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

In patients with heart failure there are distinct functional abnormalities in the myocytes themselves. This review deals with the deteriorations in the myocardial energy metabolism and the recently found alterations in the neurohumoral and hormonal signal transduction and signal realization within the cardiac cells. Beside the reduction in the volume of mitochondria in the overloaded myocardium the energy starvation is also reflected by a decrease in the content of high energy phosphates. Studies on nonfailing and failing human ventricular myocardium identified significant alterations in the neurohumoral regulation of the heart including the fluxes and the transport processes of Ca2+ as well as the beta-adrenoceptors, G-proteins, cAMP levels and cAMP-mediated processes. Recent data on the existence of auto-antibodies against the ADP/ATP translocator of the mitochondrial membrane and of stimulatory acting autoantibodies against i) the L-type calcium channel and ii) the beta 1-adrenoceptor, respectively, in patients with dilated cardiomyopathy, may open a new view in the etiology of heart failure and for consequences in the therapeutic concept of these diseases.
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PMID:[Cellular and molecular mechanisms in heart failure]. 172 87

Severe cardiac arrhythmias (Lown class IVa), rapid loss of physical capacity and dyspnoea on the slightest exertion occurred in a 55-year-old man with idiopathic dilated cardiomyopathy. In the preceding year he had recurrent diarrhoea and lost 23 kg in weight. He was found to have hypercalcaemia (3-3.2 mmol/l). The heart failure significantly improved under treatment with twice daily 12.5 mg captopril, 100 mg spironolactone daily, furosemide 40 mg twice daily, and digitoxin 0.07 mg daily. The arrhythmia responded to verapamil 80 mg and quinidine 160 mg, both drugs three times daily. Primary hyperparathyroidism was found to be the cause of the hypercalcaemia (parathormone 84 pmol/l). After the parathyroid adenoma had been removed the patient's condition again improved markedly. There were only rare monotopic extrasystoles, cardiac size regressed, and diuretics were no longer necessary. His medication at present is verapamil (80 mg three times daily), captopril (12.5 mg three times daily) and digitoxin (0.07 mg daily). It is concluded that the hypercalcaemia influenced the severity of the cardiomyopathy. It would seem that both intra- and extracellular calcium homoeostasis is of great importance in dilated cardiomyopathy.
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PMID:[The coincidence of rapidly progressing dilated cardiomyopathy and primary hyperparathyroidism. The course before and after the removal of a parathyroid adenoma]. 173 86

Ten healthy (aged 28 to 39) and ten heart failure NYHA II (aged 19 to 49) male subjects were prospectively studied under no drugs, under furosemide (40 mg/day), under captopril (150 mg/day) and under their association. Arterial compliance (ml/mmHg) was measured in all subjects at rest and supine. Heart failure etiology was dilated cardiomyopathy or ischemic heart disease without significant regurgitation. Arterial compliance was significantly higher in healthy than in heart failure patients in all studied conditions (p less than 0.001) (healthy = 2.2 + 0.29 vs. heart failure = 0.79 + 0.14). Neither single drug nor their association induced any change in healthy subjects. Arterial compliance progressively increased in heart failure with furosemide, captopril, and their association (no drug = 0.79 + 0.14; furosemide = 0.87 + 0.15; captopril = 0.94 + 0.15 and furosemide + captopril = 0.99 + 0.14). Captopril induced a higher increment than furosemide (p less than 0.001) and their association even a higher increment (p less than 0.001) than any single drug. Thus captopril and/or furosemide increased arterial compliance in heart failure but not in healthy subjects, possibly through changes in arterial wall edema and smooth muscle contraction.
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PMID:Effect of drugs on a noninvasive index of arterial compliance in healthy and heart failure patients. 174 91

Recurrent automatic atrial tachycardia can induce dilated cardiomyopathy. We present clinical and therapeutic problems of 16 years old male with ectopic left atrial tachycardia refractory to pharmacological therapy. In this patient long periods of atrial tachycardia 200-240/min due to lack of effective medication caused cardiac failure. Uncontrolled taking of various antiarrhythmic drugs and persistent tachycardia led to cardiogenic shock. The electrophysiologic study revealed focus of the tachycardia localized in the area of left cardiac auricle. The rate of the tachycardia was changing from 84 to 240/min, with periods of Mobitz I block in the AV node. In periods of 1:1 AV conduction the tachycardia had sometimes LBBB QRS morphology. The atrial tachycardia provoked unsustained ventricular one. The patient was operated. Resection of left auricle and mitral valvuloplasty were performed. After the operation the patient regained undisturbed sinus rhythm and symptoms of heart failure disappeared.
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PMID:[Indications for emergency surgical treatment of ectopic atrial tachycardia]. 175 65

A 24-year-old woman presented a severe HUS followed 3 months later by a cardiac failure diagnosed echographically as a dilated cardiomyopathy. The patient was hemodialysed and successfully transplanted. Later course of dilated cardiomyopathy was favourable. Review of literature confirms the rare and severe nature of cardiac lesions occurring in the course of HUS. We suggest a related pathophysiology concerning these two entities.
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PMID:[Dilated cardiomyopathy during post-partum hemolytic and uremic syndrome (HUS)]. 176 31

An opiate-based anaesthetic technique has been developed for use in dogs with end-stage heart failure due to dilated cardiomyopathy. It has been used in dogs undergoing translocation of the left latissimus dorsi around the descending thoracic aorta to create an autologous counterpulsation system. Anaesthesia was induced with barbiturate (10 mg/kg thiopentone) and fentanyl (500 micrograms) and maintained by an infusion of fentanyl (0.5 micrograms/kg/minute) [corrected] in addition to halothane (0.1 to 0.5 per cent) and nitrous oxide (20 to 60 per cent). This technique provided safe anaesthesia for major intrathoracic surgery.
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PMID:Development of an opiate-based anaesthetic technique for use in dogs with cardiomyopathy. 154 87

Despite the progress of the medical and surgical therapy of cardiac failure, the prognosis of this syndrome remains severe. We studied in a group of cardiac failure patients (n = 203; 18-74 years old) admitted in our division from 1982 to 1987 the most significant clinical and instrumental parameters of prognostic importance. The clinical parameters considered were: age, sex, heart rate, blood pressure, NYHA class, presence of mitral insufficiency, episodes of acute heart failure. The instrumental parameters were: presence of complete left bundle branch block (LBBB), atrial fibrillation, episodes of ventricular tachycardia, cardiothoracic index (C/T), end-diastolic and end-systolic diameters, ejection fraction (EF). Statistical analysis was performed in order to correlate single parameters with mortality. The total survival at 5 years was 50%, being higher in patients with coronary artery disease than in patients with primary dilated cardiomyopathy. The parameters worsening the prognosis were: mitral insufficiency, III-IV NYHA class, occurrence of repeated episodes of acute heart failure in the last year, complete LBBB, C/T greater than 0.55 and EF less than 20%. In conclusion, considering instrumental parameters high risk patients are detected with a precision of 80%.
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PMID:[The prognosis of the patient with heart failure: an analysis of the most significant clinical and instrumental parameters]. 176 26

To assess the prognostic significance of right ventricular function in dilated cardiomyopathy (DCM), we studied consecutive 57 DCM patients. There were 41 men and 16 women, whose mean age was 48 ys. (range 3-68 ys.). The mean LVEF in all patients was 29 +/- 11%, and the mean interval from the onset of symptom of cardiac failure (CHF history) was 4 ys. (range 0-33 ys.). With follow-up of 3.8 ys., five patients had died until the first year, and 14 had died until the third year. By using multivariate regression analysis, there were no prognostic significance in clinical parameters such as age, CHF history, sex, atrial fibrillation, except for NYHA class, and medication at the third year. In survival curves according to Kaplan-Meier method, RVEF and mean PA had predictive value (p less than 0.05), while LVEF did not. The patients with RVEF less than 45% had poor survival rate compared to those with RVEF greater than or equal to 45%. The patients with RVEF less than 45% showed lower LVEF and LVESVI. RVEF may offer prognostic predictive value through the effect of not only mean PA but also left ventricular parameter. In conclusion, radionuclide assessment of right ventricular function should be valuable for the prognostic evaluation of DCM patients.
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PMID:[Prognostic significance of radionuclide-assessed right ventricular function in dilated cardiomyopathy]. 177 Jun 60

A case of right ventricular dilated cardiomyopathy associated with primary biliary cirrhosis is described. The patient was a middle aged woman, who initially complained of fatigue and itching. The diagnosis of primary biliary cirrhosis was made based on clinical, biochemical and histological evidence of the disease. Seven years later severe right-sided heart failure developed. The diagnosis of right ventricular dilated cardiomyopathy was made based on echocardiographic and angiographic evidence of a globally dilated and poorly contracting right ventricle. Left ventricular function was within normal limits. Autoimmune serology screening at this time revealed the presence of organ-specific cardiac antibody (titre 1/20) and of antinuclear antibody (titre 1/80) by indirect immunofluorescence. There were no findings of mitochondrial antibody or other non-organ specific or organ-specific antibodies. Overall, this assessment demonstrates autoimmunity in both hepatic and heart muscle disease in a patient with primary biliary cirrhosis and right ventricular dilated cardiomyopathy.
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PMID:Right ventricular dilated cardiomyopathy associated with primary biliary cirrhosis. 178 56

This investigation is designed to study the circadian rhythm (CR) of blood pressure (BP) and heart rate (HR) in heart transplanted patients (HTP). The research was performed on 10 heart failure patients (HFP), IV NYHA class, who underwent heart transplantation (HT) because of a primary congestive cardiomyopathy. The 24-h BP and HR monitorings were performed by means of a non-invasive method in pre-operative stage, over the 4 post-operative days, 6 and 12 months after surgery. ANOVA and Cosinor method validated the occurrence of a statistically significant CR in HFP. Over the 4 days after HT, the Serial Section Analysis did not show a 24-h periodicity of BP and HR: 6 months after HT, the BP and HR CR was not validated as well. One year after HT, the BP and HR CR was statistically detected. A significant difference between HTP and the clinically healthy subjects was validated only for the mean value of HR. In our opinion, the consolidation of the BP and HR CR 1 year after HT might be regarded as a clinical feature of a reacquired matching of cardiac function with vascular activity.
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PMID:[Circadian rhythm of arterial blood pressure and heart rate in patients with heart transplantation: a longitudinal study before and after transplantation]. 179 88


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