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

Refracterin therapy of patients with chronic heart failure caused by coronary heart disease and postinfarction cardiosclerosis markedly promoted improvement in the pulmonary and systemic circulation in comparison with patients receiving traditional therapy. The mean functional class of chronic cardiac failure decreased by 43% under the effect of refracterin vs. 27% decrease in the group receiving traditional therapy. After 1-month refracterin course the end-systolic and end-diastolic sizes of the left ventricle decreased by 12 and 7%, respectively, ejection fraction increased by 7.2% in comparison with the initial level, total oxidant activity and MDA content in the plasma decreased significantly, while total antioxidant activity, catalase and SOD activities, cytochrome C, NADH, and NADPH levels increased. The prooxidant-antioxidant system was shifted towards antioxidants, which attests to activation of the defense and adaptive mechanisms after administration of refracterin, which is especially important in elderly patients with initially decreased reserve potentialities of the antioxidant defense system.
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PMID:Efficiency and mechanisms of the antioxidant effect of standard therapy and refracterin in the treatment of chronic heart failure in elderly patients with postinfarction cardiosclerosis. 1566 59

The efficacy of angiotensin converting-enzyme inhibitors in the therapy of chronic heart failure are well documented and is mainly explained by a decrease of afterload via reduction of angiotensin II formation in the vascular system and myocardium. The aim of our study was to study the effectiveness of ACCUPRO on structural and hemodynamic indices in patients with heart failure. 37 patients aged 61-84 years with postinfarction cardiosclerosis and mild or moderate hypertension, class I-III heart failure received Accupro (13,7+/-0,97 mg/day) for 3 months in combination with furosemide (40-80 mg 1-3 times a week). The treatment with Accupro and diuretics was associated with corrective effect on left ventricular and diastolic dimension, increases of left ventricular ejection fraction and cardiac index. Left ventricular diastolic function improved in more than two thirds of patients. Positive dynamics of structural-functional state of the heart was accompanied with lowering of total peripheral resistance. Our results indicates that Accupro has positive effects in treatment of chronic heart failure.
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PMID:[Effects of Accupro on structural and hemodynamic changes in patients with chronic heart failure]. 1590 28

The paper demonstrates that the hydrophilic beta-adrenoblocker (BAB) atenolol is effective in patients with III-IV functional class chronic heart failure (CHF), associated with postinfarction cardiosclerosis (PIC) and dilatational cardiomyopathy (DC). In reduction of general and cardiovascular mortality in the given category of patients atenolol was not less effective than the lipophilic BAB bisoprolol (in comparison with the results of the CIBIS II study). Sudden death was typical of the patients with DC, whereas most of PC patients died of repeated myocardial infarctions and progressive CHF. There was no significant difference between lethality in DC and PIC groups (p > 0.05). The results of the study suggest that hydrophilic BABs are not less effective in improving the prognosis than lipophilic BABs. Further research into this problem is appropriate.
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PMID:[Influence of therapy with atenolol on lethality of patients with chronic heart failure]. 1594 Nov 37

Parameters of physical working capacity (symptom limited treadmill test with gas analysis, 6 min walk test and usual everyday activity), activity of muscular metaboreflex, efficacy of pulmonary ventilation, and heart rate variability were studied in 50 patients with postinfarction cardiosclerosis with chronic class I-III heart failure and 30 patients without heart failure. Patients with heart failure of all functional classes had lowered parameters of working capacity while metaboloreflex hyperactivation and diminished effectiveness of ventilation were found only in patients with clinical signs of chronic heart failure but not in those with symptomless left ventricular dysfunction. Therapy with metoprolol was associated with lowering of activity of metaboloreflex, augmented effectiveness of ventilation and heart rate variability, improvement of results of 6 min test and everyday activity without considerable changes of peak oxygen consumption.
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PMID:[Muscular mechanisms of lowering of physical working capacity in chronic heart failure and action of beta-adrenoblockers]. 1623 66

The study of predictors of the development of arrhythmia in elderly age people with IHD is an important task requiring the thorough investigation. The presence of late potentials of ventricles (LPV) is considered presently as one of the most highly informative parameters indicating an electrical inhomogeneity of myocardium, which would result in cardiac rhythm disturbance. The presence of early, late ventricle potentials as well as a dispersion of QT, QRS and T intervals are believed to be the predictors of arrhythmia along with other indices. The study focused on determining a frequency of such predictors among patients of 60-74 y.o. with various clinical picture of IHD. 300 patients were observed: 120 of them with IHD, 100--additionally having essential hypertension, 60--PICS (postinfarction cardiosclerosis), 20--HF. 20 people aged 60-89 formed the control group. The registration of LPV, EPV as well as QT, QRS and T dispersion was carried out by means of Megacart electrocardiograph (produced by "Siemens" company, Germany). The findings are the following: 48 % of the patients with IHD were found with LPV, 33%--with EPV (early potentials of ventricles). LPV is also more frequently met in the patients with IHD complicated with heart failure (HF) and hypertension; dispersion of QRS and T is for sure higher in patients with IHD and HF.
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PMID:[High resolution electrocardiogram in the diagnosis of risk of the cardiac rhythm disorder development in elderly patients with ischemic heart disease]. 1705 4

The purpose of the study was to determine peculiarities of the clinico-morphological picture of modern infective endocarditis (IE). The authors generalize the results of 100 morphological studies of acute and subacute IE (AIE and SAIE) within the last 20 years (1985--2005). AIE and SAIE had developed in 52% and 35% of cases, respectively, after operations, medical manipulations and examinations. The development of secondary AIE was favored by congenital heart defects and mitral valvular (MV) prolapse, while secondary SAIE developed in patients with congenital heart defects as well as atherosclerotic and rheumatic heart defects. The feature of contemporary IE is the prevalence of primary clinico-morphological form with isolated aortal valvular (A V) lesion. Morphological changes in organs formed as a result of multiple septic embolism, immunocomplex lesion, panarteritis, and cardiac insufficiency. The occurrence and progress of the latter was caused by prominent AV and MV insufficiency (during several weeks in patients with AIE and several months in SAIE), myocarditis, pericarditis, myocardial dystrophy, and cardiosclerosis.
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PMID:[Modern aspects of the clinicomorphological picture of acute and subacute infective endocarditis]. 1756 33

The purpose of the study was to evaluate the influence of metoprolol succinate and carvedilol on the physical ability (FA) of patients with chronic heart failure (CHF) of different etiologies. The subjects of the study were 108 patients with postinfarction cardiosclerosis and 39 patients with dilated cardiomyopathy with I to V functional class (FC) CHF and left ventricular ejection fraction of less than 45%. The dynamics of functional parameters were assessed after 6 to 12 months of carvedilol therapy (57 patients) or metoprolol (81 patients) therapy. Therapy with beta-adrenoblockers resulted in a significant decrease in CHF FC (by 0.80 +/- 0.57; p < 0.05), an increase in the distance of six-minute walking test (by 110.7 +/- 86.5 m; p < 0.001) and everyday activity according to DASI questionnaire. The improvement was more substantial in patients with non-ischemic CHF. Peak oxygen consumption during treadmill test did not change, but CO2 ventilatory equivalent increased. The results demonstrate that carvedilol and metoprolol improve subjective and submaximum parameters of the functional status of patients with CHF without changing maximal FA.
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PMID:[The effects of beta-adrenoblocker therapy on the physical working capacity of patients with chronic heart failure of various origin]. 1766 2

The authors analyzed the medical records of 1414 patients aged 60 +/- 14 years, who were examined in a specialized cardiological clinic within a one-year period. Among the patients, 41.2% complained of dyspnea; the number of women with dyspnea prevailed over the number of men. Dyspnea was caused by chronic heart failure in 42.2% of patients, by transient myocardial ischemia in 12.3% of patients, and by paroxysmal tachyarrhythmia in 6.3% of patients. In 45.6% of the patients, mostly in women, significant non-cardial factors were revealed: obstructive or restrictive respiratory failure (20.6%), obesity (14.7%), thyroid gland dysfunction (3.9%), pulmonary arterial thromboembolism, anemia etc. A combination of two or more etiological factors took place in 22.6% of cases. The reason for respiratory discomfort remained unclear in 21.3% of the patients, mostly women. Symptom-limited load test with gas analysis (ergospirometry) was performed in 70 patients with dyspnea of unclear origin. According to its results, in 75% of elderly patients with essential hypertension and postinfarction cardiosclerosis, who did not have significant systolic dysfunction, restrictive diastolic dysfunction, valvular disorder, or atrial fibrillation, dyspnea was caused by hyperventilation, obesity, and respiratory pathology.
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PMID:[Chronic dyspnea in cardiological patients: prevalence and etiology]. 1768 90

Regenerative and plastic heart failure resulted in impaired or inhibited biosynthetic processes (plastic metabolism) and hence decreased or ceased intracellular cardiomyocytic regeneration. Atrophic (involutional) processes of cardiomyocytes and their progressive deficiency due to apoptotic death (diffuse cardiomyocytic depopulation), accompanied by the development of diffuse cardiosclerosis play the key role in regenerative and plastic heart failure. Diffuse myocardial sclerosis may be regarded as a corrected compensatory connective tissue response to a pronounced decrease in muscle fiber mass. In anthracycline-induced cardiomyopathy, myocardial remodeling as a result of changes in the pattern of parenchymal and stromal interactions occurs in the dilatation mode and induces no severe cardiac deformation, which is a favorable factor in restoring the normal myocardial architectonics when regenerative processes are resumed.
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PMID:[Regenerative and plastic heart failure: molecular biological mechanisms and morphological bases]. 1772 86

Aim of the investigation was the study of influence of spironolactone (25 - 75 mg/day) on clinico-functional status, parameters of left ventricular (LV) remodeling, as well as safety of its long term application in patients with chronic heart failure (CHF) receiving optimal therapy. Forty nine patients were included in the study - 44 men (89,8%) and 5 women (10,2%) in the age from 28 to 75 years with II-IV NYHA functional class (FC) CHF, LV ejection fraction (EF) 35%, plasma levels of creatinine 150 mmol/L and potassium 5 mmol/L. Main causes of development of CHF were dilated cardiomyopathy, ischemic heart disease (large focal postinfarction cardiosclerosis) and decompensated hypertensive heart [25/20/4 (51%/40,8%/8,2%), respectively]. As a result of randomization procedure 2 groups of observation were formed: group 1 - 19 patients receiving spironolactone in a 24 hour dose 25 - 75 mg, group 2 - control group - 30 patients without therapy with spironolactone. Inhibitors of angiotensin converting enzyme (ACE) took 100%, b-adrenoblockers - 63,2% of patients. Control examination was conducted before randomization, in 6 and 12 months of follow up. During period of observation no changes of FC were noted in control group. In the group of treatment with spironolactone after 6 months in 6 patients FC lowered ( =0,028). By the end of follow up the given effect lost its significance, but 5 (38,5%) patients by termination of the study had FC II of CHF, what was accompanied with moderate increase of distance walked during 6-minute walk test from 354 to 378 m. In patients in the group of spironolactone treatment already after 6 months of treatment there occurred decrease of LV volumes, what by the end of period of observation for LV end diastolic volume (EDV) amounted - 76 ( - 118; - 7), and for LV end systolic volume (ESV) - 53 ml ( - 96; - 7) ml ( =0,008) at absolute increment of LVEF by 3 (0; 12)% ( =0,05). In control group in 12 months decrease of LVEDV was less pronounced and LV ESV did not change. Finally after 12 months of observation the groups became to differ by change of LVEF ( =0,035) and LVESV ( =0,02). Changes of LV volumes were followed by lowering of median concentration of atrial natriuretic peptide (ANP) in plasma by - 51,9 ( - 87; - 43,9) mg/ml. At the same time in control group gradual rise of concentration of the given peptide was observed from initial 107,3 to 168,5 mg/ml at the moment of study termination. Changes of BP level, creatinine concentration in patients in the study were not fixed in any of treatment groups. Development of moderate hyperkaliemia amounted 21.0%, gynecomastia or pain in the region of mammary glands were fixed in 26,3% of patients in 12 months of treatment. Addition of spironolactone in a dose of 75 mg/day to optimal therapy, including ACE inhibitor and b-adrenoblocker is accompanied with improvement of clinical state and FC of patients with moderate and severe CHF. Long term therapy with spironolactone blocks processes of desadaptive LV remodeling and improves LV contractile function, what is reflected in lowering of ANP concentration in plasma of patients with CHF. Application of spironolactone in combination with ACE inhibitor and b-adrenoblocker bisoprolol does not lead to lowering of BP level and worsening of renal function, but is accompanied with development of hyperkaliemia in patients with CHF. Gynecomastia appears to be main reason limiting long term use of spironolactone in patients with CHF in a dose of 75 mg/day.
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PMID:[Efficacy and safety of long-term application of spironolactone in patients with moderate and severe chronic heart failure receiving optimal therapy]. 1826 Sep 39


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