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

Cardiac hemodynamics were assessed by right and left heart catheterizations in nine patients on hemodialysis. Results showed increased stroke work index and left ventricular work indices. Left ventricular end-diastolic pressure was elevated in all patients (markedly so in five) and did not fall with occlusion of arteriovenous communications. Cardiac output was significantly elevated, but fell to normal postocclusion. Myocardial oxygen consumption, indirectly assessed by tension time and pressure rate indices, appeared increased. Six patients died: four from complications attributed to myocardial failure without infarction, one from transplant-related complications, and one from bacterial meningitis. Five had increased cardiac weights at autopsy, but none showed infarction. This study suggests that increased cardiac work is present in chronic renal failure. Myocardial mass increases result in increased myocardial oxygen demand; however, the increased oxygen requirements may not be met because of reduced erythrocyte mass. Persistance of pressure-volume overload and severe anemia are conducive to myocardial failure.
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PMID:Cardiac work demands and left ventricular function in end-stage renal disease. 13 18

The role of hypertension in cardiovascular disease was studied in the hypertensive coarcted monkey during the feeding of an atherogenic and nonatherogenic diet. During the 15-month period of observation, half of the hypertensive coarcted monkeys developed cardiovascular disease which included heart failure, ischemic heart disease, stroke, and sudden death. There were no cardiovascular complications in the control normotensive monkeys except for one cholesterol-fed animal. The incidence of ischemic heart disease and sudden cardiac death was higher in monkeys with both hypertension and hypercholesterolemia than in those with hypertension or hypercholesterolemia alone. Postmortem studies revealed that the former monkeys had both hypertensive and atherosclerotic heart disease, whereas the monkeys with hypertension or hypercholesterolemia had either hypertensive or atherosclerotic heart disease. Hypertensive heart disease was characterized not only by hypertrophy of the left ventricle but also by focal myocardial degeneration and fibrosis and by focal thickening and narrowing of the small coronary arteries, particularly the sinus node artery and the atrioventricular node artery. The finding of transmural myocardial infarction in two monkeys with patient coronary arteries suggests a possible role of coronary artery spasm in ischemic heart disease in hypertension. The cerebral vascular complications of hypertension included hypertensive encephalopathy, transient "ischemic" attacks, and hemorrhagic stroke. The complications were associated with severe hypertension and with hypertensive vascular disease or hypertensive and atherosclerotic vascular disease of the cerebral arteries.
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PMID:Role of hypertension in ischemic heart disease and cerebral vascular disease in the cynomolgus monkey with coarctation of the aorta. 14 28

"Relative Cross-sectional area Differences" (RCD) and "Relative Velocities of Contraction" (RVC) permit a differentiation between normal subjects and patients with different degrees of myocardial failure, as previously described. Important determinants of the parameters RCD and RVC are changed, if ventricular volume and stroke volume increase and heart rate decreases, as is commonly observed in athletes. Examinations were performed at rest and after exercise on 31 athletes and 33 untrained normal subjects. Ventricular volumes were clearly increased in athletes. RCD, however, which is an equivalent to the ejection fraction, showed only slight alterations with physical training. RVC was obviously not changed by athletic training. After exercise athletes showed a significant increase in RCD. In untrained subjects only small changes in RCD were observed. In conclusion, the results show that RCD and RVC can quantitatively assess the degree of myocardial failure in cases of left ventricular dilatation without having to take into account the patients' degree of physical training.
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PMID:[Heart diagnosis using M-mode-echocardiography. Continuous registration of the left ventricular transversal internal diameter. III. Measurements on highly trained athletes (author's transl)]. 14 May 48

Adequate antihypertensive therapy will lower blood pressure to normotensive or near normotensive levels in 80-85% of patients. Long-term treatment results in a marked decrease in strokes and stroke recurrence, heart failure, renal failure, and progression to accelerated hypertension. The effects of long-term therapy on the occurrence of coronary artery disease are unclear.
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PMID:Prognosis of adequately treated hypertensive patients. 14 27

Left ventricular and myocardial performance were analyzed in 9 patients with chronic volume overload by mitral regurgitation from biplane cineventriculograms, simultaneous pressure recordings and cardiac output (thermodilution method) determinations. In spite of a considerable regurgitant fraction (49 +/- 17% of total stroke volume) cardiac index on the average is normal (CI = 3.3 +/- 0.7 l . min-1). The main compensatory mechanism to maintain cardiac ouput in hypertorphy (WED = 1.1 +/- 0.2 cm; LVMI = 216 +/- 62 g . m-2; LVMI/EDVI = 1.3 +/- 0.3 g . ml-1) and dilatation (EDVI = 163 +/- 37 ml . m-2). An increase of preload is of minor importance (PLVED = 15 +/- 7 mmHg; sigma ED = (40 +/- 19) x 10(3) dyn . cm-2). Left ventricular enlargement and wall mass are related to the degree of clinical heart failure (NYHA). Enddiastolic volume on the average is more increased than total stroke volume (89 +/- 31 ml . m-2). Ejection fraction (EF = 54 +/- 7%) was depressed despite a normal afterload (sigma tej = (171 +/- 37 x 10(3) dyn. cm-2; sigma max = (247 +/- 48 x 10(3) dyn . cm-2). The reduced ejection fraction and diminished myocardial power are related to an impairment of myocardial function (VMW . sigma tej = (83 +/- 39) x 10(3) dyn . cm-2 . s-1; VMW . sigma tej/ln sigma ED = 7.9 +/- 3.6 x 10(3) dyn . cm-2 . s-1). In comparable degrees of heart failure myocardial function is more compromised in patients with mitral than with aortic regurgitation.
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PMID:[Ventricular and myocardial function in mitral regurgitation (author's transl)]. 15 44

The effects of gram-negative endotoxin (Escherichia coli 4 mg/kg) induced myocardial failure in the pentobarbital-anesthesized dog were examined by monitoring its influence on coronary and systemic hemodynamics and correlating these results with myofibrillar ATPase activity. An identical series of studies was performed incorporating a femoral-femoral arterial-venous shunt to augment venous return. Over a five-hour period, gram-negative endotoxemia was associated with a progressive fall in arterial pressure, stroke volume, cardiac output, coronary flow, and a rise in total peripheral resistance and diastolic coronary vascular resistance. Augmenting venous return by 313 +/- 71 ml/min significantly increased cardiac output, stroke volume, and coronary flow and substantially reduced total peripheral resistance and coronary vascular resistance. Myofibrillar ATPase activity from both endocardium and epicardium was significantly depressed in the endotoxin-shocked preparations. However, with the augmentation of venous return with the A-V shunt in the endotoxin-treated animal, myofibrillar ATPase activity is normal. It appears that endotoxin causes a decrease both in venous return and in cardiac contractility by increasing total peripheral resistance, coronary vascular resistance, and impedance to left ventricular ejection. Augmenting venous return by optimizing preload and reducing afterload prevents any significant increase in total peripheral resistance, coronary vascular resistance, or impedance to left ventricular ejection. This is manifested by a rise in cardiac output, stroke volume, and coronary flow and the preservation of myocardial function. This is the first successful application of left ventricular afterload reduction in noncardiogenic shock.
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PMID:Augmented venous return: protection of the ischemic myocardium during endotoxemia. 16 74

Left ventricular performance was studied in 23 young patients with severe chronic anemia due to beta-thalassemia major and intermedia. The patients were divided into three groups according to the number of blood transfusions they had received. The left ventricle (LV) was enlarged in patients who had not received blood and larger still in patients who had received multiple transfusions. Echocardiography and systolic time interval measurements showed that systolic function of the LV was good in all the patients and that there was no statistical difference in systolic function in patients who had and those who had not received multiple transfusions. Heart rate was increased in the latter group. Stroke index and cardiac index were high, especially in patients in Group 3. The diastolic closure rate (EF slope) of the anterior mitral leaflet and its amplitude of movement were increased, but less so in Group 3; this may reflect an alteration in diastolic LV distensibility. The results indicate that despite the presence of cardiomegaly and severe clinical congestive heart failure, LV performance is well preserved in patients with beta-thalassemia, even in those who have received repeated blood transfusions. Clinical cardiac failure is the consequence of volume overload and abnormal chamber compliance. There was no evidence in this of a congestive cardiomyopathy.
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PMID:Left ventricular function in beta-thalassemia and the effect of multiple transfusions. 16 23

The hemodynamic effects of tazolol, a new long-acting beta-stimulating drug, were studied in dogs with acute pump failure caused by experimental myocardial infarction and the results were compared with the actions of isoproterenol given in small and large doses. Tazolol produced a significant and sustained increase in cardiac output and stroke volume, while causing a decrease in peripheral resistance and mean aortic pressure. Heart rate was only modestly increased. Compared with isoproterenol at equivalent doses. tazolol appeared to cause less S-T segment elevation at the margin of infarction. The increase in double product (systolic pressure X heart rate) produced by tazolol was also considerably less than that of isoproterenol. Tazolol may prove to be a useful addition to the drugs available for the treatment of myocardial failure of various causes. It is now being studied in patients with heart failure due to coronary artery disease.
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PMID:Circulatory effects of tazolol in experimental myocardial infarction. 23 34

In eight patients undergoing cardiac surgery for aortic and/or mitral valvular disease, mean arterial blood pressure (MAP), central venous pressure (CVP), cardiac index (CI), stroke index (SI), pulmonary capillary wedge pressure (PCWP), and pulmonary arterial mean pressure (PAMP) were measured after premedications with diazepam-scopolamine (I), after breathing 100% oxygen (II), and on controlled respiration (III) after induction of anaesthesia with enflurane-O2, and endotracheal intubation facilitated by succinylcholine. All measurements were done prior to surgery. Enflurane anaesthesia was found not to affect cardiac index. The average SI decreased by 27%, but was compensated for by an average increase in heart rate (HR) of 33%. The average systemic vascular resistance (SVR) decreased by 14%. All other measured parameters were found to be unaffected by enflurane-O2 anaesthesia. It is concluded that the cardiovascular stability observed in healthy young normals during enflurane anaesthesia is preserved in patients with moderate to severe heart failure, making enflurane an anaesthetic agent well suited for patients with cardiac disease.
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PMID:Haemodynamic effects of enflurane in patients with valvular heart disease. 27 53

The effect of dopamine was tested in 20 patients with cardiogenic shock. 14 patients suffered from acute myocardial infarction, 6 patients from severe heart failure. In the beginning the dosis of dopamine was 200 to 300 microgram/min. 4 patients with an acute myocardial infarction died in shock. The remaining 10 patients survived the first shock symptomes. All patients with heart failure survived the cardiogenic shock. Hemodynamic studies showed a sigificant increase of the arterial mean pressure and a decrease of the diastolic arterial pulmonary pressure. During dopamine a statistically not significant increase of cardiac index and stroke volume was observed.
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PMID:[Dopamine in patients with cardiogenic shock (author's transl)]. 32 88


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