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

A study of 44 Nigerians with heart muscle disease defined as congestive cardiac failure and cardiac enlargement of unknown cause with a presenting diastolic blood pressure of not more than 100 mm Hg has shown 20 were alcoholics. 12 of these belonged to the high socioeconomic class. 17 were thiamine deficient; 11 of these consumed alcohol excessively and 8 of the 11 belonged to the high socioeconomic class. Only 3 alcoholics were identified in 52 controls. None of the 3 patients was thiamine deficient but 10 others were. Only 1 patient with heart muscle disease had a reversible high output cardiac failure. The mean serum albumin of the patients with heart muscle disease was significantly lower than controls. There was no significant difference between the mean levels of serum potassium in the study group and controls. It is concluded that chronic alcoholism is not rare among Nigerians with heart muscle disease. Although there is no convincing evidence to show that malnutrition or thiamine deficiency could in themselves cause the chronic myocardial failure seen in heart muscle disease, they could be conditioning factors which increase the susceptibility of the heart to other injurious agents.
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PMID:Heart muscle disease among adult Nigerians: role of nutritional factors in its aetiology. 15 80

The inotropic effects of albumin were studied in 94 seriously injured patients who received an average of 14.5 transfusions, 9.2 liters of crystalloid and 0.9 liters of plasma prior to end of operation; 46 patients, by random selection, received added albumin averaging 31 gm during operation, 198 gm during the early postoperative period of extravascular fluid sequestration, and 395 gm during the first 4 days of the later fluid mobilization period. Left ventricular stroke work index (LVSWI) was plotted against pulmonary wedge pressure (Ppw) in 22 patients who had indwelling thermistor pulmonary artery catheters at the time of the first study. Calculated heart work units (WU) were derived from the pulse pressure, mean arterial pressure, pulse rate, and central venous pressure (CVP) in patients without LVSWI measurements. Albumin supplementation increased serum albumin (4.2 vs. 2.9 gm%), plasma volume, CVP (15 vs. 9 cm H2O), but did not alter red cell volume (1,531 vs. 1,519 ml). The ratio of LVSWI/Ppw fell in albumin patients (1.9 +/- 1.6 vs. 4.8 +/- 1.8), and the ratio of WU/CVP was significantly depressed in albumin patients (4.9 +/- 2.3 vs. 7.3 +/- 2.1). The slopes of the LVSWI/Ppw and WU/CVP were shifted to the right in albumin patients. This negative inotropic effect was associated with impaired oxygenation, as reflected by an increased ratio of inspired oxygen per arterial oxygen tension (0.62 +/- 0.06 vs. 0.33 +/- 0.1). Finally, 24 of the 46 albumin-treated patients were digitalized for heart failure, compared to only 11 of the 48 nonalbumin patients. Pending subsequent studies, albumin should be considered a potentially negative inotropic agent.
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PMID:Negative inotropic effect of albumin resuscitation for shock. 46 73

Digitoxin concentration, measured by radio-immunoassay, was significantly lower in 51 patients in chronic renal failure (23.2 +/- 7.8 mug/l) than in 29 patients in heart failure (26.5 +/- 7.3 mug/l), although both groups were on the same maintenance dose of 0.1 mg daily. Despite a normal serum albumin concentration, digitoxin protein binding was less in uraemic patients than in those with normal renal function. Renal failure did not affect intestinal digitoxin absorption. In patients in chronic renal failure elimination half-time was significantly shorter (5.7 +/- 0.9 days) than in healthy controls (7.6 +/- 1.6 days). There was no significant difference in the excretion of water-soluble ("cardioinactive") digitoxin metabolites in urine between patients in chronic renal and those in heart failure. In patients with normal renal function, of dichloromethane-soluble (cardioactive) metabolites only digitoxin could be demonstrated by thin-layer chromatography. The results indicate that patients in chronic renal failure can safely be given the same dose as those with normal renal function, without danger of over- or underdosage.
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PMID:[Pharmacokinetics of digitoxin in chronic renal failure (author's transl)]. 83 89

The transcapillary escape rate of albumin (TERalb), i.e., the fraction of intravascular mass of albumin that passes to the extravascular space per unit of time, was determined from the disappearance of intravenously injected 125I-labeled human serum albumin during the first 60 minutes after injection in 10 subjects with chronic right heart failure. The investigation was repeated after sodium and water depletion. Before treatment TERalb was significantly elevated (mean 8.3 +/- 1.6% (SD)/hour, in comparison to values for normal subjects (mean 5.4 +/- 1.1%/hour, P less than 0.001). With treatment TERalb decreased significantly (mean 5.9 +/- 1.2%/hour, P less than 0.01). Right atrial pressure decreased from an average of 10 mm Hg to 6 mm Hg during treatment. A statistically significant, positive correlation was found between TERalb and right atrial pressure (r = 0.77, P less than 0.001). Our results best can be explained by increased filtration, mainly through the venous end of the microvasculature, due to the increased venous pressure in heart failure.
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PMID:Transcapillary escape rate of albumin and right atrial pressure in chronic congestive heart failure before and after treatment. 95 65

The use of colloids in hypo-oncotic individuals to increase plasma volume has been shown to have distinct and consistent advantages compared with the use of crystalloid fluids. Colloids increase plasma colloid oncotic pressure, whereas crystalloids decrease it, an effect that can be extremely detrimental in individuals with low basal plasma colloid oncotic pressure. Increasing plasma volume in hypo-oncotic individuals without inducing large increases in interstitial water content is difficult when crystalloid fluids are used. However, colloids have much better plasma volume expansion ability without the induction of concurrent increases in interstitial water content, even in hypooncotic individuals. Review of the literature indicates that hetastarch is an extremely safe colloid for acute and long-term use in humans and dogs. Its excellent safety record probably is attributable to its structural analogy to the natural compound glycogen. The lack of availability of a substance analogous to human 5% serum albumin and the scarcity of plasma in veterinary medicine leaves hetastarch as the safest option of available colloids. Its ability to increase plasma volume and colloid oncotic pressure is equal to or better than dextran 70 and 5% albumin and is clearly better than plasma or whole blood. Increases in plasma volume and colloid oncotic pressure usually last approximately 48 hours after a single injection, but the duration of increases significantly after multiple infusions. Contraindications to its use include heart failure and oliguric renal failure, because of its excellent ability to increase plasma volume, and the presence of von Willebrand's disease, because of its ability to significantly lower all components of Factor VIII-related complex in humans.
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PMID:The use of hetastarch for plasma expansion. 128 53

Thirty Nigerian hypertensives with heart failure and 30 without heart failure, matched for age and sex, were studied. Diastolic blood pressures were similar in the two groups (118 +/- 15 and 118.5 +/- 13.6 mmHg, respectively) (P greater than 0.5), while systolic blood pressures were higher in the non-heart failure group (176.7 +/- 29.7 and 198.8 +/- 29.8 mmHg, respectively) (P less than 0.01). The mean durations of initial detection of high blood pressure in the previously known hypertensives in the two groups were 4.9 +/- 3.8 and 4.4 +/- 3.3 years, respectively (P greater than 0.05), and their drug compliance prior to this study was similarly poor (P greater than 0.1). In the two groups, 33.3% and 10% were thiamine deficient, respectively (P less than 0.001), with TPP greater than 15%; 23.3% and 0% had hypoalbuminaemia (P less than 0.02), with a mean serum albumin of 35 +/- 7 and 42 +/- 3 g/l, respectively (P less than 0.001); while 36.7% and 13.3% were anaemic, respectively (P less than 0.05). Heart failure was more severe in those with more than one of these adverse factors (P less than 0.05). The results suggest that these factors, more prevalent in the heart failure group, would have hastened and worsened their heart failure. It is suggested that an active nutritional approach be incorporated into the management of hypertensives, particularly in the developing world.
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PMID:Nutritional factors and heart failure in Nigerians with hypertensive heart disease. 156 82

This study was to search if captopril (C) reduces albuminuria in a group of type II diabetics with diabetic nephropathy (DN). Eleven type II diabetics with DN and hypertension, with albuminuria over 0.30 g/L/24th, fasten blood glucose under 250 mg/dL, serum albumin over 3 g/dL, without infection, cardiac failure or diuretic treatment, were treated with C for six months, as the only treatment for hypertension and albuminuria. Every month, albuminuria in a 24h urinary collection, medium arterial pressure (MAP), serum creatinine and fasten blood glucose were measured. Ten women and one man with 60 (50-70) years of average age (0 to 100th percentile), with 18 (8-35) years of diabetic disease, and 4 (1-7) years of clinic hypertension were studied. Before the treatment with C they had albuminuria of 6.9 (0.7 to 12.5) g/L/24h, MAP of 119.7 (93.2 to 139) mmHg, serum creatinine of 2.2 (0.7 to 7.5) mg/dL and glucose of 168 (78 to 250) mg/dL. After 6 months with C, they had albuminuria of 3.5 (0.2 to 9.6) g/L/24h (p less than 0.01), MAP of 113.4 (92.9 to 132.4) mmHg (p = 0.5), serum creatinine of 2.3 (0.5 to 6.4) mg/dL (p = 0.23) and glucose of 133 (87.5 to 239) mg/dL (p = 0.32). The MAP showed a predictive relation over albuminuria (p = less than 0.004). During the six months of study, C reduced albuminuria in type II diabetics with hypertension and diabetic nephropathy.
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PMID:[Captopril reduction of albuminuria in type-II diabetics with diabetic nephropathy]. 180 Feb 20

Protein-losing enteropathology (PLE) occurs rarely in congestive cardiac failure (CCF). Using fecal alpha 1-antitrypsin, an endogenous marker of enteric protein loss, we studied 25 patients in severe CCF to determine the frequency, degree, and clinical significance of PLE. Excessive enteric protein loss was found in only two patients, confirming the relative infrequency of this condition. In addition, enteric protein loss did not appear to correlate with the serum albumin level; neither did it influence treatment or prognosis of the CCF. It is concluded that PLE associated with CCF is of minor clinical significance.
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PMID:Protein-losing enteropathy in congestive cardiac failure: an entity of minor clinical significance. 230 37

The clinical background relating to edema in elderly inpatients was investigated, in terms of various items in elderly (aged greater than or equal to 65) cases with edema (n = 96) and without edema (controls, n = 95). Both groups were matched for sex, age, and underlying diseases. As compared with the control patients, the patients with edema had longer hospital stays with more disabled status, and showed less activity of daily living (ADL). The rates of bed-restricted patients, dementia patients, and patients with decubitus, muscle atrophy, or incontinence were found to be significantly higher in the patients with edema. The measurement of biochemical parameters revealed that the patients with edema had significantly lower levels of serum albumin, Na, Cl, creatinine, and uric acid, in contrast to higher levels of C-reactive protein. According to the classification of the assumed causes of edema, we divided the patients with edema into five groups; group 1 (n = 33): edema associated with immobilization, group 2 (n = 18): edema due to heart failure, group 3 (n = 15): edema on paretic limbs, group 4 (n = 6): edema due to hypoproteinemia, group 5 (n = 5): edema associated with liver cirrhosis. Both group 1 and group 4 patients had lower levels of hemoglobin and albumin, whereas group 3 patients had higher scores of ADL, higher blood pressure, and higher levels of hemoglobin and albumin. These results suggest that immobilization and restriction in bed, as well as malnutrition, were important factors in causing edema in elderly inpatients.
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PMID:[A controlled study on edema in elderly inpatients]. 238 89

Malnutrition is associated with a delayed recovery from illness and an increased rate of complications. Heart failure, respiratory diseases, impaired immune function and postoperative wound healing are influenced by the nutritional status. Nutritional assessment includes patients history, physical examination, anthropometric measurements, laboratory dates and changes of immunocompetence. Anthropometric assessment, like skinfold and muscle area measurements, is not an extremely accurate method predicting nutritional status of an individual patient. Multifactorial influence on the concentration of the serum proteins, albumine, transferrin and retinolbinding protein caused a wide range of normal values. Therefore the validity and sensitivity of these parameters to assess nutritional status are diminished for the individual patient. The concentration of serum albumin seems to be of some value as a marker for nutritional status. The influence of malnutrition on immunity is complex. There are no sensitive markers available to assess the influence of malnutrition on the immuno competence of an individual patient for the clinical routine. Malnutrition may be assessed and the resulting clinical complications may be predicted by calculating a prognostic nutritional index, which include several nutritional parameters.
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PMID:[Assessing nutritional status]. 268 65


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