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

In 50 patients with encephalomalacia and 50 patients with a transient cerebral ischemic attack (TIA) the risk factors and viscosity of the whole blood as well as the hematocrit were determined before the start of treatment. Compared to a control group, the blood viscosity in patients with encephalomalacia was significantly increased (p less than 0.001) in all ranges of shearing velocity tested, in patients with TIA only at that shearing velocity which may be assumed for the area of microcirculation. This increase was related to the presence of arterial hypertension, hyperlipemia, heart failure, diabetes mellitus, hyperfibrinogenemia and increased tendency of thrombocytes and erythrocytes to aggregate. From the results obtained it was concluded that increased blood viscosity in the cerebral area of microcirculation with insufficient cerebral collateral circulation may decisively favor the development of encephalomalacia.
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PMID:[Clinical significance of changes in blood viscosity in cerebrovascular insufficiency (author's transl)]. 81 Jun 86

Echocardiographic predictors of clinical outcome were examined in subjects from the Framingham Heart Study with overt coronary artery disease. The study population consisted of 185 men and 147 women with coronary artery disease who underwent M-mode echocardiography and were followed for a mean of 3.90 years. At baseline, 37 men (18.4%) and 16 women (10.9%) had reduced fractional shortening, 43 men (23.2%) and 28 women (19%) had left ventricular (LV) dilatation, and 76 men (41%) and 76 women (51.7%) had LV hypertrophy. During the follow-up period new cardiovascular disease events (coronary disease, stroke, transient ischemic attack, claudication, heart failure and deaths from cardiovascular disease) occurred in 60 men (32%) and 58 women (39%). With use of age-adjusted proportional hazards analyses, LV mass/height in men (relative risk [RR] = 1.25/50 g/m increment, 95% confidence interval [CI] 1.01 to 1.55) and LV end-diastolic diameter in women (RR = 1.36/5 mm increment, 95% CI 1.05 to 1.76) were predictors of new cardiovascular disease events. Cardiovascular risk was also associated with LV end-systolic diameter in both sexes (in men RR = 1.28/1 SD increment, 95% CI 1.02 to 1.63; in women RR = 1.40/1 standard deviation increment, 95% CI 1.09 to 1.82). Reduced fractional shortening alone (RR = 1.91, 95% CI 1.11 to 3.31) and in combination with LV dilatation (RR = 2.13, 95% CI 1.13 to 4.02) was associated with the incidence of new cardiovascular disease outcomes in men.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Echocardiographic determinants of clinical outcome in subjects with coronary artery disease (the Framingham Heart Study). 141 14

The above study was undertaken in order to evaluate the efficacy and tolerability of low dose calcium heparin for postinfarct ischemic heart disease (CIPI). In particular, the incidence was checked of: cardiovascular death, reinfarction, angina pectoris, TIA or RIND, stroke, arterial thromboembolism, venous thromboses, heart failure, complex ventricular arrhythmias, silent myocardial ischemia. Eighty patients with CIPI were divided into two groups similar for age, sex, physical features, cardiovascular risk factors, site of infarction, length of hospitalization, complications during hospitalization, clinical and instrumental findings at discharge, concomitant pathology. Upon discharge, patients were randomized into group 1 for traditional treatment and group 2 which in addition received 12,000 U calcium heparin s.c. every 24 h. After 12 months, during which patients were submitted to periodical laboratory and instrumental (standard and dynamic ECG, echoG) evaluation, group 2 had significantly fewer cardiovascular events than group 1 both as to overall number of events and as to number of events per individual patient. Especially, silent myocardial ischemia and ventricular arrhythmias were less frequent in group 2 patients and these two events, especially if coincident, are known to have severe prognostic implications. The efficacy of low-dose calcium heparin must be attributed to the enhancement of physiological antithrombotic mechanisms with compensation of blood clotting disorders that are fairly frequent in CIPI patients. Long-term s.c. administration was well tolerated.
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PMID:[The efficacy and tolerance of heparin-calcium at low doses in postinfarct ischemic cardiopathy]. 149 66

Several models of total artificial hearts have been used for transient or permanent circulatory support in patients with decompensation. The most successful and widely used device, however, has been the Symbion total artificial heart. From Dec. 12, 1982, to Jan. 1, 1991, 180 Symbion total artificial hearts were implanted in 176 patients in 28 centers. Five patients received a Symbion total artificial heart as a permanent circulatory support device, whereas 171 patients received the device as a bridge to heart transplantation. Of the 175 bridge devices (171 patients) 141 were Symbion J7-70 hearts and 34 were Symbion J7-100 hearts. Four patients received two total artificial hearts, the second one after the failure of a transplanted heart because of either rejection (two patients) or donor heart failure (2 patients). Most of the recipients were males (152). The age was 42 +/- 12 years (mean +/- SD) with a weight of 74 +/- 14 kg. The most common indications for implantation included deterioration while awaiting heart transplant (36%) and acute cardiogenic shock (32%). The cause of heart disease was primarily ischemic (52%) and idiopathic (35%) cardiomyopathy. Duration of implantation ranged from 0 to 603 days (mean 25 +/- 64 days). One hundred three (60%) patients had the device less than 2 weeks, 37 (22%) between 2 to 4 weeks and 31 (18%) more than 4 weeks. Complications during implantation included infection (37%), thromboembolic events (stroke 7%, transient ischemic attack 4%), kidney failure requiring dialysis (20%), bleeding requiring intervention (26%), and device malfunction (4%). Of the 171 patients, 118 (69%) underwent orthotopic heart transplantation. Actuarial survival for all patients with implants was 62% for 30 days and 42% for 1 year, and for patients with transplants was 72% for 30 days and 57% for 1 year. The main causes of death were sepsis (33%), multiorgan failure (21%), and posttransplant rejection (10%). The results indicate a relative success of this treatment for patients with an otherwise fatal prognosis. Moreover, as the demand for donor organs far exceeds availability, continued investigation of total artificial hearts is justified.
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PMID:Summary of the clinical use of the Symbion total artificial heart: a registry report. 154 May 98

During 2 years and 8 months (1980.9.-1983.4), 100 patients of arteriosclerosis were admitted to our hospital. Of these patients, 43 who had clinical symptoms of TIA, RIND, or bruits on the neck or supraclavicular fossa, were reviewed. Ages ranged from 46 to 81 years (mean: 66.3). Male to female ratio was 1.9:1. Of the 43 patients, 33 were submitted to arteriography of the branches of the aortic arch. Thirty-two but one had arteriosclerotic lesions on the 62 arteries: 32 carotid, 18 vertebral, and 12 subclavian arteries, respectively. Morphologically there were 42 stenoses, 13 occlusions, 7 aneurysmal dilatations, and three other lesions. Seven patients were involved only one artery and 25 were involved more than two arteries. Eight patients were involved other regions such as lower extremities, too. Of the 43 patients, 12 were operated upon and there were no operative deaths and complications. Three of 31 who were treated conservatively, died of malignancies and heart failure. Although operative indications for TIA or RIND have been defined, those for asymptomatic lesions have not been established. Once stroke occurred, however, it would become difficult to recover from it. It is hoped that operative indications for asymptomatic lesions are established as soon as possible.
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PMID:[Arteriosclerosis of the aortic arch branches. An analysis of 43 cases]. 398 83

By means of a case-control study, social and biomedical factors were considered in relation to transient cerebral ischemic attack occurrence as determined by questionnaire and interview among a population of females ( greater than 50 years of age) residing in the city of utrecht and surroundings. Contrary to earlier expectations, a greater TIA risk was found associated with: lower systolic and diastolic blood pressure, a low-salt diet for high blood pressure, lower body weight, smaller body surface, and use of medicines for cardiac insufficiency/arrhythmias and chronic anxiety. The importance of hemodynamic processes (i.e. hypotensive episodes of cerebral circulation) for TIA within the general population is emphasized.
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PMID:Unexpected trends in the analysis of a questionnaire and interview procedure to detect transient cerebral ischemic attack in a female population. 627 71

186 carotid endarterectomies (142 patients) were performed under regional anaesthesia between 1976 and 1983: 32% in asymptomatic stage, 36% in TIA, 4% in frank stroke, 28% in completed stroke. Postoperative mortality was 3.8%, neurologic deficit following endarterectomy 4% (2% transient, 2% permanent). Patients were followed-up six months to seven years after the operation: The incidence of late stroke amounted to 7% (11% in TIA-patients, 5% in patients with completed stroke before endarterectomy). 24% of the operated patients died during the follow-up period, 46% because of myocardial infarction or heart failure, 14% because of stroke. Recurrent stenosis occurred in 6% (indirect Doppler-sonogramm), two patients (3%) with symptomatic recurrent stenosis underwent reoperation.
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PMID:[Late results following carotid endarterectomy]. 652 80

The current study was undertaken to determine prospectively the risk of cerebral thromboembolism and the prognostic significance of left ventricular thrombus in ambulatory patients with chronic congestive heart failure. A total of 264 ambulatory patients (mean age 62 years, mean left ventricular ejection fraction 27%) were followed prospectively for 24 +/- 9 months to determine the incidence of nonhemorrhagic stroke, transient ischemic attack, and mortality. Two-dimensional echocardiographic studies, performed for clinical indications other than previous systemic thromboembolism in 109 patients, were analyzed to relate the presence of left ventricular thrombus to subsequent outcome. Nine cerebral thromboembolic events occurred in 264 patients during the two-year mean follow-up period, yielding a rate of 1.7 thromboembolic events per 100 patient-years of follow-up. Known risk factors for stroke (hypertension, diabetes mellitus, and/or atrial fibrillation) were present in all nine patients with cerebral thromboembolic events. The 109 patients with echocardiographic studies had more severe heart failure than patients without echocardiographic studies (functional class 2.6 vs 2.1, p < 0.01), greater risk of a thromboembolic event (2.4 vs 1.4 events/100 patient-years of follow-up, p < 0.01), and higher mortality (21.3 vs 5.5 deaths/100 patient-years, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Low incidence of stroke in ambulatory patients with heart failure: a prospective study. 832 56

We present a 81-year old male who developed dementia, gait disturbance and right hemiparesis. He was well until the age of 74 when he developed a hemorrhagic infarction in the right occipital region, which left him left homonymous hemianopsia. One year later he had one TIA attack consisting of dizziness, headache, and some clouding of consciousness. At that time, atrial fibrillation was found. At age 79, he was attacked by right hemiparesis. Cranial CT scans revealed a lesion consistent with a hemorrhagic infarct in the left middle cerebral artery territory. Two months prior to his final admission, he had a gradual onset of forgetfulness, labile affect, nocturnal agitation and hallucination which were followed by gait disturbance and urinary incontinence. On admission, he was alert but moderately demented. In addition he showed difficulty in repetition, limb kinetic and ideomotor apraxia of the left hand indicative of sympathetic apraxia, and constructional apraxia bilaterally. Granial nerves appeared intact except for left homonymous hemianopsia. His gait was wide-based and small stepped. No weakness or ataxia was noted. Deep reflexes were diminished on the left side. Plantar reflex was equivocally extensor of the left. Light touch and pain was slightly diminished on the right side. Cranial CT scans revealed a large low density area in the left fronto-temporo-parietal region. Also ventricular dilatation, diffuse low density change in the subcortical white matter, and diffuse cortical atrophy were seen. His clinical course was complicated by melena, anemia, pneumonia, cardiac failure and renal failure. He expired 2 months after his admission.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A 81-year-old man with dementia, gait disturbance, hemiparesis, and sympathetic apraxia]. 833 25

Patients with AF have a mortality rate about twice that of age-and sex-matched individuals without AF, and a stroke rate that is about fivefold greater. Patients less than 60 years of age with lone AF have an extremely low risk of stroke. Patients less than 65 years of age who do not have diabetes, a history of hypertension, a previous TIA or stroke, or heart failure have an annual risk of stroke of about 1% per year. Unfortunately, patients older than 65 or younger patients with any of the four risk factors have an annual risk of stroke of 4% or greater. Transthoracic and transesophageal echocardiography may be able to refine the risk stratification further, but additional studies are needed to establish their role.
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PMID:Prognosis of individuals with atrial fibrillation. 859 95


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