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

Comparative studies of the differences in elderly patients with and without cardiovascular disorders were made in regard to complications occurring during and after operation. The subjects included 38 patients (6 men and 32 women) aged 70 to 99 years (mean: 84 years) at Nagoya City Kouseiin Geriatric Hospital who had orthopedic surgery under general anesthesia, between March 1990 and October 1992. Diseases identified in these subjects were sequelae of cerebrovascular disease (38 subjects), heart disease (22 subjects), hypertension (9 subjects), senile dementia (6 subjects), Parkinson's disease (5 subjects), malignant disease (3 subjects) and diabetes mellitus (2 subjects). They were initially divided into 2 groups according to ultrasonic cardiography: a normal group comprising 20 patients without cardiovascular abnormalities, and a disorder group comprising 18 patients with reduction of left ventricule function, left ventricular hypertrophy and/or valvular disease (more than moderate). All subjects were examined with regard to age, weight, the nutrition index proposed by Onodera, activity of daily living (ADL), cardiac output, left ventricular ejection fraction, serum level of BUN and albumin etc. Moreover, the disorder group subjects were divided into 2 groups according to the presence or absence of heart failure occurring after surgery. In addition to the above-mentioned, we also studied the duration of surgery and anesthesia, and water balance during and after surgery. Results showed that the ADL and nutrition index in the disorder group were lower compared to the normal group.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Comparative studies on complications occurring during and after surgery in elderly patients with and without cardiovascular disorders]. 829 52

Nephrogenic ascites is a clinical diagnosis defined as persistent ascites in a uraemic patient without evidence of a causative specific underlying disease. Contributing mechanisms may include peritoneal membrane changes, fluid overload, hyperparathyroidism, reduced lymphatic drainage, heart failure and hypoproteinemia. A specific treatment has not yet been found. Rigid fluid control, intensive haemodialysis, high-protein diet, intravenous albumin infusion, intraperitoneal steroid injections and paracenteses as well as implantation of a peritoneoatrial pump were all found to be ineffective. Use of peritoneal dialysis has been shown to resolve ascites, but the only effective treatment is renal transplantation, as demonstrated in the case-report.
 ...
PMID:[Nephrogenic ascites]. 831 65

In order to study nutritional assessment and nutritional support therapy for elderly patients, we conducted energy supply therapy on 15 elderly (aged over 75) patients disabled with diseases such as cerebrovascular disease, pneumonia and heart failure. After recovery from acute phase, they were divided into 3 groups, and assigned to 3 different energy supply methods for 2 weeks: Six (3 males, 3 females) could take hospital diet, but only could absorb about 50% of the energy, amounting only 1,000 to 1,400 kcal/day. Additional 246 kcal was given by peripheral parental nutrition (PPN). Five (2 males, 3 females) were unable to take nutrition orally. Therefore, they were given high caloric nutrients by total parental nutrition (TPN), giving (1,222 kcal daily for a week), then 1,666 kcal for another week. Four (1 male, 3 females) also could not take meals orally, and had to be nourished by enteral nutrition (EN) with a nutrient preparation of 1,120 kcal for one week, then with 1,600 kcal for another week. In all 3 groups, the indices of rapid turnover proteins (pre-albumin, retinol binding protein and transferrin), choline esterase and vitamin A significantly elevated after 2 weeks of therapy, though the increase of pre-albumin and RBP in TPN group was slightly below the significant level. The increase in rapid turnover proteins and choline esterase was greater in the order of EN, TPN and PPN. Vitamin C, on the other hand, decreased significantly with treatment in all the groups, while vitamin E remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Nutritional assessment and nutritional support therapy in elderly patients]. 836 Oct 76

Brain Natriuretic Peptide (BNP) is a recently identified hormone which is secreted by the human heart and circulates in plasma. To determine the effects of pathophysiological levels of human BNP (hBNP), we have studied the integrated renal, hormonal, and hemodynamic response in six normal men receiving 2-h infusions of synthetic hBNP (2.0 pmol/kg.min) or placebo in random order. Steady state levels of hBNP (20-30 pmol/L), achieved at 90-120 min, were similar to levels observed in mild heart failure. Compared to placebo infusions, hBNP induced a greater than 2-fold increase in sodium excretion (P = 0.014) and suppressed plasma aldosterone (P < 0.004) to levels less than 50% of placebo values. These changes were associated with an increase in both plasma (P = 0.028) and urine excretion (P < 0.004) of cGMP. Effects on blood pressure were not statistically significant but increases in both heart rate (P < 0.0001) and plasma albumin (P = 0.007) after cessation of hBNP infusions indicate significant hemodynamic effects of hBNP. High MCR (5.8 +/- 0.7 L/min) yet slow disappearance rate (mean t1/2 22.6 min) indicate that hBNP has a large volume of distribution in humans. These studies show that hBNP, at plasma levels observed in patients with mild heart failure, has potentially important natriuretic, endocrine, and hemodynamic effects which are similar to those observed with comparable infusion rates of ANF.
 ...
PMID:Renal, endocrine, and hemodynamic effects of human brain natriuretic peptide in normal man. 838 Jun 6

Characteristic alterations in the serum and urine biochemical profiles of Doberman Pinschers with congestive heart failure (CHF) resulting from idiopathic dilated cardiomyopathy were determined. We compared these alterations with those observed in 2 other models of CHF: rate overload induced by rapid ventricular pacing in dogs, and biventricular hypertrophy and dilatation induced in turkey poults by furazolidone toxicosis. Serum and urine biochemical changes in both models of CHF in dogs were mild to moderate in degree, and were moderately consistent. They could be attributed to secondary neurohumoral, hepatic, and renal effects of heart failure. The most marked and consistent changes observed were mildly decreased anion gap that developed, in part, because of decreased serum sodium concentration, moderately increased catecholamine concentrations, moderate lactaciduria, hyposthenuria, and mildly increased urea concentrations and liver enzyme activities. In birds with furazolidone cardiomyopathy, we observed mild increases in serum urate concentration, liver and muscle enzyme activities, but moderately increased sodium concentration with decreased chloride concentration. In the pacing and furazolidone models, in which CHF was rapidly induced, moderate to marked hypoproteinemia was attributable to decreases in albumin and globulin concentrations. Using the avian model we found that the hypoproteinemia could be largely attributed to blood volume expansion, and to a lesser extent, inanition. Development of hypoalbuminemia during rapid ventricular pacing and furazolidone treatment may contribute to the effects of rate overload or drug toxicity in the pathogenesis of CHF, because hypoalbuminemia may contribute to altered hemodynamics and neuroendocrine system activation. Our data indicate that clinical biochemical analysis of serum and urine may be useful for assessing progression of CHF.
 ...
PMID:Clinical pathologic profiles of dogs and turkeys with congestive heart failure, either noninduced or induced by rapid ventricular pacing, and turkeys with furazolidone toxicosis. 842 73

Whether excessive ventilatory response to exercise is related to the maldistribution of pulmonary blood flow was examined in 23 patients with chronic heart failure and nine age-matched normal subjects. With the use of technetium 99m macroaggregated albumin, the resting distribution of pulmonary blood flow was assessed by the scintigraphic counts ratio of upper to lower lung fields. The ventilatory response to exercise was assessed by the slope of the relationship between minute ventilation and carbon dioxide production during exercise. Eight patients (group A) had slope less than 33, the upper limit of the normal range, and 15 patients had slope of 33 or greater (group B). In group B pulmonary blood flow was distributed more to the upper lung, which made the counts ratio (60%) higher than in normal subjects (34%) or in patients in group A (38%). There was no significant difference in pulmonary flow distribution between normal subjects and patients in group A. In group B tidal volume did not increase during exercise as much as it did in normal subjects and in patients in group A; therefore, the respiratory pattern was rapid and shallow. Although the ratio of physiologic dead space to tidal volume fell by 20% during exercise in normal subjects and by 23% in patients in group A, it failed to decrease in patients in group B (-1%), which indicates a relative increase in dead space respiration during exercise. These data indicate that decreased lung compliance and regional ventilation-perfusion mismatch caused by pulmonary vascular and parenchymal abnormalities would play an important role in the excessive exercise ventilation in chronic heart failure.
 ...
PMID:Importance of abnormal lung perfusion in excessive exercise ventilation in chronic heart failure. 843 8

Hypertension is an important cardiovascular risk factor. High blood pressure per se is not a disease but a hemodynamic alteration associated with vascular disease. Two classes of drugs are especially effective in lowering blood pressure and preventing cardiovascular complications, angiotensin converting enzyme (ACE) inhibitors and calcium antagonists. The hemodynamic effects of ACE inhibitors and calcium antagonists are complementary. While ACE inhibitors inhibit the renin-angiotensin system and reduce sympathetic outflow, calcium antagonists dilate large conduit and resistance arteries. Certain calcium antagonists, such as verapamil, lower heart rate. In the blood vessel wall, the local vascular effects of ACE inhibitors and calcium antagonists are also complementary. While ACE inhibitors inhibit activation of angiotensin I into angiotensin II and prevent the breakdown of bradykinin (which stimulates nitric oxide and prostacyclin formation), calcium antagonists inhibit the effects of vasoconstrictor hormones such as angiotensin II at the level of vascular smooth muscle by reducing calcium inflow and facilitating the vasodilator effects of nitric oxide. Calcium antagonists reduce smooth muscle cell proliferation and atherosclerosis. In hypertensive animals, verapamil and trandolapril normalize endothelial dysfunction. In large angiographic trials, nifedipine and nicardipine reduced the development of new atherosclerotic plaques. After myocardial infarction, verapamil reduces mortality and cardiac events in patients without heart failure. In contrast, ACE inhibitors are effective after myocardial infarction in patients with impaired left ventricular function. Urinary albumin excretion rate decreases during ACE inhibitor therapy or with a calcium antagonist such as verapamil; combination of the two drugs has an additive effect. In resistance arteries, hypertension is associated with an increased media/lumen ratio. ACE inhibitors, but not beta-blockers, markedly improve these structural changes. In summary, ACE inhibitors and calcium antagonists have a complementary profile, both in their hemodynamic and local vascular action. Hence, combination therapy with these two classes of drugs appears particularly useful in patients with hypertension, not only to lower blood pressure, but hopefully to achieve improved cardiovascular protection.
 ...
PMID:Vascular protective effects of ACE inhibitors and calcium antagonists: theoretical basis for a combination therapy in hypertension and other cardiovascular diseases. 856 68

The effect of the non-ionic contrast medium iohexol (Omnipaque) on renal function was investigated in diabetic patients with signs of peripheral ischaemia. Forty-six patients, 70 +/- 11 years (mean +/- SD) old, age at diabetes diagnosis 53 +/- 17 years, and with varying degrees of diabetic nephropathy were studied before 1, 2, and 30 days after aortobifemoral arteriography. Serum creatinine, creatinine clearance, urinary excretion of immunoglobulin G, albumin collagen IV (NC1), kappa and lambda chains, alpha-1 microglobulin and Tamm-Horsfall protein were evaluated. Within 1 month before and 30 days after arteriography, the glomerular filtration rate was measured by clearance of iohexol. The acute effect of the radiocontrast medium was an increase in the serum creatinine level in 41 (89%) patients, with a more than 25% increase in 12 (26%) patients. The excretion rates of immunoglobulin G and albumin decreased, whereas the proximal and distal tubular function and the excretion of collagen IV did not change. The increment in serum creatinine was associated with the preangiographic renal function (p < 0.05), a history of heart failure (p < 0.01), but not with age, duration and type of diabetes, gender, systolic or diastolic blood pressure, glycated haemoglobin (HbAlc) or blood glucose levels. The increase of serum creatinine was associated with a pre-existing proximal tubular dysfunction and a worsening of distal tubular function. No changes in the parameters measured persisted 30 days after angiography. In summary, a transient increment in serum creatinine level after arteriography occurred in 89% of diabetic patients. It was associated with the preangiographic renal function, a history of heart failure and signs of preexisting proximal tubular dysfunction and worsening of distal tubular function. However, these changes were reversible.
 ...
PMID:The effect of the non-ionic contrast medium iohexol on glomerular and tubular function in diabetic patients. 873 33

Previous studies showed increased growth hormone (GH) plasma levels in patients with severe heart failure. It has been hypothesized that the activation of adenohypophysis determines the enhanced release of GH. The present study was designed to verify whether impaired hepatic function, due to biventricular cardiac failure and hepatic stasis, by reducing synthesis and release of insulin-like growth factor-1 (IGF-1), may affect the negative feedback mechanism of the IGF-1 on GH secretion. We studied 20 normotensive, non diabetic patients without primitive liver disease; 10 patients in NYHA functional class IV with clinical signs of biventricular cardiac impairment and hepatic stasis (Group A); 10 patients in NYHA functional class III with prevalent left ventricular dysfunction (Group B). Blood samples for radioimmunologic determination of GH, IGF-1, atrial natriuretic factor (ANF), proteins, albumin plasma levels and transaminase plasma levels measurements, were collected 24 hours before hemodynamic study. Group A patients had clinical and hemodynamic signs of hepatic stasis with impaired liver function (SGOT 68 +/- 5.5 U/l; SGPT 89 +/- 4.3 U/1; proteins 4.56 +/- 0.4 g/dl with albumin/globulin ratio < 1; albumin plasma levels 2.8 +/- 0.7 g/dl). The parameters were normal in Group B (SGOT 16 +/- 3.7 U/l;SGPT 13 +/- 1.9 U/l; proteins 7.5 +/- 0.7 g/dl with albumin/globulin ratio > or = 1.5;albumin plasma levels 4.2 +/- 1.2 g/dl). ANF values, over normal range in both groups, were significantly higher in Group A (157.9 +/- 43.9 vs 65.6 +/- 14.6 fmol/ml.p < 0.0001). In Group A GH values were increased (4.9 +/- 4.5 vs 0.12 +/- 0.04 ng/ml); on the contrary IGF-1 values were lower (187.9 +/- 98.2 vs 260.4 +/- 141.4 ng/ml, p < 0.01). The comparison between IGF-1 and albumin plasma levels showed a high correlation either in Group A (r = 0.88, p < 0.001;) or in Group B (r = 0.81, p < 0.001). Our findings allow to hypothesize that the reduced hepatic synthesis and release of IGF-1 may be responsible for the lack of trophic action of GH on cardiac myocytes in patients with biventricular heart failure and hepatic stasis.
 ...
PMID:[Changes in growth hormone/insulin-like growth factor-1 axis in patients with normal pituitary function and biventricular cardiac failure and hepatic stasis]. 876 34

Heart failure in hypertensive patients is known to be dependent not only on the absolute value of blood pressure but also on other factors, hence the prognosis varies. In this study, the effect of renal dysfunction on the development of heart failure in hypertensive patients was assessed. Fifty-five patients who were admitted in hypertensive heart failure (HHF) were compared with 55 hypertensive patients who had never been in heart failure (HT), in their renal function, assessed by serum creatinine and urea levels. The haemoglobin (Hb) and serum albumin (Alb) levels were also measured. The two groups were matched for age, sex, level of blood pressure and body mass index. The duration of hypertension was similar in both groups. Mean serum creatinine was higher in the HHF group: 4.50 +/- 0.90 vs. 0.97 +/- 0.06 mg/100ml (P < 0.001). Also the Hb and Alb levels were lower in the HHF than the HT group: 11.63 +/- 0.40 vs. 13.2 +/- 0.21 g/100 ml (P < 0.001) and 3.7 +/- 0.1 vs. 4.40 +/- 0.09 g/100 ml (P < 0.001), respectively. The proportion with abnormal renal function (creatinine > 1.5 mg%) was also significantly higher in HHF: 28/55 vs. 8/54, chi 2 = 16.3 (P < 0.001). When adjustment was made for low serum albumin, Hb and fundal changes by multivariate analysis, serum creatinine was significantly higher in the HHF group: F = 4.294 (P < 0.05). Low serum albumin was also independent of haemoglobin and creatinine: F = 19.52 (P < 0.001), but Hb was not significantly different after adjustment for Alb and creatinine. This study suggests that renal dysfunction is independently associated with the development of heart failure in HT patients.
 ...
PMID:Heart failure in Nigerian hypertensive patients: the role of renal dysfunction. 878 84


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>