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)

The level of lactates and pyruvates in arterial blood of 35 patients with myocardial infarction without shock (17-without heart insufficiency and 18-with manifested but in various degrees) is higher as compared with the level of 18 healthy subject and the elevation is better manifested in the patients with cardiac insufficiency. The highest level of lactates and pyruvates is reached in the first 48 hours of the onset of the disease, after which they decrease progressively and in patients without cardiac insufficiency is normalized by the 5-6th day and in those with insufficiency-remains elevated. Slight to moderate correlation exists between the level of lactates and BE and PaCO2. Lacate and pyruvate level reoresents a more sensitive index for the existence of distrubances in the tissue metabolism as compared with the indices of alkaline-acid equilibtrium.
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PMID:[Metabolic disorders in the acute stage of cardiac infarction]. 0 32

Sodium nitroprusside (SNP) is rarely used in cardiology. It is reserved traditionally for severe episodes of arterial hypertension. Certain states of refractory heart failure represent new indications for use, which implies a double haemodynamic monitoring system: continuous control of systemic blood pressure by intra-arterial catheterization; control of pulmonary pressure and repeated measurements of cardiac output. Prolonged treatment requires continuous biological monitoring of toxicity and careful control of kidney function. As a moderator of blood pressure, SNP is remarkably effective. The hypotensive effect is immediate, readily reversible and generally tachyphylaxis is not observed. The effect of SNP on cardiac work is one of double load reduction: mainly a reduction in afterload or pressure and systemic resistance and a reduction in preload or pressure of ventricular filling. In this respect, SNP can be used effectively for severe cases of heart failure intractable to traditional cardio-stimulatory and diuretic treatments and stemming from diverse causes: acute stage of myocardial infarction, ventricular dilatation, mitral papillary syndrome, heart failure, either subacute or chronic, of various causes. As a rule, the immediate results are positive. Taking the patient off the drug can be difficult and may cause a return to the previous haemodynamic situation.
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PMID:[Use of sodium nitroprusside in cardiology]. 1 64

Since 1972, UK in moderate doses have been used in the treatment of severe or massive pulmonary emboli (PE) and of myocardial infarction (MI) present for less than 24 hours. The standard dose is 2,700,000 CTA units per 24 hours administered as a continuous infusion, in association with appropriate heparin therapy and a platelet anti-aggregant agent in order to palliate the hyperagregant effects of thrombolytic drugs. Laboratory surveillance has now been greatly simplified and is limited to that of the associated heparin therapy. In the acute phase of myocardial infarction, a personal randomised study of 120 cases consisting of 60 treated with heparin + UK and 60 with heparin alone showed that UK decreased mortality, cardiac arrhythmias and cardiac failure. Comparative studies at lower doses have failed to show any significant difference between the two groups of patients treated and the authors feel that the use of UK should be reserved for very recent infarctions in young subjects. In PE, the effectiveness of UK was assessed in 180 severe cases. It depended upon the length of time for which the thrombus had been present. Before the 5th day, there was early average revascularisation of 40 p. 100 of the avascular territory. Mortality was reduced to 15 p. 100 and at the 3rd week 32 p. 100 of the survivors had complete revascularisation, and 68 p. 100 partial but adequate revascularisation. Adjuvant therapy such as a combination of Lysil Plasminogen and/or defibrinating agent currently make it possible to reinforce therapeutic thrombolysis.
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PMID:[Moderate doses of urokinase (UK) in the treatment of myocardial infarct and pulmonary embolism]. 3 Nov 18

In 59 digitalized and 3 non digitalized patients the effect of digitalis during the 1st to 4th days after transmural myocardial infarction was controlled. Rhythm disturbances in acute myocardial infarction may arise secondary to a complicating cardiac failure and may be influenced by digitalis. In 9 of 17 cases (53 p.c.) with ventricular or supraventricular extrasystoles daily doses of 0,4 mg beta-Methyldigoxin or 0,4 mg Digoxin i.v. resulted in undisturbed sinus rhythm. In two cases supraventricular tachycardia and extrasystoles with rapid ventricular rate were abolished by 1,2 mg beta-Methyldigoxin within 12 hours, in three other cases an improvement was recorded. Dysrhythmias or other complications did not occur in previously non digitalized patients. When the antiarrhythmic effect of digitalis cannot be obtained cardiodepressive complications by treatment with typical antiarrhythmic agents are diminished. In patients on digitalis and in cardiogenic shock, digitalization should be performed carefully. Intoxication leads to a diminution of cardiac output and to cardiac dysrhythmias.
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PMID:[The antiarrhythmic effect of digitalis in acute myocardial infarction with cardiac failure (author's transl)]. 5 51

13 male patients suffering from arteriosclerotic heart disease and/or arterial hypertension were monitored continuously before and after vascular surgical procedures using an arrhythmia computer. Heart rate, paroxysmal supraventricular tachycardias, ventricular extrasystoles, ventricular tachycardias, ventricular fibrillation and prematurity index (QnQe/QTn) were recorded numerically. Ventricular arrhythmias were detected as follows preoperatively in 12 patients, after operation in all patients, paired ventricular extrasystoles or episodes of ventricular tachycardia were found in 5 cases before and in 7 after operation, ventricular fibrillation in one case. The incidence of ventricular dysrhythmias increased significantly (p less than 0.05) early after operation, as did the heart rate during the observed postoperative period (p less than 0.001). The prematurity index dropped below 1.0 during the two days following operation. This differed significantly from the preoperative value (p less than 0.05). The incidence of ventricular extrasystoles was related to postoperative myocardial infarction and heart failure (p less than 0.01), which occurred in 6 cases, with a lethal outcome in three. Only occasionally controlled by trained staff in a normal surgical ward the "Servomed Dysrhythmiemonitor" yielded reliable numerical results during the main part of the monitored period. In two cases it led to immediate detection and rapid institution of treatment of severe tachyar rhythmias.
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PMID:[Postoperative cardiac arrhythmias (author's transl)]. 8 Sep 61

Nine patients with cardiac failure which was refractory to medical treatment, and which was caused by chronic malfunction of the posterior papillary muscle, as a result of a myocardial infarction, were studied by cardiac catheterisation and coronary arteriography. The mean pulmonary capillary pressure was 31+/-16 mm of mercury with a nu wave at 51+/-27 mm of mercury. The end diastolic volume was increased (141+/-68 ml/m2) and the ejection fraction lowered (0.40+/-0.13). The left ventricle had overall hypokinesia in 5 patients and akinesia of the inferior wall, representing 21+/-24% of the end diastolic perimeter, in 3 others. All these patients had significant lesions of two or three of the main coronary trunks. At operation lengthening of the posterior papillary muscle and/or the cordae was found. All patients had a replacement mitral valve of the Starr-Edwards type, associated with an aorto-coronary bypass of the anterior descending artery. The operative mortality was zero. At a mean follow-up period of 21 months, there had been no late death, and all the patients were improved.
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PMID:[Surgical treatment by valve replacement and aorto-coronary bypass in mitral valve insufficiency caused by chronic dysfunction of the posterior papillary muscle]. 10 89

Ventricular aneurysm formation in the 3 months following transmural myocardial infarction is rare but may cause serious complications. Cardiac failure and/or ventricular arrhythmias resistant to medical treatment are indications for ventricular resection. The operative mortality is high in this group of patients. 8 patients with ventricular aneurysms of average volume (124 +/- 117 ml/m2) and very impaired left ventricular function (EF : 21 +/- 10%, akinesia : 53 +/- 10%) were operated on with two early deaths and one death in the 7th post operative month. The long term clinical result was satisfactory in the surviving patients, and confirmed by haemodynamic investigation in two of them. The benefical effects of intra-aortic balloon pumping, used preoperatively in all patients, and associated myocardial revascularisation procedures performed in some of them are discussed.
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PMID:[Treatment of early post-infarction ventricular aneurysms by assisted circulation and surgery]. 10 96

Of a total of 4,800 coronary arteriogrammes, 1,280 of which were carried out after myocardial infarction, 25 cases of proven infarction with normal coronary arteriography, confirmed by several "blind" interpretations, were retained. The interval between acute infarction and coronary arteriography was usually less than 6 months. The average age of the patients was 36.9 years, affecting more women than in classical coronary artery disease. The acute infarction was nearly always the first symptom. Cigarette consumption and hormonal factors is women were coronary risks factors of note. Ventricular sequellae were frequent, cardiac failure exceptional, exercise testing nearly always negative and occupational rehabilitation usually normal. It would seem that this affection is less serious than classical myocardial infarction due to atheroma probably because the non-infarcted myocardium is healthy, but the true prognosis of this type of coronary accident will only be revealed by long term studies. In the meantime the most useful investigations and the management of these patients are discussed.
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PMID:[Epidemiological profile of patients with myocardial infarction and normal coronary arteriography]. 10 79

Sixty-three patients suffering from acute myocardial infarction were examined within the first 24 hours of the disease (27 within the first 6 hours) by means of catheterization of the right parts of the heart with a Swan-Ganz balloon catheter and thermodilution. Comparison between the cardiac output and the pressure of left ventricular filling allowed the following hemodynamic variants of myocardial infarction to be distinguished: normo-, hypokinetic, with increased pressure of left ventricular filling and normal cardiac output, hypovolemic, and hyperdynamic. The results of the tests with acute rheopolyglucin load (9 patients) showed that some of the patients with normal values of hemodynamics had latent cardiac insufficiency. Hemodynamic study and recognition of the variant of hemodynamic changes in the acute period of myocardial infarction made it possible to determine properly the indications for the use of vasodilators, active inotropic agents, and infusion therapy.
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PMID:[Variants of hemodynamic changes in acute period of myocardial infarct and the importance of their detection for treatment]. 10 48

Of 945 patients hospitalised for myocardial infarction between January 1st 1972 and December 31st 1975, 40 with anterior myocardial infarction (Group I-A) and 53 with posterior myocardial infarction (Group II-A) were complicated by atrioventricular and/or intraventricular arrhythmias. The average follow up period is now of 48 months (range 24 to 78 months). Their outcome was compared to two control groups of 50 anterior myocardial infarctions (Group I-B) and 50 posterior myocardial infarctions (Group II-B) uncomplicated by arrhythmias in the acute phase. The immediate (10%) and secondary (30%) mortality was identical in the two groups II-A and II-B with posterior wall necrosis. The immediate (32%) and secondary (40%) mortality in Group I-A was much higher than in Group I-B (22% and 28% respectively). Sudden death was the most frequent form of demise in all groups (I-A, II-A, II-B) except Group I-B in which heart failure predominated. Death occured earlier in Group I-A than in the control Group II-B. These results pose the problem of the indication of prophylactic permanent pacing to decrease the incidence of sudden death.
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PMID:[Outcome of myocardial infarctions complicated by heart conduction disorders in the acute phase]. 11 18


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