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)

2127 patients with operations of the stomach, colon, lungs, vascular system, and amputations were analysed with regard to postoperative mortality and age. There was a striking relationship between age and risk in each group of diseases. The perioperative mortality rate rose from 2.3% in the age group under 50 years to 8.5% in patients between 51 and 70 years of age, and to 18.6% in patients older than 71 years. There was no sex related difference. The causes of death in 219 cases were exactly analysed. Cardiac insufficiency, myocardial infarction, cachexia in malignancies, pulmonary embolism, and renal insufficiency were the main lethal complications in elderly patients.
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PMID:[Surgery of elderly patients--evaluation of perioperative mortality]. 686 49

From June, 1977 to August, 1981, 388 patients underwent open heart surgery for acquired valvular heart diseases. The over-all surgical mortality rate during this period was only 4%, but a high incidence of postoperative complications (26% for major complications) was still observed. It is an urgent concern for all cardiac-surgeons to reduce postoperative complications in order to obtain better surgical results. Even with improved techniques in modern cardiac surgery, 28 patients with a giant left atrium were still in the high risk group, with an over-all mortality rate of 29% and with a high incidence (68%) of postoperative complications. This seemed to be attributable mainly to deteriorated conditions such as cardiac cachexia, but not necessarily to impaired pulmonary function. Therefore, more careful considerations should be paid not only for their circulatory and pulmonary conditions, but also for the improvement of their general condition, including nutrition and metabolism. On the other hand, 27 patients with infective endocarditis showed a remarkable improvement after prosthetic valve replacement in spite of their seriously deteriorated preoperative condition. There were 4 hospital deaths (15% mortality). All transferred to our institution in a far advanced stage of the disease. Early surgical intervention for intractable cardiac failure should be strongly recommended for these patients.
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PMID:Recent results and problems in the surgical treatment of acquired valvular heart disease. 688 97

Case histories are reported of three patients, 1 to 4 years of age, with severe mitral regurgitation that occurred as a sequela of mucocutaneous lymph node syndrome (MCLS). These patients were found among 12 patients with coronary artery lesions such as aneurysms, narrowings, and obstructions. One of them with multiple coronary aneurysms and also severely impaired left ventricular function died of congestive heart failure in the 2 years and 7 months' follow-up period after the acute illness. The second patient, 1 year of age, had multiple coronary aneurysms and mitral regurgitation. Because of the difficulty in treating coronary artery lesions at this patient's age and also because of medically controllable mitral regurgitation at present, this patient is now under careful observation. The third patient, whose condition was complicated by inferior wall myocardial infarction due to occlusion of the right coronary artery, underwent mitral valve replacement for intractable heart failure and cardiac cachexia. This patient had slow but definite improvement postoperatively. Mitral regurgitation secondary to MCLS usually is complicated by the associated difficult coronary artery lesions and impaired left ventricular function. Although this fact causes an extra-difficult situation, mitral regurgitation consequent to MCLS is amenable to surgical treatment and this disease should now be considered as a new surgical entity.
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PMID:Severe mitral regurgitation due to coronary arteritis of mucocutaneous lymph node syndrome. A new surgical entity. 742 Dec 97

We examine the association of the menopause transition, congestive heart failure, and Parkinson's disease on body composition and energy expenditure. We present evidence suggesting that the normal menopausal transition is associated with accelerated loss of fat-free mass, a decline in resting metabolic rate, and increased central body fatness. Second, we show that the cardiac cachexia associated with heart failure is partially due to an elevated level of energy expenditure. Despite having a lower quantity of fat-free mass, congestive heart failure patients have a higher resting metabolic rate (approximately 283 kcal/d) for their metabolic size than healthy elderly. The elevated level of resting energy expenditure probably contributes to their unexplained weight loss. Parkinson's patients experience muscular rigidity and tremor which could contribute to inappropriately high levels of energy expenditure and difficulty in maintaining body weight and composition. We examined resting metabolic rate and body composition in eight Parkinson's patients and 34 healthy age-matched controls. Parkinson's patients showed lower levels of fat-free mass (approximately 6 kg), but similar resting metabolic rates (1601 +/- 250 kcal/d) versus healthy controls (1671 +/- 212 kcal/d), suggesting a hypermetabolic state. A re-examination of daily energy needs and the metabolic factors contributing to periods of energy imbalance during the menopausal transition and in several disease states may be a prerequisite to offsetting accelerated sarcopenia.
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PMID:Sarcopenia in aging humans: the impact of menopause and disease. 749 23

The study of the current status of renal replacement therapy in Japan is based on the analysis of data from the registry reports for regular dialysis therapy and kidney transplantation. The total number of patients receiving regular dialysis therapy was 123,926 at the end of 1992: 117,809 (95.1%) on hemodialysis and 6,117 (4.9%) on peritoneal dialysis. The primary diseases of newly accepted patients were chronic glomerulonephritis (42.2%), diabetic nephropathy (28.4%), nephrosclerosis (5.9%), polycystic kidney disease (2.7%), chronic pyelonephritis (1.6%), and others. The number of kidney transplant patients in Japan was 8,384 at the end of 1991: 6,154 (73.4%) received a living donor transplantation and 2,230 (26.9%) received a cadaver donor transplantation. Overall 5-year survival rates of dialysis patients were 60.4%: 69.7% for chronic glomerulonephritis, 41.7% for diabetic nephropathy, 39.6% for nephrosclerosis, 73.6% for diffuse polycystic kidney disease, and 66.6% for chronic pyelonephritis. The causes of death of dialysis patients were heart failure (31.1%), cerebrovascular accident (13.6%), infectious diseases (11.3%), malignancies (7.1%), cachexia/uremia (6.7%), myocardial infarction (5.8%), and others. The gross mortality rate of dialysis patients was increased in cases of less than 4 hours of the average length of each dialysis session, less than 4% and more than 9% of the average weight loss during each dialysis session, less than 1.0 of Kt/V, and less than 0.9 and more than 1.7 g/kg/d of protein catabolic rate. Overall 5-year patient and graft survival rates of kidney transplant patients since 1964 were 82.7% and 60.3%: 84.4% and 65.0% in living donor cases, and 77.4% and 46.2% in cadaver donor case, respectively. Those since 1983 were 90.1% and 68.2%: 91.3% and 72.6% in living donor cases, and 87.8% and 59.3%, respectively. Graft survival rates were superior in cases treated with combined steroid, cyclosporine and azathioprine or mizoribine, to those treated with other immuno-suppressive regimens, and they decreased as the number of HLA-A, -B and -DR increased.
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PMID:Current status of renal replacement therapy in Japan. 781 May 20

A 71-year-old woman underwent surgical repair of a ruptured aneurysm of the sinus Valsalva. She had an aneurysm of the right coronary sinus ruptured into the right atrium. There was no VSD. The patient suffered from heart failure for 38 years and went into cardiac cachexia. Direct closure from the right atrium was performed and the patient has resumed full physical activities. As far as we know, this is one of the oldest patients who underwent successful surgery for this disease in this country.
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PMID:[A case report of surgical repair of a ruptured aneurysm of the sinus Valsalva in an aged person with cardiac cachexia]. 783 Mar 61

We reviewed the clinical records of 769 patients with primary systemic amyloidosis who had been examined at Mayo Clinic Jacksonville (Jacksonville, Florida) or Mayo Clinic Rochester (Rochester, Minnesota) during a 12-year period (1978 through 1989). Of these 769 patients, 59 (8%) had biopsy-established gastrointestinal amyloidosis, and 8 (1%) had symptomatic gastric amyloidosis. All eight patients with symptomatic gastric amyloidosis had hematemesis or prolonged nausea and vomiting in association with weight loss. Additional findings were gastroparesis (in three patients), gastric tumor (in one), and gastric outlet obstruction (in one). Macroglossia was present in two patients, and multiple myeloma was diagnosed in three. Six of the eight patients had coexisting small bowel amyloidosis and weight losses of 6.5 to 22.5 kg. Congo red staining identified gastric amyloid in the media of blood vessels in all cases. All cases stained selectively for lambda (seven cases) or kappa (one) light chain. All eight patients died; the median duration of survival after diagnosis was 13.8 months (range, 0.5 to 39.5). Death was due to cardiac failure (three patients), renal failure (two), chronic gastrointestinal obstruction and severe cachexia (two), or hepatic failure (one). Chemotherapy was given to seven patients but was only partially effective for ameliorating symptoms in one.
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PMID:Symptomatic gastric amyloidosis in patients with primary systemic amyloidosis. 833 78

Malnutrition resulting from chronic congestive heart failure (cardiac cachexia, CC) is not uncommon and contributes to mortality and morbidity especially of elderly people. The aetiology of cardiac cachexia is probably multifactorial. We have assessed whether malabsorption of fat is associated with CC and if so whether it is due to small-bowel bacterial overgrowth. Three groups of subjects were studied: 29 (20 women) patients (mean age 76.1 years) with controlled congestive heart failure and weight loss (CC); 14 (seven women) patients (mean age 74.0 years) with controlled congestive heart failure and no weight loss (non-cachexia, NON-CC); and 29 (20 women) healthy controls (mean age 74.9 years). Fast absorption was quantified using the cumulative 6 h 14CO2 exhalation in the 14C-triolein breath test and small-bowel bacterial overgrowth was quantified using the cumulative 8 h 14CO2 exhalation in the 14C-glycocholic acid breath test. The cumulative 6 h 14CO2 exhalation in the triolein breath test was reduced in the CC group (p = 0.001) implying impaired fat absorption. There was no evidence of small-bowel bacterial overgrowth in any group. Impaired absorption of fat was related to the clinical severity of heart failure and its duration. Impaired fat absorption is associated with cardiac cachexia. It is not due to small-bowel bacterial overgrowth. The aetiology of fat malabsorption in heart failure requires further studies.
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PMID:Fat malabsorption in elderly patients with cardiac cachexia. 867 May 44

To ascertain whether elevated levels of circulating proinflammatory cytokines in patients with advanced heart failure are due to congestive heart failure or due to cachexia or infection complicating heart failure, we measured prospectively plasma concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), interleukin 2 (IL-2), and interleukin-6 (IL-6) in 12 patients with mitral stenosis with moderate congestive heart failure, but not with cachexia or infection. Blood samples were obtained from the peripheral vein and right and left atria of the patients during percutaneous mitral valvuloplasty. Levels of TNF-alpha, IL-1 beta, IL-2, and IL-6 in the plasma form the peripheral vein and right and left atria of these patients were not elevated compared with those from the peripheral vein of a control group of 10 normal subjects. On the other hand, plasma levels of TNF-alpha but not IL-1 beta, IL-2 or IL-6, were elevated in 4 of 9 patients with congestive heart failure complicated with cachexia and/or infection. Our results suggest that proinflammatory cytokine levels are not elevated in congestive heart failure uncomplicated with cachexia or infection.
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PMID:Plasma cytokine levels in cardiac chambers of patients with mitral stenosis with congestive heart failure. 890 73

Elevated tumour necrosis factor alpha (TNF-alpha) has been demonstrated in chronic cardiac failure (CCF) and may relate to severity of CCF and development of cachexia. We measured TNF receptor p55 in addition to TNF-alpha in an attempt to improve the detection rate of TNF-alpha activation, and simultaneously measured interleukin 6 (IL-6), interleukin 8 (IL-8) and C-reactive protein. Thirty-four patients with CCF and 24 control subjects were studied. Only TNF receptor p55 [6.95 (0.77-42.3) vs. 5.52 (1.50-13.36) ng mL-1 (median (range)] and IL-6 [0.335 (0-9.79) vs. 0(0-14.71) pg mL-1) were significantly elevated in patients compared with control subjects (both P < 0.05). All inflammatory markers were more frequently elevated in patients, but none correlated with any of the clinical parameters studied. Reasons for inflammatory marker elevation in CCF are uncertain, but future studies should measure the p55 TNF receptor and IL-6 in addition to TNF-alpha, to improve detection of cytokine activity.
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PMID:Cytokine profile in chronic cardiac failure. 895 9


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