Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 11085 patients have been operated on for rheumatic heart diseases over thirty years, 85.4% of those, for mitral stenosis or its relapse, using the "closed" method (total mortality was 2.7%). In recent years, the mortality rate has dropped to 1.5% in that group of patients. Prevention of heart failure and thromboembolic complications still are the principal problem of mitral commissurotomy. Traumatic regurgitation was seen in 2%. The operation was performed under extracorporeal circulation in 6.2% of patients. Mortality, associated with mitral prosthesis implantation, has decreased threefold (to 10.8%) over 15 years. A total of 131 patients have been operated on for constrictive pericarditis, the mortality rate was 10.7%. Primary implantation of electric pacemaker for complete transverse heart block has been performed in 196 patients, and the generator was replaced in 143 patients.
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PMID:[Results of 30 years' surgical treatment of acquired defects and diseases of the heart]. 296 20

Encainide is a class IC antiarrhythmic agent that has been under clinical investigation for the last decade. Laboratory and clinical studies have demonstrated it to be a potent suppressor of ventricular extrasystoles. It is effective in approximately one-half of patients with malignant ventricular arrhythmias. The preliminary experience in patients with supraventricular arrhythmias indicates that the drug is particularly effective in arrhythmias associated with an accessory pathway. Side effects most commonly include blurred vision, nausea, heart block, and proarrhythmic effects. The hemodynamic effect of oral encainide are insignificant in patients with well-preserved left ventricular function. Despite minimal myocardial depression in patients with left ventricular dysfunction, there is the potential for worsening of heart failure. Encainide has a short half-life of 3 hours, but has 2 active metabolites with longer half-lives. No clinically significant drug interaction has been demonstrated with encainide therapy.
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PMID:Encainide: its electrophysiologic and antiarrhythmic effects, pharmacokinetics, and safety. 312 82

We studied 181 patients aged under 65 years and 129 patients over 65 with acute myocardial infarction. There were no major differences in the prevalence of coronary risk factors, angina or previous myocardial infarction. A larger percentage of elderly patients had congestive heart failure (51.4% vs 32.6%, P less than 0.001) and complete heart block (17.1% vs 7.2%, P less than 0.01) during the acute phase. In-hospital mortality was significantly higher in the elderly patients (34% vs 16%, P less than 0.01). Late mortality rates correlated in both groups with the Killip class at the time of infarction and with the occurrence of reinfarction. In the elderly group, it was also associated with complete heart block during the acute phase. Five-year survival was 80% in the older and 72% in the younger patients (P = 0.1). Age did not affect survival of Killip class I patients (85% vs 86%, P = 0.83), but life expectancy was significantly reduced in elderly patients in Killip class greater than II (39% vs 60%, P less than 0.05). In conclusion, elderly patients cannot be considered a homogeneous group of high-risk patients. Clinical variables at the time of infarction can identify low- and high-risk subsets among them. Age constitutes an independent prognostic factor for late mortality when any degree of heart failure is present.
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PMID:Effect of age on long-term prognosis of patients with myocardial infarction. 320 52

In 11 of 21 fetuses with prenatally diagnosed complete heart block, congestive heart failure with signs of non-immune hydrops fetalis was seen. In all 11 fetuses, cardiac malformations were present: complete atrioventricular canal with levocardia, situs inversus viscerum, and polysplenia: 5 cases; tricuspid atresia with situs inversus viscerum, endocardial fibroelastosis, common atrium with aortic valve atresia, hypoplastic left heart, atrial septal defect of secundum type: one case each. All these cardiac malformations can also cause intrauterine heart failure without heart block except hypoplastic left heart and atrial septal defect. A review of the literature confirms, that only the association between complete heart block and cardiac malformation--in particular AV-canal and endocardial fibroelastosis--can cause an intrauterine congestive heart failure, whereas in the case of fetal complete heart block without cardiac malformation or with prenatally hemodynamically insignificant cardiac malformations--in particular "corrected" transposition of great arteries--a congestive heart failure is rare.
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PMID:[Non-immunologically-induced hydrops fetalis in complete atrioventricular block of the fetus. A summary of 11 prenatally diagnosed cases]. 321 45

Calcium channel blocking drugs are a chemically heterogenous group, so it might be expected that their effects on vascular smooth muscle, cardiac contractility, and conduction tissue may differ. However, the majority of adverse reactions are predictable from their pharmacological actions and may be conveniently grouped in the following categories: 1) vasodilatation, 2) negative inotropic effects, 3) conduction disturbances, 4) gastrointestinal effects, 5) metabolic effects, and 6) drug interactions. Vasodilatory symptoms, namely, dizziness, headaches, flushing sensation, and palpitation, are more likely with nifedipine. Peripheral edema is also common with nifedipine, but the mechanism is uncertain. For a given degree of vasodilation, the greatest negative inotropic effect is seen with verapamil first, diltiazem second, and nifedipine last. Calcium channel blocking drugs are contraindicated in hypertensive patients with second and third degree heart block, sick sinus syndrome, and severe heart failure. Verapamil and diltiazem have a significant effect on cardiac conduction, whereas nifedipine, in therapeutic doses, does not. Local gastrointestinal symptoms, such as nausea and constipation, are common with verapamil. None of the calcium channel blocking drugs have been reported to adversely affect lipid or protein metabolism. However, nifedipine, verapamil, and diltiazem in high doses may inhibit liberation of insulin. The significance of this finding needs to be explored further in hypertensive diabetics. Serum digoxin levels have been shown to increase after administration of verapamil and nifedipine, but there is no evidence that this change has any clinical relevance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Side effects of calcium channel blockers. 328 Apr 92

Isolated congenital complete heart block is frequently found in offspring of mothers who have IgG anti-Ro/SSA autoantibodies. IgG deposition was reported in the heart of a baby who died from heart block and heart failure. The pattern of antibody deposition observed was the same as that reproduced in animal models for anti-Ro/SSA binding. The IgG deposition was present in, but not limited to, the conduction system. Scattered small infiltrates of mononuclear cells and a limited, patchy deposition of complement were also observed. These findings support the possibility that isolated congenital heart block may be causally related to autoantibodies.
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PMID:Cardiac immunoglobulin deposition in congenital heart block associated with maternal anti-Ro autoantibodies. 331 97

Sixty-six children aged between 8 months and 15 years (average age 5.5 +/- 3.8 years) underwent mitral reconstructive operations for congenital mitral regurgitation between June 1969 and February 1987. The pathologic findings of the mitral valves were annular dilatation in 37 patients, cleft of the leaflet in eight, hypoplasia of the leaflet in 44, perforation of the leaflet in one, chordal elongation in 22, chordal absence in 16, and chordal shortening in seven. The methods of repair consisted of asymmetric annuloplasty (Kay-Reed method) in 61 patients, De Vega-type annuloplasty in one, plication of redundant leaflet in 15, and closure of cleft or perforation in nine. The single operative death (1.5%) was due to heart block. Follow-up data were available over 373.8 patient-years (average 5.7 years). The four late deaths (6.0%) were due to heart failure in two patients, pneumonia in one, and hepatitis in one. The actuarial survival rate was 93.1% +/- 3.1% at 7 years and 88.4% +/- 5.1% after 17 years. Valvuloplasty failed in 19 of the long-term survivors. One of these patients underwent mitral valve replacement 11 years after initial operation. The rate of freedom from reoperation was 86% +/- 10% after 17 years. The rate of freedom from valvuloplasty failure was 80% +/- 6.7% after 5 years, 67% +/- 7.2% after 10 years, and 44% +/- 11.9% after 15 years.
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PMID:Early and late results of reconstructive operation for congenital mitral regurgitation in pediatric age group. 339 49

A 28-year-old woman with cardiac failure, heart block, and both pleural and pericardial effusions is described. Despite numerous investigations, the diagnosis of a non-Hodgkin's lymphoma was not made until after the patient's death. Cardiac involvement by lymphoma is reviewed.
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PMID:Pericardial effusion and heart block caused by lymphoma. A case report. 341 16

A double-blind study comparing verapamil with placebo was conducted in 16 Danish departments of internal medicine with coronary care units (CCU). All patients below 75 years of age admitted to the CCU with a suspicion of acute myocardial infarction (AMI) were evaluated. Of 7415 patients, 3917 were excluded on admission because of heart failure, heart block, other severely disabling diseases, or treatment with beta-adrenoceptor blockers or calcium antagonists. Treatment was started in 3498 patients with 0.1 mg kg-1 verapamil i.v. and 120 mg orally on admission followed by 120 mg three times daily, or matched placebo. Treatment was continued for 6 months for patients verified to have had an AMI according to all three WHO criteria. Treatment was stopped in patients for whom the diagnosis of AMI was ruled out. Of 1436 patients with AMI, 717 were treated with verapamil and 719 with placebo. After 6 months, 92 patients (12.8%) in the verapamil group and 100 patients (13.9%) in the placebo group were dead (NS). Fifty patients (7%) in the verapamil group and 60 patients (8.3%) in the placebo group had reinfarctions (NS). After 12 months, 109 patients (15.2%) in the verapamil group and 118 patients (16.4%) in the placebo group were dead (NS). It is concluded that verapamil treatment used in the early phase of an AMI does not improve survival. Based on the experience from the first study we are at present performing a further secondary prevention study with verapamil to a modified design.
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PMID:The Danish studies on verapamil in acute myocardial infarction. The Danish Study Group on Verapamil in Myocardial Infarction. 353 Mar 1

Prosthetic valve endocarditis (PVE) is an infrequent but dread complication, occurring in 1 to 2% of patients both early (less than 60 days) and late postoperatively. Diagnosis is always (99%) possible by two sets of blood cultures, but occasional exogenous causes of bacteremia may cloud the diagnosis, as will culture-negative cases of PVE and skin contaminants. With obvious exogenous sources of bacteremia, achieving sterile blood cultures after eradication of the noncardiac source permits discontinuation of antibiotics after two weeks. When skin contaminants are suspected, withholding antibiotics and obtaining two sets of blood cultures is recommended, because the bacteremia with PVE is continuous. Preventive measures, including perioperative antibiotics, are warranted but will probably not significantly reduce the low incidence of infection already achieved. The major cause of improved survival in recent years is earlier operation (valve rereplacement). This has been demonstrated in the last ten years and is absolutely indicated for major heart failure, ongoing sepsis, fungous etiology, valve obstruction, new-onset heart block, and unstable prosthesis by fluoroscopy.
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PMID:A practical approach to prosthetic valve endocarditis. 355 64


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