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)

From 1980 to 1995, sixteen patients with T4 lung cancer underwent resection of left atrium (LA) or great vessels combined with pulmonary resection. For eight patients with lung cancer invading LA, LA was resected under simple clamp of LA in seven cases, and under extracorporeal circulation in one case. For three patients with lung cancer invading aorta, resection and reconstruction of aorta was performed under femoro-femoral bypass in one case, and under temporary bypass using a heparin-coated tube in two cases. For five patients with lung cancer invading superior vena cava (SVC), SVC was resected under partial clamp or simple clamp of SVC in each case. In remaining three patients, SVC was resected under internal bypass in one case, and under temporary bypass using a heparin-coated tube in two cases. Three were two operative deaths, one (SVC) died of acute heart failure, and the other (LA) died of acute respiratory distress syndrome. Four patients are alive without recurrence and three of them (one LA and two SVC) have been surviving more than five years after operation.
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PMID:[Surgical treatment of T4 lung cancer: combined resection of lung and heart or great vessels]. 902 68

The characteristics and outcome of acute respiratory distress syndrome (ARDS) may have changed with time. Some studies have reported that mortality is more commonly related to the development of sepsis/multiple organ failure (MOF), and others that it is related to the severity of acute respiratory failure (ARF). The present study evaluates the relative importance of the two phenomena in a large series of patients. The clinical and biological data of all patients who developed ARDS during a 26 month period (January 1993 until February 1995) in our intensive care unit (ICU) were reviewed retrospectively. A total of 129 patients developed ARDS during the study period, representing an incidence of 2.4% of all ICU admissions. The mortality rate was 52%. The primary cause of death was sepsis/MOF (49%), followed by respiratory failure (16%), cardiac failure or arrhythmias (15%), neurological failure (10%), and other causes (8%). The mortality rate was related to age and degree of organ failure. MOF was not always a cause of late death, since half the deaths occurred within 5 days after admission. In addition, mortality was higher in septic than in nonseptic patients, and lower in trauma and surgical than in medical patients. We conclude that sepsis/multiple organ failure is still the most common cause of death in acute respiratory distress syndrome. Improvements in outcome of acute respiratory distress syndrome may depend more on treatment of sepsis and multiple organ failure than on oxygenation measures.
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PMID:Is outcome from ARDS related to the severity of respiratory failure? 919 32

The authors review published data devoted to a new trend in intensive care of pulmonary hypertension: therapy of right ventricular heart failure and gas exchange disorders caused by impaired ventilation-perfusion relationship by inhalation of nitrogen oxide (NO). Mechanisms of NO effect, its metabolism, method of application and safety regulations, and doses and efficacy in various clinical situations (pulmonary hypertension in heart diseases, transplantations of the heart and lungs, respiratory distress syndrome, persistent pulmonary hypertension of the newborns) are analyzed. The first clinical experience gained by the authors demonstrated a favorable effect of NO therapy on the central hemodynamics in patients with acquired valvular defects and patients subjected to orthotopic transplantations of the heart. Approaches to research and pathogenetic validation of NO therapy are outlined.
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PMID:[Clinical use of nitric oxide inhalation. Review of the literature and initial clinical experiences]. 943

A 72-year-old woman with a history of anterolateral myocardial infarction was in severe respiratory distress with frothy sputum production. Electrocardiogram and echocardiogram detected evidence of ischemic change due to anterolateral myocardial injury. Chest roentogenogram showed unilateral, right side pulmonary edema with a clear left lung field. Mechanical ventilation and diuretic administration contributed to her recovery from heart failure and pulmonary edema. Computed tomographic scan showed no abnormality of the bilateral lung fields or pulmonary vasculature; however, pulmonary perfusion scan and pulmonary angiography revealed reduced blood perfusion in the entire left lung field. Although we have no histological evidence, some pulmonary parenchymal change on the left side might have been the cause of unilateral pulmonary edema in this case. In conclusion, a woman with ischemic heart failure developed unilateral pulmonary edema on the right side, showing reduced blood perfusion on the left side.
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PMID:Unilateral pulmonary edema in a patient with ischemic heart failure. 948 39

The efficacy and safety of the angiotensin converting enzyme inhibitor enalapril in dogs with naturally acquired class III or class IV heart failure was evaluated in this study. Eighteen small-breed dogs with insufficiency of their mitral valves, but without other diseases were included in this study over a period of six months. When necessary due to massive pulmonary edema or high serum potassium concentrations, furosemide was added to the therapy with enalapril. No other drugs, including digitalis, were used in this study. The treatment was followed by anamnesis, clinical examinations, electrocardiography, radiography, echocardiography and laboratory diagnosis. Examinations were performed before treatment and after one week, after six weeks and after six months of treatment. 72% of the dogs improved in NYHA classification until the end of the study (p < 0.05). The incidence of seizures due to syncopes or severe respiratory distress decreased during this study (p < 0.01). For 28% of the dogs this treatment was not successful. In the electrocardiographic, radiographic and laboratory examinations statistically significant changes could not be recorded. The decrease in heart rate did not reach statistical significance. The echocardiographic investigation evaluated a significant decrease in fractional shortening and in the diastolic diameter of the left ventricular wall (p < 0.05 respectively p < 0.01), but no significant change in the diastolic or systolic diameter of the interventricular septum. The average oral dose of enalapril was 0.38 mg/kg body weight b.i.d., the average dose of furosemide was 0.37 mg/kg body weight b.i.d. in the first week of the study and was raised to 0.74 mg/kg body weight b.i.d. until the end of the study. Side effects like diarrhea, vomiting or reduced appetite did not increase during the course of the study. However one dog was excluded from the study because of repeated vomiting after six weeks of treatment. This study shows the beneficial clinical and hemodynamic effects and the security of the therapy with enalapril for dogs with heart failure due to mitral insufficiency.
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PMID:[Treatment of mitral valve insufficiency in dogs with the ACE inhibitor enalapril. A clinical progress study]. 953 70

From July 1, 1989 to June 30, 1996, a total of six patients, four male and two female, with double aortic arch (DAA) were registered. They aged 16 days to 6.5 years. There were two patients with isolated DAA, and four complicated with intracardiac anomalies. All six patients presented respiratory distress and feeding problem early in life. However, cyanosis, owing to decreased pulmonary blood flow, predominated the clinical picture in each patient having DAA intricated with tetralogy of Fallot (TOF) and pulmonary stenosis, TOF with absent pulmonary valve syndrome, and type II-A tricuspid atresia. DiGeorge syndrome was documented in one patient with TOF and pulmonary stenosis. Expiratory wheezing was remarkable in the patient with TOF and absent pulmonary valve syndrome. Mild cyanosis and heart failure was noted in one patient with ventricular septal defect (VSD), and bicuspid pulmonary valve with mild valvular stenosis. Barium esophagogram showed indentations on esophagus in five patients. Echocardiography was yielding in three infants. Four patients, two isolated and two complex DAA, survived the surgical division of the smaller left aortic arch. One-stage and two-stage operation was performed in patients having DAA intricated with VSD and TOF, respectively. The other two patients with complex DAA remained in close observation owing to the tolerance of symptoms related to intracardiac anomalies.
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PMID:Clinical implications of isolated double aortic arch and its complex with intracardiac anomalies. 957 45

Ischemic hepatitis, a relatively infrequent disorder occurring in 0.16% to 0.50% of patients admitted to medical intensive care units, often follows episodes of hypotension or acute heart failure. Investigating the clinical characteristics of patients with ischemic hepatitis may add to our understanding of the pathogenesis and significance of this syndrome. We therefore conducted a retrospective analysis of 34 patients to examine the possible contribution of the various baseline characteristics to the severity of the hepatic damage. In all patients liver disease was unexpected and in some, liver dysfunction dominated the clinical picture. All patients had high serum glutamic pyruvic transaminase (SGPT) and lactic dehydrogenase (LDH) levels (mean +/- SE, 2073 +/- 255 international units and 6085 +/- 748 international units, respectively). The mean SGPT/LDH ratio was 0.34. Most patients had coagulopathy with a prolonged prothrombin time (mean +/- SE, 5.86 +/- 1.37 international normalized ratio [INR]). The most common diagnosis on admission was respiratory distress secondary to various causes. Before the development of the hepatic dysfunction, respiratory failure and hypoxemia were observed in 68% of the patients, whereas hypotension was observed in only 38%. More than 90% of the patients had three or more associated comorbid conditions. The most frequent of these were left heart failure (88.2%), right heart failure (67.6%), chronic obstructive lung disease (58.8%), and chronic renal failure (55.9%). During the acute episode, more than 90% of the patients had transient deterioration of their renal functions. Hypoglycemia was noted in 11 patients (32.4%), and the glucose level was inversely correlated with the SGPT level (r = -0.43, p = 0.01). Stepwise multiple regression analysis showed that left heart failure, systolic blood pressure lower than 90 mm Hg, and female gender, together, accounted for 34% of the variance of the peak SGPT levels (p = 0.002). Fourteen (41.2%) patients died during the 3-month follow-up period, but none from the hepatic injury. None of the clinical or laboratory parameters measured predicted mortality. Clearly, ischemic hepatitis is associated with a high risk of death. The characteristic patients are those with multiple underlying systemic diseases and conditions, especially those with left heart failure. Liver function test results and levels of liver enzymes should be monitored in these patients, particularly when they are admitted for respiratory deterioration and episodes of hypotension.
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PMID:Ischemic hepatitis: clinical and laboratory observations of 34 patients. 960 Mar 66

The aim of this study is to review the recent developments in research on the pathophysiological role of endothelins in the reproductive system and lungs, as well as in systemic disorders such as sepsis, acute respiratory distress syndrome and multiple organ failure. The international literature of the last 9 years, as available on MEDLINE, was duly scanned. Only relevant, original and update studies were selected for the purpose of this survey. The results of the most significant studies in humans are summarized. The potential roles of endothelins in systemic diseases are currently under investigation. A possible role of these peptides is suggested in the pathophysiology of heart failure and in the mechanism of post-ischemic renal failure. Studies have been conducted also on other systems, namely the reproductive system, the endocrine system and the lungs as well as on a number of tissue disorders such as sepsis, acute respiratory distress syndrome multiple organ failure, preeclampsia and related abnormalities. Full understanding of the role and action of this group of regulatory mediators in tissues should enable complete insight into the pathophysiological mechanisms of localized diseases as well as of multiple organ diseases. As a result, adequate therapy may be established.
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PMID:Endothelins: an overview of recent achievements. 973 41

The caval syndrome is a serious complication of chronic heartworm (Dirofilaria immitis) disease in dogs and cats. The syndrome is characterized by acute anorexia, respiratory distress, weakness, right-sided cardiac murmur, anemia, hemoglobinuria, hepatic and renal dysfunction, signs of forward and backward heart failure, and, possibly, disseminated intravascular coagulation (DIC). Retrograde migration of adult heartworms from the pulmonary arteries to the right ventricle, right atrium, and venae cavae causes disruption of the tricuspid apparatus. Valvular insufficiency, with concurrent pulmonary hypertension, reduces cardiac output thus resulting in forward and backward heart failure. Additionally, red blood cells are traumatized and hemolyzed as they flow through the mass of worms. Therapy consists of supportive care and the removal of the heartworm mass from the right ventricular inflow tract. Caval syndrome in dogs and cats is associated with high mortality rates and generally has a guarded to poor prognosis.
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PMID:Canine and feline caval syndrome. 975 97

Fish venoms can be lethal for Vertebrates. The effect depends of dose and subject, more than incriminated fish. The most constant symptom is a violent pain; but the serious pharmacological effects are respiratory and heart failure with marked hypotension and cardiac perturbations, neurologic damage, such as seizure and coma. Experimentation is difficult due to venom instability. Activity is lost by distilled water, lyophilisation in buffers, several successive freezing and defreezing. In addition, when venom is broken, other pharmacological effects are evidenced, for instance, with Synanceia verrucosa venom, hypertensive phase takes the place of hypotension. It is difficult to distinguish toxin effect from this of denaturation products of the toxin. Noradrenaline is present in Synanceia venom, and it seems that acetylcholine exists in some venom, at least when diluted in saline solution. Other biological active products are present. Purified toxins allow pharmacological investigations. Stonefish venom is better studied, because venomous glands contain relatively high venom quantity. Stonustoxin from Synanceia horrida exerts its action through NO-synthase liberation, and its primary action can be attributed to its potent vasorelaxant activity, causing a rapid, marked and irreversible hypotension. Trachynilysin, from Synanceia trachynis, causes massive release and depletion of acetylcholine and damage to nerve and muscle fibres, which can account for the inhibition of neuromuscular function, and skeletal paralysis. But the used doses are not compatible with respiratory arrest. Verrucotoxin from Synanceia verrucosa activates potassium channels dependent from ATP; this can explain damage, and probably neurologic and respiratory distress.
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PMID:[Pharmacological properties of fish venoms]. 975 86


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