Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

---

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

Arterial blood gases were measured during 7 hours of sleep in 15 patients with severe stable chronic obstructive pulmonary discrease (COPD); 6 awake patients with COPD studies in recumbency for an average of 5 hours served as controls. Mean maximal decrease in arterial oxygen partial pressure (PaO2) (plus or minus SD) was 13.5 plus or minus 3.9 mm Hg for sleeping patients (p less than 0.005) and 5.5 plus or minus 1.7 mm Hg for controls (p less than 0.1), respectively. Changes in pH during sleep were of the magnitude expected with acute changes in arterial carbon dioxide partial pressure (PaCO2) in patients with chronic hypercapnia. Consistent changes in heart rate, respiratory frequency or cardiac rhythm were not observed during sleep. Nocturnal worsening of hypoxemia could be explained by alveolar hypoventilation in six sleeping patients and in five controls; in nine sleeping patients, further impariment of ventilation-perfusion mismatch also contributed to worsening of hypoxemia. There was no relationship between the decrease in PaO2 during sleep and the degree of airways obstruction or the PaO2 level when awake. Because of low PaO2, when awake, a fall in PaO2 during sleep brings values into the steep part of the oxyhemoglobin dissociation curve where slight changes in PaO2 result in marked changes in oxygen content. All patients with COPD whose waking PaO2 was below 60 mm Hg had PaO2 below 50 mm Hg during sleep; nocturnal oxygen therapy should be considered in such patients, particularly in the presence of polycythemia or troublesome right-sided heart failure.
...
PMID:Arterial blood gases and pH during sleep in chronic obstructive pulmonary disease. 23 52

Patients with chronic obstructive lung disease often present with a combination of respiratory and circulatory insufficiency. In secondary erythrocytosis (polycythemia) blood viscosity rises and further impairs peripheral oxygenation. Against this background, a patient with acute exacerbation of a chronic respiratory disease with secondary erythrocytosis was treated with isovolemic hemodilution during two periods of hospitalization. During each of these two periods, hemodilution was achieved by removing 1 700 and 1750 ml blood, respectively, and replacing this simultaneously by infusing equal volumes of dextran 70 (Maacrodex). The patient's general condition improved, her dependence on supplementary oxygen drastically decreased and the blood gas values improved after hemodilution. The progress of the disease in this case suggests that the raised hematocrit rather than hypervolemia contributed to the patient's poor condition. It also illustrates that too intensive diuretic therapy in cardiac insufficiency with concomitant erythrocytosis can lead to hemoconcentration and thereby add to the strain on an already overloaded circulation.
...
PMID:Isovolemic hemodilution in erythrocytosis secondary to chronic obstructive lung disease. 50 7

After Mustard operation for transposition of the great arteries, hemodynamic and angiocardiographic changes were evaluated in 25 patients. In 19 patients, postoperative studies were done electively and, in 6 patients, they were required to investigate symptoms of heart failure, these symptoms were temporary in 4 patients and progressive in 2. Both of the latter had pulmonary venous obstruction which was later relieved successfully by reoperation. After operation, systemic arterial oxygen saturation and blood pressure increased and polycythemia disappeared in every patient. However, several complications-some of them unsuspected clinically-were identified by cardiac catheterization: (a) patch detachment in 5 patients; (b) obstruction of superior vena caval return in 10 patients; (c) obstruction of inferior vena return in 1 patient; and (d) pulmonary venous obstruction in 2 patients. The incidence of pulmonary or systemic venous obstruction was higher in patients who had a Dacron intraatrial baffle (8 of 19 patients). Comparison of 21 sets of preoperative and postoperative right ventricular angiograms demonstrated an increase in right ventricular trabeculations in each patient, poorer right ventricular contractility in 12 patients, and development of tricuspid insufficiency in nine patients. None of the patients with poor right ventricular contractility had had surgical ventriculotomy. Although Mustard operation for transposition of the great arteries is effective in relieving cyanosis, it may be followed by obstruction to systemic or pulmonary venous return, intraatrial patch detachment, tricuspid insufficiency and angiocardiographic evidences of poor right ventricular contractility.
...
PMID:Hemodynamic and angiographic changes after Mustard operation for transposition of the great arteries. 113 8

Experiments were performed on pentobarbital-anesthetized cats to test the hypothesis that hypovolemia rather than cardiac failure is responsible for the acute lethal toxicity of the trichothecene mycotoxin, T-2 toxin (T2T). Measurements were made on mean arterial blood pressure (MAP), arterial pulse pressure (PP), and heart rate (HR) in eight otherwise untreated cats given T2T (2 mg/kg iv) and in three cats similarly injected with T2T but then transfused with plasma and blood. The transfusions to their available extent significantly delayed or counteracted the development of mycotoxic shock (i.e., depressed MAP and PP) and prevented or reversed a rise in the hematocrit. HR remained stable under all conditions. Plasmapheresis followed by whole-blood removal was found best to simulate mechanistically the mycotoxic shock syndrome in six blood donor cats free of T2T. It is concluded that hypovolemia with polycythemia resulting from plasma leakage and internal bleeding accounts for acute lethal T-2 mycotoxicosis.
...
PMID:Hypovolemic shock in acute lethal T-2 mycotoxicosis. 200 98

Four male patients aged 32 to 42 years were followed up. The clinical picture of the disease was typical of dilated (congestive) cardiomyopathy with a subacute onset, development of pronounced heart failure; all the patients were found to have exudate pericarditis. All the men were of the same occupation; they worked at the hard alloy works at a bay of wet grinding in ethanol of metallic Co and hard alloy carbides. The content of Co in the air of the working premises exceeded the MAC and amounted to 7.8-10 mg/m3. Besides, 47 workers of the same occupation (90% of the number of persons engaged in making up powdered compositions of hard alloys) were examined in addition. 16 persons showed the signs of alcoholization, including 9 (out of 11) working at a bay of wet grinding. During the recent 20 years, no cases of respiratory occupational diseases were recorded at the bay. The cardiotoxic properties of Co manifest themselves after the preceding toxic exposures, among which the leading part is played by alcohol. Of the 4 patients, 3 developed the disease in the presence of alcoholism, in 1 patient, it was coupled with tuberculous intoxication. Marked tendency towards polycythemia and increase of the content of hemoglobin was a frequently occurring manifestation of Co action on the workers (rather than a sign of intoxication).
...
PMID:[Cobalt-induced cardiomyopathy in workers engaged in the manufacture of hard alloys]. 206 57

Double outlet right ventricle (DORV) is a rare cardiac malformation especially in adulthood. We report a woman with DORV who survived to the age of 33 years. She had not been seriously limited, before she visited our hospital for cardiac evaluation at the age of 25 years. She was cyanotic, and had clubbing of fingers and toes and facial edema. Holosystolic murmur and diastolic regurgitant murmur were audible along the left sternal border. Chest X-ray showed cardiomegaly and enlarged pulmonary trunks. Electrocardiography showed right axis deviation and biventricular hypertrophy. Laboratory examination revealed polycythemia (Hb: 22.4 g/dl), increased levels of hepatic enzymes due to congestive liver and marked hypoxemia (Pao2: 40 mmHg), Diagnosis of DORV was made with cardioangiography. Surgical repair was not indicated. Thereafter, she experienced recurrent heart failure which progressed gradually. She died probably of ventricular arrhythmia at the age of 33 years. At autopsy, the heart showed dilatation of the right atrium and ventricle, and hypertrophy of the bilateral ventricles. Both the pulmonary artery without stenosis and the aorta originated completely from the right ventricle, which were almost normally positioned with bilateral conus. Large ventricule septal defect was found at the subaortic portion. Patent ductus arteriosus and preductal aortic coarctation co-existed. To our knowledge, few cases with DORV who survived over 30 years have been reported, and they all manifested pulmonary stenosis. The present case is a very rare DORV that survived over 30 years without the complication of pulmonary stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[A rare adult case of double-outlet right ventricle without pulmonary stenosis: an autopsy case]. 228 22

Serum erythropoietin levels were measured by radioimmunoassay in 146 children and young adults with congenital heart disease to assess the relationship between erythropoietin and clinical factors (heart failure, anemia, cyanosis) and hemodynamic variables affecting oxygen delivery and utilization. Erythropoietin values were in the normal range (10 to 30 microU/mL) in 73% (58 of 80) of the patients with and 82% (54 of 66) of those without cyanosis. Elevated erythropoietin values in cyanotic patients were associated with lower mixed venous oxygen saturation and tension than in cyanotic patients with normal erythropoietin levels, even though the degree of polycythemia was similar. In contrast, most of the acyanotic patients who had elevated erythropoietin levels were anemic. Of the blood oxygen measurements, mixed venous oxygen saturation and tension had the closest inverse correlation with erythropoietin values. The normal erythropoietin values in most patients are in accord with other observations that show that an elevation in erythropoietin level in response to hypoxia will be transient if it results in a rise in hemoglobin concentration "appropriate" to the degree of hypoxia. Persistent elevation of erythropoietin in patients with congenital heart disease may indicate harmful impairment of hemoglobin production that is potentially correctable.
...
PMID:Serum erythropoietin levels in patients with congenital heart disease. 355 1

Left ventricular performance has been studied in 50 patients affected by primary polycythemia (P.V.) by determining systolic time intervals. 50 normal subjects were used as control group. All cases underwent a pharmacodynamic test with Amyl Nitrite. The results indicate that patients with P.V. present an abnormal behaviour of left ventricular performance after Amyl Nitrite; this alteration is more evident in patients with arterial hypertension. Amyl Nitrite, through its pharmacological action, causes changes in systolic time intervals and reveals a state of latent cardiac failure.
...
PMID:[Study of left ventricular function using systolic time intervals in a group of patients with polycythemia vera (Vaquez-Osler disease)]. 615 Nov 50

Four male patients with pulmonary arterio-venous fistulae are reported. Familiar occurrence was noticed in 2 brothers. Physiological effects, clinical pictures and treatment of these lesions depend on the size and number of the fistulae. A 4-day-old baby presented with severe cyanosis and cardiomegaly. Cardiac catheterization and angiography demonstrated a large arterio-venous fistula affecting the whole of the right upper lobe and a small ventricular septal defect resulting in a high output cardiac failure. The patient underwent emergency lobectomy with good early and long-term results. The other 3 patients (mean age of 7.6 years) developed progressive cyanosis and polycythemia. Cardiac catheterization showed normal intracardiac pressures and peripheral arterial desaturation. Pulmonary angiogram demonstrated multiple fistulae in both lungs. Surgery was not performed because of the diffuse nature of the lesions. The patients reported in this paper illustrate the wide spectrum of clinico-pathological conditions of this anomaly.
...
PMID:The spectrum of pulmonary arterio-venous fistulae. Clinico-pathological correlations. 616 19

A 62 year-old woman with a bilateral carotid body paraganglioma presented, 2 years after the removal of the right one, with signs of right-heart failure. Hypoxemia, hypercapnia, polycythemia and pulmonary hypertension with normal ventilatory capacity were found. Central alveolar hypoventilation was diagnosed on the basis of absence of ventilatory response and sensation of provoked hypercapnia, prolonged breath-holding time and correction of hypercapnia by voluntary ventilation. Progesterone (200 mg/d during 3 weeks) or naloxone did not improve either arterial blood gases (ABG) or the P 0.1/PCO2 curve. Hypoxemia and hypercapnia were not corrected during metabolic acidosis provoked by acetazolamide (250 mg/d). Nasal CPAP did not control hypoventilation periods. Mechanical ventilation was initiated with negative pressure (NPV) through a poncho. The patient presented severe discomfort with NPV and obstructive apneas were verified during it. She refused to continue NPV. Mechanical ventilation was initiated with positive intermittent pressure (IPPV) through a nasal mask. The patient had excellent tolerance to the procedure. SpO2 during IPPV was always higher than 95%. During sleep induction (under IPPV), respiration in phase with the ventilator 1: 1 was observed; instead, during consolidated sleep there was a complete dependence of the ventilator with apnea for over 2 min when IPPV was interrupted (Fig. 1). After 2 months of treatment, a relief of right ventricular failure occurred and hematocrit fell to 39%. There was an improvement of day-time ABG (Table I). The P. 0.1/PaCO2 curve 3 months after IPPV was the same as the previous one (Fig. 2). The patient has been for 18 months on home ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Central alveolar hypoventilation with cor pulmonale: successful treatment by non-invasive intermittent positive pressure ventilation]. 771 33


1 2 Next >>

---