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

Idiopathic hypereosinophilic syndrome is a rare systemic manifestation of eosinophilia that may cause endocardial fibrosis. Endocardial fibrosis and overlying thrombus typically lead to a restrictive cardiomyopathy and heart failure. Occasionally mitral or tricuspid regurgitation (or both) occurs as a result of the fibrosis and thrombus formation. This report describes a patient with hypereosinophilic syndrome who was seen with an unusually localized form of cardiac involvement that resulted in predominantly aortic and mitral stenosis. This was treated with bivalvular replacement.
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PMID:Aortic and mitral valve replacement in idiopathic hypereosinophilic syndrome. 319 Mar 33

Immediate results of closed surgical correction of recurrence of mitral stenosis in 127 patients at late stages of the disease performed in 1957-1986 are described. Closed re-commissurotomy proved to be possible in 98.5% and was effective in 80% of the patients operated upon. The complications were related with hemorrhage, acute cardiac failure. The intrahospital lethality was 11.8%. Immediate improvement was obtained in 70.1% of the patients after operation. A conclusion was made that closed commissurotomy could be used with sufficient effects in cases where the artificial circulation was impossible.
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PMID:[Immediate results of closed correction of recurrent mitral valve stenosis in the late stages of the disease]. 322 90

Serial changes in cardiac function after surgery were studied in 84 patients with various valvular heart diseases using M-mode and two-dimensional echocardiography (2-DE). The results were as follows: 1. Serial postoperative changes in cardiac dimensions and left ventricular functions were well documented by M-mode and 2-DE. 2. The change in left ventricular function became most pronounced one month after surgery, and remained unchanged in many patients during the subsequent observation periods. 3. Open mitral commissurotomy (OMC) and mitral valve replacement (MVR) were compared as to their benefits for patients with isolated mitral stenosis (MS) accompanied by left ventricular dysfunction, and MVR proved superior to OMC in terms of magnitude of functional improvement. 4. (a) Ejection fraction (EF) in patients with left ventricular volume overload was overestimated due to the influence of increased preload. Accordingly, EF which tended to be depressed one month after surgery was judged to reflect altered loading conditions; it did not represent myocardial damage caused by valve replacement. (b) In patients who had MVR or aortic valve replacement (AVR) without postoperative heart failure, EF remained unchanged in the MVR group after a lapse of one month postoperatively, while it tended to improve in the AVR group. This difference was thought to be caused by changes in left ventricular systolic overload resulting from correction of regurgitation. (c) In patients with MR and postoperative heart failure, there was a tendency for EF to decrease after a lapse of one month postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Serial changes in cardiovascular dimensions and left ventricular function after surgery of valvular heart disease: a follow-up study by echocardiography]. 342 23

Our experience from 1968 to 1985 in 12 women requiring closed mitral valvotomy during pregnancy is reviewed. All patients had severe mitral stenosis and were in functional class 3 (2 patients) or class 4 (10 patients). Mitral valvotomy was performed between the 18th and the 30th week of pregnancy using a transventricular dilator. Improvement in functional class was noted in all patients postoperatively. One patient had postvalvotomy mitral regurgitation and heart failure, which responded to diuretics; the subsequent course was uneventful. Eleven patients had normal deliveries; whilst one patient had a Caesarean section for an obstetric indication. All babies were normal and there was no maternal death. This series confirms that closed mitral valvotomy can be performed with an acceptable degree of safety during pregnancy, when indicated.
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PMID:Closed mitral valvotomy in pregnancy--a Malaysian experience. 343 54

Functional status of the pulmonary circulation network and the right compartments of the heart was assessed by two-dimensional Doppler echocardiography at rest and under isometric stress (handgrip with both hands) in 36 patients with varying degrees of mitral stenosis. An early stage of the condition is characterized by hyper-reactivity of the pulmonary circulation vessels as well as intact right-ventricular contractility. Hypertensive response of the pulmonary circulation vessels in combination with inadequately small increase in right-ventricular contractility are suggestive of an early stage of right-ventricular heart failure.
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PMID:[Noninvasive assessment of the function of the lesser circulation and of the right heart in mitral stenosis]. 344 12

Cardiac function is difficult to assess in patients with atrial fibrillation due to the widely fluctuating cycle lengths resulting in variable ventricular hemodynamics. With respect to ECG-gated blood pool scintigraphy, distortion of the time activity curve occurs due to a summation of irregular cycle lengths. Therefore, performing such a study has been regarded meaningless. To evaluate left ventricular function during atrial fibrillation using scintigraphic technique, a new processing algorithm was devised to make multiple gated images which are discriminated by the preceding R-R interval, and left ventricular filling and function curves were established. The left ventricular filling curve, obtained by plotting end-diastolic volume against the preceding R-R intervals demonstrated an impairment of blood filling in cases of mitral stenosis and constrictive pericarditis, which resolved after mitral commissurotomy in case of mitral stenosis. The left ventricular function curve, established by plotting stroke volume against end-diastolic volume, was analyzed according to indices such as "slope" and "position". Both of these indices were significantly reduced in relation to the severity of heart failure according to the NYHA's functional classification and cardiomegaly on chest radiography. On individual comparisons of underlying diseases, the indices decreased in the following order; lone atrial fibrillation, hyperthyroidism, aging, hypertension, mitral valve disease, ischemic heart disease, dilated cardiomyopathy and aortic regurgitation. The indices correlated closely with ejection fraction. In cases of mitral regurgitation, however, the function curves were situated to the right and above those of lone atrial fibrillation and decreased in slope despite the fairly well-maintained ejection fraction. After treatment with digitalis and/or diuretics, the function curves shifted to the left and upward. In conclusion, left ventricular filling and function curves based on a newly-devised algorithm of ECG-gated blood pool scintigraphy are of considerable clinical value in evaluating cardiac performance in patients with atrial fibrillation. They are widely applicable to the assessment of therapeutic and interventional effects.
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PMID:[Left ventricular function during atrial fibrillation assessed by left ventricular function curve using ECG-gated blood pool scintigraphy]. 350 42

Sixty one patients were studied that were subjected to mitral valvular prosthesis--28 patients with pure or prevailing mitral stenosis, 12 with pure or prevailing mitral insufficiency and 21 patients with degree competitive stenosis and insufficiency. The patients, to have mitral valvular prosthesis, undergo the operation, most often, in the presence of pronounced pulmonary capillary and arterial hypertension and preserved right-ventricular and left-ventricular function. The pulmonary hypertension is with the highest values in the patients with mitral stenosis leading. In the patients with leading stenosis, passes of compromised right-ventricular function could be established. The cases with disturbed left-ventricular function are from the groups with prevailing mitral insufficiency or competitive stenosis and insufficiency. The time for mitral valvular prosthesis should be selected so as not to allow the manifestation of bilateral cardiac insufficiency as well as the formation of essential pulmonary disorders.
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PMID:[Preoperative clinical and hemodynamic characteristics of patients with mitral valve defects subjected to valve prosthesis]. 361 4

A total of 592 women in child-birth, at an average age between 15 and 42, mean 26.8 +/- 8.4 years, have been studied. The women with mitral valve defects predominate--83.9% (mitral stenosis--39.8%, mitral insufficiency--18.5% and combined mitral stenosis and insufficiency--41.7%), followed by the women with combined) aorto-mitral defects--9.8% and those with isolated aortic defects--6.3% (out of them with aortic stenosis 35.1%), aortic insufficiency--43.2% and combined aortic defect 21.7%). Pulmonary hypertension proved to have 83 women (14%), all with mitral and mitral-aortic defects. Cardiac insufficiency was established in 130 patients (22%-53.8%, stage I, 38.5%, stage II A and 7.7%--stage II B). Cardiac complications during pregnancy were observed in 29.6% of the patients, during delivery--in 5.4 and in puerperium--in 7.4%. Three women have died--one during delivery and two--during the early puerperal period. The percentage of the women that have given birth by via naturalis is 81.6% and the women that needed assistance--18.4%. A total of 587 viable children have been born (7 twins), 9--non-viable and 3--stillborn. A proper evaluation, in advance, of the cardiac affection and adequate behaviour during pregnancy and labour are necessary for the successful outcome of the pregnancy and delivery in females with valvular heart defects.
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PMID:[Pregnancy, labor and puerperal problems of women with acquired heart defects]. 371 61

The functional capacity was tested in 83 patients with mitral heart defect by step-like loading of bicycle ergometric test, making use of the indices of physical capacity for work. A complex of clinical, non-invasive and invasive investigation methods was used for the hemodynamic evaluation of the patients. A comparison was performed of the threshold power of loading with the pressure in the cardiac cavities, pulmonary artery and pulmonary capillaries, the degree of valvular stenosis, degree and duration of cardiac insufficiency, cardiac rhythm. The indices of the physical capacity for work and the pressures in the cardiac cavities were juxtaposed in the patients undergone operations and patients with postponed operations. The patients with mitral defect were established to have considerably lower indices of physical capacity for work than the healthy non-trained subjects of the same age. The correlation of threshold power of loading with the pressures in right cardiac catheterization was low. The correlation with the mean pressure in pulmonary capillaries was moderate only in the patients with mitral stenosis but--considerable (with the degree of valvular stenosis in mitral stenosis, degree of cardiac insufficiency in both patient groups and with the functional class according to NIKA)--in combined mitral defect. The patients with postponed operations had better indices of physical capacity for work and were with lower pressures, determined by right cardiac catheterization.
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PMID:[Preoperative assessment of the functional capacity of patients with a mitral defect]. 376 82

A 13-year follow-up study was performed in 301 patients with rheumatic heart disease (RHD). Of these patient, 223 cases, 78 men (average age 59.3 years) and 145 women (average age 60.4 years), survived. Seventy-eight cases including 38 men (mean age of death 72.5 years) and 40 women (mean age of death 64.8 years) died. RHD consisted of 51% mitral valvular diseases, 40% combined valvular diseases and 9% aortic valvular diseases. The mean mortality for all patients with RHD was 25.9%. Seventy percent of the deaths were due to severe, chronic heart failure, sudden death and cerebral emboli. Atrial fibrillation was observed in 50% of the patients. Cerebral emboli occurred frequently in patients with mitral stenosis (MS), mitral stenoregurgitation (MSR) and combined valvular disease (CVD), which were associated with atrial fibrillation. However, cerebral emboli were rarely found in cases with MSR, CVD and aortic valvular disease with sinus rhythm. The mortality of cardiac surgery was low, 13.3%.
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PMID:A 13-year follow-up study of rheumatic valvular diseases. 382 May 40


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