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)

Forty-one men with documented myocardial infarction greater than 6 months previously were randomized to long-term (48 weeks) therapy with placebo or enalapril on a double-blind basis. All patients were receiving concurrent therapy with digitalis and a diuretic drug for symptomatic heart failure (functional class II or III). The mean age was 64 +/- 7.3 years and no patient suffered from exertional chest pain. Patients underwent maximal cardiopulmonary exertional chest pain. Patients underwent maximal cardiopulmonary exercise testing to exhaustion on an ergometer cycle nine times over the course of 48 weeks. Gas exchange data were collected on a breath by breath basis with use of a continuous ramp protocol. In the placebo group (n = 21), the mean (+/- SD) peak oxygen consumption (VO2) at baseline was 18.8 +/- 5.2 versus 18.5 +/- 5.5 ml/kg per min at 48 weeks (-1.4%, p = NS). In the enalapril group (n = 20), the corresponding values were 18.1 +/- 3.1 versus 18.3 +/- 2.6 ml/kg per min (+2.8%, p = NS). The mean VO2 at the anaerobic threshold for the placebo group at baseline study was 13.1 +/- 3.5 versus 12.8 +/- 2.1 ml/kg per min at 48 weeks (-2.2%, p = NS). The corresponding values for the enalapril group were 11.8 +/- 2.3 versus 11.8 +/- 2.4 ml/kg per min (+1.4%, p = NS). The mean total exercise duration in the placebo group at baseline study was 589 +/- 153 versus 620 +/- 181 s at 48 weeks (+5.4%, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of long-term enalapril therapy on cardiopulmonary exercise performance in men with mild heart failure and previous myocardial infarction. 185 29

A 48-year-old man had angina pectoris and symptoms of heart failure. Cardiac catheterization showed severe aortic stenosis and regurgitation, and he underwent aortic valve replacement in 1976 with a 23-mm Carpentier-Edwards aortic porcine heterograft. Initially there was symptomatic improvement, but one year later the patient had the onset of dyspnea and exertional chest pain that became progressively more severe over the next three years. Repeat cardiac catheterization was performed 45 months after valve implantation, and a 76 mm Hg peak to peak and a 44 mm Hg mean systolic gradient across the aortic bioprosthesis were recorded. The porcine heterograft was surgically explanted and found to be obstructed by a subvalvular thrombus that appeared to arise from the junction of the aortic and mitral valve annuli.
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PMID:Subvalvular thrombotic obstruction of an aortic porcine heterograft. 707 13

Retrospective analysis of the clinical course of 254 patients with hypertrophic cardiomyopathy, followed up for 1 to 23 years (mean 6), disclosed that 58 had died, 32 of them suddenly. The 196 survivors were compared with the 32 patients who died suddenly and with the 38 who died suddenly or with heart failure. The combination of young age (14 years or less), syncope at diagnosis, severe dyspnea at last follow-up and a family history of hypertrophic cardiomyopathy and sudden death best predicted sudden death (false negative rate 30 percent, false positive rate 27 percent). A "malignant" family history was associated with poor prognosis, particularly in the younger patients; a family history of hypertrophic cardiomyopathy without sudden death was more frequent in the survivors (12 percent) than in the dead (5 percent). Patients who had a diagnosis in childhood were usually asymptomatic, had an unfavorable family history and a 5.9 percent annual mortality rate. In those aged 15 to 45 years at diagnosis, there was a 2.5 percent annual mortality rate and syncope was the only prognostic feature. Among those diagnosed between age 45 and 60 years, dyspnea and exertional chest pain were more common in the patients who died, and the annual mortality rate was 2.6 percent. Poor prognosis was better predicted by the history at the time of diagnosis and by changes in symptoms during follow-up than by an electrocardiographic or hemodynamic measurement.
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PMID:Prognosis in hypertrophic cardiomyopathy: role of age and clinical, electrocardiographic and hemodynamic features. 719 6

Congenital absence of the pulmonary valve is a rare congenital cardiac malformation, usually seen in association with tetralogy of Fallot. Patients generally present early in life with respiratory distress or recurrent respiratory tract infections, failure to thrive, cyanosis, infective endocarditis, or heart failure. Isolated absent pulmonary valve is quite rare and may be discovered in older age-group as in our patient, a nine-year-old male child who presented with atypical symptoms of exertional chest pain. Unusual echocardiographic features in this case include intact ventricular septum and prominent trabeculations of the right ventricle. Surgical implantation of a bioprosthetic valve was followed by hemodynamic and symptomatic improvement.
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PMID:Absent pulmonary valve: a case with rare presentation treated with bioprosthetic valve replacement. 2532 69

Isolated left ventricular noncompaction (LVNC) is a rare form of cardiomyopathy that is characterized by deep intertrabecular recesses and abnormal trabeculations that can be observed on transthoracic echocardiogram (TTE) or cardiac MRI (CMR) studies. Our case describes a 41-year-old male who presented with exertional chest pain and was discovered to have significantly reduced left ventricular ejection fraction (LVEF) which was nonischemic in etiology as confirmed by cardiac catheterization. Subsequent evaluation with CMR imaging revealed noncompaction of the left ventricle. The patient received defibrillation and lifelong anticoagulation given his elevated risk of sudden cardiac death (SCD). This case highlights the importance of considering unconventional etiologies of cardiomyopathy when investigating new-onset heart failure as well as the necessity of life-saving measures such as anticoagulation and defibrillator implantation in view of arrhythmogenic structural heart diseases.
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PMID:Left Ventricular Noncompaction: A Rare Case of Nonischemic Cardiomyopathy. 3148 54

Hypothyroidism is a common medical condition. The low metabolic state in hypothyroidism leads to significant cardiovascular and hemodynamic changes. Hypothyroidism is associated with heart failure, diastolic hypertension, atherosclerosis, coronary artery disease (CAD), and decreased insulin sensitivity. Similarly, the administration of levothyroxine worsens the cardiovascular disease by establishing a supply-demand mismatch. Here, we present a case of a 45-year-old woman with hypothyroidism who presented to us with exertional chest pain and later got diagnosed with severe three-vessel disease. Coronary artery bypass grafting (CABG) surgery was planned after the establishment of euthyroid state.
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PMID:Thyroid and Heart: Severe Three Vessel Coronary Artery Disease in a Middle-Aged Female with Hypothyroidism. 3185 27