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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The majority of therapies used in the contemporary management of chronic heart failure (CHF) have been rigorously evaluated by means of large-scale clinical trials to assess their beneficial effects on quality of life and prognosis. Such therapies include angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and cardiac resynchronization therapy (CRT). Diuretics are the most commonly prescribed class of drugs in CHF patients and in the short term they remain the most efficacious treatment for relief from fluid congestion. There is, however, scant evidence to suggest that they confer any long term benefit in terms of disease progression or prognosis to the CHF sufferer. Injudicious use of diuretics has been demonstrated to be potentially harmful and consideration should be paid to avoiding dietary salt indiscretion as well as the pharmacokinetic properties of individual diuretics to achieve optimal diuretic response. In this article, we explore the current insight into the use of diuretics in CHF.
Heart Fail Monit 2006
PMID:Current thinking regarding the use of diuretics in heart failure. 1681 77

Hyperthyroidism occurs in approximately 1 in every 1000 to 2000 pregnancies. Although the signs and symptoms of the disease are similar in the pregnant and nonpregnant patient, the complications of hyperthyroidism can have even more profound consequences for the mother and fetus during gestation. These include maternal heart failure, preeclampsia, miscarriage, and preterm labor; as well as fetal loss and low birth weight. Furthermore, thyroid function and laboratory testing for hyperthyroidism are altered in pregnancy. The gestational increase in thyroid size, increased thyroid-binding globulin levels, increased serum total T4 and total T3 levels, and decreased thyroid stimulating hormone levels often confuses the evaluation of the thyroid status in pregnancy. Worldwide, the thionamides-propylthiouracil, methimazole, and carbimazole-have been used in pregnancy for the treatment of hyperthyroidism. However, propylthiouracil has been the drug of choice in the United States because it is believed to have less potential to induce fetal/neonatal hypothyrodism, to cross the placenta and into breast milk to a lesser degree, and to be less teratogenic than methimazole or carbimazole. None of the above have been substantiated in more recent studies. The pharmacokinetics of the thionamides in the pregnant and nonpregnant states, as well as the pharmacotherapeutic recommendation for hyperthyroidism will be reviewed.
Ther Drug Monit 2006 Aug
PMID:Pharmacokinetics and pharmacotherapy of thionamides in pregnancy. 1688 14

Congestive heart failure has a high mortality, as reflected in different clinical trials and observational studies. Spain, as other countries around the Mediterranean basin, have a relatively low rate of coronary deaths, attributed to the so-called Mediterranean lifestyle. Andalusia, in the southern most part of Spain, constitutes the paradigm of Mediterranean lifestyle. However, different reports show that the prevalence of ischemic heart disease is higher in Andalusia than in other zones of Spain. Thus the mortality rate due to heart failure in Spain in the year 2000 per 100,000 inhabitants was 27.3 in men and 28.88 in women and each one of the eight Andalusia provinces had greater rates than the national mean in both men and woman. Even in countries with a relatively low prevalence of coronary heart disease as is the case in Spain, heart failure mortality seems to be parallel to local differences in IHD prevalence.
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PMID:[Heart failure mortality in Spain: is there an andalusian paradox?]. 1690 12

The study of predictors of the development of arrhythmia in elderly age people with IHD is an important task requiring the thorough investigation. The presence of late potentials of ventricles (LPV) is considered presently as one of the most highly informative parameters indicating an electrical inhomogeneity of myocardium, which would result in cardiac rhythm disturbance. The presence of early, late ventricle potentials as well as a dispersion of QT, QRS and T intervals are believed to be the predictors of arrhythmia along with other indices. The study focused on determining a frequency of such predictors among patients of 60-74 y.o. with various clinical picture of IHD. 300 patients were observed: 120 of them with IHD, 100--additionally having essential hypertension, 60--PICS (postinfarction cardiosclerosis), 20--HF. 20 people aged 60-89 formed the control group. The registration of LPV, EPV as well as QT, QRS and T dispersion was carried out by means of Megacart electrocardiograph (produced by "Siemens" company, Germany). The findings are the following: 48 % of the patients with IHD were found with LPV, 33%--with EPV (early potentials of ventricles). LPV is also more frequently met in the patients with IHD complicated with heart failure (HF) and hypertension; dispersion of QRS and T is for sure higher in patients with IHD and HF.
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PMID:[High resolution electrocardiogram in the diagnosis of risk of the cardiac rhythm disorder development in elderly patients with ischemic heart disease]. 1705 4

Cardiac biomarkers play an important role in and provide better pathophysiological understanding of chronic heart failure (CHF). Natriuretic peptides, especially B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP), were found to be useful in the diagnostic assessment and prognostic stratification of patients with CHF. However, they fail to fulfill all the criteria of an ideal biomarker. Currently, we still do not have a single biomarker or a combination of biomarkers to answer all the clinically relevant questions in CHF. Consequently, some widely available biomarkers might have been overlooked in the field of heart failure. This review discusses several biomarkers, and speculates on the possible roles of combining two or more of them. In this respect, hemoglobin, cholesterol, uric acid, and recently identified proteins may prove to be relevant to the field of CHF. Lastly, we anticipate the potential of biomarkers in a variety of chronic diseases with similar pathophysiology.
Heart Fail Monit 2007
PMID:Biomarkers for chronic heart failure. 1748 96

At least half of patients with heart failure (HF) suffer from sleep apnea. Growing evidence suggests that there may be a strong pathophysiological link between chronic HF and sleep apnea due to nocturnal oxygen desaturation and sympathetic activation. It seems that sleep apnea contributes to systolic and diastolic HF, reduced left and right ventricular function, and arrhythmia (e.g. atrial fibrillation, bradycardia, or ventricular ectopy). Therefore, treatment of sleep apnea might alleviate cardiac symptoms and improve cardiac function. Nevertheless, the exact role of long-term treatment of sleep apnea in HF patients remains to be elucidated, as important clinical endpoints (e.g mortality) have been assessed in only a few studies. Heart Fail Monit 2008;5(4):106-11.
Heart Fail Monit 2008 Feb 01
PMID:The potential benefits of treatment of sleep apnea in heart failure. 1827 93

Hypertrophy is the response of cardiac muscle to altered hemodynamic loads. The increase in ventricular wall thickness normalizes increased wall stress and, therefore, hypertrophy is initially beneficial. However, progressive hypertrophy is associated with deleterious long-term consequences that significantly increase the risk of mortality. This review outlines the events associated with hypertrophy and discusses how strategies can be aimed at preventing pathological hypertrophy. The fact that heart failure is one of the leading causes of death in the West demands a detailed understanding of the complexities underlying this response. Complete dissection of hypertrophy will aid the development of novel therapeutic approaches that could take advantage of its beneficial features while removing the deleterious consequences caused by hypertrophic growth of the heart. Heart Fail Monit 2008;5(4):112-8.
Heart Fail Monit 2008 Feb 01
PMID:State-of-the-Art Prevention of Heart Failure: Maladaptive versus Adaptive Hypertrophy. 1827 94

The rapidly evolving insights into the protective and modulatory function of neuregulin-1 (NRG-1) in the adult heart are discussed in this review. The actions of NRG-1 in the adult heart have begun to be elucidated following the unexpected clinical observation that trastuzumab can cause ventricular dysfunction and increases the risk of cardiomyopathy induced by anthracyclines. Trastuzumab is an inhibitory antibody against the NRG receptor erythroblastic leukemia viral oncogene homolog 2 (ErbB2) and is used in the treatment of breast cancer. In vitro studies have demonstrated that NRG-1 promotes growth and survival of isolated cardiomyocytes. Ventricular dysfunction following anti-ErbB2 treatment was initially explained by a loss of ErbB2-dependent cell survival pathways in the heart. However, in vivo studies in genetically modified mice did not uniformly confirm this finding. More recent studies have revealed that NRG-1 counterbalances the adrenergic inotropic response of the adult myocardium through an obligatory interaction with the muscarinic cholinergic system. In addition, it was demonstrated that cardiac NRG-1 synthesis and release from the cardiac endothelium, the principal source of NRG-1 in the heart, is dynamically controlled by neurohormonal and biomechanical stimuli, allowing adaptive tuning of ErbB signaling during cardiovascular stress. Cardiac NRG-1 is beginning to emerge as a cardioprotective factor implicated in the physiological regulation of myocardial performance and sympathovagal balances. Cardiac NRG-1/ErbB signaling has implications for the treatment of both cancer and heart failure. As novel ErbB inhibitors are currently being tested in broader oncological indications, there is a need to better understand their cardiovascular side effects. It is possible that pharmacological activation of ErbB signaling is an indirect, beneficial effect of the drugs currently used in heart failure, and this could be a promising therapeutic approach for prevention or reversal of myocardial dysfunction. Heart Fail Monit 2008;5(4):119-24.
Heart Fail Monit 2008 Feb 01
PMID:Neuregulin-1 and its potential role in the control of cardiac function. 1827 95

The syndrome of heart failure in adult non-congenital heart disease patients includes myocardial disease and ventricular dysfunction. In the presence of congenital abnormalities the cause of heart failure is often multi-factorial and can be a result of the underlying anomaly, surgical intervention, or ventricular dysfunction. Despite the possible clinical similarities, the two conditions are fundamentally different. In congenital heart disease the neurohormonal system is already abnormal even in the absence of clinical manifestations of heart failure and, in many cases, exercise intolerance is related to cyanosis. The approach to heart failure management in the two etiologies might be similar. Preventative attempts to preserve ventricular function in coronary or valve disease parallels early reparative therapy in congenital heart disease Pharmacological therapy is common for the two conditions, despite the limited number of evidence-based recommendations for congenital diseases. In drug-resistant patients, cardiac electrical resynchronization is an established therapy for treating ventricular asynchrony in non-congenital heart failure sufferers, but has only recently been adopted in selected congenital cases. Due to this, congenital heart disease patients are managed in highly specialized unites in close cooperation with cardiologists and surgeons. The ideal follow-up protocol for such patients remains to be determined, particularly in those individuals with subclinical signs of residual cardiac dysfunction. Heart Fail Monit 2008;6(1):2-8.
Heart Fail Monit 2008
PMID:Congenital heart disease and heart failure. 1860 16

Diuretics have been the cornerstone of acute heart failure (AHF) therapy for >200 years, although the treatment of chronic heart failure has changed dramatically over the past decades with the introduction of angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, beta-blockers, and aldosterone inhibitors. These treatment modalities were never tested prospectively in the acute setting. Furthermore, there is a significant lack of prospective data on the use of diuretics in both chronic (CHF) and AHF. Hence, despite lack of knowledge on their efficacy and safety, diuretics remain an essential component of the current management of AHF and CHF. In the present manuscript we will address the practical concerns regarding diuretic selection, dosage, combination regimens, and the importance of achieving clinical improvement with minimal changes to kidney function in patients with AHF. Heart Fail Monit 2008;6(1):9-19.
Heart Fail Monit 2008
PMID:Diuretics - a panacea for acute heart failure? Different formulations, doses, and combinations. 1860 17


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