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

The Valsalva manoeuvre was used to examine circulatory reflexes in 22 patients with acute myocardial infarction. Four patients had the 'square wave' response of cardiac failure and two responded normally to the manoeuvre. In the remaining 18 patients there was a 20 per cent or more fall in pulse pressure during the manoeuvre, but no ensuing rise in diastolic pressure, implying impairment of vasoconstriction. This impairment cannot be explained by acidosis, hypocapnia, or arterial hypoxaemia but may be explained by reflex inhibition of vasoconstriction. This abnormal response has important implications when transporting patients; furthermore, it could explain the rapid deterioration sometimes seen in patients with arrhythmias.
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PMID:Circulatory reflexes in myocardial infarction. 83 30

1463 patients with acute myocardial infarction were treated in 26 hospitals in Northern Germany from June 1972 till August 1973. The time elapsed between onset of symptoms and admission to the regional hospital was similar in rural patients and those living in cities. 39% were admitted later than 12 hours after onset of symptoms. Having survived the prehospital phase the age of infarction did not influence the mortality. The treatment in the different hospitals was in no way standardized, except the treatment with streptokinase. Regarding this procedure, the following results can be presented. The overall mortality was 25.8%. Mortality was higher in cases of high age, preexisting myocardial failure, diabetes mellitus and in cases of shock and/or arrhythmia. Anterior wall infarction showed a higher mortality than posterior wall infarction. In this study the average results of treating 1463 patients with acute myocardial infarction treated in Northern Germany were presented.
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PMID:[Investigations of the clinical course of acute myocardial infarction. II. Epidemiological facts (author's transl)]. 84 Jan 18

Serial measurements of left ventricular systolic time intervals (STI) were carried out in 44 patients with acute myocardial infarction (AMI) in the first 5 days after onset, by indirect methods. The patients with heart failure showed significant decreases of ejection time (ET) (p less than 0.001) and of the ejection time index (p less than 0.005) and increases of Wiessler's ratio (PEP/ET) (p less than 0.001). The pre-ejection period (PEP), the isovolumetric contraction time and the total electromechanical systole were unsignificantly changed. Ejection time was shorter than 250 msec in the patients with acute pulmonary edema or congestive heart failure, in most of the patients with flutter or atrial fibrillation and in 16 of the 17 patients who died. Ejection time may have a prognostic significance and may be useful in the early detection of heart failure in AMI. The changes of STI after administration of lanatosid C show the positive inotropic effect of this drug in patients with AMI.
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PMID:Value of systolic time intervals in the estimation of heart failure secondary to acute myocardial infarction. 84 Dec 49

A haemodynamic study was conducted in 96 patients with acute myocardial infarction. The method of right heart catheterization at the bedside using the Swan-Ganz floating balloon-tipped catheter is safe and feisible. An elevation of pressure in the pulmonary circulation was revealed in patients with transmural myocardial infarction and in those without clinical signs of heart failure. The pressure elevation is detected the more often the sooner after the onset of infarction the examination is conducted. To evaluate fast pressure changes heart catheterization is essential and cannot be substituted by any other technique of examination Digoxin administration during the acute phase of myocardial infarction fails to produce any significant reduction of the pulmonary circulation pressure, but a prompt reduction of the pulmonary circulation pressure can be achieved by way of Phentolamine infusion. The pulmonary circulation pressure measurements during the acute phase of myocardial infarction are believed to be an indispensable component of examinations for the heart failure therapy.
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PMID:[Hemodynamic observations in acute myocardial infarct]. 85 47

Technetium-99m stannous pyrophosphate (99mTc-PYP) myocardial scintigrams were obtained in 68 patients during acute myocardial infarction (AMI) and at follow-up 15.9 +/- 8.8 weeks later. All patients with AMI had a positive scintigram (2+ or greater); only one of 46 control patients (2%) had a positive (2+) scintigram. At follow-up scintigraphy 6 to 37 weeks following AMI, 57% of patients had a persistently positive scintigram even though recurrent AMI was suspected in only one of these patients. Patients with persistently positive scintigrams tended to have more severe disease as evidenced by compensated congested heart failure (41%) persistent angina (77%), and ECG evidence of ventricular dyssynergy (51%), We conclude that 1) in patients with prior AMI, a 2+ abnormality on 99mTc-PYP scintigram may not represent new AMI; 2) a persistently positive 99mTc- PYP scintigram may have prognostic implications since it occurs predominantly in patients with severe symptomatic coronary disease.
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PMID:Follow-up technetium-99m stannous pyrophosphate myocardial scintigrams after acute myocardial infarction. 87 8

Sodium nitroprusside is an excellent agent for lowering blood pressure in hypertensive emergencies, for producing controlled hypotension during anesthesia, and for treating acute myocardial infarction and chronic heart failure. Toxic effects of this drug have been reported and above-normal cyanide and thiocyanate concentrations have been observed in the blood of a small proportion of subjects receiving nitroprusside. Nitrite, syanide, and thiocyanate are major decomposition products of nitroprusside, resulting from an in vitro reaction with human blood. On the basis of the conversion mechanism, we suggest that, in the cyanide/thiocyanate cycle, only cyanide is directly responsible for any acute toxicity attributed to sodium nitroprusside. In this work, the extent of cyanide production by erythrocytes in vitro was studied. The rate of detoxification of cyanide by human liver in vitro was experimentally determined and data from a search for a possible inhibitor of the nitroprusside/hemoglobin reaction are presented. Also, the possible mechanism of the nitroprusside/hemoglobin reaction is discussed.
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PMID:Some aspects of sodium nitroprusside reaction with human erythrocytes. 92 83

On 55 patients with acute myocardial infarction blood gas changes and A-aDO2 while breathing room air were observed for a period of 5 weeks. PaO2 during the 35% O2 inhalation was measured on admission and 5 weeks later for comparisons with the PaO2 while breathing room air. Pulmonary circulatory hemodynamics was measured in 29 cases on admission using Swan-Ganz's right heart flow directed catheter 7F, and the catheter was kept in the pulmonary artery in 13 cases for a maximum of 9 days. The mean PaO2 while breathing room air on admission was 66.7 mmHg in the 55 cases. It was 52.3 mmHg in the heart failure group and 74.9 mmHg in the non-heart failure group, showing prominent hypoxemia in the heart failure group. The mean PaO2 recovered to normal (84.1 mmHg and 87.0 mmHg) 5 weeks later. Inhalation of 35% O2 was performed for 20 minutes on admission and 5 weeks later. The elevation of PaO2 during the oxygen inhalation on admission was smaller than that 5 weeks later, significantly smaller in the heart failure group (P less than 0.001). The mean A-aDO2 on admission was higher in the heart failure group (58.1 mmHg) than in the non-heart failure group (34.8 mmHg). PaO2 showed significant correlations with cardiac index and SvO2. Although it was significantly correlated with PA diast. and TPR, no correlation with CVP was observed. Hypoxemia in acute myocardial infarction is caused by the following process: the onset of myocardial infarction causes low output, leading to left ventricular failure. As the result of elevated left atrial pressure and pulmonary venous pressure, intestinal pulmonary edema develops provoking ventilation-perfusion inequality, intra-pulmonary shunting, and diffusing defect.
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PMID:Studies of hypoxemia and pulmonary hemodynamics in acute myocardial infarction. 93 22

Systolic time intervals were studied in acute and old myocardial infarction, and the following conclusions were drawn: 1. Acute myocardial infarction. a) LVET was the shortest on the 3rd and 4th day of the illness, normalizing on the 14th day in cases without heart failure; but generally lower values were encountered in cases with heart failure, with a delay in recovery. b) PEP tended to be prolonged in the initial stage in cases with heart faii showed scarcely any change. d) PEP/LVET was the greatest prolongation near the 4th day of the illness, normalizing on the 14th day in cases without heart failure; but no recovery was seen after 10th week in cases with heart failure. e) Correlation was found between LVET or PEP/LVET and SI, but no concentration was seen between Q-II or PEP and SI. f) A tendency of correlation was noted between Peel's prognostic index and LVET or PEP/LVET. g) A marked deviation of either one of STI, especially that of PEP/LVET, suggests a poor prognosis. Persistence of the LVET value less than 240 msec up to the 7th day of the illness suggests the complication of heart failure. 2. Old myocardial infarction. While LVET was almost normal, PEP was considerably high regardless of the presence or absence of heart failure, with a tendency of aggravation in the course of years. The tendency of PEP/LVET was similar to that of PEP.
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PMID:[Evaluation of left ventricular function in acute and old myocardial infaraction by non-invasive method with special reference to systolic time intervals]. 93 30

To determine the effects of early ambulation on peripheral venous thrombosis in the coronary care unit, 29 patients with acute myocardial infarction had daily 125I-fibrinogen point counting of both legs using a standard portable technique in the first 3 to 7 days after admission. Twenty-one patients underwent early ambulation during the initial 3 days, while 8 remained at complete bed rest for 5 days. Only 2 of 21 early ambulated patients had positive fibrinogen point counts, in contrast to 5 of 8 nonambulated patients (P less than 0.01). With heart failure, only 2 of 9 ambulated patients had positive point counts, compared with 4 of 5 nonambulated patients (P less than 0.05). In 16 patients undergoing venography, point counts were confirmed in 6 positive and 10 negative findings. These results show that the high frequency of peripheral venous thrombosis in immobilized acute myocardial infarction patients, particularly those with heart failure, can be effectively reduced by early ambulation.
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PMID:Prevention of lower extremity venous thrombosis by early mobilization. Confirmation in patients with acute myocardial infarction by 125I-fibrinogen uptake and venography. 93 82

An anabolic hormone, methandrostenolone, was shown to be able to decrease significantly the cicatrization-time on animals with induced sperimental acute myocardial infarction (AMI). A controlled clinical trial was performed on group of 246 patients affected by AMI, giving them methandrostenolone at dose of 25 mg im.m. per day, for the first ten days from the beginning of symptoms. An omogeneous group of 240 patients with AMI was used as control. The mortality rate resulted 13,4% in the treated group 18,7% in the control's. 10 patients in the treated group (4,2%) died of cardiac failure versus 17 (7,1%) in the control group, 9 (3,7%) of cardiac rupture in the former versus 6 (2,4%) in the latter. As far as these differences are concerned statistical significance was not reached. A larger number of patients would be requested.
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PMID:[On the use of an anabolic hormone in the acute myocardial infarction. Experimental trial on 486 patients (author's transl)]. 94 54


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