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

Diagnostic value of a scope of peripheric parameters of thyroid function was assessed in an unselected group of untreated patients with suspected thyroid disorder, further in untraeted selected patients (without cardiac involvement) and in treated patients. Comparison of relative values of individual tests was performed, based on relation to plasma thyroid hormone level represented by PBI. It was found that: 1. The diagnostic value of heart rate, plasma cholesterol level, B. M. R. and Hegglin's sign (T-2s interval) is of a very limited degree. 2. The diagnostic accuracy of AJT, Q-Kd interval and PEP was found to be of considerable interest even in unselected patients. Values of IRVD and D indices found for these tests are comparable and allow the immediate estimation of thyroid function in bedside diagnosis. 3. The diagnostic value of PEP could be enhanced by exclusion of patients with suspected or proved cardiac disorder or myocardial failure; this may be useful for physiologic studies. 4. While heart rate is profoundly and inconsistently influenced by beta-blockade, AJT is influenced to a minimal degree only and Q-Kd and PEP are uniformly shifted to higher values, allowing thus diagnostic evaluation during this form of treatment also. 5. As Q-Kd is considerably age-and height-dependent, AJT and PEP are believed to be the most suitable test for immediated clinical diagnosis.
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PMID:Comparison of diagnostic accuracy of different peripheric parameters of thyroid function. 6 35

The study revealed the usefulness of the apexcardiogram in the assessment of the contractile state of left ventricle in cases of ventricular extrasystolia. The pre-ejection period/left ventricular ejection time (PEP/LVET) ratio and isovolumic contraction period (IVCP) are good parameters for demonstrating the postextrasystolic potentiation, the lack of which occurs in severe heart failure. PEP/LVET and IVCP are R-R-interval dependent in parasystolia. In the establishment of the postextrasystolic potentiation, the authors contribute an important role to the ventricular filling during the compensatory pause.
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PMID:Significance of the apexcardiogram in non-invasive assessment of postextrasystolic potentiation. 8 17

Right ventricular endomyocardial biopsy, right heart catheterization, and systolic time intervals were done in 33 adult patients receiving doxorubicin (AdriamycinTM). Doxorubicin administration was associated with a dose-related increase in the degree of myocyte damage, and 27 of 29 patients biopsied at doses greater than or equal to 240 mg/m2 had doxorubicin-associated degenerative changes identified on biopsy. The pre-ejection period to left ventriculr ejection time ratio (PEP/LVET) showed a threshold phenomenon and did not begin to increase until a total dose of 400 mg/m2 had been reached. Seven patients with catheterization-proven heart failure had a significantly greater amount of myocyte damage on biopsy than dose-matched control subjects (P less than 0.01). Preveious mediastinal radiation appeared to potentiate the doxorubicin-associated degenerative process. Mediastinal radiation and age greater than or equal to 70 years appeared to be risk factors for doxorubicin-associated heart failure. Dose limitation by combined clinical, noninvasive, invasive, and morphologic criteria offered an advantage over empirical dose limitation or dose limitation by PEP/LVET alone.
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PMID:Doxorubicin cardiomyopathy: evaluation by phonocardiography, endomyocardial biopsy, and cardiac catheterization. 62 45

Systolic time intervals are of value in measuring left ventricular function. The ratio of the pre-ejection period to the left ventricular ejection time (PEP/LVET) was determined serially in 60 children with cancer receiving anthracycline drugs. Measurements were examined for their predictive value in determining incipient anthracycline cardiomyopathy. An increase in the PEP/LVET ratio was not followed by clinical failure in the majority of patients. Of two patients who developed presumed anthracycline cardiomyopathy, only one demonstrated an increase in the ratio prior to going into heart failure. The value of the PEP/LVET ratio in children for predicting anthracycline cardiomyopathy appears limited, based on the results of this study.
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PMID:Systolic time intervals in monitoring for anthracycline cardiomyopathy in pediatric patients. 66 66

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

The authors describe differences in behaviour of left ventricular systolic time intervals after isometric exercise between patients with ischemic heart disease and normal control. Isometric exercise consists of tonic hand-grip, which is to be gauged by hand-grip dynamometer for 5 minutes at 30% of the patient's maximum voluntary contraction or for 2-3 minutes at 50%. The parameters referred to are pre-ejection period and left ventricular ejection time index (PEPI, TETI), the PEP/TET ration, heart rate and arterial pressure. The authors conclude that from isometric exercise it is possible to point out the heart failure degree in patients with ischemic heart disease.
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PMID:[Behaviour of left ventricular systolic time intervals after isometric exercise in patients with ischemic heart disease (author's transl)]. 114 63

Left ventricular assist systems (LVAS) can maintain the systemic circulation of patients with acute, profound heart failure. The assessment of natural heart (NH) function, however, is difficult in the clinical setting. The authors introduced a new index, heart rate-corrected ejection time/left atrial pressure (ETc/LAP) using echocardiography to evaluate NH function in 15 adult patients on the original LVAS for greater than 2 days. Bypass flow (BF) was gradually decreased according to the recovery of NH. Five patients were weaned from LVAS within 15 days, and LV function was well maintained (Group 1). Another six patients were weaned from LVAS within 21 days but died within 2 weeks (Group 2). The other four patients died on LVAS without recovery of NH (Group 3). In Group 1 patients, ejection time/pre-ejection period (ET/PEP) with LVAS assist increased continuously. In Groups 2 and 3, ET/PEP increased slowly and reached a plateau at approximately 10 days or remained low. Group 1 patients reached an ETc/LAP of 35 +/- 10 on LVAS within 7 days. Group 2 and Group 3 patient values were 18 +/- 2 (p less than 0.05) and 9 +/- 6 (p less than 0.01), respectively, on the seventh day. Based on these data, this new index provides an estimate of global NH function and a prediction of the probability of NH recovery.
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PMID:Practical assessment of natural heart function using echocardiography in mechanically assisted patients. 175 Dec 17

The inotropic effect of a per os single dose of 200 mg disopyramide phosphate was studied in 25 patients during the second week after acute myocardial infarction with no signs of heart failure. Systolic time intervals and the indices derived from the uncalibrated differentiated carotidogram and apexcardiogram were used to assess changes in cardiac performance. The results were as follows: a) Reduction by 3.2% of the haemodynamic ratio LVET/PEP. b) Reduction by 20.1% of the maximal relative upstroke velocity in the differentiated carotidogram (B/S2) p less than 0.05). c) Decrease by 13.1% of the ratio, total amplitude/dicrotic deflection (T/S2) in the same tracing (p less than 0.05). d) Decrease by 2.8% of the ratio, early systolic wave/early diastolic complex wave (b/ef) in the differentiated apexcardiogram. e) Increase by 3.2% of the ratio early diastolic complex total amplitude (ef/ZN) in the previous tracing. The above changes were indicative of a slight negative inotropic effect of the drug.
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PMID:Mechanographic assessment of disopyramide in postinfarction patients. 178 51

Ibopamine, a dopamine derivative suitable for oral administration, is reported to improve cardiac function in patients with chronic heart failure. In order to evaluate the inotropic effect of ibopamine and to compare it with that of digoxin, we studied 10 patients with chronic heart failure (NYHA II-III). All patients were in sinus rhythm. After a washout period of 5 days, when the patients received a constant diuretic dosage and a placebo, ibopamine 100 mg t.i.d. or digoxin 0.25 mg o.d. was randomly given double-blind. The active treatment was continued for a 10-day period, and was followed by a second washout period of 5 days. Subsequently, the patients received digoxin if previously on ibopamine or ibopamine if previously on digoxin for 10 days. Diuretic was continued at the same dosage throughout the study. At the end of the two washout periods, all patients performed a static (hand grip) and a dynamic exercise (bicycle ergometer). Both ibopamine and digoxin improved cardiac response to both types of exercise compared to the washout periods. In particular, PEP/LVET decreased (p less than 0.001 for both drugs) and O2 consumption improved (from 586 +/- 48 to 716 +/- 35 ml/min for ibopamine and from 585 +/- 38 to 713 +/- 52 ml/min for digoxin). No difference was noted between the two drugs in the improvement of exercise tolerance. No side effects were noted with the two drugs. These data indicate that ibopamine could be a valid alternative to digoxin in heart failure patients in sinus rhythm when given for 10 days. More data are needed to evaluate the long-term efficacy of ibopamine.
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PMID:Ibopamine vs. digoxin in chronic heart failure: a double-blind, crossover study. 248 44

In patients with Duchenne muscular dystrophy (DMD), heart failure appears in later stage of the disease due to myocardial degeneration and respiratory insufficiency, and sometimes causes death. However, there have been no adequate parameters which can be used easily to evaluate the grade of heart failure in DMD, except cardiac enlargement and pulmonary congestion observed by chest X-ray picture. Thus, we measured the plasma concentrations of atrial natriuretic peptide (ANP) in the patients with muscular dystrophy of various types, and studied a relationship between plasma ANP concentration and heart failure, expecting that it could be an index of heart failure in DMD patients. The plasma ANP concentrations in patients with DMD were 35.5 +/- 3.3pg/ml (mean +/- SE) and higher than in normal subjects (19.3 +/- 1.0pg/ml). In the patients with limb-girdle muscular dystrophy, facioscapulohumeral muscular dystrophy and neurogenic muscular atrophy, the plasma ANP concentration showed a tendency to elevate. However, no elevation of plasma ANP levels was observed in the patients with other types of muscular dystrophy. In DMD, number of the patients having a high plasma ANP concentration was increased with progress of disability grade, and decrease in serum creatine kinase activity and serum myoglobin concentration. There was a significant correlation (p less than 0.01) between plasma ANP concentration and cardiothoracic ratio or PEP/LVET, but no correlation between the concentration and respiratory failure. Immunohistochemistry of the atrial cardiac muscle of an autopsied DMD case revealed many ANP-positive atrial muscle cells, indicating the preservation of ANP-secreting function.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Secretion and clinical significance of atrial natriuretic peptide in patients with muscular dystrophy]. 252 1


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