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

The effects of intravenous trinitrin on myocardial function have been studied in 40 patients with heart failure (26 cases of coronary artery disease and 14 of apparently primary cardiomyopathy). Each patient had measurements made of left ventricular pressure, of cardiac output by the dye dilution method, of volume, of the left ventricular ejection fraction, and of the segmental parietal kinetics by means of left side ventriculography both before and after trinitrin. The following results were obtained after injection of trinitrin:--no change in rhythm and cardiac index;--an almost constant decrease in left ventricular end diastolic pressure (38 cases out of 40);--a decrease in arterial pressure and ventricular volume in about two thirds of cases;--improvement of the ejection fraction (25 cases out of 40), and of segmental parietal kinetics (26 cases out of 40) in the left ventricle. These findings were equally true in the patients with coronary artery disease and in the cardiomyopathies. In the light of these results, it appears that when used in left ventricular failure, trinitrin almost always decreases the load, but improves ventricular kinetics only in two thirds of cases, while it has no influence on cardiac output. In addition, given the difficulties in establishing a standard dose of trinitrin, the authors discuss the methods of establishing the optimal dose.
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PMID:[Effects of intravenous trinitrine on myocardial function in left ventricular insufficiency]. 10 Nov 68

Of a total of 4,800 coronary arteriogrammes, 1,280 of which were carried out after myocardial infarction, 25 cases of proven infarction with normal coronary arteriography, confirmed by several "blind" interpretations, were retained. The interval between acute infarction and coronary arteriography was usually less than 6 months. The average age of the patients was 36.9 years, affecting more women than in classical coronary artery disease. The acute infarction was nearly always the first symptom. Cigarette consumption and hormonal factors is women were coronary risks factors of note. Ventricular sequellae were frequent, cardiac failure exceptional, exercise testing nearly always negative and occupational rehabilitation usually normal. It would seem that this affection is less serious than classical myocardial infarction due to atheroma probably because the non-infarcted myocardium is healthy, but the true prognosis of this type of coronary accident will only be revealed by long term studies. In the meantime the most useful investigations and the management of these patients are discussed.
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PMID:[Epidemiological profile of patients with myocardial infarction and normal coronary arteriography]. 10 79

A retrospective study of adult congestive cardiomyopathy was carried out; the admission criteria being heart failure with cardiomegaly after the exclusion of known causes of heart failure. Coronary artery disease was excluded by forming two sub groups, one with proven normal coronary arteries at angiography or autopsy and the other with only assumedly normal coronary arteries. The results concern the study of the incidence of this disease which has been regularly seen over the last 10 years in departments with a large number of referrals of cardiomyopathy. --Professional factors are analysed to see if there is a higher incidence amongst the working classes. --Other factors are analysed by comparison with three control groups: normal, coronary and valvular disease, and diabetes which may be a predisposing factor, but not the serum cholesterol which is decreased in these patients. There is a significant association with smoking and alcoholism and the main biological sign of the latter condition, macrocytosis. This is also found in both coronary sub groups. The isolation of this alcohol factor in the genesis of congestive cardiomyopathy implies the possibility of reversing or stabilising the myocardial damage after its withdrawal, so changing the severe diagnosis associated with this disease.
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PMID:[Multicenter epidemiological survey of primary myocardiopathies. Apropos of 380 cases]. 12 Jan 46

A group of ten acromegalic patients, who had no history of heart failure, was studied to determine whether subtle carciac impairment may also be common. None had clinical evidence of coronary artery disease or severe hypertension. Systolic time intervals were recorded in each patient and compared with normal values predicted for sex and heart rate by our own controls and published data. The results indicate that measurable abnormalities in left ventricular performance are common in this sampling. Known duration and activity of disease (growth hormone levels at time of study) did not correlate with the time intervals. The results are consistent with cardiomyopathic effect of excessive growth hormone.
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PMID:Evidence of subclinical heart muscle dysfunction in acromegaly. 12 91

The role of hypertension in cardiovascular disease was studied in the hypertensive coarcted monkey during the feeding of an atherogenic and nonatherogenic diet. During the 15-month period of observation, half of the hypertensive coarcted monkeys developed cardiovascular disease which included heart failure, ischemic heart disease, stroke, and sudden death. There were no cardiovascular complications in the control normotensive monkeys except for one cholesterol-fed animal. The incidence of ischemic heart disease and sudden cardiac death was higher in monkeys with both hypertension and hypercholesterolemia than in those with hypertension or hypercholesterolemia alone. Postmortem studies revealed that the former monkeys had both hypertensive and atherosclerotic heart disease, whereas the monkeys with hypertension or hypercholesterolemia had either hypertensive or atherosclerotic heart disease. Hypertensive heart disease was characterized not only by hypertrophy of the left ventricle but also by focal myocardial degeneration and fibrosis and by focal thickening and narrowing of the small coronary arteries, particularly the sinus node artery and the atrioventricular node artery. The finding of transmural myocardial infarction in two monkeys with patient coronary arteries suggests a possible role of coronary artery spasm in ischemic heart disease in hypertension. The cerebral vascular complications of hypertension included hypertensive encephalopathy, transient "ischemic" attacks, and hemorrhagic stroke. The complications were associated with severe hypertension and with hypertensive vascular disease or hypertensive and atherosclerotic vascular disease of the cerebral arteries.
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PMID:Role of hypertension in ischemic heart disease and cerebral vascular disease in the cynomolgus monkey with coarctation of the aorta. 14 28

Adequate antihypertensive therapy will lower blood pressure to normotensive or near normotensive levels in 80-85% of patients. Long-term treatment results in a marked decrease in strokes and stroke recurrence, heart failure, renal failure, and progression to accelerated hypertension. The effects of long-term therapy on the occurrence of coronary artery disease are unclear.
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PMID:Prognosis of adequately treated hypertensive patients. 14 27

The hemodynamic effects of tazolol, a new long-acting beta-stimulating drug, were studied in dogs with acute pump failure caused by experimental myocardial infarction and the results were compared with the actions of isoproterenol given in small and large doses. Tazolol produced a significant and sustained increase in cardiac output and stroke volume, while causing a decrease in peripheral resistance and mean aortic pressure. Heart rate was only modestly increased. Compared with isoproterenol at equivalent doses. tazolol appeared to cause less S-T segment elevation at the margin of infarction. The increase in double product (systolic pressure X heart rate) produced by tazolol was also considerably less than that of isoproterenol. Tazolol may prove to be a useful addition to the drugs available for the treatment of myocardial failure of various causes. It is now being studied in patients with heart failure due to coronary artery disease.
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PMID:Circulatory effects of tazolol in experimental myocardial infarction. 23 34

Twenty-one patients with postinfarction angina (2 to 15 days after acute myocardial infarction) unresponsive to medical therapy were treated by intra-aortic balloon pumping (IABP). Anginal pain and electrocardiographic (ECG) ST-segment changes were prevented in all patients. Coronary angiograms were obtained during IABP without complication and confirmed severe coronary artery disease. Of the four nonoperated patients, three had reinfarction and two died of cardiogenic shock. Seventeen patients underwent aorta-coronary bypass grafting, associated with aneurysmectomy in two patients and closure of a ventricular septal defect in one. Sixteen patients survived the operation. All survivors are in clinically improved condition and 14 are pain free from 9 to 28 months postoperatively, but three have mild heart failure.
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PMID:Treatment of post-myocardial infarction angina by intra-aortic ballon pumping and emergency revascularization. 30 68

Technetium 99m Pyrophosphate imaging before and after open heart surgery was performed in 38 patients to estimate the incidence of peri-operative infarction. Positive images were present pre-operatively in 11 of 30 patients with coronary artery disease. In three patients the images changed from negative to positive and in two this was thought to be due to infarction produced at operation. The high incidence of positive pre-operative images emphasises that many patients with evolving myocardial infarction, unstable angina or severe heart failure are now operated upon without delay. Because many patients have positive images before surgery pre-operative and post-operative images must be compared to assess myocardial damage due to surgery.
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PMID:Radionuclide imaging to assess myocardial damage during open heart surgery. 30 50

Forty-six patients who underwent mitral valve replacement for mitral regurgitation due to coronary artery disease during 1970-1975 were identified. Forty patients underwent aortocoronary bypass procedures at the same operation. The survival rate at the fourth postoperative year was 73% in the 22 patients in whom the preoperative left ventricular ejection fraction exceeded 0.35, 38% in the 16 patients in whom the preoperative left ventricular ejection fraction was 35% or less, and 25% in the eight patients in whom aneurysmectomy was performed at the time of mitral valve replacement (p less than 0.05 for the former group compared to the latter two groups). Heart failure, present preoperatively in 41 patients, was improved in most of the long-term survivors. Neither the angiographic extent of coronary artery disease nor whether mitral valve replacement was performed in the acute (within 2 months in 13 patients) or chronic phase of myocardial infarction were distinctly correlated with survival.
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PMID:Survival following mitral valve replacement for mitral regurgitation due to coronary artery disease. 31 11


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