...... the most common ECG abnormality in COPD patients (28%) being significantly more prevalent than in patients without COPD (11%, p heart rate was higher in COPD patients (72 bpm (SD 14)) compared to controls (65 bpm (SD 13), p ... the importance of an integrated-care approach for COPD patients, paying attention to early detection of unrecognized coexisting cardiac disorders....

  3. Acquired heart conditions in adults with congenital heart disease: a growing problem.

    Science.gov (United States)

    Tutarel, Oktay

    2014-09-01

    The number of adults with congenital heart disease is increasing due to the great achievements in the field of paediatric cardiology, congenital heart surgery and intensive care medicine over the last decades. Mortality has shifted away from the infant and childhood period towards adulthood. As congenital heart disease patients get older, a high prevalence of cardiovascular risk factors is encountered similar to the general population. Consequently, the contribution of acquired morbidities, especially acquired heart conditions to patient outcome, is becoming increasingly important. Therefore, to continue the success story of the last decades in the treatment of congenital heart disease and to further improve the outcome of these patients, more attention has to be given to the prevention, detection and adequate therapy of acquired heart conditions. The aim of this review is to give an overview about acquired heart conditions that may be encountered in adults with congenital heart disease.

  4. Heart rate and heart rate variability modification in chronic insomnia patients.

    Science.gov (United States)

    Farina, Benedetto; Dittoni, Serena; Colicchio, Salvatore; Testani, Elisa; Losurdo, Anna; Gnoni, Valentina; Di Blasi, Chiara; Brunetti, Riccardo; Contardi, Anna; Mazza, Salvatore; Della Marca, Giacomo

    2014-01-01

    Chronic insomnia is highly prevalent in the general population, provoking personal distress and increased risk for psychiatric and medical disorders. Autonomic hyper-arousal could be a pathogenic mechanism of chronic primary insomnia. The aim of this study was to investigate autonomic activity in patients with chronic primary insomnia by means of heart rate variability (HRV) analysis. Eighty-five consecutive patients affected by chronic primary insomnia were enrolled (38 men and 47 women; mean age: 53.2 ± 13.6). Patients were compared with a control group composed of 55 healthy participants matched for age and gender (23 men and 32 women; mean age: 54.2 ± 13.9). Patients underwent an insomnia study protocol that included subjective sleep evaluation, psychometric measures, and home-based polysomnography with evaluation of HRV in wake before sleep, in all sleep stages, and in wake after final awakening. Patients showed modifications of heart rate and HRV parameters, consistent with increased sympathetic activity, while awake before sleep and during Stage-2 non-REM sleep. No significant differences between insomniacs and controls could be detected during slow-wave sleep, REM sleep, and post-sleep wake. These results are consistent with the hypothesis that autonomic hyper-arousal is a major pathogenic mechanism in primary insomnia, and confirm that this condition is associated with an increased cardiovascular risk.

  5. Probiotics and chronic kidney disease.

    Science.gov (United States)

    Koppe, Laetitia; Mafra, Denise; Fouque, Denis

    2015-11-01

    Probiotics are the focus of a thorough investigation as a natural biotreatment due to their various health-promoting effects and inherent ability to fight specific diseases including chronic kidney disease (CKD). Indeed, intestinal microbiota has recently emerged as an important player in the progression and complications of CKD. Because many of the multifactorial physiological functions of probiotics are highly strain specific, preselection of appropriate probiotic strains based on their expression of functional biomarkers is critical. The interest in developing new research initiatives on probiotics in CKD have increased over the last decade with the goal of fully exploring their therapeutic potentials. The efficacy of probiotics to decrease uremic toxin production and to improve renal function has been investigated in in vitro models and in various animal and human CKD studies. However to date, the quality of intervention trials investigating this novel CKD therapy is still lacking. This review outlines potential mechanisms of action and efficacy of probiotics as a new CKD management tool, with a particular emphasis on uremic toxin production and inflammation.

  6. Congenital Heart Disease: Vascular Risk Factors and Medication

    NARCIS (Netherlands)

    H.P.M. Smedts (Dineke)

    2011-01-01

    textabstractCongenital heart disease (CHD) is among the most common congenital abnormalities and involves structural anomalies of the heart and/or related major blood vessels. Congenital heart disease arises in the fi rst trimester of pregnancy, occurring often and in many forms. The reported CHD bi

  7. Neurologic complications of valvular heart disease.

    Science.gov (United States)

    Cruz-Flores, Salvador

    2014-01-01

    Valvular heart disease (VHD) is frequently associated with neurologic complications; cerebral embolism is the most common of these since thrombus formation results from the abnormalities in the valvular surfaces or from the anatomic and physiologic changes associated with valve dysfunction, such as atrial or ventricular enlargement, intracardiac thrombi, and cardiac dysrhythmias. Prosthetic heart valves, particularly mechanical valves, are very thrombogenic, which explains the high risk of thromboembolism and the need for anticoagulation for the prevention of embolism. Infective endocarditis is a disease process with protean manifestations that include not only cerebral embolism but also intracranial hemorrhage, mycotic aneurysms, and systemic manifestations such as fever and encephalopathy. Other neurologic complications include nonbacterial thrombotic endocarditis, a process associated with systemic diseases such as cancer and systemic lupus erythematosus. For many of these conditions, anticoagulation is the mainstay of treatment to prevent cerebral embolism, therefore it is the potential complications of anticoagulation that can explain other neurologic complications in patients with VHD. The prevention and management of these complications requires an understanding of their natural history in order to balance the risks posed by valvular disease itself against the risks and benefits associated with treatment.

  8. 10.9.Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930272 Clinical relevant factors of the my-ocardial ischemic threshold.LU Duan (鲁端),et al.1st Affil Hosp,Zhejiang Med Univ,Hangzhou,310003.Chin J cardiol 1992;20(6):357—358.The myocardial ischemic threshold (heart rateat the onset of ischemia) was assessed in 92 pa-tients with coronary heart disease.The highestmyocardial ischemic threshold (HMIT) rangedfrom 83 to 163 (122±18) beats/min usuallyhappened during activities at the daytime.Thelowest myocardial ischemic threshold (LMIT)ranged from 45 to 115 (82±17) beats/min usu-ally happened when awaken in early morning orasleep at night.The differences were statistical-

  9. Nutrition in neonatal congenital heart disease

    Directory of Open Access Journals (Sweden)

    Morgan CT

    2013-09-01

    Full Text Available Conall T Morgan,1 Anne Marie Shine,2 Colin J McMahon1 1Department of Pediatric Cardiology, 2Department of Clinical Nutrition and Dietetics, Our Lady's Children's Hospital Crumlin, Dublin, Republic of Ireland Abstract: There are 40,000 infants born in the USA with congenital heart disease annually. Achievement of adequate oral nutrition is difficult in this population. Malnutrition is common. Single ventricle physiology, the risk of necrotizing enterocolitis, and cardiopulmonary bypass prevent the establishment of normal oral feeding patterns. Improved nutrition results in improved surgical outcomes, lower mortality, and shorter hospital stay. In this review, we discuss the challenges this population faces. Keywords: necrotizing enterocolitis, malnutrition, growth failure, hypoplastic left heart

  10. The Inflammatory Heart Diseases: Causes, Symptoms, and Treatments.

    Science.gov (United States)

    Lu, Lei; Sun, RongRong; Liu, Min; Zheng, Yi; Zhang, Peiying

    2015-07-01

    The inflammation of the heart muscles, such as myocarditis, the membrane sac which surrounds the heart called as pericarditis, and the inner lining of the heart or the myocardium, heart muscle as endocarditis are known as the inflammatory heart diseases. Inflammation of heart is caused by known infectious agents, viruses, bacteria, fungi or parasites, and by toxic materials from the environment, water, food, air, toxic gases, smoke, and pollution, or by an unknown origin. Myocarditis is induced by infection of heart muscle by virus like sarcoidosis and immune diseases. The symptoms include chest pain, angina, pain in heart muscle, and shortness of breath, edema, swelling of feet or ankles, and fatigue. The ECG, X-ray, and MRI can diagnose the disease; blood test and rise in enzymes levels provide abnormality in heart function. The treatment includes use of antibiotics for inflammation of heart muscle and medications. The ultrasound imaging indicates further damage to the heart muscle. In severe cases of infection heart failure can occur so long-term medications are necessary to control inflammation. The various biomarkers are reported for the inflammatory heart diseases. The causes, symptoms and treatments of inflammatory heart diseases are described.

  11. Congenital heart disease and rheumatic heart disease in Africa: recent advances and current priorities.

    Science.gov (United States)

    Zühlke, Liesl; Mirabel, Mariana; Marijon, Eloi

    2013-11-01

    Africa has one of the highest prevalence of heart diseases in children and young adults, including congenital heart disease (CHD) and rheumatic heart disease (RHD). We present here an extensive review of recent data from the African continent highlighting key studies and information regarding progress in CHD and RHD since 2005. Main findings include evidence that the CHD burden is underestimated mainly due to the poor outcome of African children with CHD. The interest in primary prevention for RHD has been recently re-emphasised, and new data are available regarding echocardiographic screening for subclinical RHD and initiation of secondary prevention. There is an urgent need for comprehensive service frameworks to improve access and level of care and services for patients, educational programmes to reinforce the importance of prevention and early diagnosis and a relevant research agenda focusing on the African context.

  12. Therapeutic effects of adenosine cyclophosphate combined with Shenmai injection on chronic heart failure in aged patients with coronary heart disease%环磷腺苷联合参麦注射液治疗老年冠心病慢性心力衰竭的疗效

    Institute of Scientific and Technical Information of China (English)

    李建平; 付细娥

    2011-01-01

    Objective: To observe the therapeutic effects of adenosine cyclophosphate combined with Shenmai injection on chronic heart failure (CHF) in aged patients with coronary heart disease (CHD). Methods: A total of 126 aged CHD patients with CHF were randomly divided into routine treatment group (n = 62, received routine anti-heart failure treatment) and observation group (n=64, received adenosine cyclophosphate and Shenmai injection intravenous drip for 14d based on routine treatment). Clinical therapeutic effects and changes of plasma level of brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and peak early diastolic velocity/peak late dias-tolic velocity (E/A) were observed and compared between the two groups before and after treatment. Results: After treatment, all indicators in the two groups significantly improved except for E/A in routine treatment group, P <0. 01 all. Compared with routine treatment group, there were significant increase in total effective rate (77. 42% vs. 89.06%), LVEF[ (44. 51±7. 85)% vs. (58.35 + 7.80)%], E/A [ (0. 69±0. 35) vs. (0. 88±0. 36)] , 6 min walking distance [ (526. 70± 12. 00) m vs. (629. 20± 12. 20) m], and significant decrease in BNP concentration [ (558. 20±79. 30) ng/L vs. (437.10±67. 90) ng/L] in observation group, P<0. 01 all. Conclusion: Adenosine cyclophosphate combined with Shenmai injection is safe and effective in treatment of chronic heart failure in aged patients with coronary heart disease.%目的:观察环磷腺苷联合参麦注射液治疗老年冠心病慢性心力衰竭(CHF)的临床疗效.方法:老年冠心病CHF患者126例,随机分为常规治疗组62例,给予常规抗心衰治疗;观察组64例,在常规治疗的基础上静脉滴注环磷腺苷及参麦注射液14d.观察两组治疗前后血浆脑钠肽(BNP)水平、左室射血分数(LVEF),舒张早期/晚期最大血流速度比值(E/A)等指标的变化及临床疗效.结果:治疗后,两组各指标(常规治疗组

  13. Is acute recurrent pancreatitis a chronic disease?

    OpenAIRE

    Mariani, Alberto; Testoni, Pier Alberto

    2008-01-01

    Whether acute recurrent pancreatitis is a chronic disease is still debated and a consensus is not still reached as demonstrated by differences in the classification of acute recurrent pancreatitis. There is major evidence for considering alcoholic pancreatitis as a chronic disease ab initio while chronic pancreatitis lesions detectable in biliary acute recurrent pancreatitis (ARP) seem a casual association. Cystic fibrosis transmembrane conductance regulator (CFTR) gene mutation, hereditary a...

  14. Comorbidity of chronic diseases in general practice.

    NARCIS (Netherlands)

    Schellevis, F.G.; Velden, J. van der; Lisdonk, E. van de; Eijk, J.T.M. van; Weel, C. van

    1993-01-01

    With the increasing number of elderly people in The Netherlands the prevalence of chronic diseases will rise in the next decades. It is recognized in general practice that many older patients suffer from more than one chronic disease (comorbidity). The aim of this study is to describe the extent of

  15. Chronic diseases among older cancer patients.

    NARCIS (Netherlands)

    Deckx, L.D.; Akker, M.A. van der; Metsemakers, J.M.; Knottnerus, A.K.; Schellevis, F.G.; Buntinx, F.B.

    2011-01-01

    Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of

  16. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  17. Incidence of cancer in patients with chronic heart failure

    DEFF Research Database (Denmark)

    Banke, Ann; Schou, Morten; Videbaek, Lars;

    2016-01-01

    AIMS: With improvement in survival of chronic heart failure (HF), the clinical importance of co-morbidity is increasing. The aim of this study was to assess the incidence and risk of cancer and all-cause mortality in a large Danish HF cohort. METHODS AND RESULTS: A total of 9307 outpatients......-specific risk of cancer was analysed in an adjusted Poisson and Cox regression analysis. The 975 diagnoses of cancer in the HF cohort and 330 843 in the background population corresponded to incidence rates per 10 000 patient-years of 188.9 [95% confidence interval (CI) 177.2-200.6] and 63.0 (95% CI 63...

  18. Benefits of Heart Rate Slowing With Ivabradine in Patients With Systolic Heart Failure and Coronary Artery Disease.

    Science.gov (United States)

    Borer, Jeffrey S; Deedwania, Prakash C; Kim, Jae B; Böhm, Michael

    2016-12-15

    Heart rate (HR) is a risk factor in patients with chronic systolic heart failure (HF) that, when reduced, provides outcome benefits. It is also a target for angina pectoris prevention and a risk marker in chronic coronary artery disease without HF. HR can be reduced by drugs; however, among those used clinically, only ivabradine reduces HR directly in the sinoatrial nodal cells without other known effects on the cardiovascular system. This review provides current information regarding the safety and efficacy of HR reduction with ivabradine in clinical studies involving >36,000 patients with chronic stable coronary artery disease and >6,500 patients with systolic HF. The largest trials, Morbidity-Mortality Evaluation of the If Inhibitor Ivabradine in Patients With Coronary Disease and Left Ventricular Dysfunction and Study Assessing the Morbidity-Mortality Benefits of the If Inhibitor Ivabradine in Patients With Coronary Artery Disease, showed no effect on outcomes. The Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial, a randomized controlled trial in >6,500 patients with HF, revealed marked and significant HR-mediated reduction in cardiovascular mortality or HF hospitalizations while improving quality of life and left ventricular mechanical function after treatment with ivabradine. The adverse effects of ivabradine predominantly included bradycardia and atrial fibrillation (both uncommon) and ocular flashing scotomata (phosphenes) but otherwise were similar to placebo. In conclusion, ivabradine improves outcomes in patients with systolic HF; rates of overall adverse events are similar to placebo.

  19. Vascular and Valvular Calcifications in Chronic Kidney Disease: An Update

    Directory of Open Access Journals (Sweden)

    Luca Di Lullo

    2016-07-01

    Full Text Available In chronic kidney disease (CKD and end-stage renal disease patients cardiovascular disease is the main cause of morbidity and mortality, with incidence of cardiac related mortality increasing as renal function declines. Even after controlling for traditional cardiovascular risk factors such as smoking, age, gender, dyslipidaemia, and arterial hypertension, patients with CKD have a higher incidence of major cardiovascular events. CKD is characterised by the presence of many other non-traditional cardiovascular risk factors, such as chronic inflammation and accelerated atherosclerosis, oxidative stress, and especially, secondary hyperparathyroidism. This review will summarise the current evidence on vascular calcifications and valvular heart disease in CKD patients, from pathophysiology to therapeutic strategies.

  20. Pulmonary hypertension in chronic obstructive and interstitial lung diseases

    DEFF Research Database (Denmark)

    Andersen, Charlotte U; Mellemkjær, Søren; Nielsen-Kudsk, Jens Erik

    2013-01-01

    , and is considered one of the most frequent types of PH. However, the prevalence of PH among patients with COPD and ILD is not clear. The diagnosis of PH in chronic lung disease is often established by echocardiographic screening, but definitive diagnosis requires right heart catheterization, which...... is not systematically performed in clinical practice. Given the large number of patients with chronic lung disease, biomarkers to preclude or increase suspicion of PH are needed. NT-proBNP may be used as a rule-out test, but biomarkers with a high specificity for PH are still required. It is not known whether specific...... treatment with existent drugs effective in pulmonary arterial hypertension (PAH) is beneficial in lung disease related PH. Studies investigating existing PAH drugs in animal models of lung disease related PH have indicated a positive effect, and so have case reports and open label studies. However...