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

To evaluate the cardiac dysfunction of the cerebral infarction (cerebral thrombosis) patients in the chronic period, non-invasive studies were performed on 45 cerebral infarction patients (CI group: 25 males and 16 females, mean age 64.1 y). Forty hospitalized patient without cerebral infarction served as controls (non-CI group: 23 males and 19 females, mean age 64.8 y). The CI and non-CI group were divided into two sub-groups: patients with a past history of hypertension (HT) and without (NT). In each sub-group, the cardiac functions were compared between CI and non-CI by M-mode and Doppler echocardiography. In echocardiography, research based on the premise that the function of the left ventricle can be divided into preload (EDVi), afterload (SVR), contractility (EF, mVcf, SBP/ESV) and distensibility (E/A). On results show that there were no significant differences in preload, afterload and contractility of the left ventricle between CI and non-CI group in each HT and NT sub group. However, a significant difference was demonstrated in the diastolic function the left ventricle between the two groups in the HT (p = 0.007) and NT (p = 0.04) sub-groups. In conclusion, left ventricle diastolic function was deteriorated in cerebral infarction patients although systolic function not deteriorated. Because diastolic dysfunction may be caused by existing latent heart failure and/or silent myocardial ischemia, echocardiographic study is useful for early detection of left ventricle impairments in cerebral infarction patients.
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PMID:[Study of left ventricular function in cerebral thrombosis with pulsed Doppler echocardiography]. 811 52

We report a 70-year-old man who had a sudden onset of right hemiparesis and mutism. The lower extremity was more involved than the upper one. He had a long history of diabetes and chronic renal failure for which hemodialysis was necessary. On August 30, 1990, he had an sudden onset of right hemiparesis and mutism. Neurological examination revealed awake but mute in no acute distress. He could only respond to very simple commands such as opening his mouth or protruding his tongue. He did not appear to understand more difficult questions. In addition, he could not answer verbally. He was totally mute. Cranial nerves appeared intact except for slight right central facial paresis and severe diabetic retinopathy. He had complete paralysis of his right leg and a moderate weakness in his right upper extremity. Deep reflexes were diminished in both upper extremities and absent in the lower limbs. Frotal signs such as grasp and snout reflexes were present. Cranial CT scans revealed an ill-defined low density area in the left parasagittal subcortical area and a part of the anterior cerebral artery territory. The supplementary motor area appeared at least in part to be involved. He was treated with glycerol and other supportive cares, however, his clinical course was complicated by pneumonia, heart failure, septicemia, and he expired two months after his stroke. The patient was discussed in a neurological CPC, and the chief discussant arrived at a conclusion that he had an artery-to-artery embolism at the internal carotid bifurcation resulting in the cerebral infarction mainly in the territory of the anterior cerebral artery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A 70-year-old man with right hemiparesis and mutism]. 836 54

Since 1982, fourteen patients with aortic aneurysms received thromboexclusion operation. This method was performed in 7 patients with dissecting aortic aneurysms, 6 patients with true thoracic aneurysms, and 1 patient with true thoracoabdominal aneurysm. Among them, 12 patients received the operation of ascending aorta-supraceliac abdominal aorta bypass, one patient received descending aorta-descending aorta bypass, and another one received bilateral axillo-iliac artery bypass. Graft sizes in diameter were from 16 mm to 22 mm. 9 patients received permanent paired-clamps at both the proximal and the distal parts of the thoracic aneurysm, and 5 patients received permanent single-clamp only at the proximal part of the thoracic aneurysm. 5 patients (35.7%) died perioperatively because of low output syndrome, cerebral infarction, hepato-renal insufficiency, and aneurysmal rupture, respectively. 4 late deaths (28.6%) occurred after 4 months, 5 months, 26 months, and 5 years of operation, respectively. Among them, three deaths were due to aneurysmal rupture and one due to heart failure. Although paired-clamps at both the proximal and the distal parts of the thoracic aneurysm were performed in 1 to 3 ruptured-cases, thrombo-occlusion of the thoracic aorta did not occur in any of the cases. Long-term survival was 35.7% in 5 patients after 14 years and 4 months of mean follow-up. Although a single-clamp only at the proximal part of the thoracic aneurysm was performed in 2 of these 5 cases, thrombo-occlusion of the thoracic aorta occurred in all cases. For the four survivors of them, we ran a follow-up survey and found left ventricular hypertrophic pattern in ECG, concentric left ventricular hypertrophy in UCG, and hypertension, but those were absent before operation. We conclude that thromboexclusion method for thoracic aneurysm should be limited only to high-risk patients particularly in bad conditions or to cases with severe adhesion to lung which seem to be inaccessible through direct approach.
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PMID:[Long-term survival after treatment of thoracic aneurysms by thromboexclusion operation]. 891 Oct 49

The objective of the investigation was an attempt to analyze some aspects of the heart-brain relationship. The group was formed by 626 patients with the diagnosis of focal cerebral ischaemia (CI) and 191 patients with the diagnosis of subarachnoidal haemorrhage (SAH). It was revealed that the CI group comprised 77.3% patients with a pathological finding on the heart. Analysis revealed moreover that in the group of patients with "congestive heart failure" there was a significantly higher percentage of patients with a severe neurological deficit as compared to the group with a "normal" ECG (p < 0.001). Atrial fibrillation causes a fivefold increase of the risk of cerebral infarction. The incidence of ECG abnormalities of various types was significantly higher in the group of patients with CI during long-term ECG monitoring, as compared to the results of conventional ECG examination (p < 0.001). The value of long-term ECG monitoring was confirmed also in an investigation of these changes in a group of patients with arterial hypertension, quari potential candidates of cerebral infarction. The relationship between cardiac and cerebral function was tested also in an investigation focused on the incidence of ectopic activity and changes of the QT interval. It was revealed that while the percentage rate of ectopic activity assessed by conventional ECG examination was in the group of "improved" patients 18.0%, long-term monitoring revealed a rate as high as 48.0%, the difference being statistically significant. Similar significant differences were observed also on analysis of the QT interval: in the group of patients with neurological "improvement" the QT interval was significantly shorter, as compared with the group with neurological "deterioration". It was assumed that the prolonged QT interval could be the cause of sudden death. A cardio-cerebral relationship was found also on analysis of changes of the cerebral circulation (CBF) in different forms of cardiac insufficiency. It was revealed that isolated ventricular extrasystoles reduced the CBF by 8.0%, isolated atrial extrasystoles by 12% and in atrio-ventricular tachyarrhythmia the CBF is reduced by as much as 25.0%. The cerebro-cardiac relationship was tested in a group of patients with SAH. ECG abnormalities of a varying type were found in 30.7% of the patients with SAH. They are described in as many as 100% of patients and were detected also other in cerebral disorders, such as contusion of the brain, intraoerebral haemorrhage and cerebral tumours.
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PMID:[The heart and the brain. Aspects of their interrelations]. 892 26

One hundred and sixty-eight out of 296 patients who died of acute myocardial infarction (AMI) in the Coronary Care Unit were studied to assess the cause of death. Twenty-two of them had received thrombolytic therapy. The mean age of these patients was 64.3 +/- 18.2 years. One hundred and eight subjects were male and 60 were female. One hundred and nine cases (64.8%) showed, at postmortem examination, histopathologic alterations due to acute myocardial infarction (AMI). Death was due to heart failure in 35.8%, cardiogenic shock in 20% and ventricular arrhythmia in 44%. The other 59 patients died from complications superimposed upon AMI: reinfarction (23.7%), heart rupture (40.7%), myocardial fibrosis and reinfarction (18.6%), and cerebral infarction (17%). Two of these patients also showed massive pneumonia. In those subjects who had received thrombolytic therapy, a broad spectrum of arrhythmic and haemorrhagic complications were seen (68%). Four causes of death were seen in the subjects studied: AMI, superimposed cardiac complications, side-effects of thrombolytic treatment, and non-cardiac causes. Patients who did not receive thrombolysis mechanical events eg heart failure, characterized their deaths. In subjects who had received thrombolytic therapy, arrhythmic and haemorrhagic were widely observed.
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PMID:Causes of death from myocardial infarction before and after thrombolysis era: a pathologic study. 894 26

We performed double valve replacement for a patient with active endocarditis 2 days after the onset of cerebral infarction because of intractable cardiac failure. The use of heparin and the hypotension brought by cardiopulmonary bypass can lead exacerbation of the cerebral symptoms after open heart surgery which is performed during acute phase of cerebral infarction. Perfusion pressure was maintained over 70 mmHg during cardiopulmonary bypass and activated clotting time was kept about 400 seconds to prevent aggravation of cerebral complications in this case. The patients recovered from surgery uneventfully. We described a case who was received double valve replacement 2 days after the onset of cerebral infarction successfully.
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PMID:[A case of successful surgical treatment for active endocarditis 2 days after the onset of cerebral infarction]. 909 91

We analyzed the risk of mitral valve re-replacement (re-MVR) in patients over 70-year-old. Surgical and late follow-up results were compared between 14 elderly patients over 70-year-old (group I) and 23 patients aged from 60 to 69-year-old (group II) who underwent re-MVR due to primary tissue failure (PTF). Donation of autologous blood and a rate of replaced valve prosthesis (mechanical/biological) were different between the two groups. There were no differences in the other factors such as clinical profile, preoperative organ function, operative characteristics, post operative relating factors. No operative death occurred in both groups. There was one hospital death in group I (a hospital mortality rate of 7.1%). The cause of death was related to massive cerebral infarction due to anticoagulant-related thromboembolic event. 4-64 months after re-MVR, the improvement of a NYHA function class was I-II in the two groups. With improvement in myocardial protection and intraoperative strategies, the operative risk in patients undergoing re-MVR over 70-year-old has been markedly reduced. Surgical results in aged patients were satisfactory and age alone is not a contraindication for this operation. The re-MVR in aged patients should be done at the early stage of PTF before progress of cardiac failure.
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PMID:[Mitral valve re-replacement in patients aged 70 years and older: is age alone not operative risk factor?]. 925 86

Apical hypertrophic cardiomyopathy (apical HCM) has been believed to be a special type of hypertrophic cardiomyopathy. It usually occurs in middle-aged or elderly men and the prognosis is thought to be good. However, recent reports suggest that approximately 10% of middle-aged patients with apical HCM have cardiac events and poor outcomes. We studied electrocardiograms and echocardiograms, the occurrence of cardiac events, and clinical characteristics in elderly patients with apical HCM (13 men and 7 women, 61 to 95 years old, mean age 74 +/- 7). Three of 20 patients (15%) had cardiac events (sudden death, 1; heart failure, 1; chest pain, 1), 2 had cerebral infarction with atrial fibrillation, and 2 died of non-cardiac causes. There were no differences in age, sex, medication, complications, or in initial values of electrocardiographic or echocardiographic variables between patients who had and did not have cardiac events. However, left ventricular end-systolic dimension (LVEDs) and left atrial diameter at the time of the last evaluation were larger in patients who had cardiac events than in those who did not (26 vs. 34 mm, p = 0.019, 33 vs. 38 mm, p = 0.1325, respectively). These results suggest that the prognosis for patients with apical HCM is not necessarily good, and that enlargement of the LVEDs might be used to predict cardiac events in elderly patients with apical HCM.
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PMID:[Clinical characteristics and cardiac events in elderly patients with apical hypertrophic cardiomyopathy]. 930 Dec 62

Hypertension is observed in three-fourths of the patients in the acute phase of a cerebral infarction. Treatment of an elevated blood pressure in the acute phase of a cerebral infarction is discouraged for the following arguments: In most instances the elevated blood pressure decreases spontaneously in the first few days after the infarction and stabilisation of the blood pressure is usually seen within 4 to 7 days. The elevated blood pressure in the acute phase of the cerebral infarction may be considered a favourable adaptation mechanism aimed at maintaining cerebral perfusion in the region surrounding the infarction. As a consequence lowering of the elevated blood pressure may be harmful because it can lead to expansion of the infarction. No controlled prospective studies to determine if treatment of hypertension in the acute phase of a cerebral infarction might be of benefit have been performed. There are, however, several case reports showing that treatment of an elevated blood pressure in the acute phase of a cerebral infarction is associated with dramatic progression of the neurological deficit. Exceptions can be made for situations where diastolic blood is repeatedly higher than 130-140 mmHg or where there are concomitant cardiovascular diseases, such as myocardial infarction, heart failure or a dissecting aneurysm requiring immediate antihypertensive treatment.
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PMID:[Hypertension in the acute phase of cerebral infarction; not always to be treated]. 954 60

For 13 years between 1980 and 1992, 23 patients needed pacemaker (PM) implantation because of bradyarrhythmia, 21 of atrial fibrillation and two of complete A-V block, after valve surgery. Five of 88 survivors (5.7%) after OMC, 11 of 227 (4.8%) after MVR, one of 169 (0.6%) after AVR, five of 67 (7.4%) after MVR + AVR and one of 15 (6.7%) after TVR underwent PM implantation in postoperative period. Two cases who had heart failure was implanted PM in early postoperative period. In late period, the mean duration between previous valve surgery and PM implantation was 6.4 years in 12 cases after initial valve surgery and 2.3 years in nine after second valve surgery. Postoperative course after PM implantation was almost good, but one case was died due to critical arrhythmia. And one case underwent re-MVR because of mitral bioprosthesis dysfunction and one, without anticoagulant after OMC, was complicated cerebral infarction.
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PMID:[A study of pacemaker implantation to cases performed valve surgery]. 942 29


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