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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Incidence of pericarditis has increased in sub-Saharan Africa, because of the HIV infection pandemia. We have done a retrospective study in the cardiology unit of the national hospital of Ouagadougou (Burkina Faso), in order to describe epidemiological, clinical, and therapeutic aspects of pericarditis occurring in HIV infected patients. Inclusion criteria were pericarditis proved by echography, and positive HIV serology. We have included forty patients (28 men and 12 women), mean aged of 34.45 years. General signs were fever (87.5%), and weight loss (70%). Thirty-six patients (90%) were in CDC stage C AIDS classification, three (7.5%) in stage B, and one (2.5%) in stage A. The symptoms described by the patients were dyspnea (92.5%), cough 77.5%), chest pain (65%), liver effort pain (27.5%), and palpitations (20%). Heart failure was present in 80% of the patients who had myocarditis. Pericardial effusion was small in 21%, moderate in 31,6%, and large in 47.4% of the patients. Tamponade occurred in for cases (10%). The etiology was tuberculosis in 75% of cases. Pericardial puncture (done in six patients) showed purulent fluid in two cases. Before hospital discharge, eight patients died, giving a mortality rate of 20%. Symptomatic pericardial involvement is frequently associated with stage C of HIV infection. Myocarditis is often associated (37.5%). Mortality rate is high.
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PMID:[Pericarditis in HIV infected patients: retrospective study of 40 cases in Ouagadougou, Burkina Faso]. 1164 Oct 80

Cardiomyopathies are observed with increasing frequency in association with AIDS and HIV infection. Although indirect evidence exists suggesting an association between apoptosis regulation and HIV infection, there is yet no direct evidence that HIV-associated cardiomyopathies involve increased level of apoptosis in the heart. However, since it is now known that apoptosis plays a significant role in heart injury associated with other conditions such as ischemia/reperfusion and heart failure, there is a possibility that dysregulation of apoptosis plays a similarly important role in HIV-associate cardiomyopathies. Here we will briefly review the evidence that apoptotic death of cardiomyocytes occurs and what novel therapeutic strategies may be suggested.
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PMID:Apoptosis and the heart: a brief review. 1176 84

The wider availability of recombinant human growth hormone and insulin-like growth factor-I has resulted in an investigation into the potential benefits of the pharmacological administration of these anabolic peptides in a variety of clinical conditions, characterized by an increase in catabolic rate. The initial studies were small, often uncontrolled open investigations, but investigators have more recently concentrated on larger, controlled multi-centre trials. Studies to date have included patients with cardiac failure, sepsis, burns, cancer cachexia, end-stage renal failure, trauma and AIDS, and those prior to or following major surgery. The authors have in general cautiously interpreted positive effects of treatment with growth hormone and insulin-like growth factor-I, either alone or in combination, on net protein balance, body composition, well-being and performance. Two large, randomized, placebo-controlled European multi-centre studies have recently detailed the effects of growth hormone treatment in critically ill intensive care patients. Major increases in mortality and morbidity were associated with growth hormone treatment. The mechanism(s) accounting for the increased mortality remain poorly understood. These negative findings have led to a decrease in the clinical use of growth hormone and in research activity in the area of anabolic treatment in human illness.
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PMID:Treatment with growth hormone and insulin-like growth factor-I in critical illness. 1180 May 16

Three cases of dilated cardiomyopathy in patients with IIIV/AIDS are being reported. The three patients are of young age group and they presented with cardiac symptoms for the first time. They were all heterosexuals and not known was as intravenous drug abuser. There was no history of rheumatic fever or hypertension or diabetes mellitus and ischaemic heart disease. Examination confirmed cardiac failure and investigations including chest x-ray, echocardiograph and electrocardiograph confirmed dilated heart. All the patients tested positive to HIV-1 antibodies. They were managed with the usual anticardiac failure regimen. Two of the patients died on admission, one developed multi organ failure and the other had tonic-clonic seizure. In other parts of Africa reports have also emerged describing the cardiovascular involvement in HIV/AIDS.
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PMID:Cardiovascular involvement in HIV/AIDS: report of 3 cases. 1188 84

Spiritual expression has been proposed as a dimension of quality of life. Persons with chronic diseases such as AIDS or cancer have described the value of spiritual expression in living with their illnesses. The authors examined the role spirituality plays in the lives of 58 people with heart failure being treated medically or by transplant. Instruments used included the Medical Outcome Survey Short Form 36 and Index of Well-Being measures of quality of life, the Spiritual Well-Being Scale, and the Relative Importance Scale. Combined spirituality scores predicted 24% of the variance in global quality of life. There were no significant gender differences in spiritual well-being or quality of life.
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PMID:Spirituality in persons with heart failure. 1189 88

Every year in the US heart failure accounts for roughly 60,000 deaths and is the contributing cause in another 300,000 deaths. The two-year survival rate for patients with advanced heart failure is less than 50%, with the incidence of death at 106 in 100,000, more than that for AIDS and breast cancer combined. As these figures attest, the economic burden is quite extensive. The Centers for Medicaid and Medicare estimate a cost of $10 billion a year for this diagnosis alone. Both the human and financial cost have impelled doctors and researchers to improve their capacity to treat heart failure both through conventional methods and, in the most serious cases, through transplantation. Many pioneers have either directly or indirectly contributed to our ability to treat heart failure. Among these early researchers were: Dr Alexis Carrel, who was awarded the Nobel Prize for his pioneering work in vascular anastomosis; Dr John Gibbon, who did important work in the development of the cardiopulmonary bypass machine; Drs Normal Shumway, Richard Lower, and Demikhov, who developed heart transplant procedures in the canine model; Dr Christian Barnaard, who performed the first technically successful human-to-human heart transplant (1967); and Dr Thomas Hardy, who attempted the first xenotransplant (1963). While these achievements were phenomenal advances, long-term survival for transplant recipients was minimal until progress was made in immunosuppressive techniques.
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PMID:Heart transplants: need versus availability. 1191 Oct 12

HIV transmission is the greatest single risk of blood transfusion today. The World Health Organization estimated in late 1900 that 8-10 million persons worldwide were HIV seropositive. In Africa, 10% of adult and 25% of early childhood HIV infections are believed to be caused by contaminated transfusions. 90% of patients transfused with contaminated blood will become infected. The other serious infectious risks of transfusion are hepatitis B, malaria, and syphilis. Accidents and complications of transfusion can be avoided if transfusions are limited to absolute indications, clinical examinations of donors are thorough, the blood group is reliably determined, and testing of blood for HIV is reliably conducted. Transfusions not formally indicated are now formally contraindicated. The vital risk if the patient is not transfused must be assessed before the transfusion is done, as should the risk of transmitting infection through the transfusion. When emergencies occur in isolated areas, the donor is often a family member or person accompanying the patient. The blood of the donor as well as of the patient must be typed. The medical history and clinical examination of the donor to exclude contraindications must be thorough. The physical contraindications to blood donation are infectious disorders and especially AIDS, a history of untreated syphilis or jaundice, and recent malaria. Blood should never be donated by persons with fever, jaundice, cutaneous lesions suggesting syphilis or AIDS, clinical anemia, or cardiac insufficiency. Pregnant women and children under 15 should not donate blood. Aseptic conditions must be maintained during all handling of the blood. ABO and rhesus grouping and testing for HIV infection must be done in all cases. ELISA tests are most often used for blood screening, but the rapid tests developed a few years ago are equally reliable and more suited to isolated medical facilities or those that perform few transfusions. Because the tests give false positive results in a significant proportion of cases, they should be repeated before a positive result is reported. The results of an HIV test, whether positive or negative, should only be reported to the donor if information on the consequences of a positive test has been provided and consent to the test has been obtained, the screening test results have been confirmed by a diagnostic test, and the seropositive individual can receive medical follow-up and counselling. Prevention of syphilis transmission can be achieved by limitation of indications for transfusion, selection of low risk donors, clinical examination of donors, use of blood stored for 72 hours at 4 degrees celsius or lower, use of screening tests, and prophylactic administration of antibiotics. Clinical examination and a careful medical history are the main tools for preventing hepatitis B transmission. Systematic prophylaxis against malaria following national protocols is recommended.
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PMID:[Transfusion practice in isolated areas: prevention of HIV transmission]. 1228 4

Extensive reviews of pulmonary infections in AIDS have reported few herpetic infections. Generally these infections are due to Herpes simplex type 1. Pneumonia due to herpes type 2 is extremely rare. We describe a 40 year-old HIV positive woman who complained of fever, cough and dyspnea for seven years. She had signs of heart failure and the appearance of her genital vesicles was highly suggestive of genital herpes. Echocardiography showed marked pulmonary hypertension, right ventricular hypertrophy and tricuspid insufficiency. After a few days of hospitalization she was treated with Aciclovir and later with Ganciclovir. An open pulmonary biopsy revealed an interstitial inflammation, localized in the alveolar walls. Some pulmonary arteries had widened walls and focal hyaline degeneration. Immunohistochemistry indicated that the nuclei had herpes simplex virus type 2 in many endothelial cells (including vessels with widened walls), macrophages in the alveolar septa and pneumocytes. There was clinical improvement after treatment for herpes. We concluded that as a consequence of herpes infection, endothelial involvement and interstitial inflammation supervene, with thickening of vascular walls and partial obliteration of the vessel lumen. A direct consequence of these changes in pulmonary vasculature was pulmonary hypertension followed by heart failure.
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PMID:Herpes simplex type 2 pneumonia. 1258 74

The objective of this work was to evaluate the most frequent causes of emergency in patients with Chagas disease. Between January 1998-January 1999, individuals with Chagas disease inside the shock-room of Santojanni Hospital in Buenos Aires city, were included in a prospective study. For the statistical analysis, X test with Yates correction has been used. From a total of 1.680 patients entered, there were 95 (6%) with reactive serology for Chagas disease. In 31 individuals the enter cause was syncope, in 28 cardiac insufficiency, in 18 acute coronary events, in 5 stroke, in 3 acute edema of hypertensive lung and in 2 acute encephalitis associated to AIDS. In conclusion, significant association has been observed between: 1) presence of cardiopathy and hospitalization, 2) cardiac insufficiency, syncope, acute encephalitis and mortality, 3) cardiopathy development and mortality and 4) origin place and mortality.
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PMID:[Emergencies in patients with Chagas' disease in Buenos Aires city, Argentina]. 1261 43

As longevity increases in HIV-infected individuals after the introduction of highly active antiretroviral therapy regimens, long-term effects such as cardiovascular disease and, more specifically, symptomatic heart failure are emerging as leading health issues. In the present review article, we discuss HIV-associated cardiovascular disease, focusing on etiopathogenetic mechanisms that may play a role in diagnosis, management, and therapy of HIV-associated heart failure in the highly active antiretroviral therapy era.
AIDS 2003 Apr
PMID:Pathogenesis of HIV-associated heart disease. 1287 May 26


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