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

In eight patients undergoing cardiac surgery for aortic and/or mitral valvular disease, mean arterial blood pressure (MAP), central venous pressure (CVP), cardiac index (CI), stroke index (SI), pulmonary capillary wedge pressure (PCWP), and pulmonary arterial mean pressure (PAMP) were measured after premedications with diazepam-scopolamine (I), after breathing 100% oxygen (II), and on controlled respiration (III) after induction of anaesthesia with enflurane-O2, and endotracheal intubation facilitated by succinylcholine. All measurements were done prior to surgery. Enflurane anaesthesia was found not to affect cardiac index. The average SI decreased by 27%, but was compensated for by an average increase in heart rate (HR) of 33%. The average systemic vascular resistance (SVR) decreased by 14%. All other measured parameters were found to be unaffected by enflurane-O2 anaesthesia. It is concluded that the cardiovascular stability observed in healthy young normals during enflurane anaesthesia is preserved in patients with moderate to severe heart failure, making enflurane an anaesthetic agent well suited for patients with cardiac disease.
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PMID:Haemodynamic effects of enflurane in patients with valvular heart disease. 27 53

Changes in the hemodynamic parameters under conditions of physical load on a bicycle ergometer were studied in 107 pregnant women among whom 73 had mitral valvular disease and 34 did not have a somatic disease. Three groups of tolerance to physical load and the criteria of an adequate or inadequate reaction to it were determined. This method of examination of the reserve potentialities of the heart reveals the preclinical stage of cardiac insufficiency and borderline conditions, owing to which the most rational predelivery therapy and the method of delivery may be chosen in advance.
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PMID:[Hemodynamics and load tolerance in pregnant women with mitral heart defects]. 49 89

The course of the postoperative period was studied in 107 patients subjected to adequate correction of mitral valvular disease; 88 of them underwent open heart surgery. The cardiac output was measured by radiocardiography. Total postoperative mortality was 13%, cardiac insufficiency mortality 8.4%. Cardiac insufficiency was encountered in 42% of patients who had been operated on. Significant increase in the rate of cardiac insufficiency with the diminution of the cardiac index with "critical" value of 21/min/m2 was established: cardiac insufficiency was found in 76.3% of patients subjected to operation with cardiac index below 21/min/m2 and in 23.2% among those with cardiac index equal to or more than 21/min/m2. A similar regularity was revealed in analysis of cardiac insufficiency mortality:with cardiac index below 21/min/m2 it was 18.4%, with cardiac index of 21/min/m2 or more, it was 2.9%. No interrelationship was revealed between cardiac insufficiency incidence and mortality and the type of mitral valve lesion, extent of surgical intervention, and duration of extracorporeal circulation.
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PMID:[Cardiac insufficiency and mortality after correction of the mitral valve defect, depending on the degree of cardiac output before the operation]. 67 54

In the present study, renal A-V oxygen difference and renal blood flow were measured in 18 patients with mitral valvular disease. The renal sodium reabsorption and oxygen consumption have also been measured. The renal A-V oxygen difference was small and remained within the normal range despite large reductions in renal blood flow. Only when flow fell to between 400 and 500 ml. per minute there was a rise in A-V oxygen difference. The renal oxygen consumption was in general reduced compared with normal subjects, but tended to increase in those patients who also had the greatest values for A-V oxygen difference. The renal oxygen consumption was found to vary independently of the sodium reabsorption. Our results indicate a shift to a more aerobic renal metabolism in advanced heart failure when renal blood flow is drastically reduced. It is possible that the variations in oxygen demand may reflect changes in substrate requirements for transport of sodium in different circulatory situations. Redistribution of flow within the kidney at low renal blood flow as well as the possibility of passive transport of sodium in the proximal tubules might also account for the changing relationship between A-V difference and renal blood flow.
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PMID:Influence of variations in blood flow on renal A-V oxygen difference and renal oxygen consumption in heart failure. A clinical study. 116 39

Left atrial myocardial excursions were intraoperatively recorded in patients with mitral valvular disease (33 patients with mitral stenosis and 17 with mitral regurgitations). Three types of atrial myocardial excursions were identified. There was a high correlation between the types of myocardial excursions and the incidence of heart failure. The patients with Types I and II myocardial excursions had no virtually heart failure, those with Type III showed the highest (70%) incidence of heart failure. It is concluded that intraoperative assessment of left atrial myocardial excursions is of great significance in patients with mitral valvular disease.
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PMID:[Clinical and functional correlations of left atrial excursion characteristics in patients with mitral valve diseases. Part II]. 152 42

Seventy four patients aged 35-74 years who had mitral valvular disease were examined for renin, angiotensin II, aldosterone, and vasopressin, of whom 49 patients were diagnosed as having a mitral valve defect with prevalent stenosis, 25 presented with a mitral valve defect with prevalent heart failure. Circulatory disorders, Stages I-II, were found in 41 patients, Stage IIB in 23, and Stage III in 10 patients. There were no significant differences in the parameters of the renin-angiotensin-aldosterone system (RAAS) and vasopressin in untreated adult and elderly patients with mitral valvular disease at rest. As circulatory disorders progressed, the RAAS parameters significantly increased in all the groups. However, the patients with prevalent stenosis showed higher blood renin levels than did those with prevalent heart failure, irrespective of its severity. In refractory heart failure, the significant differences remained to a greater extent only for renin. The treatment with peripheral vasodilators (isosorbide dinitrate and corinfar) resulted in compensatory activation of the neurohumoral vasoconstrictive system, thereafter the RAAS parameters significantly increased after the drugs.
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PMID:[Renin-angiotensin-aldosterone system and vasopressin in adult and aged patients with acquired mitral valve defects]. 179 80

Thirty patients over 40 years of age with atrial septal defects were operated on between 1981 and 1989. They were divided into two groups according to operative technique, group A of patients with direct suture of defect (17 cases) and group B patch closure (13 cases), in order to investigate the incidence of postoperative complications. Patient age and size of defect in group B were both greater than in group A. One group A patient had pulmonary stenosis, two group B patients had mitral valvular disease and six group B patients had pulmonary hypertension. The incidence of postoperative heart failure was 29% in group A and 61% in group B and that of arrhythmia was 47% and 69% respectively, however there were no intraoperative and postoperative deaths. We concluded that, although a high incidence of postoperative complications was observed in group B, patch closure was recommended for older patients with atrial septal defect because direct suture was more likely to distort the atrial septum.
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PMID:[Surgery of atrial septal defect in patients aged over 40 years: comparative study of direct suture and patch closure]. 205 80

As many as 59 patients aged 35 to 74 years suffering from mitral valvular disease (MVD) were examined for excretion of dopamine (DA), noradrenaline (NA) and adrenaline, parameters indicating the activity of the sympathoadrenal system. Administration of L-DOPA brought about a significant increase of excretion of all catecholamines in all the patients under 59 years and in those aged 60 to 74 years. In patients with stage I and IIA heart failure, DA excretion rose 50-fold in response to L-DOPA administration, in those with stage IIB and III, 17-fold (p less than 0.001). In patients suffering from MVD, no age-associated differences were revealed in the levels of catecholamines and ICM. In patients suffering from MVD with the predominance of stenosis and in those with stage I and IIA heart failure, background excretion of NA was significantly higher than in patients suffering from MVD with the predominance of heart failure (p less than 0.01). Administration of L-DOPA was followed by an appreciable increment of NA exactly in patients suffering from MVD with the predominance of stenosis (p less than 0.001). In the majority of patients with stage III heart failure refractory to multimodality treatment, the L-DOPA test revealed the smallest increment of DA; its excretion rose only 12-fold. Therefore, the progress of heart failure entails a decrease of the reserve potentialities of the sympathoadrenal system, marked by less output of its mediators.
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PMID:[The sympathetic-adrenal system in mitral heart defects in patients of different ages studied by the use of a specific L-DOPA test]. 209 2

A study was undertaken to examine 55 (27 females and 28 males) patients aged 25 to 74 years who had ventricular arrhythmias. Twenty five patients were diagnosed as having mitral valvular disease concurrent with predominant stenosis, 30 presented with prevalent mitral dysfunction. Twenty eight patients showed Stages I to IIA circulatory failure, and 27 had Stages IIB to III heart failure. All the patients displayed perpetual ciliary arrhythmia of various duration. More frequent and severe ventricular arrhythmias were recorded in mitral valvular disease patients with predominant mitral dysfunction than in those with stenoses. When the plasma digoxin concentration was less than 1.1 ng/ml in patients with a low end-diastolic volume and initial signs of circulatory failure, the agent produced an antiarrhythmic effects on ventricular arrhythmias in many cases, in mitral valvular disease patients with predominant stenosis in particular. The arrhythmogenic effect of digoxin was found in 47.6% patients with prevalent mitral dysfunction concurrent with Stages IIB-III circulatory failure. The agent may show arrhythmogenic action in mitral valvular disease patients with prevalent mitral dysfunction who had larger cardiac volumes and plasma digoxin concentrations of no more than 1.6 ng/ml in the absence of clinical signs of digitalis intoxication.
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PMID:[Effects of digoxin on ventricular arrhythmias in patients with mitral valve defects]. 225 38

Pathologic signs of left atrial load are found very often in arterial hypertension. The diagnostic combinations are very slightly expressed, more often in the orthogonal ECG. Pathologic criteria found most often are: pathologic end-strength of the P wave in lead V1 (in 42% of the patients) and increased amplitude of PX (in 39% of the patients). The pathologic changes of the P wave increase with the development of left ventricular hypertrophy and heart failure. The values of the end-strength of the P wave in lead V1 when they are negative more than - 0.03 mm.s should be considered pathologic in contrast to mitral valvular disease.
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PMID:[Effect of arterial hypertension on the atrial portion of the electrocardiogram]. 296 39


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