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

The effect of intermediate coronary care, with and without ECG monitoring, was compared with general medical ward care on the basis of mortality, resuscitation, and detection and treatment of arrhythmias from days 3 to 14 after admission in 2,095 cases of acute coronary heart disease. Mortality was significantly reduced (P less than .02), and number of successful resuscitations for ventricular fibrillation was increased (P less than .05) but only in the unit with monitoring. Number of arrhythmias detected was significantly increased, particularly incidence of ventricular ectopics and heart block (P less than .02). Number of arrhythmias corrected to sinus rhythm was increased, but not significantly. Death from pulmonary embolism fell (P less than .01). Review of causes of death and autopsies showed an increased proportion of deaths due to intractable heart failure and cardiogenic shock. Not only specially trained nurses, but also ECG monitoring, were necessary to obtain the benefits of this treatment.
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PMID:An assessment of intermediate coronary care. 71 43

To evaluate the relationship between myocardial infarction and angina pectoris, history of symptomatic coronary heart disease was analyzed in 146 patients who had had documented myocardial infarction. There were 126 males and 70 females of mean age 55 years (range 32 to 70 years). Infarction had occurred 6 to 63 months prior to the study (mean: 30 months). Angina pectoris occurred at some time during the clinical course of 75 patients (51%), and 71 patients (49%) had not experienced angina. In the majority of the group with angina (n = 39; 52%) the symptom had not been present before infarction, appearing initially thereafter. Angina was present both before and after infarction in 31 patients (41%). In only 5 patients (7%) was precedent angina lost after infarction. Angina was, therefore, present in 70 of 146 patients (48%) after, compared to 36 patients (25%) before, infarction and in 86% (31/36) of patients with angina before infarction it persisted following the attack. Prior angina following myocardial infarction was not related to increased activity since in the majority of patients activity level was less after than before infarction. Post-infarction cardiac failure, which developed in 9 patients who had prior angina, was not associated with abolition of angina in any of this group. It is concluded that: 1. angina is frequent after myocardial infarction, 2. when present before infarction it usually persists thereafter, 3. angina commonly appears as a new symptom after infarction when not previously present and 4. disappearance of angina after infarction is distinctly uncommon.
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PMID:Relationship of myocardial infarction to presence of angina pectoris in patients with coronary heart disease: lack of abolition of angina by infarction. 75 12

The activity of the beta-receptor blocker pindolol (0.4 mg i.v.) was investigated alone and in combination with digitalis (moderately fast loading) in 12 patients with coronary heart disease and without manifest signs of cardiac insufficiency. These patients showed pathological increase of left ventricular filling pressure during exercise testing. The exercise-induced rise of the mean pulmonary arterial and capillary pressures were increased by pindolol. Concurrently the increase of cardiac frequency was clearly diminished during ergometry (from 107/min without pindolol to 96/min, P less than 0.005). Digoxin given orally for an average of 5 days prevented the pressure increase in the pulmonary circulation induced by pindolol during exercise testing and at rest. The frequency reducing effect of pindolol was potentiated by digitalis. Use of digitalis alone did not influence mean exercise-induced pressure increase of the pulmonary circulation. In fact in some cases deterioration of these parameters was observed.
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PMID:[Influence of digitalis on pindolol activity in exercise-induced cardiac failure in patients with coronary disease (author's transl)]. 75 58

Left ventricular pressure and volume during diastole reflect the interaction of ventricular elastic, viscous, and inertial properties, and the completeness of myocardial relazation. Myocardial relaxation may be impaired in the acutely ischemic ventricle, partly accounting for the abnormal diastolic pressure-volume relation in this condition. Altered elasticity of its wall can cause increased stiffness of the ventricular chamber, as in aortic stenosis, coronary heart disease, and infiltrative cardiomyopathies. In aortic stenosis, increased left ventricular stiffness results in an increase in pressure increment associated with left atrial contraction. Generation of such a high filling pressure is critical in maintaining adequate end diastolic sarcomere stretch in the left ventricle and probably accounts for the frequent deterioration of patients with aortic stenosis after development of atrial fibrillation or nodal rhythm. Many signs and symptoms of cardiac failure, previously attributed to impaired systolic performance, may be due to partly to altered diastolic properties of the ventricular chambers.
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PMID:Diastolic properties of the left ventricle. 76 26

The circulatory effects of anileridine, a derivative of pethidine, have been little studied. Therefore we compared the haemodynamic effects of equianalgesic doses of pethidine (1 mg/kg i.v.) and anileridine (0.25 mg/kg) in matched patients requiring myocardial revascularization. Cardiac output was significantly increased 5 min after the administration of pethidine, mainly due to an increase in heart rate. A transient rise in the systolic pulmonary-arterial pressure was found after anileridine. No remarkable changes were found in systemic arterial pressures, central venous pressure, balloon-occluded pulmonary-arterial pressure, stoke volume, systemic or pulmonary vascular resistances and derived oxygen consumption. Further, 20 min after drug administration, there were no significant differences in any circulatory parameters between the two groups. One patient developed acute cardiac failure after anileridine, though as he had very severe coronary heart disease it remains an open question whether this was spontaneous or drug-induced. Since the rate-pressure product tended to increase after pethidine, this drug may not be considered an ideal analgesic for patients with ischaemic heart disease. Anileridine had less influence on this variable. Since the circulatory effects of pethidine seem to depend on the haemodynamic status of the patient, the haemodynamic properties of anileridine may also deserve further investigation.
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PMID:Comparison of haemodynamic effects of pethidine and anileridine in patients with coronary-artery disease. 77 91

The action of the contrast material over the various contractility indices was assessed five minutes after left ventriculography. There was an increase of the contractility index in normal subjects. On the contrary, in coronary patients, the contractility function remained unchanged or was depressed, related to the presence or not, of signs of cardiac failure. Depression of the various indices was noted in subjects with primary cardiomyopathy. After recalling the mechanism of action of the contrast products on the cardiovascular haemodynamic parameters, the following practical conclusions were drawn in relation with a series of 65 cases of coronary heart disease: the late diastolic left ventricular pressure remained lower than 20 mmHg after ventriculography in the subjects with a normal ejection fraction; it incraeased between 20 and 30 mmHg in most of the subjects with an ejection fraction ranging from 0.4 and 0.6, finally it was constantly found above 35 mmHg in the subjects with severely disturbed ventricular contraction with an ejection fraction lower than 0.4. These results underline the interest of this simple test, easy to perform, consisting in measuring the left ventricular late diastolic pressure before and 5 minutes after left ventriculography.
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PMID:[Modifications of contractility after left ventriculography. A new test in evaluation of myocardial function]. 80 84

Long-term cardiological and neurological observations of 8 patients struck with electric current are presented. It was found that electric shock causes chronic myocardiac lesions followed by the coronary heart disease, cardiac insufficiency and arrhythmia, occuring mostly as premature ventricular extrasystoles. In most of affected persons, symptoms of distonia vegetativa were present during several years. EEG changes and Marinesco-Radovici symptom suggest that in some cases the observed vegetative symptoms can depend on organic changes in the central nervous system.
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PMID:[Prolonged cardiologic and neurologic complications following electric shock]. 86 76

Bicycle exercise stress tests of 39 patients with coronary heart disease are compared to those of 33 healthy persons. The difference in enddiastolic pulmonary artery pressure (PAEDP) of the patients compared to the healthy is low at rest (PAEDPhec healthy = 8.49 +/- 2.80, PAEDPCHD = 10.51 +/- 5.09, p = 0.05). Stress testing (50 Watts) brings significant differences of the average enddiastolic pressures (PAEDP healthy = 12.76 +/- 3.61, PAEDPCHD = 19.38 +/- 7.96, p = 0.001). More important than this (already well known difference) is the wide divergence of results within the group of patients with CHD. For this reason this type of investigation seems to be a good "screening method" regarding selection for coronary arteriography. The reason for the pathological rise of PAEDP can be found in a decrease of compliance due to ischaemia ("coronary factor"), or in exercise induced temporary heart failure ("myocardial factor"), or both.
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PMID:[Behavior of pulmonary artery pressure in the egometric exercise test in chronic coronary disease]. 86 59

The long-term efficacy of the new oral vasodilator, prazosin (PZ), was evaluated in nine patients with refractory heart failure due to chronic coronary heart disease. Ventricular function was assessed by cardiac catheterization, echocardiography, and treadmill testing; symptomatic evaluation was carried out for two to four months. One hour following 2-7 mg PZ, control left ventricular filling pressure was reduced (32 to 18 mm Hg, P less than 0.001) and cardiac index was elevated (1.95 to 2.89 L/min/m2, P less than 0.001) for a 6-hour period. After two weeks of PZ 2 to 7 mg four times daily, echographic end-diastolic dimension fell (5.7 to 5.4 cm, P less than 0.001) while shortening fraction increased (27.6 to 30.2%, P less than 0.005). Treadmill exercise duration increased from 209 to 317 seconds (P less than 0.001). Symptoms diminished throughout the duration of follow-up (mean 94 days) with improvement in NYHA functional class (3.7 to 2.2, P less than 0.001). Thus, prazosin possesses sustained nitroprusside-like balanced dilator actions on the systemic arterial and venous systems and is effective in the ambulatory management of chronic severe heart failure.
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PMID:Efficacy of ambulatory systemic vasodilator therapy with oral prazosin in chronic refractory heart failure. Concomitant relief of pulmonary congestion and elevation of pump output demonstrated by improvements in symptomatology, exercise tolerance, hemodynamics and echocardiography. 88 89

In 17 patients with coronary heart disease, hemodynamic measurements were performed before and after sublingual application of 10 mg isosorbide dinitrate (ISDN). 10 patients showed signs of heart failure with pulmonary congestion and a left ventricular filling pressure above 15 mmHg, resting hemodynamics were normal in 7 patients. Eight of the patients with left ventricular failure had sustained acute myocardial infarctions the size of which was assessed by serial determinations of serum creatine phosphokinase. Application of ISDN resulted in a significant decrease of systemic and pulmonary artery pressures and pulmonary capillary wedge and right atrial pressures of patients both with and without left ventricular failure. Cardiac index and stroke index as well as systemic and pulmonary resistances did not change significantly. ISDN did not affect left ventricular stroke work in patients with elevated filling pressures; however, a decrease of normal filling pressures was associated with a decrease of stroke work. Thus, in coronary patients with chronic congestive heart failure, sublingual application of nitrates results in a beneficial hemodynamic unloading. However, if the acute infarct size is taken into account, it can be demonstrated that hemodynamic improvement after ISDN--judged by the relation stroke work/filling pressure--becomes less pronounced with increasing infarct size.
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PMID:[Effect of sublingual isosorbide dinitrate on hemodynamics in coronary patients with and without congestive heart failure (author's transl)]. 89 50


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