Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pathogenesis of alcohol cardiomyopathy is obscure. Because systemic hypertension is observed in one-third of alcoholics, the relation of this finding to left ventricular (LV) function was analyzed in 66 alcoholics (26 with a blood pressure of 160/95 mm Hg or higher) 4 to 5 days after alcohol withdrawal. Hypertensive alcoholics had a more abnormal ratio of preejection period/LV ejection time (PEP/ET) (0.398 +/- 0.01 vs 0.35 +/- 0.01, p less than 0.02) than normotensive alcoholics (matched normal 0.290 +/- 0.01). Hypertensive alcoholics (transitory hypertension) with blood pressures of 120/80 mm Hg or less at time of study also had more abnormal PEP/LVET than matched normotensive alcoholics (0.415 +/- 0.03 vs 0.331 +/- 0.01, p less than 0.05). In both hypertensive (77 +/- 6 dynes/cm2 X 10(3)) and normotensive alcoholics (67 +/- 4 dynes/cm2 X 10(3) LV stress was elevated (normal 46 +/- 3 dynes/cm2 X 10(3), both p less than 0.02). However, LV mass was not increased (hypertensive 96 +/- 4 g/m2; vs normotensive 100 +/- 4 g/m2; (normal 92 +/- 5 g/m2), resulting in a markedly increased stress to mass ratio (hypertensive 0.8 +/- 0.06; Normal 0.05 +/- 0.05, p less than 0.02). Hypertensive alcoholics also had LV "hyperfunction," with an increased stress/LV end-systolic volume ratio (1.7 +/- 0.1 vs 1.3 +/- 0.1 dynes/cm2 X 10(3)/ml, p less than 0.02). Thus, hypertensive alcoholics, even those with transitory hypertension, have more abnormal cardiac function than normotensive alcoholics. Presence of hypertension with hyperdynamic LV features may be a prelude to heart failure.
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PMID:Cardiac function in alcohol-associated systemic hypertension. 394 13

The objective of this study was to evaluate the haemodynamic and antiarrhythmic effects of flecainide acetate in patients with heart failure. Flecainide acetate, a class Ic antiarrhythmic agent, was given intravenously to 9 patients with congestive heart failure and frequent ventricular arrhythmias with nonsustained ventricular tachycardia. The drug (2 mg/kg) was infused slowly over 60 minutes. The maximum plasma level achieved was 218 (range 142-350) ng/ml. Six of the 9 patients experienced a 90% suppression of their arrhythmias for an average of 6.5 (range 2-15) hours. Pre-ejection period control (PEPc, 148.8 +/- 3.6 msec) increased to 157 msec and pre-ejection period/ejection time (PEP/ET) [control 0.449 +/- 0.027] to 0.516 (p less than 0.005), while the ejection time index (ETI) did not change. Cardiac index (control 2.4 +/- 0.36 L/min/m2) decreased by 11% (p less than 0.02), and pulmonary wedge pressure (control 13.4 +/- 2.4mm Hg) increased by 23% (p less than 0.05). Stroke work index, arterial pressure and vascular resistance did not change significantly. The parameters returned to control values on completion of the infusion. Flecainide acetate can be safely administered at the usual dose of 2 mg/kg to patients with congestive heart failure, provided that the infusion time is doubled. Antiarrhythmic efficacy under these conditions is good even at lower plasma concentrations.
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PMID:Haemodynamic and antiarrhythmic effects of intravenous flecainide acetate in chronic congestive heart failure. 400 80

The effect of diltiazem (D) on the pharmacokinetics and pharmacodynamics of beta-acetyldigoxin (AD; n = 12) and digitoxin (DGT; n = 10) was studied in 22 patients with cardiac insufficiency stages II-III by the New York Heart Association. Glycoside plasma concentration and renal excretion as well as electrocardiogram [heart rate, atrioventricular transconduction time (PQ), duration of electrical systole corrected for heart rate (QTc), mean amplitude of T-waves in leads V2 to V6 (TV2-6)] and systole time intervals [total electromechanical systole index (QS21), left ventricular ejection time index (LVETI), pre-ejection period index (PEPI), PEP/LVET ratio] were recorded repeatedly before and during co-administration of 180 mg/day D. In eight patients digoxin plasma levels increased continuously during additional D administration. After reaching a new steady state at 0.93 +/- 0.35 ng/ml digoxin concentrations were at an average 43% higher than before D administration (0.65 +/- 0.27 ng/ml) with a simultaneous increase in renal glycoside excretion. The other four patients showed neither changes in digoxin concentrations in plasma nor in renal glycoside excretion. Only half the patients treated with DGT and D revealed an increase in DGT plasma levels of 21.4%. Daily renal glycoside excretion was not altered by D administration. In accordance to the increasing AD plasma concentration, PQ-interval was prolonged and T-wave flattening was intensified, whereas the systolic time intervals after concomitant treatment of AD and D did not differ from those after AD alone.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pharmacokinetic and cardiac efficacy of beta-acetyldigoxin and digitoxin in combination therapy with diltiazem]. 403 88

Heart rate (HR), blood pressure and systolic time intervals (STI), including total electromechanical systole (QS2), left ventricular ejection time (LVETc), pre-ejection period (PEPc), the PEP/LVET index and the time to the peak of carotid upstroke (Ut), were measured in 24 patients with moderate essential hypertension after 15 days of treatment with oral furosemide (F), hydrochlorothiazide (H), propranolol (P), atenolol (A), furosemide + propranolol (F + P) and hydrochlorothiazide + propranolol (H + P). Except F, all treatments significantly reduced blood pressure; maximal reductions were brought about by A and H + P. The heart rate was most reduced by A. THe QS2c interval was reduced only after F and H, LVETc was significantly reduced by H, A and H + P. Drug combinations prolonged PEPc, while the PEP/LVET index was increased only by H + P. Beta-blockers significantly prolonged the Ut. It is concluded that diuretics shorten QS2c mainly through reduction in blood volume. The H + P combination diminishes contractility and cardiac output and should not be employed in heart failure.
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PMID:Modification of blood pressure and systolic time intervals by diuretics and beta-blockers in essential hypertension. 613 68

Left ventricular performance in 54 patients with acute myocardial infarction was studied by means of systolic time intervals (STI) and ejection fraction (EF) determined using radionuclide technique. The data were correlated to clinical parameters of left ventricular heart failure and size of infarction. Thirty-seven patients were studied in the convalescent period with repeated registrations at 6, 10 and 24 weeks. Patients with left ventricular heart failure had markedly depressed EF, significantly different from EF in the non-heart failure group. STI did not show any difference. A strong correlation between infarct size and EF could be demonstrated. STI discriminated significantly transmural from non-transmural infarctions, and presented significant differences between those with normal EF (greater than 50%) and patients with EF below 35%. No significant changes could be found in left ventricular performance during the convalescent period, except for an increase in corrected preejection period (PEPc) probably due to drugs. The correlation between EF and STI was poor, the highest correlation coefficient being 0.55 between EF and the ratio PEP/LVET.
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PMID:Systolic time intervals and ejection fraction in assessing left ventricular performance following acute myocardial infarction. Comparison of systolic time intervals and equilibrium radionuclide ventriculography. 623 43

To assess the functional reserve of left ventricle and appreciate prognosis in patients with acute myocardial infarction (AMI) showing ventricular premature beats, the systolic time intervals (STI) and the apexcardiogram (ACG) were determined in sinus rhythm and at the first postextrasystolic beat in 30 patients with AMI (12 mens, 18 women, average age 49 years), distributed into the first three functional classes (Killip), 10 in each class. Location of AMI was anterior in 21 cases, inferior in 1 and anteroinferior in 8. At the first postextrasystolic beat, class III patients showed a lengthening of PEP interval and increase of the PEP/LVET ratio, compared to those in initial sinus rhythm, thus indicating an absence of potentiation; ACG tracings in the same group revealed a lengthening of isovolumic relaxation time (IRT). In classes I and II, both the STI measurement and ACG data indicated the presence of potentiation at the first postextrasystolic beat, manifested by PEP shortening and decrease of PEP/LVET ratio, as well as by a reduction of IRT. Of the patients in classes I and II, only one developed heart failure, while of class III patients, 4 died of heart failure within one year and 3 showed cardiogenic shock on admission. The absence of potentiation in the latter category (with congestive heart failure) is interpreted as a sign of severe prognosis for the subsequent course and outcome of AMI.
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PMID:Prognostic value of postextrasystolic potentiation in patients with acute myocardial infarction. 644 55

Echocardiographic assessment of cardiac function was made on 24 children with chronic renal failure of varying etiology and severity. In 20 patients without evidence of cardiac failure, parameters of left ventricular performance as represented by PEP/LVET and mean velocity of circumferential fiber shortening were within normal limits in the majority of patients. In addition, ejection fraction and shortening fraction were, in most children, within the 95% confidence limits for their age. In 4 patients who presented with congestive heart failure, marked left ventricular dilatation was noted in association with decreased shortening and ejection fractions and depressed mean velocity of circumferential fiber shortening. Also the PEP/LVET in these patients suggested the presence of a uremic cardiomyopathic condition. These studies, in addition to our own studies on children who have undergone fistula construction, hemodialysis, and transplantation, suggest that cardiac performance, in the majority of pediatric patients with end-stage renal disease, is well maintained and that the major factor involved in reducing exercise tolerance is the presence of uremic anemia. Only a minority of patients may develop severe uremic heart disease.
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PMID:Echocardiographic assessment of cardiac function in children with chronic renal failure. 658 80

To better understand the effects of high-altitude hypoxia on cardiac performance, healthy lowland-residing volunteers were studied in 2 groups: 10 subjects after acute ascent to 12,500 ft (3,810 m) (acute group) and 9 subjects after chronic exposure for 6 weeks to 17,600 ft (5,365 m) and 11,000 ft (3,353 m) (chronic group). Systolic time intervals and M-mode echocardiograms were recorded at low and high altitudes. Heart rate was 21% greater at high altitude for all subjects. Preejection period/left ventricular ejection time (PEP/LVET) increased by 16% in the acute group and by 22% in the chronic group. Heart size was smaller at high altitude in both groups, with left atrial and left ventricular (LV) diameters decreasing by 10 to 12%. These changes were statistically significant (p less than or equal to 0.01). Despite the increase in PEP/LVET, echocardiographic measurements of LV function (percent fractional shortening and mean normalized velocity of circumferential fiber shortening) remained normal. LV isovolumic contraction time was shorter at high altitude, suggesting heightened, rather than depressed, contractility. LV function does not appear to deteriorate at high altitude. Alterations in systolic time intervals probably result from decreased preload, as reflected by smaller heart size, rather than from heart failure or depressed LV contractility.
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PMID:Left ventricular function at high altitude examined by systolic time intervals and M-mode echocardiography. 662 78

26 patients with moderate hypertension and no signs of heart failure were treated with metoprolol, labetalol or prazosin. Systolic time intervals (STI) were measured before and after several months of treatment. During treatment with metoprolol, a decrease in the preejection period index (PEPI), and preejection period/left ventricular ejection time ratio (PEP/LVET), was found. During treatment with labetalol or prazosin, a minor decrease in PEPI was observed, so that a significant decrease in PEP/LVET was not obtained. A decrease in PEPI and PEP/LVET may be due to improved cardiac performance, but in the given type of patients it is more dependent on the reduction in afterload. The STI measurement is less sensitive in discerning different mechanisms involved in lowering the blood pressure and cannot therefore be used for selecting the optimal antihypertensive drug.
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PMID:The use of systolic time intervals in the evaluation of antihypertensive treatment with metoprolol, labetalol and prazosin. 665 28

The haemodynamic effects of prenalterol, a new beta-1 agonist, were studied in 10 patients with chronic heart failure. Following intravenous prenalterol infusions of 1 mg, 2.5 mg and 5 mg at 15 min intervals, oral slow release prenalterol 20 mg, 30 mg and 50 mg was given at 2 h intervals and then 50-100 mg bid for one month. There were no significant changes in heart rate or blood pressure. Cardiac output increased significantly from control of 4.4 +/- 0.91/min to a maximum of 5.8 +/- 1.81/min (p less than 0.01) following the 5 mg prenalterol infusion and this increase was maintained following oral prenalterol on Days 1 and 2 and at 1 month. Significant increases in stroke volume and stroke work indices and reduction in systemic vascular resistance were also observed. Maximum increases in cardiac output and stroke work index following intravenous prenalterol correlated significantly with maximum increases observed following oral prenalterol on Day 2. Non-invasive evaluation showed no change in echocardiographic left ventricular end-diastolic dimension but a significant reduction in left ventricular end-systolic dimension on Day 30. PEP/LVET was significantly reduced from control of 0.56 +/- 0.15 to 0.47 +/- 0.12 (p less than 0.05) on Day 2 and 0.49 +/- 0.09 (p less than 0.05) at 1 month. Treadmill exercise duration was significantly improved for the group at 1 month and no adverse effects were noted. Oral slow release prenalterol is a potentially useful new drug for patients with chronic heart failure.
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PMID:Prenalterol, an oral beta-1 adrenoceptor agonist, in the treatment of chronic heart failure. 665 50


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