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)

A 62 year-old woman with a bilateral carotid body paraganglioma presented, 2 years after the removal of the right one, with signs of right-heart failure. Hypoxemia, hypercapnia, polycythemia and pulmonary hypertension with normal ventilatory capacity were found. Central alveolar hypoventilation was diagnosed on the basis of absence of ventilatory response and sensation of provoked hypercapnia, prolonged breath-holding time and correction of hypercapnia by voluntary ventilation. Progesterone (200 mg/d during 3 weeks) or naloxone did not improve either arterial blood gases (ABG) or the P 0.1/PCO2 curve. Hypoxemia and hypercapnia were not corrected during metabolic acidosis provoked by acetazolamide (250 mg/d). Nasal CPAP did not control hypoventilation periods. Mechanical ventilation was initiated with negative pressure (NPV) through a poncho. The patient presented severe discomfort with NPV and obstructive apneas were verified during it. She refused to continue NPV. Mechanical ventilation was initiated with positive intermittent pressure (IPPV) through a nasal mask. The patient had excellent tolerance to the procedure. SpO2 during IPPV was always higher than 95%. During sleep induction (under IPPV), respiration in phase with the ventilator 1: 1 was observed; instead, during consolidated sleep there was a complete dependence of the ventilator with apnea for over 2 min when IPPV was interrupted (Fig. 1). After 2 months of treatment, a relief of right ventricular failure occurred and hematocrit fell to 39%. There was an improvement of day-time ABG (Table I). The P. 0.1/PaCO2 curve 3 months after IPPV was the same as the previous one (Fig. 2). The patient has been for 18 months on home ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Central alveolar hypoventilation with cor pulmonale: successful treatment by non-invasive intermittent positive pressure ventilation]. 771 33

Quality of life was assessed 4-6 months after an acute myocardial infarction in a randomized double-blind study of enalapril versus placebo. Quality of life was evaluated using the Nottingham Health Profile (NHP), the Physical Symptoms Distress Index (PSDI), the Work Performance Scale (WPS) and the Life Satisfaction Index (LSI). The study comprised 36 women (aged 46-85 years, mean 68) and 96 males (aged 39-81 years, mean 62). Quality of life did not differ significantly between patients treated with enalapril versus placebo. The scores were (enalapril vs placebo, mean +/- SE): average NHP 15.4 +/- 2.3 vs 17.1 +/- 2.3; PSDI 9.5 +/- 1.0 vs 10.8 +/- 0.9; WPS 19.8 +/- 2.0 vs 19.4 +/- 1.4; LSI 24.1 +/- 1.0 vs 22.5 +/- 1.4. Men reported a better quality of life than women on most assessments, and non-smokers and ex-smokers better than smokers. Patients with moderate or severe angina pectoris had a worse quality of life measured by PSDI and NHP than patients with minimal or no angina pectoris. Patients with congestive heart failure had a higher PSDI than those without (13.6 +/- 1.7 vs 9.4 +/- 0.7, P < 0.05), while no significant differences were observed in the NHP scores. In conclusion, quality of life was similar in enalapril and placebo-treated patients after an acute myocardial infarction. However, it was reduced in patients with angina pectoris or heart failure and in those who continued smoking.
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PMID:Quality of life on enalapril after acute myocardial infarction. 798 8

A 43-year-old man had a 9-year history of congestive heart failure manifested by an enlarged heart and symptoms of shortness of breath and chest discomfort. Heart failure had been preceded by a "viral illness" and he had been a heavy alcohol user until that time. Autopsy showed congestion and edema characteristic of heart failure and cardiomegaly with biventricular dilatation. Either viral or alcoholic disease, or both, could have been the cause of the cardiac problems.
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PMID:Idiopathic dilated cardiomyopathy. 800 42

Cardiomyoplasty has recently been used as a surgical treatment for refractory heart failure, but its results have not been well described in quality-of-life patterns. We studied the quality of life of 14 patients (13 men, with a mean age of 43.3 +/- 7.4 years) submitted to this procedure for treatment of dilated or ischemic cardiomyopathies. They were approached by personal, structured interviews before and 13 +/- 9 months after the procedure, focusing on the following areas: physical activity, food and sleep patterns, working status, social activity, sexual activity, psychologic state, and perceptions and expectations about the treatment. The presence of limitation descriptors (discomfort, disability, and dissatisfaction) was recorded for all patients. The results showed an important decrease in limitation of physical activity, sleep pattern, social activity, and perceptions and expectations about the treatment. These findings suggest that cardiomyoplasty may improve the quality of life of a selected group of patients.
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PMID:Quality of life after cardiomyoplasty. 803 11

The long-term acceptability of perindopril in mild-to-moderate chronic heart failure (CHF) was evaluated in a multicenter open study. A total of 320 patients with a mean age of 62 +/- 1 years and CHF of New York Heart Association (NYHA) class I (2 patients), II (204 patients), or III (114 patients) were included after a 2-week run-in period during which time vasodilators were stopped and diuretic and/or digoxin therapy stabilized. Perindopril treatment was started at 2 mg, increasing to 4 mg once daily after 2 weeks if supine systolic blood pressure remained > 100 mm Hg. After this dose titration period, follow-up visits were scheduled at monthly intervals for the first 3 months, then at 3-month intervals with a maximum period of follow-up being 30 months. At the time of analysis, mean duration of treatment was 276 days and 208 patients were treated > or = 6 months. Of the 320 patients, 10 (3.1%) died, 9 (2.8%) were withdrawn for worsening heart failure, and 38 (11.9%) for nonfatal adverse events, including cough (2.8%), dizziness or orthostatic discomfort (1.9%), angina pectoris (1.6%), and cutaneous signs (1.3%). Exercise test duration increased from 516 +/- 14 to 659 +/- 19 sec after 6 months of treatment (p < 0.01). At 6 months, 55.6% of patients improved by at least 1 NYHA class. Supine systolic blood pressure decreased slightly from 137 +/- 2 to 132 +/- 1 mm Hg (p < 0.01) and plasma creatinine levels remained stable from 100 +/- 2 to 102 +/- 2 mumol/liter after 6 months of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Acceptability of perindopril in mild-to-moderate chronic congestive heart failure. Results of a long-term open study in 320 patients. 832 69

The improvement of aspects of a patient's quality of life may be as important as prolonging survival in evaluating clinical trials of heart failure. The purpose of this study was to analyze the psychometric properties of the baseline measures from the quality-of-life substudy from the Studies of Left Ventricular Dysfunction (SOLVD) trial. The measures included the 6-Minute Walk Test, Dyspnea Scale, Living with Heart Failure, Physical Limitations, Psychologic Distress and Health Perceptions, as reported by both patients and staff. Cognitive functioning, such as Vocabulary, Digit Span and Trails Making, was also assessed. Patients were classified as New York Heart Association class I (n = 158) versus II or III (n = 150). The internal consistencies (i.e., reliabilities) of the self-report measures were high, except for the Health Perceptions of Class II or III patients. Reliability of the SOLVD quality-of-life battery was confirmed by significantly better life quality among New York Heart Association class I patients versus class II or III patients combined on the Walk Test, Physical Limitations, Dyspnea, Living with Heart Failure, Psychologic Distress and staff perceptions of patient health. In accordance with prior studies, the measures were uncorrelated with left ventricular ejection fraction. By demonstrating strong internal consistencies, reliability based on physician reports, and independence of ejection fraction levels, use of this quality-of-life assessment battery in this and other clinical trials of compromised ventricular functioning is supported.
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PMID:Assessment of quality of life as observed from the baseline data of the Studies of Left Ventricular Dysfunction (SOLVD) trial quality-of-life substudy. 847 71

43-year-old male with non-Hodgkin's lymphoma which was resistant to standard treatment received high-dose chemotherapy followed by autologous stem cell transplantation. He had a past history of nephrectomy due to renal cell carcinoma. He had received adriamycin at a total dose of 280mg/m2, but had no episode of heart disease. His chest radiograph, electrocardiogram and serum creatinine were within normal ranges at the start of high-dose chemotherapy. He was given 120 mg/kg of cyclophosphamide (CPM) over two days. Serum creatinine levels elevated two days before transplantation, and he felt discomfort of the chest followed by severe arrhythmia. He died of heart failure one day after the transplantation. Postmortem examination revealed diffuse myocardial hemorrhage with degeneration and necrosis of the heart muscle. CPM is one of the useful antitumor alkylating agents for the treatment of malignant neoplasms. Although conventional doses of CPM can be used without adverse cardiac effects, high-dose CPM has been reported to induce cardiotoxicity in a few cases. Patients often develop fatal acute heart failure. For the safe use of high-dose CPM, we must consider about the dosing schedule, early detection of adverse cardiac effects, and patient risk factors.
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PMID:[Myocardial hemorrhage due to high-dose cyclophosphamide treatment in a case of non-Hodgkin's lymphoma]. 847 91

Heart transplantation is an effective means of treating irreversible heart failure in selected patients. Preventing organ rejection requires immunosuppressor treatment with corticosteroids, azathioprine and/or cyclosporine. Bone and joint complications are frequent and increase overall morbidity directly related to anti-rejection therapy. Corticosteroids favour osteopenia which can be detected by measurement of bone density. The risks include spontaneous wedge fractures of the spine and aseptic necrosis. The frequency of complications has been reduced with the use of cyclosporine allowing a reduction in corticosteroids. Raised serum urate levels and increased risk of gout can be induced by cyclosporine. The gout in these patients has a particular course since it appears rapidly after only a few months of hyperuricaemia. Several joints may be involved with production of tophi. Treatment is particularly difficult. Its frequency increases after heart transplantation compared with other organs which can be explained by the more prevalent prescription of diuretics which further aggravate urate secretion. These complications cause further discomfort in transplant recipients.
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PMID:[Osteo-articular complications of heart transplantation]. 854 32

Physical training in water might be included in a comprehensive pulmonary rehabilitation programme, but data on the feasibility and safety of this technique in chronic obstructive pulmonary disease (COPD) patients are lacking. We studied cardiorespiratory parameters of 20 stable COPD patients (10 with forced expiratory volume in one second (FEV1) < 35% of predicted value, and 10 with FEV1 > or = 35% pred) on land and in a temperate-controlled pool (32 degrees C) both at rest and during a 15 min submaximal upper body muscle training programme. Compared to resting values on land, we found in water a decrease of systolic and diastolic blood pressure (14 and 6 mmHg, respectively), rate-pressure product (7%) and lung function (vital capacity (VC) 12%, FEV1 14%, peak expiratory flow (PEF) 18%). There were no differences in heart rate, breathing frequency or O2 saturation. The most strenuous exercise in water resulted in a slightly lower O2 saturation compared to work on land (95 and 93%, respectively), and an increase of Borg rating for dyspnoea from 4 to 5. In spite of the restriction of lung function in water, all patients (even those with FEV1 < 35% pred) performed the training in the pool well, without clinically relevant desaturation, arrhythmia or discomfort. No training session was discontinued due to dyspnoea. We conclude that a 15 min session of submaximal physical training in a pool with a water temperature of 32 degrees C is feasible and safe for nonhypoxaemic normotensive COPD patients without cardiac failure.
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PMID:Cardiorespiratory adaptation of COPD patients to physical training on land and in water. 877 60

Because of the limitations resulting from the severity of heart failure, patients in the waiting list for cardiac transplantation often show a worsening in their social life. They usually present with psychological problems caused by symptoms, medical or surgical therapies and consequences on their own work. We have devised and utilized an experimental psychodiagnostic protocol to study the psychological characteristics of a sample of patients with heart failure (NYHA functional class III and IV) candidate to heart transplantation. Our study was particularly aimed at investigating the quality of life and the psychological mechanisms of adaptation. Findings show a strong attempt of denying the discomfort deriving from the disease and the expectation for transplant. Patients seem to have an adequate reaction to the illness and, otherwise, they feel anxiety and trouble that make very fragile their psychological adaptation. This behaviour is probably correlated with symptoms and the clinical history of heart failure, and does not match with a visible state of well-being that can be detected with a superficial analysis. Nevertheless patients have a good availability in receiving a psychological support from the whole medical staff (physicians, nurses): this suggests that the benefits deriving from a contemporary medical and psychological therapy are able to prevent the appearance of clear psychiatric symptoms. Additional studies involving larger samples of selected populations are needed to confirm the results of the present investigation.
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PMID:[The psychological evaluation of patients with severe heart failure awaiting a heart transplant]. 913 52


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