1/7. Cardiovascular consequences of renal anaemia and erythropoietin therapy.Cardiovascular disease is the leading cause of increased mortality in patients with renal failure and vigorous attention to cardiovascular risk factors is therefore required to improve patient outcome. The availability of recombinant human Epo has focused the interest on the role of chronic anaemia in the pathogenesis of cardiovascular disease. Severalfold evidence indicates that anaemia can contribute to cardiac volume overload and together with overhydration, fistula flow and the pressure overload secondary to arterial hypertension, it may play a significant role in the development of cardiac hypertrophy. As in the general population left ventricular hypertrophy is a severe adverse risk factor in renal patients. In addition, in the presence of ischaemic heart disease anaemia may further worsen cardiac oxygen supply. This dual effect of anaemia probably explains why epidemiological studies have shown that a 1 g/dl decrease in haemoglobin levels is an independent, statistically significant risk factor for the development of cardiac morbidity and mortality. Follow-up examinations have demonstrated that partial correction of anaemia with recombinant Epo can improve cardiac oxygen supply and partially reverse pathological changes in left ventricular geometry. However, although partial anaemia correction regularly reduces left ventricular volume, the effects on wall thickness are far less significant. Moreover, in patients with advanced cardiac disease it has recently not been possible to demonstrate that a normalization of haemoglobin levels provides further benefit. It is not unlikely therefore that the development of severe anaemia has to be prevented by early implementation of Epo therapy in order to achieve the maximum benefit with respect to the cardiovascular system.- - - - - - - - - - ranking = 1keywords = cardiovascular system (Clic here for more details about this article) |
2/7. Impairment rating of the cardiovascular system: Idiopathic cardiomyopathy.disease of the cardiovascular system is the leading cause of morbidity and mortality among the adult population in the united states. physicians performing impairment ratings attributable to cardiovascular disease are required to correlate the extent of the disease and its impact on a person's daily activities. A person's final impairment determination may vary based on the specific guidelines used (american medical association Guides to the Evaluation for Permanent Impairment, social security, State Worker Compensation requirements, etc.), the version of the guidelines (year, edition), and each guide's specific criteria. The examiner needs to know which rating system to use, the system's criteria, critical definitions, and potential limitations.- - - - - - - - - - ranking = 5keywords = cardiovascular system (Clic here for more details about this article) |
3/7. Circadian influence on coronary events.The circadian variation of major cardiovascular disorders, that is, TMI, AMI, SCD, and stroke, reflects an increased vulnerability to myocardial and cerebral ischemia and myocardial dysfunction in the early hours of the morning after awakening and rising. A comprehensive approach to treatment in patients with ischemic heart disease must take into consideration the chronobiology of the cardiovascular system and its relevance to the underlying disease process that affects the cardiovascular system.- - - - - - - - - - ranking = 2keywords = cardiovascular system (Clic here for more details about this article) |
4/7. Primary and secondary tumors of childhood involving the heart, pericardium, and great vessels. A report of 75 cases and review of the literature.Between 1919 and 1981, 16 children with primary cardiac tumors (8 rhabdomyomas, 5 fibromas, 2 myxomas, and 1 rhabdomyosarcoma) and 59 children with secondary tumors of the cardiovascular system were seen at The Hospital for Sick Children in Toronto. Distant metastases in 45 children of the latter group, in descending order of frequency, were from non-Hodgkin's lymphoma, neuroblastoma, soft tissue and bone sarcoma, Wilms' tumor, and hepatoma, and involved the myocardium and pericardium. In the remaining 14 children, tumor thrombi from Wilms' tumor (9 cases), adrenal (2 cases) and hepatocellular carcinoma (2 cases), and endodermal sinus tumor (1 case) extended directly into the great veins and/or cardiac chambers. Children with primary and secondary tumors often present with nonspecific clinical, plain radiographic, electrocardiographic, and M-mode echocardiographic findings. Early recognition, utilizing special diagnostic procedures such as two-dimensional echocardiography, computerized axial tomography, angiocardiography, and inferior venocavography, followed by elective surgical resection of tumor under cardiopulmonary bypass and/or radiation and chemotherapy, offers patients with cardiovascular tumors the best chance of cure.- - - - - - - - - - ranking = 1keywords = cardiovascular system (Clic here for more details about this article) |
5/7. Clinical psychiatry and cardiovascular disease in the aged.The geriatric patient has a high incidence of cardiovascular and psychiatric illness; treatment of either may lead to emergence or aggravation of the other. Toxic side effects can frequently be managed by a reduction in dose or a change in medication. In general, the psychiatric problems of elderly patients, including patients with cardiovascular disease, can be managed despite the cardiovascular toxicity of most psychotropic drugs. Psychiatrists who treat geriatric patients need an understanding of psychopharmacology and clinical manifestations of the cardiovascular system in order to provide well-rounded care.- - - - - - - - - - ranking = 1keywords = cardiovascular system (Clic here for more details about this article) |
6/7. magnetic resonance imaging of the cardiovascular system and airway.Cardiovascular MR imaging is unique in its ability to combine anatomic, physiologic, and functional information in a single examination. Established applications in the pediatric population include the evaluation of the child with a suspected thoracic aortic arch anomaly, vascular compression of the airway, coarctation of the aorta, pulmonary arterial and venous abnormalities, and cardiac or paracardiac masses. The increasing availability of radiologists with the knowledge and commitment to cardiac imaging will allow this exciting technique to thrive in the future, to the benefit of our patients.- - - - - - - - - - ranking = 4keywords = cardiovascular system (Clic here for more details about this article) |
7/7. A major involvement of the cardiovascular system in patients affected by marfan syndrome: novel mutations in fibrillin 1 gene.The aim of our study was to characterize the molecular defect in Italian Marfan patients, thus contributing to the effort of correlating the genotype with the phenotype. In particular, our ultimate goal was to identify the region(s) of the fibrillin 1 (FBN1) gene mainly involved in the health of the heart and of the aorta in terms of the cardiovascular system. We searched for a molecular defect in three patients with classic marfan syndrome (MFS). The mutations were detected applying heteroduplex analysis to each of the 65 exons of the FBN1 gene amplified by polymerase chain reaction (PCR). exons containing heteroduplex bands were sequenced directly from PCR products. This study reports the detection of three unique missense mutations in the FBN1 gene in three Italian patients: a 44-year-old adult male and 36-year-old female affected by classic MFS (with all the cardinal manifestations in the cardiovascular, ocular and skeletal systems), and an 11-year-old male affected by infantile (earlier onset) classic MFS. The first two are sporadic cases and present a Cys-->Arg amino acid substitution (T-->C substitution at nucleotide 7729) in exon 62 and a Cys-->Tyr amino acid substitution (G-->A substitution at nucleotide 6695) in exon 54. The third is a familial case which presents a Cys-->Trp aminoacidic substitution (C-->G substitution at nucleotide 3546) in exon 28. Our data confirm that cysteine substitutions in calcium binding epidermal growth factor (cbEGF)-like domains cause severe Marfan phenotype. Exon 24-32 cluster seems to produce an even more severe phenotype. The early characterization may be of clinical relevance for prevention and early surgical treatment of aortic aneurysm or dissection.- - - - - - - - - - ranking = 5keywords = cardiovascular system (Clic here for more details about this article) |