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)

d-3-Acetoxy-cis-2,3-dihydro-5-]2-(dimethylamino)ethyl]-2-(p-methoxyphenyl)-1,5-benzothiazepin-4(5H)-one hydrochloride (diltiazem HCl) was orally administered to 9 patients with chronic congestive heart failure (Class IIb to III, NYHA) to examine whether the drug induces sodium retention and aggravates congestive heart failure. Renal hemodynamics and urinary electrolytes excretion were measured for 3 h after the medication in 6 out of 9 patients. Four of the rest of patients had received chronic administration of the drug for about 2 weeks. There was a significant increase in urinary sodium excretion without noticeable change in renal hemodynamics after diltiazem administration, demonstrating the presence of its direct inhibitory action on renal tubules. The increase in urinary sodium excretion was more marked in patients with heart failure than in those without. This difference in the response to diltiazem may be due to the functional constriction of renal cortical vessels in heart failure. This constriction may be related to renin-angiotensin system which diltiazem was reported to antagonize. The chronic administration of the drug did not induce sodium retention and edema. There was no deterioration of symptoms due to congestive heart failure such as dyspnea and body weight increase. It may be concluded that diltiazem does not aggravate congestive heart failure through its diuretic action and probably its systemic vasodilating action.
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PMID:The effect of diltiazem hydrochloride upon sodium diuresis and renal function in chronic congestive heart failure. 58 67

Following episodes of pulmonary embolism, the presence of thrombi in the pulmonary arteries leads to severe respiratory insufficiency and chronic right heart failure. We have operated upon 16 such patients, nine men and seven women from 23 to 68 years of age. All had severe dyspnea, 14 had chronic cor pulmonale, six had mental disturbances with syncope, and four had severe cardiac failure. The presence of clots was demonstrated by pulmonary angiography, and the permeability of the distal arterial bed was ascertained by selective injection of the bronchial arteries. In all cases but two a lateral thoracotomy was used so that the obstructed arterial branches could be approached distally. The inferior vena cava was always ligated to prevent recurrences. There were six operative deaths, three from cardiac failure, one from acute pulmonary edema, one from hemothorax, and one following a pyothorax. Ten patients are surviving after 6 months to 10 years. One is still limited because of significant pleuropulmonary sequelae. Six are enjoying good results with marked improvement in their functional limitations, a significant drop in the pulmonary artery pressure, and radiological permeability of previously obstructed arteries. Three are excellent condition--completely asymptomatic.
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PMID:Surgical correction of chronic postembolic obstructions of the pulmonary arteries. 70 66

A very rare case of a myxosarcoma with metastases to the brain is reported. A 33-year-old female was admitted to our hospital because of lassitude, fever, slight left hemiparesis, headache and other signs of intracranial hypertension and cardiac symptoms such as dyspnea and palpitation. She had the cardiac symptoms once 14 years before, which reappeared and rapidly aggravated two months before the admission. Cerebral angiography revealed a mass in the right temporal lobe and physical and laboratory examinations revealed mitral value failure and hyperthyroidism. On the next day, March 19, 1976, a grossly cystic 60 gm tumor was totally removed which was largely imbedded in the subcortex of the right temporal lobe. The symptoms except for the cardiac symptoms and disseminated intravascular coagulopathy rapidly improved, but headache and left hemiparesis returned 13 days postoperatively. She died suddenly 18 days after the operation due to acute cardiac failure. Autopsy revealed two separate hard and solid tumors both attached to the mitral valve and occupied the whole left atrium and another metastasis to the frontal lobe which had not been diagnosed before the death. Microscopic examinations including electronmicroscopic study established the diagnosis of myxosarcoma in all the four tumors.
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PMID:[Brain metastases from primary cardiac myxosarcoma--report of a case (author's transl)]. 71 43

The therapeutic efficacy of cephacetrile (CEC) in bacterial pneumonia was evaluated in contrast with that of cefazolin (CEZ) by a double blind method. Both drugs were administered via intravenous route at a dose of 1 g twice daily for 14 days. 1) Of 81 patients, each 2 from both groups were eliminated from the study because of unknown results. In CEC group, 36 out of 38 obtained a slightly effective or better results (94.7% of effectiveness). In CEZ group, 31 out of 39 showed a similar result and there was no significant difference between the two groups. 2) In more detail, CEC achieved significantly better results in AaDo2 and cardiac insufficiency than CEZ, and this trend was also seen in dyspnea. 3) Regarding background factors, pretreatment severity was slightly in favor of CEC. However, so long as supplementary analysis is concerned, we could not find any relation between the pretreatment severity of symptom and drug efficacy or improvement of symptom. 4) Since there was a slight bias in the background factors, it is difficult to conclude that CEC is better than CEZ in terms of effectiveness. However, we consider CEC is superior to CEZ if compared in details. 5) Both drugs had the same incidence of side effect (6.25%, 3/48 in both groups). When clinical efficacy of CEC in bacterial pneumonia is evaluated together with the incidence of side effect, we may consider that CEC is an effective antibiotic agent equal to or better than CEZ.
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PMID:[A clinical evaluation of the effect of cephacetrile on bacterial pneumonia. A comparative test with cefazolin by a double blind method (author's transl)]. 79 86

In a series of 4000 patients subjected to coronary arteriography, 12 were found to have complete obstruction of three major coronary arteries, an incidence of 0.3 p. 100. The clinical manifestations did not follow a typical pattern. Although 9 had a previous myocardial infarction or heart failure, only 6 were incapacitated by angina or dyspnea. Except for one patient, the resting EKG was abnormal. Half had a markedly elevated resting end-diastolic pressure and gross abnormalities of left ventricular contraction. In spite of surgery in 7, with only one operative death, a yearly mortality rate of 20 p. 100 has been recorded during a 3-year follow-up. This extremely low survival rate, the severe functional impairment in half of the survivors, and the subsequent high yearly mortality rate, all suggest that surgery be considered before complete obstruction occurs in patients with significant disease of three coronary arteries. A 10 p. 100 yearly mortality rate reported in patients with triple vessel obstructions, also favours surgery in such patients with the hope of prolonging life, providing good distal runoff and satisfactory left ventricular contraction are present.
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PMID:[Profil and course of complete obstruction of 3 coronary trunks]. 81 16

Fibrosing alveolitis is a rare, diffuse lung disease characterized by varying combinations of two histological features: thickening of alveolar walls and the presence of large mononuclear cells in the alveolar spaces. Clinical details of 10 children with fibrosing alveolitis are reported. The main symptoms in children are tachypnoea or dyspnoea, cough, poor weight gain, and cyanosis. The condition is similar to that in adults, but it is usually a more acute illness, and if untreated, more predictably fatal. Respiratory failure, pulmonary hypertension, and cardiac failure are the major complications. Less commonly, superimposed bacterial infection and pneumothorax occur. Chest x-rays often show a sequence of changes with a ground-glass appearance and fine mottling in the early stage of the disease, progressing to a picture of mainly hilar linear markings in those children who recover. The histological features at lung biopsy or necropsy are described; these correlated poorly with the radiological features, steroid responsiveness, and clinical course. Lung function tests in 3 older children showed evidence of markedly reduced lung volumes in 2. Static lung compliance in 4 children in the acute stage of the illness was normal in 3 and diminished in one. The response to steroid therapy was analysed in cases from the literature and the 10 reported cases. No spontaneous remissions occurred, all the survivors having been treated with corticosteroids. In children fibrosing alveolitis is almost always a corticosteroid-responsive disease. An appropriate course of prednisolone would be of at least 4 week's, but preferably of 8 weeks' duration, at a minimum daily dose of 2 mg/kg. After improvement the steroid withdrawal should be cautious and protracted, comprising at least a year's continuous treatment.
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PMID:Fibrosing alveolitis in infancy and childhood. 83 51

Over the years, hemodynamic stresses and biologic changes bring about reduced cardiac function. The addition of one or more types of organic heart disease leds to further deterioration of fuction. This is why elderly patients require special consideration and management, why their clinical manifestations and therapeutic responses differ from those in young patients. Although no single abnormality characterizes the aging process, cellular, functional, and structural changes support the existence of a cardiopathy. However, there are insufficient data to link so-called senile cardiopathy directly to otherwise unexplained heart failure. Failure is usually due to the typical reasons, i.e., coronary artery or valvular disease, hypertension, amyloidosis, and chronic pulmonary lesions. Nevertheless, the possibility of senile heart failure should not be overlooked in case of impending or actual myocardial failure. In patients over 60, edema, dyspnea, or tachycardia cannot always be attributed to heart disease. It is hazardous to diagnose and prescribe treatment for cardiac failure if the heart shadow is not enlarged on the x-ray,the circulation time is not prolonged, and the heart sounds and rhythmare normal. Other reasons for the complaints should be looked for, even when the heart rate is fast.
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PMID:Cardiopathy of aging: are the changes related to congestive heart failure? 83 76

A follow-up study of 22 patients with Ebstein's anomaly has been performed. Nine patients died 1-21 years (mean 9) after the initial admission while the 13 patients alive at the end of the observation period had been followed for 5-26 years (mean 15). Clinical, ECG, radiological, and haemodynamic features were analyzed with reference to their prognostic significance. The presence or absence of cyanosis due to right-to-left shunt through an atrial septal defect (ASD) distinguished best between a good and poor prognosis. Right-sided heart failure and dyspnoea at rest, often associated with palpitations, precordial pains and syncopes, were grave prognostic findings. After the initial signs of heart failure there was a rapid deterioration, death ensuing within a few years. Operation with insertion of a prosthetic valve (and closure of the ASD) should be seriously considered at the appearance of heart failure.
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PMID:The prognosis in Ebstein's disease of the heart. Long-term follow-up of 22 patients. 85 Oct 41

A study was made of pulmonary function tests in patients averaging 2 years post MI, who did not present evidence of chronic bronchitis or other types of primary pneumopathy. The influence of smoking and moderate pulmonary congestion due to heart failure were studied. We found a significant inverse relation between dyspnea and the forced one second expiratory volume, as an expression of bronchial obstruction. There was a significant increase in the respiratory volume in patients after MI. This alteration was particularly evident in patients who smoked. On the contrary, in pulmonary congestion the tendency was towards a decrease in respiratory volume. We confirmed the importance of pulmonary function tests for the evaluation of subjective symptoms, this was confirmed by the finding of a decrease in the dynamic pulmonary volumes, specially in smokers, which demonstrates the unfavorable influence of smoking. Heart failure did not significantly influence static or dynamic parameters, although the residual functional capacity showed a tendency to decrease with the degree of congestion.
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PMID:[Static and dynamic volumes after myocardial infarction/clinical and radiological correlation]. 93 47

During the 10 years from 1964 to 1973, fifteen patients with severe syphilitic aortic regurgitation were treated surgically at the National Heart Hospital. In thirteen the valve was replaced and in two it was repaired. In addition four had replacement of an aneurysmal ascending aorta with a Dacron graft and seven some form of plastic repair to the coronary ostia. Three patients died within 1 month of surgery and a further six during the follow-up period which varied from 1 to 55 months (mean 25-5). The six survivors have been followed-up for an average of 33 months. Factors contributing to this high mortality were analysed and it was found that the mean duration of effort dyspnoea was 22 months in the survivors compared with 48 months in those who had died. Similarly the average duration of nocturnal dyspnoea was 4 months in the survivors compared with a mean of 8 months in those who had died. Only six out of the fifteen patients had angina; this was present in two of the survivors and in four of the fatalities. The pulse pressure, heart size, and haemodynamic findings were similar in the two groups. The prognostic value of an elevated erythocyte sedimentation rate was also examined. It was concluded that preoperative investigations should include aortography, coronary arteriography, an assessment of left ventricular function, and whenever possible myocardial biopsy. These data were interpreted as suggesting that patients should be referred for surgery at an earlier stage in the disease--certainly before the onset of cardiac failure and--and that if this more aggresive attitude was adopted, as it has been in non-syphilitic cases of aortic valve disease, the present high mortality in this group would be reduced.
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PMID:Syphilitic aortic regurgitation. An appraisal of surgical treatment. 100 17


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