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

Circulatory responses after thiamylal (4 mg/kg) and succinylcholine (SCh) (2 mg/kg) administration followed by direct laryngoscopy and tracheal intubation were measured in 20 patients before elective aortocoronary vein bypass graft operations. Compared with awake measurements, the mean arterial pressure (MAP) decreased 19 +/- 3 torr (mean +/- SE) and heart rate (HR) increased 9 +/- 3 bpm 1 minute after thiamylal-SCh. MAP was increased 39 +/- 4 torr and HR 20 +/- 3 bpm above awake levels in response to laryngoscopy and tracheal intubation. Blood pressure and HR returned spontaneously to near awake levels without additional anesthesia within 5 minutes of anesthetic induction. Stroke volume index was decreased significantly after tracheal intubation but cardiac index was not altered. The authors conclude that thiamylal-SCh followed by tracheal intubation is an acceptable anesthetic induction sequence for patients without evidence of left ventricular heart failure who require anesthesia for elective coronary artery revascularization.
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PMID:Circulatory changes in patients with coronary artery disease following thiamylal-succinylcholine and tracheal intubation. 94 83

In 203 patients with large focal and transmural myocardial infarctions the cardiac output was studied by means of the dye dilution method, as well as the content of the lactic (Barker and Summerson's technique) and pyruvic acids (Travina's technique). Along with the growth of cardiac insufficiency a fall was observed in the cardiac and stroke indices, and a growing content of the lactic and pyruvic acids and of the L/P factor. The stroke index and the blood lactate level proved to be the most informative values. With a stroke index below 24 ml/m2 all patients with myocardial infarction displayed signs of cardiac insufficiency, while with a stroke index above 54.2 ml/m2 cardiac insufficiency was lacking. A stroke index falling between 24 and 54.2 ml/m2 was observed in both the patients with cardiac insufficiency, and in those without it. A lactic acid content above 31.8 mg% was always concomitant with cardiac insufficiency. With the lactic acid level ranging from 16 to 31.8 mg% the probability of cardiac insufficiency was doubtful.
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PMID:[Discriminative analysis in detecting cardiac insufficiency in myocardial infarct on the basis of the values of stroke volume and blood lactic acid level]. 96 30

Vasodilator therapy has been shown to have beneficial effects in heart failure. In order to evaluate the haemodynamic actions of vasodilator administration in primary congestive cardiomyopathy, sodium nitroprusside was infused intravenously at a rate of 15 to 100 mug/min to 12 patients. Mean arterial pressure fell 15 per cent from 86+/-3-0 to 72+/-2-4 mmHg (11-40 +/- -4 to 9-6 +/- 0-3 kPa), and there was a small but significant decrease in mean heart rate from 96 +/- 4-8 to 90 +/- 4-4 beats/min. These changes were accompanied by a significant decrease in mean pulmonary artery pressure from 40 +/- 2-2 to 26 +/- 2-8 mmHg (5-3 +/- 0-3 kPa to 3-5 +/- 0-4 kPa), mean pulmonary capillary wedge pressure from 25 +/ -2-2 to 16 +/- 2-1 mmHg (3-3 +/- 0-3 to 2-1 +/- 0-3 kPa), and left ventricular end-diastolic pressure from 27 +/- 1-8 to 17 +/- 1-5 mmHg (3-6 +/- 0-3 to 2-3 +/- 0-2 kPa). Cardiac index increased by an average of 48 per cent from 2-1 to 3-1 l/min per m2, and left ventricular stroke work index increased from 18-4 +/- 1-6 to 21-3 +/- 1-9 g m/m2. These results show that pronounced left ventricular dysfunction in patients with congestive cardiomyopathy is improved during vasodilator therapy.
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PMID:Circulatory response to vasodilator therapy in congestive cardiomyopathy. 97 93

The Valsalva maneuver was evaluated by echocardiography in three groups: A) 10 normal volunteers, B) 10 patients with no history of heart failure and normal ejection fractions, and C) 10 patients with heart failure and depressed ejection fractions. Groups A and B had a significant fall in left ventricular internal dimensions and calculated stroke volume by end strain which returned rapidly to baseline in recovery without significant overshoot. Arterial pressure showed a signoidal strain pattern with a normal overshoot in early recovery in all group B patients. In group C ventricular dimensions did not diminish during strain; arterial pressures showed a "square wave" pressure elevation during strain without an overshoot in recovery. Echocardiography allows a new approach to evaluate further the left ventricular response to the Valsalva maneuver. Patients with severely depressed ejection fractions, unlike those with normal ventricular function, are unable to alter stroke output in response to acutely increased intrathoracic pressure. A square wave pressure response is a likely consequence of a fixed stroke output during the strain maneuver.
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PMID:Echocardiographic evaluation of the Valsalva Maneuver in healthy subjects and patients with and without heart failure. 99 7

Left ventricular function was studied in 14 patients with end-stage chronic renal failure using non-invasive methods (echocardiography and systolic time intervals). Patients were divided into 3 groups. Group 1 consisted of 5 patients who were normotensive at the time of study and group 2 of 7 patients who were hypertensive when studied. Group 3 consisted of 2 patients: one was receiving propranolol and the other, studied 302 days after renal transplantation, was receiving digitalis for recurrent episodes of cardiac failure. All except the patient receiving propranolol had normal left ventricular function in systole with normal measurements of fractional fibre shortening (% delta S, EF) and normal measurements relating to the velocity of ventricular contraction (mean Vcf, mean velocity of posterior wall motion). Stroke volume and cardiac output were normal in some patients but were increased in patients with fluid overload. Early diastolic compliance of the left ventricle seemed to be normal except in the patient with recurrent cardiac failure. The study provided no evidence for the existence of a specific uraemic cardiomyopathy.
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PMID:Left ventricular function in chronic renal failure. 100 67

A case-control study was performed to investigate the significance of arteriosclerosis, heredity and some infections in the etiology of Parkinson's disease. The study group consisted of all traceable patients with Parkinson's disease living in a defined area, a total of 444 patients, and of control subjects for each patient, matched in sex and age, chosen from among the general population residing in the same area. No significant differences were found between the patients and the controls concerning the occurrence of cardiac insufficiency, coronary heart disease, or stroke. The Parkinsonian patients, however, had a significantly lower incidence of clinical arterial hypertension when compared with the controls. In addition, the patients more often had low systolic blood pressures and more rarely high pressures than the controls. Even the mean systolic blood pressure was significantly lower in the patients than in the controls. The low blood pressure seems to be an effect of Parkinson's disease itself with a minor contribution of levodopa therapy. The observations above are considered to indicate that arteriosclerosis and Parkinson's disease are probably only concurrent disorders and not in etiological relationship with each other. There was no statistically significant difference in the proportion of the patients and the controls with relatives with Parkinson's disease or essential tremor, which suggests that genetic factors do not have a significant role in Parkinson's disease and on the other hand that essential tremor and Parkinson's disease are two separate disease entities. No other encephalitis than a lethargic one was found to precede Parkinson's disease and the occurrence of meningitis was rare both among the patients and the controls. The history of Spanish influenza was found to be as frequent in the patients as in the controls, thus not supporting the idea that influenza has etiological importance in Parkinson's disease.
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PMID:Arteriosclerosis, heredity, and some previous infections in the etiology of Parkinson's disease. A case-control study. 100 13

The results of a long-term observation (for 1 to 4 1/2 years) of haemodynamic changes in 32 non-treated patients with stage II essential hypertension are presented. In 18 patients the lesion did not progress throughout the observation period (group I). At re-examination the haemodynamic parameters in this group of patients did not change significantly, although in some of them the haemodynamic mechanism of maintenance of hypertension underwent certain changes: the cardiac output decreased and the total peripheral resistance increased. In 14 patients (Group 2) their essential hypertension was progressively developing. At the same time a deceleration of the heart contractions rate, a reduction of the cardiac and stroke outputs, a decrease of the circulating blood volume, and an increase of the total peripheral resistance were noted. The reduction of the cardiac output was directly proportional to its initial value (r = +0.78, P less than 0.01) and to the elevation of the arterial pressure (r = +0.71, P less than 0.01). The most distinct changes were noted in 3 patients who developed signs of cardiac insufficiency during the period between the two examinations. The possible mechanisms of haemodynamic changes under the progression of essential hypertension are discussed.
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PMID:[Change in hemodynamic indices in progressive hypertension]. 101 52

The study was conducted in 80 patients with moderate compensatid mitral valve diseases without any signs of active rheumatic disease and preserved sinus rhythm. On the basis of a clinical examination two groups of patients were singled out: those without clinical manifestations of circulatory insufficiency, and those with Stage 1 circulatory insufficiency. In both groups of patients, at rest and following exercises, a reduced tolerance of physical exercises was observed, as well as a reduction of the minute and stroke indices. Better tolerance of exercises and improved haemodynamic parameters were noted in both groups following Digoxin therapy. The results of the study prompt the presence of a latent cardiac insufficiency in patients without clinical manifestations of the latter, and permit to recommend its therapy with cardiotonic doses of cardiac glycosides.
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PMID:[Study of the adaptation to physical exertion in patients with mitral valve defects]. 101 25

1. Pindolol lowers blood pressure both, immediately after administration by a reduction of cardiac output and heart rate and after long-term administration by reducing peripheral resistance. Cardiac index, initially decreased, reached the control value after 8 weeks of treatment. 2. The persistent reduction in heart rate and increase of the cardiac index during exercise after prolonged treatment together with the increase of right and left heart filling pressures seems to be due to augmentation of the Starling mechanism. The increase of the stroke volume at rest and during exercise diminished the blood-pressure lowering effect of the drug. 4. The exercise-induced increase of noradrenalin was abolished by acute administration of pindolol. After long-term treatment, however, we found a consistent and significant elevation of the plasma-catecholamines. This may reflect the development of heart failure [1], a tyramin- or cocain-like action of pindolol [2] or an indirect sympathicomimetic effect of this drug at low doses (10--15 mg/day orally ) [3]. 5. The elevation of plasma-noradrenalin reflects increased sympathetic tone and may be responsible for the increase in stroke volume and plasma renin activity observed by several authors. 6. Since there was no evidence for a hemodynamic mode of action, the lowering of blood rpessure by pindolol may be a central effect.
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PMID:[Hemodynamic long-term effects of a beta-receptor blockader (Pindolol) in primary essential hypertension]. 103 73

1. This study includes 1038 patients (325 men and 713 women) who consulted the medical out-patient clinic, Rigshospitalet, Copenhagen, during the years 1932-38. All these patients had a blood pressure of 160/100 mmHg or 180 mmHg or more. 2. The average age at the first examination was 54 years; 97% were followed at intervals of 10 years until 1975, when sixty patients were still alive. Treatment was minimal until 1970. 3. Sixty percent of the men and 76% of the women reached an age of 65 years or more. Nine percent of the total patients lived to 85 years or more. Excess mortality was far higher in men than in women. 4. Causes of death were stroke in 17%, heart failure in 24%, coronary occlusion in 16%, uraemia in 4% and other diseases in 39%. At the first examination, thirteen cases of malignant hypertension were registered, none at later sessions.
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PMID:A 40 years' follow-up study of 1000 untreated hypertensive patients. 107 6


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