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

The effects of intravenous trinitrin on myocardial function have been studied in 40 patients with heart failure (26 cases of coronary artery disease and 14 of apparently primary cardiomyopathy). Each patient had measurements made of left ventricular pressure, of cardiac output by the dye dilution method, of volume, of the left ventricular ejection fraction, and of the segmental parietal kinetics by means of left side ventriculography both before and after trinitrin. The following results were obtained after injection of trinitrin:--no change in rhythm and cardiac index;--an almost constant decrease in left ventricular end diastolic pressure (38 cases out of 40);--a decrease in arterial pressure and ventricular volume in about two thirds of cases;--improvement of the ejection fraction (25 cases out of 40), and of segmental parietal kinetics (26 cases out of 40) in the left ventricle. These findings were equally true in the patients with coronary artery disease and in the cardiomyopathies. In the light of these results, it appears that when used in left ventricular failure, trinitrin almost always decreases the load, but improves ventricular kinetics only in two thirds of cases, while it has no influence on cardiac output. In addition, given the difficulties in establishing a standard dose of trinitrin, the authors discuss the methods of establishing the optimal dose.
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PMID:[Effects of intravenous trinitrine on myocardial function in left ventricular insufficiency]. 10 Nov 68

17 patients with severe chronic heart failure (class III and IV) were prescribed hydralazine, an arterial vasodilatator, orally at doses of 150 mg to 400 mg/day. Considerable clinical improvement was observed in most patients. After 24 to 48 hours the cardiac index rose 79 p. 100, the systolic index by 67 p. 100 and left ventricular work by 73 p. 100, whilst systemic and pulmonary resistances fell by 51 p. 100 and 34 p. 100 respectively. There was no significant change in systemic blood pressure or in heart rate. These results were confirmed at 4 months. Mean pulmonary capillary pressure varied little at the start of treatment but decreased by 52 p. 100 at medium term (4 and 12 months) in this series. No cases of systemic lupus erythematosis were observed. The main, but not the only, indication of therapy with dihydralazine is low output heart failure with little elevation in the pulmonary capillary pressure, especially in primary cardiomyopathy and valvular regurgitation. At present, treatment should be based on the results of cardiac catheterisation and the dosage adjusted according to the rate of hepatic acetylation.
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PMID:[Treatment of severe chronic cardiac insufficiency with dihydralazine. Short-and median-term results]. 11 37

The case of a 50 year old male with the Fiessinger-Leroy-Reiter syndrome, ankylosing spondylitis and generalised pustular psoriasis is reported. This condition wax complicated by non-obstructive cardiomyopathy, congestive cardiac failure and first-degree atrioventricular block, the site of which was localised by electrophysiological studies (nodal block with an infrahisian conduction defect). After failure of several therapeutic regimes, a spectacular improvement was obtained with Methotrexate associated with a diuretic; the signs of heart failure regressed and the cardiomyopathy stablised. A parallel improvement was seen in the skin, cardiac and articular lesions and has been maintained with an 18 months follow-up. Left ventricular performance was studied by echocardiography. The mechanism of the beneficial effect of Methotrexate is unclear; this therapeutic trial is to be extended to include other cases of primary cardiomyopathy without obstruction.
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PMID:[Fiessinger-Leroy-Reiter syndrome with non-obstructive cardiomyopathy treated with methotrexate]. 11 79

During a review of all cases of heart disease, including hypertensive cardiac failure, seen in Botswana during a period of sixteen months by one Specialist Physician observer, the importance of Idiopathic Cardiomyopathy as the commonest cause of cardiac failure clearly emerged. The aetiology of this condition and its relationship to hypertension and other factors causing an increased load on the myocardium are discussed. Viral myocarditis is presented as a separate entity, possibly playing a part in causation.
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PMID:Idiopathic cardiomyopathy in Botswana. 44 85

Four Black South African patients, representative of a larger group, are described in detail. The common features were long periods of observation, multiple hospital admissions in both normotensive and hypertensive cardiac failure, hypertensive retinopathy and good renal function. All had been diagnosed as having cardiomyopathy. Two of the patients in a normotensive phase became hypertensive after responding to therapy for heart failure. One patient with malignant hypertension showed the features of idiopathic cardiomyopathy at necropsy. These cases are regarded as evidence in favour of the hypothesis that many cases of cryptogenic heart disease (cardiomyopathy, congestive cardiomyopathy, idiopathic cardiomegaly) are in fact cases of hypertension presenting with normotensive cardiac failure.
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PMID:Hypertensive heart disease and cardiomyopathy in blacks. Diagnostic confusion. 45 82

The action of the contrast material over the various contractility indices was assessed five minutes after left ventriculography. There was an increase of the contractility index in normal subjects. On the contrary, in coronary patients, the contractility function remained unchanged or was depressed, related to the presence or not, of signs of cardiac failure. Depression of the various indices was noted in subjects with primary cardiomyopathy. After recalling the mechanism of action of the contrast products on the cardiovascular haemodynamic parameters, the following practical conclusions were drawn in relation with a series of 65 cases of coronary heart disease: the late diastolic left ventricular pressure remained lower than 20 mmHg after ventriculography in the subjects with a normal ejection fraction; it incraeased between 20 and 30 mmHg in most of the subjects with an ejection fraction ranging from 0.4 and 0.6, finally it was constantly found above 35 mmHg in the subjects with severely disturbed ventricular contraction with an ejection fraction lower than 0.4. These results underline the interest of this simple test, easy to perform, consisting in measuring the left ventricular late diastolic pressure before and 5 minutes after left ventriculography.
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PMID:[Modifications of contractility after left ventriculography. A new test in evaluation of myocardial function]. 80 84

Idiopathic cardiomegaly is probably the commonest single diagnosis other than hypertension made in tropical and subtropical African cardiovascular practice. Understanding of the nature of this disease has been hampered by failure to recognize the possibility that the term "idiopathic cardiomegaly" may embrace several disease entities. Evidence suggests that many factors, sometimes acting singly, but often acting in combination, may be responsible for the genesis of so-called idiopathic myocardial failure. The future attitude to research should not be one of excluding well-defined forms from the concept of idiopathic cardiomegaly, but one of clinicopathological classification, which should be a prelude to the search, within each moiety of this group of disorders, for a specific or dominant etiological factor.
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PMID:Idiopathic cardiomegaly in Africa. 82 42

In 13 patients an association existed from 1970-73 between Mycoplasma pneumoniae infection and acute pericarditis (in eight) or perimyocarditis (in five). In 12 patients the association was moderately probable, with a fourfold rise in complement-fixing antibody titers between acute and convalescent phase sera being noted. In the last patient, a lesser-order association was found using only convalsecent phase serum. The presence of influenza, herpes simplex, Coxsackie B, or adenovirus was excluded by serologic testing. Acute illness was variable, with four patients developing heart failure. Long-term evaluation (mean, 47 months) found eight patients asymptomatic and three symptomatic. Two patients died. Residual effects of the Mycoplasma infection seemed at least partially responsible in one compromised patient and in one who died. Mycoplasma infection should be considered in the presence of acute cardiovascular decompensation, especially when preceded by upper respiratory infection, and added to the possible causes of idiopathic cardiomyopathy.
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PMID:Pericarditis and perimyocarditis associated with active Mycoplasma pneumoniae infection. 85 2

Myocardial blood flow was estimated using the technique of selective xenon-133 solution injection into the coronary artery, in 20 patients with mitral stenosis, 8 patients with mitral insufficiency, 8 patients with primary cardiomyopathy, and in 7 healthy subjects. The mean value of myocardial blood flow in mitral stenosis (60.9 +/- 10.5 ml/min/100 g) and in mitral insufficiency (58.5 +/- 7.7) did not differ from the mean value obtained in the control group (66.0 +/- 9.1). On the other hand, myocardial blood flow in primary congestive cardiomyopathy was significantly diminished (54.1 +/- 8.6). Myocardial blood flow was also lowered in patients with class IV of heart failure (48.3 +/- 7.6), as compared to healthy subjects. A positive correlation was found between myocardial blood flow and the left ventricular work index (r = 0.48, p less than 0.05), as well as between myocardial blood flow and the right ventricular work index (r = 0.47, p less than 0.05). A weak correlation was noticed between myocardial blood flow and left ventricular end-diastolic pressure (r = 0.38, p less than 0.05), as well as between myocardial blood flow and right ventricular end-diastolic pressure (r = 0.34, p less than 0.05).
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PMID:Myocardial blood flow in mitral valve disease and in primary congestive cardiomyopathy, and its relation to some haemodynamic indices. 126 Dec 75

Incessant, rapid, supraventricular tachycardia may be complicated by cardiac failure with ventricular dilatation and hypokinetic wall motion on echocardiography: so-called tachycardia-induced cardiomyopathy. The diagnosis is simple when the cardiac rhythm is not sinus rhythm. The authors report the cases of 4 children aged 7 months to 12 years, referred for diagnosis and treatment of apparently primary cardiomyopathy. The findings of spontaneous or vagally-induced atrioventricular conduction defects, a permanently rapid atrial rhythm though influenced by 24 hour variations, or periodic abnormal rate increases, suggested myocardial dysfunction due to an ectopic atrial tachycardia. This was an essential step in management as the control of the tachycardia by amiodarone or betablocker therapy resulted in regression of symptoms and normalisation of left ventricular function. However, some atrial tachycardias are very resistant to medical treatment and, in such cases, there should be no hesitation in using more radical approaches, surgery or ablation, even and especially in patients with severe cardiac failure. In conclusion, apparently primary dilated cardiomyopathy in children may be due to chronic atrial arrhythmia and it is essential to perform at least Holter monitoring in order not to miss this diagnosis.
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PMID:[Rhythmogenic cardiomyopathies of atrial origin in children. Myth or reality?]. 135 26


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