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)

Cardiac transplantation is now accepted as the therapy of choice for irreversible, advanced heart failure. Improving results have been observed since 1980. This is the consequence of better defined criteria for selection of recipients, refined use of antilymphocyte serum, improved myocardial preservation methods, and the introduction of cyclosporine. Cyclosporine, a metabolite of a soil fungus, is one of the most potent and specific immunosuppressants yet discovered. Its main drawbacks are nephrotoxicity and hepatotoxicity. The immunosuppressive protocol usually includes cyclosporine and low dose steroid. Overall one-year survival has reached 80% to 85%, with a two-year survival of 65% to 75%. The incidence of rejection remains stable despite the use of cyclosporine, but rejection-related morbidity and mortality have been decreasing since 1980. Endomyocardial biopsy of the right ventricle provides good morphologic criteria for assessing the degree of rejection. The absence of myocardial edema during rejection in cyclosporine treated patients appears to be responsible for the limited hemodynamic deterioration and electrographic changes. Morbidity and mortality due to infection have been reduced with cyclosporine, as well. Lymphoma is still common after heart transplantation and may be related to high cyclosporine doses used in the beginning of the clinical trials. Accelerated coronary atherosclerosis of the graft is now the major factor limiting long-term survival and is probably related to chronic rejection. Human heart-lung transplantation began in 1981 at Stanford after excellent clinical results with cardiac transplantation. The success of early attempts was attributed to the use of cyclosporine and the use of combined heart-lung replacement.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Heart transplantation. 389 77

The necropsy findings of a large cell lymphoma involving only the pericardium and myocardium in a 62-year-old woman are reported. The initial presenting symptoms were heart failure followed by rapidly progressive heart block. The diagnosis of cardiac lymphoma was suggested by gallium and blood pool isotope studies, and was subsequently confirmed by operative myocardial biopsy. The clinical course was abrupt, and the patient died before therapy was instituted. While primary cardiac lymphoma is an extremely rare condition, experience in this case suggests that noninvasive isotope studies, particularly gallium and blood pool, are helpful in the diagnosis of atypical cardiomyopathy.
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PMID:Primary lymphoma of the heart. A case report. 630 85

A 71-year-old woman presented with intractable cardiac failure 10 years after receiving treatment for lymphoma. Extensive investigations failed to demonstrate a recurrence of her disease, but resolution of her cardiac failure following a trial of chemotherapy and subsequently a cross-sectional echocardiogram suggested intracardiac relapse. This was later confirmed at autopsy. Cardiac metastases should be suspected in patients with malignant disease who develop signs or symptoms related to the heart.
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PMID:Relapse of lymphoma in the heart after a 10-year remission. 648 2

The authors report a case of bilateral hilar lymphoma of sarcoid origin associated with a pleural effusion. With the exception of pneumothorax, the pleural manifestations in the course of sarcoidosis amount to 115 published cases, including 49 with histopathological proof enabling us to speak of a pleural sarcoidosis. When the histopathological diagnosis is missing, it is preferable to speak of sarcoidotic pleurisy: the aetiopathogenesis in this case is venous obstruction and/or lymphatic obstruction by sarcoid involved lymph nodes. Exceptionally, it could be due to heart failure due to the fibrotic stage of sarcoidosis or to an autonomous sarcoidotic myocarditis.
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PMID:[Pleurisy and sarcoidosis. Apropos of a case]. 665 55

An attempt was made to see if new forms of treatment of fungal and bacterial septicemia, or new cytostatic combinations have changed the causes of death in leukemia and lymphoma. Autopsies were studied of 16 cases with acute leukemia, 2 with chronic granulocytic leukemia and 24 with lymphoma. 10 of the 18 patients with leukemia and 10/14 lymphoma patients died although they had no, or only slight, tumor infiltration in the bone marrow and parenchymatous organs; only 1/18 leukemias had extensive infiltration. There was a statistically significant correlation between the extent of marrow and organ infiltration. Cardiac failure (5/18 patients) was almost as common as the main cause of death as septicemia (7/18) in leukemia. The corresponding figures in lymphoma were 5/24 and 9/24, respectively. The present findings contrast with earlier ones, where more septicemia and tumor infiltration were found at autopsy, and less cardiac failure was observed. 15 of 16 cases with septicemia at autopsy had terminal fever. Bacteriological and histological signs of septicemia at autopsy agreed satisfactorily. There was a surprising absence of agreement between terminal granulocytopenia and septicemia; 13 of 16 patients with septicemia had over 0.1 x 10(9) and 10 over 0.5 x 10(9) granulocytes/liter blood.
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PMID:Causes of death in leukemia and lymphoma with modern treatment. 676 15

THP-ADM is a new antitumor antibiotic which belongs to the anthracycline group. This agent was administered to 42 histology proven various malignant disease patients with a schedule of 60-80 mg per body (40-55 mg per m2) iv bolus, every three weeks. THP-ADM administration revealed mild upper GI toxicity (vomiting 19%, stomatitis 21%) and leukopenia (less than 2,000 per mm3) in 80% and thrombocytopenia (less than 60,000 per mm3) in 38% with good rebound. There was no signs or symptoms of cardiac failure including the patient who had received 740 mg per body (500 mg per m2). Definite response (CR, PR) was observed in ovarian carcinoma 4/11, cervix carcinoma 2/7, breast carcinoma 1/6, malignant lymphoma 5/5 and mesothelioma 1/2. Furthermore, some response (MR) was observed in lung metastasis from endometrial carcinoma 2/4, and stomach carcinoma 1/3. The above indicated usefulness of this agent and further study should be continued, especially a controlled study with adriamycin.
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PMID:[Preliminary phase II clinical study of 4'-O-tetrahydropyranyl doxorubicin (THP-ADM)]. 688

The incidence of primary mediastinal lymphoma in adults was investigated in 184 patients with non-Hodgkin's lymphoma. This entity was defined as disease within the mediastinum in patients who presented with symptoms due to an enlarging mediastinal mass. Of 184 patients, 17 presented with primary mediastinal lymphoma. All had a diffuse histologic pattern. The most common pathologic type was poorly differentiated lymphocytic lymphoma, diffuse (PDL-D), (11 cases). In nine of these 11 cases the patients had tumors of convoluted lymphocytes. The presentation was rapid in onset, with heart failure, pericarditis, dyspnea and superior vena caval syndrome predominating. Eleven of the 17 were clinical stage I or II, but eight of these had widespread disease on pathologic staging or rapid dissemination soon after diagnosis. In conclusion (1) primary mediastinal lymphoma is always diffuse in histology. (2) The most frequent pathologic type is PDL-D, with convoluted morphology. (3) Compression of vital intra-thoracic structures is common. (4) Although seemingly localized at presentation, this entity usually implies disseminated disease.
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PMID:Primary mediastinal lymphoma in adults. 689 53

A 32-year-old man presented with left hypochondrial pain and myalgia. On examination he was found to have widespread lymphadenopathy and splenomegaly, and lymph node biopsy revealed diffuse lymphocytic lymphoma of the small cleaved cell type. There was hypereosinophilia (20 x 10(9)/1). The patient was initially treated with chlorambucil and prednisone, which controlled the lymphoma for 9 months but did not affect the eosinophilia. He then developed thrombocytopenia with further lymph node enlargement which was managed with a combination of bleomycin, vincristine and prednisone; this again controlled both spleen and lymph node size without affecting the eosinophilia. Six months after presentation the patient developed refractory cardiorespiratory failure due to endomyocardial fibrosis and fibrosing alveolitis. The cardiac failure was thought to be related to the hypereosinophilia resulting from the lymphoma, while the respiratory insufficiency was attributed to the bleomycin. This case illustrates the rare association between lymphocytic lymphoma and eosinophilia and shows that cardiac damage can be associated with these cells.
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PMID:Lymphocytic lymphoma, hypereosinophilia and endomyocardial fibrosis. 689 45

This study was designed to evaluate major fibrinolytic parameters in relation to parameters of inflammation associated with different kinds of pleural effusion. Sixty patients with pleural effusion were studied. The underlying aetiology was empyema in 10 cases, tuberculosis in 9, cancer in 31, cardiac failure in 7, and undetermined in 3. Plasminogen, plasminogen activator inhibitor 1 (PAI-1) and 2 (PAI-2), tissue type plasminogen activator (t-PA), urokinase (u-PA) and D-dimers (D-D) were quantified in plasma samples and pleural effusion specimens. These data were then correlated with inflammatory or infectious parameters, i.e. fibrinogen, von Willebrand factor (vWF), erythrocyte sedimentation rate (ESR), protein concentration, and white blood cell count. D-D levels were higher in pleural fluid than in plasma. D-D levels were not correlated with either plasminogen activator or plasminogen activator inhibitor levels, suggesting the presence of other fibrinolytic pathways. PAI levels (PAI activity, PAI-1 antigenicity, PAI-2 antigenicity) and vWF levels were significantly higher in patients with tuberculosis and empyema than in patients with cancer or cardiac failure. Regression analysis between inflammatory and fibrinolytic parameters showed that pleural PAI levels were significantly correlated with pleural neutrophil count, vWF levels, and plasma fibrinogen levels. D-D levels were correlated with blood ESR. No significant difference in pleural t-PA, u-PA and D-D levels was observed between aetiologies. The highest pleural t-PA and u-PA values were noted in patients with cancer, especially lymphoma. Plasma t-PA levels were higher inpatients with pleural effusion secondary to congestive heart failure, but this difference did not reach statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fibrinolytic and inflammatory processes in pleural effusions. 748 3

Non-Hodgkin's lymphoma is common in patients with human immuno-deficiency virus infection, but an intracardiac localisation is rare. In this case, the malignant lymphoma presented with a degradation of the patient's condition and signs of right-sided cardiac failure. Echocardiography showed a polylobed mass invading the right ventricle. Computerised tomography provided detailed information of the extension of the lymphoma in the different cardiac chambers. The patient died after a few days of a low cardiac output state. The malignant nature of the tumour was confirmed at biopsy. This case of cardiac lymphoma in a patient with immunodepression confirms the fatal character of this condition in the very short term after the appearance of the first clinical signs, the value of echocardiography in the diagnosis and the difficulty in implementing any effective therapeutic measure.
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PMID:[Malignant tumoral lymphoma of the heart in human immunodeficiency virus infection: diagnosis by echocardiography]. 867 62


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