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

We measured cardiac functions by means of mechanocardiogram and echo-cardiogram in 93 patients with diabetes mellitus, excluding those who had apparent cardiac diseases, such as angina pectoris and cardiac failure. We used pre-ejection-period/ejection time (PEP/ET) as the index of the left ventricular systolic function and isovolumic relaxation time (IRT) as that of the left ventricular diastolic function. We compared the diabetic cases without complications to those with complications such as retinopathy, nephropathy, neuropathy and autonomic disorder. Conclusions obtained were as follows; An abnormal IRT was noted in the early stage of diabetic complications. The IRT was not normal among the subjects even when those with cardiac hypertrophy or ST-depression on the ECG were excluded. On the contrary, the PEP/ET did not show any abnormality in the early stage of diabetic complications until they advanced into, eg. renal failure or severe neuropathy. Our findings suggest that the disorder of the left ventricular diastolic function precedes that of the left ventricular systolic function, indicating the association of microangiopathy and autonomic disorder.
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PMID:[Left ventricular function in patient with diabetes mellitus--Evaluated by mechanocardiogram and echocardiogram]. 261 9

By means of impedance- and mechanocardiography the effect of the calcium-channel blocker nisoldipine on the circadian course of hemodynamic parameters was measured in a placebo-controlled randomized double-blind study in 18 patients with heart failure (NYHA II). A significant effect of nisoldipine on left ventricular function was observed after 2 h but not any more 6 h following the administration of the drug. This effect was expressed by a reduction of the pre-ejection period (PEPc) and PEP/LVET in the systolic time intervals (STI) and a rise in stroke volume (delta V) and cardiac output (CO), as well as an increase of the Heather-index in impedance cardiography (ICG). In ICG the Heather-index proved to be a more reliable parameter of left ventricular function than the calculation of stroke volume and cardiac output, respectively. This is probably due to the fact that the distance between the electrode (L) is not considered for the Heather-index, while it has to be taken into account for determining stroke volume and cardiac output. When performing impedance cardiography in the elderly, the distance between the electrodes may be a source of error because of a lack of cooperation, possible underlying corpulance, or due to a restricted motility of the chest or the vertebral column. In these patients the Heather-index should be preferred to the calculation of stroke volume and cardiac output, whereas in healthy subjects the latter parameters seem to be of sufficient validity.
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PMID:[Mechano- and impedance cardiography parameters in patients with heart failure in administration of a calcium antagonist. The significance of the Heather index]. 265 6

Ibopamine was administered in a dose of 100 mg every 8 hours for three days to 18 hospitalised heart patients of NYHA class I and II. ECHO examination, polygraphic examination, rheographic examination and carotid CW Doppler were carried out under basal conditions and at the end of treatment. B.P. did not show significant changes whereas H.R. showed a slight tendency to rise. PEPc fell significantly whereas LVETw did not change, with a parallel reduction in PEP/LVET. ECHO examination did not reveal any reduction in diameters, an increase in Vcfm and a reduction in Ses. The Ses/Vs and P/V contractility indices increased to some extent. Irrelevant changes were observed in peripheral circulation evaluated with rheography, and cerebral circulation evaluated with CW Doppler. On the basis of these results it can be concluded that ibopamine is in a position to determine an improvement in ventricular performance during heart failure and that, allowing for its sympathergic effects, it is the treatment of choice in bradykinetic decompensation.
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PMID:[Effects of short-term administration of ibopamine on hemodynamic parameters]. 274 73

In a randomized placebo-controlled study, 12 healthy volunteers were treated for one week each with nifedipine 10 mg four times daily or the same dose of nifedipine concurrently with famotidine 40 mg once daily per os. Famotidine did not significantly alter pharmacokinetic parameters of nifedipine. Determination of systolic time intervals showed that pre-ejection period (PEPc) and the ratio of pre-ejection period over left ventricular ejection time (PEP/LVET) were significantly reduced by administration of nifedipine plus placebo. Coadministration of famotidine and nifedipine, however, led to a significant increase in these parameters. Also, administration of famotidine alone to the same subjects led to a significant rise in PEPc and PEP/LVET. In impedance cardiography, stroke volume and cardiac output were significantly reduced by famotidine, whereas the H2-antagonist did not alter heart rate. This observation indicates for the first time that famotidine may exert negative effects on cardiac performance. In our opinion this could be of clinical relevance in elderly subjects or in patients with heart failure.
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PMID:[Negative inotropic action of famotidine]. 290 74

Effect and tolerance of the oral phosphodiesterase inhibitor Enoximone was tested in 14 patients with advanced cardiac failure (New York Heart Association groups II-IV). During a mean observation period of 40 weeks there were four deaths; one patient became therapy-resistant. The remainder reported sustained clinical improvement. During the observation period there were no changes in heart rate or arterial blood pressure. There were no significant changes in cardiothoracic ratio on the chest X-ray or of the echocardiographically determined left-ventricular diameters. However, there was a rise in shortening fraction from 13.5 +/- 6.4% to 16.8 +/- 6.5% after 26 weeks, and to 21.1 +/- 8.1 after 52 weeks (P less than 0.05). The ratio of the systolic time intervals, PEP/LVET, decreased correspondingly from 0.74 +/- 0.23 to 0.44 +/- 0.09 and 0.43 +/- 0.10 (P less than 0.05). Hemodynamic measurements after one-year treatment revealed an increase in cardiac index from 2.4 +/- 0.7 to 3.6 +/- 0.6 l/min X m2, and a fall in pulmonary artery wedge pressure from 25.5 +/- 9.7 to 12.6 +/- 13.0 mm Hg (P less than 0.001). The drug was well tolerated and there were no significant biochemical changes. Long-term ECG monitoring revealed no significant changes in the arrhythmia profiles. Enoximone thus proved to be a successful therapeutic agent in the management of advanced heart failure.
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PMID:[Long-term therapy of chronic cardiac insufficiency using enoximone]. 295 80

Tensiomin (captopril) was tested in 23 patients with chronic heart failure for 7.5 months on the average. In 9 outpatients suffering from congestive cardiomyopathy the effect of Tensiomin as an adjuvant to digitalis, diuretic, vasodilator etc. was evaluated by non-invasive methods. During the 3-month follow-up period the heart rate was decreased and the PEP/LVET ratio was improved. The parameters calculated from the X-ray examination (cardiothoracic index, cardiac volume index) indicated the regression of cardiomegaly. Radioisotopic circulatory examinations (systolic volume index, cardiac output index) indicated an increase in cardiac performance. In addition to the significant changes of these parameters the patients' clinical state was also improved in all cases as assessed according to the NYHA classification. Significant side effects were not observed during the treatment.
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PMID:Study of the effect of Tensiomin (captopril) in chronic heart failure. 307 5

To evaluate the effects of dobutamine on myocardial function in newborns, left ventricular systolic time intervals (STI) - normalized pre-ejection period (PEPI), normalized left ventricular ejection time (LVETI) and pre-ejection period to left ventricular ejection time ratio (PEP/LVET) - were assessed by echocardiography in 18 newborns treated with dobutamine for clinically diagnosed heart failure. Examinations were performed prior to and 30 min after starting dobutamine infusion (7.5 or 10 micrograms/kg per min). Patients were assigned to two groups according to their PEP/LVET prior to dobutamine administration: group I (n = 9) with pre-treatment PEP/LVET less than or equal to 0.35 and group II (n = 9) with pre-treatment PEP/LVET greater than 0.35. While there was no change of STI in group I, dobutamine infusion resulted in a significant decrease in PEPI (from 102 +/- 4.8 to 87.8 +/- 4.2; mean +/- SEM; P less than 0.01) and of PEP/LVET (from 0.56 +/- 0.05 to 0.45 +/- 0.05; mean +/- SEM; P less than 0.01) and in a significant increase of LVETI (from 237.6 +/- 5.6 to 253.3 +/- 5.2; mean +/- SEM; P less than 0.01) in group II. Heart rate increased significantly in both groups. Left ventricular end-diastolic dimension, also assessed by echocardiography, did not change in the eight studies performed. An increase in mean arterial pressure was found in three out of five newborns of group II and in one out of four patients in group I. It is concluded that dobutamine can improve cardiac performance in newborns with impaired left ventricular function. This effect is probably due to an improvement in myocardial contractility.
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PMID:Effects of dobutamine on left ventricular performance in newborns as determined by systolic time intervals. 356 49

The relationship between the pharmacokinetics and dynamics of digoxin was investigated using a skin blistering technique that allows experimental access to tissue fluid concentrations. Eight healthy volunteers received digoxin, 1.0 mg, and placebo intravenously according to a double-blind crossover design. Drug concentrations were determined during a 72-hour period in serum, urine, and cantharides blister fluid (CBF). Digoxin levels in the hypothetic peripheral compartments were calculated from serum concentrations. Digoxin effects (total electromechanical systole [QS2c], left ventricular ejection time [LVETc], preejection period [PEPc], QTc time, heart rate, and T wave amplitude) were measured simultaneously. Peak levels in the shallow and deep compartments occurred at 12 1/2 to 20 minutes and 3 hours and the maximum concentration in CBF (2.75 +/- 0.48 ng/ml) occurred at 1 hour. Digoxin effects on QS2c, PEPc, and the ratio PEP/LVET were not related to serum concentrations but were closely related to CBF concentrations (r = 0.90). CBF concentrations were then within the range of serum digoxin concentrations usually associated with the treatment of heart failure. Thus, CBF allows experimental access to active drug concentrations after a single intravenous dose.
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PMID:Digoxin concentrations in serum and cantharides blister fluid: correlations with cardiac response. 369 Sep 39

48 patients with chest pain or unexplained heart failure were examined with exercise test, systolic time intervals, apexcardiogram and left- and right-sided heart catheterization including coronary arteriography. The 23 patients with ischemic heart disease (IHD) and 19 patients with congestive cardiomyopathy (COCM) could as groups be separated by several of the parameters. Two major patterns of change were present when using the whole range of parameters, probably reflecting that the heart and circulation had compensated for left ventricular dysfunction in different ways in IHD and COCM. Comparing patients with the same ejection fraction (EF), preejection-period index (PEPI) pre-ejection-period/left ventricular ejection time (PEP/LVET) and systolic blood pressure/left ventricular end systolic volume index (SBP/LVESVI), were all more abnormal in patients with COCM than with IHD at most EF levels. The best separation between the diseases was obtained using exercise capacity in combination with PEP/LVET. The correlations between invasive and noninvasive parameters underlined that no single parameter can satisfactorily characterize the circulatory function in patients with individual differences in preload, afterload, pulse rate, cardiac volumes, compliance and contractility. No or poor correlations were found between exercise capacity and the different function parameters used.
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PMID:Different patterns of hemodynamic abnormalities in patients with ischemic heart disease compared with patients with congestive cardiomyopathy. 371 97

Coenzyme Q10 (CoQ10) treatment, orally administered as 100 mg daily dose, was initiated in a series of patients with advanced heart failure in an open, controlled design. They were all showing an insufficient response to classical therapy with diuretics and digitalis. Twelve patients with various causes of heart failure, classified clinically by echocardiography (ECHO), (12/12), and heart catheterization with endomyocardial biopsy, (10/12), were followed prospectively for a mean period of seven months. Serial assessments: Clinical examination (with questionnaire), ECG, chest X-ray, ECHO, systolic time intervals (STI) and blood levels of CoQ10 were performed. With a mean latency period of 30 days, eight out of 12 patients (67%) showed definite clinical improvement. Subjectively, the patients felt less tired, their general activity tolerance increased and dyspnoea at rest disappeared. There were obvious signs of decreased right-sided stasis (hepatic congestion). The heart rate fell significantly, and the heart volume (chest X-ray) decreased in the eight responders (although n.s.). A significant reduction in the left atrial size (ECHO) was registered, suggesting a reduced preload of the left ventricle, Furthermore, a significant decline in the PEP/LVET ratio (STI) was indicative of an improved myocardial performance. Preliminary CoQ10 withdrawal results showed severe clinical relapse with subsequent improvement on CoQ10 reinstatement, supporting the interpretation that treatment of these patients corrected a myocardial deficiency of CoQ10 and increased contractility. Hence CoQ10 appears to be an effective therapeutic agent in advanced cases of heart failure. This is an attractive circumvention of the traditional principles of therapy: supporting the myocardium directly by ameliorating a supposed underlying mitochondrial dysfunction (exhausted bioenergetics).
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PMID:Long-term coenzyme Q10 therapy: a major advance in the management of resistant myocardial failure. 383 76


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