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

A cross-sectional echocardiographic study of 50 black Zimbabwean children with clinical human immunodeficiency virus (HIV) infection was carried out. The median age was 9 months. Seventy per cent had chronic cough, 60% respiratory distress and 40% cyanosis. Sixty per cent had pericardial effusion and 48% right ventricular hypertrophy (RVH) and dilation. However, the clinical diagnosis of heart failure was difficult as most of these children (80%) had hepatomegaly. These findings suggest that respiratory disease plays a role in the causation of RVH in these children. As cardiac causes of RVH were absent, this was presumed to be due to cor pulmonale. HIV-infected children presenting with respiratory distress may have clinically unapparent cor pulmonale. Early and appropriate management may by beneficial.
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PMID:Cor pulmonale in children with human immunodeficiency virus infection. 767 13

The acute systemic complications of perinatal asphyxia, defined as an umbilical artery pH at birth of 7.10 or less, were evaluated in fifty full-term newborn infants. We also investigated the prenatal complications that lead to asphyxia, and the relationship between Apgar score and cord pH. Asphyxia or fetal distress was not identified in 56% of the cases. The most common condition associated with asphyxia was prolonged labor followed by abruptio placentae. About half of the babies studied, suffered some degree of renal and brain dysfunction; 24% had severe respiratory disease. Myocardial failure was present in 24%. Regarding metabolic complications, the most frequent was hypocalcemia, present in 44%. On the other hand, there was no correlation between Apgar score and cord pH. Mortality was 22%. The main cause of death was Persistent Pulmonary Hypertension.
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PMID:[Acute complications in full term neonates with severe neonatal asphyxia]. 774 93

The aim of this study was to bring to light new and simple criteria, obtained during cardiopulmonary exercise testing, in order to demonstrate in patients the cardiac or the pulmonary origin of a comparable exertional dyspnea. Forty male subjects were compared, who exercised with a 30-W/3-min protocol and were divided into three groups: the cardiac heart failure (CHF) group (n = 15), the chronic obstructive lung disease (COLD) group (n = 15), and the control group (n = 10). The two groups of patients differed totally from the control group concerning their spirometric values at rest and a clear inability during effort which was confirmed by all the studied cardiopulmonary parameters at maximal exercise. The CHF and COLD groups differed slightly concerning their maximum symptom-limited oxygen uptake, only when related to body mass (13.26 +/- 0.69 ml/kg/min in CHF group, 17.05 +/- 1.59 ml/kg/min in COLD group; p < 0.05), and concerning their maximum ventilatory equivalent for oxygen which tended to be higher in the CHF group in comparison with the COLD group (p = 0.082). Furthermore, and as foreseen, the two groups of patients clearly differed at maximum exercise concerning the ventilatory reserve respiratory parameter (49.73 +/- 3.18 percent in CHF group, 8.38 +/- 5.85 percent in COLD group; p < 0.01). On the other hand, they did not differ concerning cardiac parameters or those considered as such (maximum heart rate [HR], HR reserve, HR response, maximum O2 pulse measurement). While their maximum ventilation was similar in the CHF and COLD groups, a difference in adaptation during exercise was found by observing their breathing pattern. In the CHF group, this was demonstrated by a significantly lower breathing frequency at maximum exercise (31.24 +/- 1.53 beats/min vs 37.75 +/- 2.24 beats/min; p < 0.05) and a tidal volume that tended to be higher at maximum exercise (p = 0.077) and significantly higher at 60-W work load (p < 0.05). This work shows that the study of ventilatory reserve and breathing pattern during exercise testing allows one to discriminate if dyspnea on exertion in patients is due to cardiac or respiratory disease.
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PMID:Cardiopulmonary exercise testing. Determinants of dyspnea due to cardiac or pulmonary limitation. 777 2

A 60-year-old man with a myeloproliferative syndrome and extramedullary hematopoiesis had progressive respiratory and cardiac insufficiency during the previous 18 months, with advancing interstitial pulmonary disease on chest x-ray. During analysis of his respiratory disease, results of a transbronchial biopsy showed interstitial involvement with increased numbers of megakaryocytes and other panhematopoietic staining elements. Results of a bone marrow scan demonstrated diffuse replacement of pulmonary interstitium with bone marrow, as a component of known ongoing extramedullary hematopoiesis.
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PMID:Tc-99m sulfur colloid demonstration of diffuse pulmonary interstitial extramedullary hematopoiesis in a patient with myelofibrosis. A case report and review of the literature. 787 7

The pathophysiology and the treatment of heart failure in patients with chronic cor pulmonale is described. The patients with chronic cor pulmonale were divided into two categories in terms of the cause of the disease, that is, due to chronic respiratory failure and due to chronic pulmonary vascular obstruction. The treatment for the patients in the first category is, mainly to control respiration and to continue chronic oxygen therapy, and in the second category is, to utilize vasodilator and anticoagulant therapy. The results of these treatments are rather poor, though in terms of improvement in the quality of life and the survival. In the patients with chronic respiratory disease, the prevention of chronic cor pulmonale and heart failure is essential.
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PMID:[Chronic cor pulmonale and heart failure]. 833 4

The causes of admission to hospital over a 5-year period of 3539 persons aged 60 years and above in Riyadh, Saudi Arabia have been analysed; 54.2% were males and 45.8% females and 68.5% were aged 65 years and above. The causes of morbidity were chronic degenerative disorders of which cardiovascular diseases were the most frequent followed by acute respiratory problems, diabetes, and digestive and neoplastic diseases. The pattern of disease was very similar to that in the industrialized countries. The median stay in hospital was 10.7 days. Respiratory diseases and diabetes mellitus were significantly higher in females than males (P < 0.02), while cardiovascular diseases, particularly ischaemic heart disease and heart failure, as well as malignant neoplastic diseases mainly of the digestive system, were more prevalent in males.
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PMID:Causes of morbidity among a sample of elderly hospital patients in Riyadh, Saudi Arabia. 850 69

Eighty-four patients of severe pancreatitis were divided by different line of age and the mortality of patients with severe pancreatitis above and below the line was comared. The results showed that the 60-year of age was the age with the lowest mortality. The analysis of 35 patients with severe pancreatitis who were older than 60 years of age indicated that multiple gallstones was the most common cause initiating the disease. The common severe concurrent diseases were hypertension, coronary disease, cerebrovascular disease, and respiratory disease. Common organ failures were ARDS, shock and heart failure. The number of failed organs in elderly patients in the fifth and seventh day after admission was obviously more than that in young patients.
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PMID:[Influence of age on severe pancreatitis]. 873 73

Maximal exercise performance in patients with chronic heart failure, as determined by peak oxygen consumption (VO2max.) during exercise testing has been shown to correlate well with mortality and its use as primary determining factor in the selection of patients for heart transplant has been advocated. Patients with a VO2max of less than 14 ml/kg/min appear at particularly high risk for mortality. Exercise performance can be influenced by a number of independent factors including subject motivation, peripheral deconditioning or other intrinsic abnormalities of skeletal muscle, and primary respiratory disease. It appears to be a precise gauge of functional impairment. VO2max can be used to accurately and reproducibly place an individual in a predefined functional class.
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PMID:[The importance of determining oxygen consumption in the indications for a heart transplant]. 877 10

Progressive tissue iron deposition from multiple blood transfusions is common in beta-thalassaemia and pulmonary iron deposition may result in parenchymal damage. The objectives of this study were to: 1) determine the predominant pulmonary dysfunction in patients with thalassaemia major; and 2) demonstrate that parenchymal disease, if present, is at the level of the alveolocapillary membrane. Fourteen thalassaemia major patients (13 nonsmokers) receiving regular blood transfusion and without any history of chronic respiratory disease were recruited. Pulmonary function tests and echocardiography were performed before the scheduled transfusions. Three patients with the most restricted lung function were selected for high resolution computerized tomography (CT) of the lungs. One patient had an obstructive pattern with a forced expiratory volume in one second as percentage of forced vital capacity (FEV1/FVC) of 71%. Four patients demonstrated a restrictive pattern, as defined by total lung capacity (TLC) less than 80% predicted with normal FEV1/FVC%. Twelve patients had pulmonary transfer factors for carbon monoxide (TL,CO) below 80% pred, even after correction for the anaemia, indicating parenchymal disease. Eight of these 12 patients had alveolocapillary membrane defect, as demonstrated by a gas transfer factor of the pulmonary membrane (Tm) less than 80% pred. Mean resting arterial oxygen saturation was 95 +/- 2 (range 92-98) %. Eleven patients had oxygen desaturation of 5% or more during exercise on a bicycle ergometer, consistent with interstitial lung disease. There was no clinical or echocardiographic evidence of heart failure. Percentage predicted TLC was inversely correlated with age (r = -0.547; p = 0.043). Both percentage predicted TLC and TL,CO were not correlated with iron burden or desferoxamine ratio. High resolution CT in the three selected patients showed no evidence of pulmonary fibrosis. We conclude that thalassaemia major patients have a predominant restrictive lung dysfunction with pulmonary parenchymal disease and alveolocapillary membrane block. The restrictive and interstitial lung disease could not be accounted for by iron loading or pulmonary fibrosis in our patients.
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PMID:Lungs in thalassaemia major patients receiving regular transfusion. 883 48

Respiratory muscle dysfunction has been demonstrated in several clinical situations including chronic respiratory disease, such as chronic obstructive pulmonary disease, as well as cardiac insufficiency. In the latter case, respiratory muscle dysfunction has been demonstrated in acute situation (cardiogenic shock) and in chronic cardiac insufficiency. In the former case, it has been shown in an animal model that respiratory muscle dysfunction could influence markedly the outcome of cardiogenic shock. In chronic cardiac insufficiency histologic, biochemical and contractile abnormalities of the respiratory muscles have been demonstrated in an animal model as well as in humans. These alterations may account, at least in part, for the sensation of dyspnea that these patients encountered. Finally, several pharmacological agents such as angiotensin-converting enzyme inhibitors have been shown to restore muscle abnormalities observed during chronic cardiac insufficiency.
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PMID:Alteration in diaphragmatic function during cardiac insufficiency: potential pharmacology modulation. 893 83


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