Active clinical trials for "Heart Diseases"

The goal is to determine if prehydration based on LEVDP is superior to a standard hydratation with NaCl 0.9% or NaHCO3 for the prevention of contrast nephropathy related to a diagnostic coronary angiogram or to PCI.

This is a prospective, multi-center study examining the clinical impact of the Corus CAD (Age/Sex/Gene Expression score - ASGES) assay in approximately 250 evaluable subjects with no history of obstructive coronary artery disease who now present with chest pain or anginal-equivalent symptoms to a primary care physician (PCP) for evaluation.

Patients with congenital heart disease in whom the right ventricle is exposed to pressure or volume overload show progressive systolic dysfunction of the right ventricle, the fact of which conveys substantial morbidity and mortality. The aim of this study is to investigate the myocardial perfusion in these patients by myocardial contrast echocardiography (MCE) in order to determine whether disturbed blood flow plays a role in the development of right ventricular systolic dysfunction.

The overall objective is to increase the adherence to national guidelines for patients with established CVD and/or Type 2 diabetes by means of repeated post-graduate educational meetings and regular evaluation of the optimisation initiatives, demonstrated by improvement of goal attainment in general practice.

There is substantial, continuing, and unexplained rise in prescribing of proton pump inhibitors. It is unknown whether their use in practice has corresponded to their licensed indications. Although the indications for H2RA or PPI administration in the treatment of acid-related diseases and the prevention of gastric mucosal damage have been well defined in the medical literature, the perception of benefit from their use frequently tends to be extrapolated to all patients in general, leading to an excessive consumption of these drugs in general practice. To date, however, little has been published with regard to the overall use or misuse of these drugs in hospital populations in ischemic heart disease patients as a secondary prevention to Aspirin use. We will undertake a 6-months retrospective survey (about 1200 patients) to evaluate the use of acid-suppressive medications in the general internal medicine ward of Rambam Hospital. We will extract all records of prescribing of a proton pump inhibitor within Rambam Hospital computerized patients file program (Premetheuos) in period of half year, categorized and analyze them using statistical X2 test.

The objective of these studies is to identify genetic factors that contribute to the pathogenesis of complex congenital heart disease and other more rare conditions resulting from disturbances in organ positioning. These are a group of medical conditions that are thought to stem from a poorly understood disturbance in the establishment of the basic body plan in the embryo. While the outside of the human body is generally symmetric with mirror image left and right sides, the positions of some internal organs are distinctly asymmetric. For example, the heart could not function properly as a mechanical pump if its connections to major blood vessels retained their initial symmetry. The left ventricle of the heart normally pumps blood to the body, while the right ventricle normally pumps blood to the lungs. Reversals in these blood vessel connections can be fatal. Similarly, the gut characteristically loops in a counterclockwise direction placing the stomach on the left side in most cases. Rare laterality anomalies can occur if this looping is in the other direction, or randomized (equally likely to loop in either direction). Serious medical problems can be caused by disturbances in the establishment, or maintenance of left-right (L-R) differences as key organs are developing in the embryo. We have established formal collaborative agreements with three major centers who have collected a large number of coded cases of congenital cardiac disease. Our research objective is to try to understand if specific genetic changes can contribute to a range of cardiac malformations. We utilize mutational analysis of candidate genes as our principal tool to study the genetics of L-R axis malformations. This protocol is also open to other conditions whose basis is also thought to result from L-R problems. In all cases, the patients continue under the care of the referring physician. We anticipate a minor role of NIH researchers and genetic counseling services if subjects either do not have, or cannot afford, similar services in their local area. This is not a treatment protocol. Our empiric ability to generate medically significant research results is limited by the extensive genetic and other etiologic heterogeneity. Therefore, this research is not a diagnostic study. At this stage of research, we are not sufficiently confident that our research results will have direct medical implications for research subjects. Results that are of potential medical importance will be discussed with the primary physician who is (in most cases) a trained cardiologist (and/or medical geneticist). We will emphasize that these are only preliminary research findings, that they are not CLIA-approved, and must be disclosed to the patient or included in the medical record. Repeat testing in a CLIA-approved lab under another protocol would be required before the genetic information could be shared with the patient and family.

To determine the rate of progression of sub-clinical cardiovascular disease as measured in carotid intimal medial thickness over a period of 8 to 10 years.

To identify new dilated cardiomyopathy genes by genetic linkage and mutational analyses.

To investigate the role of racial and socioeconomic disparities in coronary heart disease (CHD) mortality in the United States.

To determine the genetics and epidemiology of different types of early familial coronary disease. Accurate markers of major gene syndromes for early coronary disease were identified using a genetic segregation and linkage study of lipids, lipoproteins, apolipoproteins, and DNA probes in 36 large Utah pedigrees.