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

Plasma dobutamine concentrations and hemodynamic and noninvasive cardiac measurements were made during dobutamine infusions in eight patients with congestive cardiomyopathy and low output heart failure. Plasma concentrations correlated well with infusion rates (2.5, 5.0, 7.5 and 10 microgram/kg/min). Cardiac output and stroke volume increased linearly, whereas pulmonary capillary wedge pressure, and total pulmonary and systemic resistances decreased linearly with increasing dobutamine concentrations. No constant relationship existed between plasma dobutamine levels and changes in heart rate or mean arterial pressure. The noninvasive left ventricular function data (echocardiographic and systolic time intervals) correlated linearly with plasma concentrations and suggest that these noninvasive technics be employed in guiding the administration of this new inotropic agent.
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PMID:The relationship between plasma dobutamine concentrations and cardiovascular responses in cardiac failure. 42 67

During a three-year period 10 patients with critical aortic stenosis were referred to a cardiac referral centre with symptoms and signs of intractable cardiac failure and low cardiac output. In nine patients the correct diagnosis was not suspected at the referring hospital, and in the remaining patient the true severity of the aortic stenosis was not appreciated and cardiomyopathy was suggested as an additional diagnosis. The most common referral diagnoses were severe mitral regurgitation (four patients), congestive cardiomyopathy (two patients), or both (three patients). Only two patients had soft ejection systolic murmurs at the base of the heart radiating into the neck, and such a murmur appeared in a third patient during medical treatment. The carotid pulses were of small volume but the characteristic slow-rising, anacrotic nature of the pulse could not be appreciated clinically. The diagnosis was suspected in nine patients because of aortic valve calcification detected by lateral chest x-ray examination in seven patients and by x-ray screening of the heart in two, and because of abnormal aortic valve echoes in the echocardiogram of all five patients in whom the aortic valve could be seen. Eight patients underwent aortic valve replacement despite seemingly poor preoperative left ventricular function. Three patients died, of whom two had severe coexistent coronary artery disease. The five survivors all returned to normal lives and needed little or no medication.Critical aortic stenosis should be actively sought in patients with severe heart failure of unknown cause since surgery may enable them to resume their normal lives.
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PMID:Occult aortic stenosis as cause of intractable heart failure. 43 94

Four Black South African patients, representative of a larger group, are described in detail. The common features were long periods of observation, multiple hospital admissions in both normotensive and hypertensive cardiac failure, hypertensive retinopathy and good renal function. All had been diagnosed as having cardiomyopathy. Two of the patients in a normotensive phase became hypertensive after responding to therapy for heart failure. One patient with malignant hypertension showed the features of idiopathic cardiomyopathy at necropsy. These cases are regarded as evidence in favour of the hypothesis that many cases of cryptogenic heart disease (cardiomyopathy, congestive cardiomyopathy, idiopathic cardiomegaly) are in fact cases of hypertension presenting with normotensive cardiac failure.
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PMID:Hypertensive heart disease and cardiomyopathy in blacks. Diagnostic confusion. 45 82

In the period from 1968 to 1977, in the Departments of Cardiology of the S. Camillo Hospital, a study has been made about 200 cases of Congestive Cardiomyopathy (MPC) and 100 about hypertrophic obstructive (MP0). Congestive cardiomyopathies constitute 1.5% of hospitalizations with a constant trend in the long run. In comparing these two forms, Authors have noticed some differences in the symptomatology of clinical and instrumental signs: 1) in case of MPO prevail angina, syncope, ejection systolic murmur, left ventricular overload in the ECG; 2) in case of MPC they find more frequently heart failure, embolism, diastolic gallop, cardiomegaly, A/V and intraventricular conduction disturbs. The AA. conclude, in accordance with Goodwin's classification, that there is not an uniformity of these two kinds of cardiomyopathies.
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PMID:[Epidemiological and clinical observations on 300 cases of primary myocardiopathy]. 45 5

The diagnosis of primary dilated cardiomyopathy depends on the recognition of a dilated poorly contracting left ventricle with increased end-diastolic and end-systolic volumes in the absence of a detectable cause. The diagnosis is made only after exclusion both of structural heart disease and of known causes of secondary heart muscle disorder. The natural history is still largely unknown and is probably as variable as the likely causes. The left ventricular disorder does not cause symptoms until heart failure supervenes except for occasional patients who develop an early atrial or ventricular dysrhythmia, conduction defect, chest pain or murmur of mitral regurgitation. This period of latency may be short, prolonged or even permanent since it is unlikely that all cases progess to the point of failure. A few patients recover normal or near-normal cardiac function. The interplay between high blood pressure, hypertensive heart failure and dilated cardiomyopathy is illustrated by patients who recover from heart failure to become hypertensive and vice versa and in current treatment with vasodilators and diuretics for patients at either end of the spectrum.
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PMID:Diagnosis and natural history of congested (dilated) cardiomyopathies. 70 14

Congestive cardiomyopathy principally affects adolescent young men. The prognosis is very serious, mortality is almost 50%. Symptomatology, clinical and radiological findings are chiefly determined by signs of cardiac insufficiency. The ECG almost always shows a pathological but not a pathognomonic finding. If ventricular dilation is marked, left ventricular function is partly extremely limited. As causes of congestive cardiomyopathy, inflammatory changes, autoimmunological processes and metabolic disorders are discussed.
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PMID:[Congestive cardiomyopathy (author's transl)]. 81 2

1.26 of 340 patients with chronic heart failure (aortic-valve or mitral-valve disease, congestive cardiomyopathy) showed Cheyne-Stokes respiration in supine position. 2. The incidence of Cheyne-Stokes respiration in males is more than twice as high as in females with similar hemodynamic conditions. 3. Lung volumes and airway resistance did not appreciably deviate from the predicted values and are therefore of no etiologic significance. 4. Delay of the feedback between changes in the alveolar gas tensions and respiratory center caused by a prolonged circulation time (decreased cardiac index and increased central blood volume) is the predominant cause of Cheyne-Stokes breathing in patients with chronic heart failure. 5. Metabolic alkalosis (e.g. after diuretics) favors Cheyne-Stokes respiration in patients with congestive heart failure and low cardiac output, by lessening respiratory changes in pH of blood and cerebrospinal fluid.
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PMID:[Cheyne-Stokes respiration in chronic heart insufficiency]. 87 30

It is reported on the course of an idiopathic congestive cardiomyopathy in a younger man which could be observed during three years. After a longer period free of symptoms acutely appeared the signs of a myocardial failure, in which case disturbances of cardiac rhythm at length caused death. In detail the clinical fingings, pathologo-anatomical changes as well as the differential-diagnostic considerations are discussed, which are important for the demarcation of the other forms of the idiopathic and secondary cardiomyopathies.
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PMID:[Problems of idiopathic congestive cardiomyopathy]. 96 Aug 59

Vasodilator therapy has been shown to have beneficial effects in heart failure. In order to evaluate the haemodynamic actions of vasodilator administration in primary congestive cardiomyopathy, sodium nitroprusside was infused intravenously at a rate of 15 to 100 mug/min to 12 patients. Mean arterial pressure fell 15 per cent from 86+/-3-0 to 72+/-2-4 mmHg (11-40 +/- -4 to 9-6 +/- 0-3 kPa), and there was a small but significant decrease in mean heart rate from 96 +/- 4-8 to 90 +/- 4-4 beats/min. These changes were accompanied by a significant decrease in mean pulmonary artery pressure from 40 +/- 2-2 to 26 +/- 2-8 mmHg (5-3 +/- 0-3 kPa to 3-5 +/- 0-4 kPa), mean pulmonary capillary wedge pressure from 25 +/ -2-2 to 16 +/- 2-1 mmHg (3-3 +/- 0-3 to 2-1 +/- 0-3 kPa), and left ventricular end-diastolic pressure from 27 +/- 1-8 to 17 +/- 1-5 mmHg (3-6 +/- 0-3 to 2-3 +/- 0-2 kPa). Cardiac index increased by an average of 48 per cent from 2-1 to 3-1 l/min per m2, and left ventricular stroke work index increased from 18-4 +/- 1-6 to 21-3 +/- 1-9 g m/m2. These results show that pronounced left ventricular dysfunction in patients with congestive cardiomyopathy is improved during vasodilator therapy.
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PMID:Circulatory response to vasodilator therapy in congestive cardiomyopathy. 97 93

A group of 43 patients with cardiomyopathy was assessed clinically and hemodynamically. Disturbances in the electric myocardial activity and hemodynamic changes concerning the duration of the different phases of left ventricular systole were observed. Despite the presence of these changes, in the early atypical forms no impairment of the myocardial contractility was found. In the advanced forms (hypertrophic cardiomyopathy and congestive cardiomyopathy) the myocardial contractility was impaired, this contributing to the development of heart failure manifestations.
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PMID:Clinical and hemodynamic assessment of cardiomyopathy. 99 69


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