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

To test the efficacy of exogenous prostaglandins for vasodilator therapy in heart failure, we studied the effects of the prostacyclin-derivative iloprost (1.5-150 ng/kg/min) in seven conscious dogs before and after induction of heart failure by right ventricular pacing (250/min. 10 days). In healthy dogs, iloprost (150 ng/kg/min) decreased mean arterial blood pressure (MAP) (-45%) by a decrease in total peripheral resistance (TPR) (-55%), and increased cardiac output (CO) (+24%) and heart rate (HR) (+20%) with no effect on right atrial and pulmonary arterial pressures (RAP, PAP). Plasma norepinephrine (NE) (+47%), renin (+351%), and aldosterone (+126%) were increased. Urine flow (-70%) and Na excretion (-53%) were decreased. Iloprost (15 ng/kg/min) increased renal blood flow (RBF) (+29%), but did not change glomerular filtration rate (GFR). In dogs with heart failure, iloprost decreased arterial BP (-31%), TPR (-42%) and pulmonary vascular resistance (-28%) and increased CO (+29%), with no change in RAP and PAP. Plasma NE (+34%), renin (+385%), and aldosterone (+146%) were increased. RBF was unchanged. GFR (-24%) and filtration fraction (FF) (-30%) were decreased, as was urine flow (-65%). In experimental heart failure, iloprost is a potent arteriolar dilator, increasing CO with no preload effect. These beneficial effects are limited, however, by further neurohumoral activation and deterioration of renal function.
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PMID:Hemodynamic, hormonal, and renal effects of the prostacyclin analogue iloprost in conscious dogs with and without heart failure. 170 1

Fructose-1,6-diphosphate (FDP) was given to 30 patients with chronic heart failure (CHF) caused by various kinds of heart diseases with the purpose to evaluate the effects of FDP on CHF patients. Definite hemodynamic and clinical improvement has been found in this group. CO increased by 1.61 +/- 0.31 L/Min (35%) (P less than 0.01) PCWP decreased by 5.5 +/- 1.08 mmHg (31%); mean PAP decreased by 5.8 +/- 2.07 mmHg (P less than 0.05). EF increased by 6.9 +/- 1.5 (15.1%) as shown by echocardiography and the peak effect of the drug appeared at 2 hours after administration. The results showed that FDP is effective in the treatment of heart failure, especially in patients with dysfunction of other organs.
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PMID:[Fructose-1,6-diphosphate in the treatment of chronic heart failure]. 280 65

Administration of 25 mg of captopril to 10 patients with heart failure (NYHA II, III) produces at rest after 60 min bradycardia (-7 per cent, p less than 0.01), hypotension (-8 per cent) and improvement of the preload (-30 per cent, p less than 0.01). This effect is still apparent after two months of treatment where PAP is decreased by 20 per cent (p less than 0.05). A prolonged effect of captopril is present in these 10 patients. The capacity to perform a muscular exercise on an ergometric bicycle is prolonged by 10 per cent (p less than 0.01) on the first day and by 18 per cent (p less than 0.01) after two months of treatment. This improvement seems to be related to improvement of the hemodynamic parameters, especially of preload indices. In 5 patients, lactacidemia, the arterio-venous difference and the extraction coefficient of O2 were studied at rest and during exercise. No significant difference are noted after the treatment with the inhibitors of conversion enzymes.
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PMID:[Short and intermediate-term hemodynamic study at rest and during exercise of cardiac insufficiency treated by captopril]. 310 35

Left ventricular (LV) function in 45 patients with native aortic valve infective endocarditis was studied in order to identify high surgical risk patients and the pattern of irreversible myocardial damage. LV function was studied by M-mode and 2D-echocardiography (LV volumes; ejection fraction, EF; peak systolic pressure to end-systolic volume ratio (PAP/ESV) as an index of myocardial contractility; LV mean systolic wall stress as an index of LV afterload and the radius to thickness ratio (R/Th). Thirteen patients underwent aortic valve replacement with an overall operative mortality of 15%. The cause of death was intractable heart failure. Different EF vs stress relationships could be described for different level of myocardial contractility: patients with intractable heart failure had a severely depressed myocardial contractility so that for a given level of LV stress, EF was significantly lower. High operative risk patients were identified by the PAP/ESV vs R/Th relation. All surgical deaths occurred in patients with a severely depressed myocardial contractility (PAP/ESV less than 2) and inadequate hypertrophy (R/Th greater than 4). Reversal of LV dysfunction in patients with moderately depressed myocardial contractility depended on the pattern of LV hypertrophy; a normal post-operative EF was achieved only in patients with adequate hypertrophy (R/Th less than 4).
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PMID:[Quantitative echocardiographic study of the left ventricular function in acute aortic infective endocarditis]. 321 22

To determine the factors conditioning the variability of positive inotropic response after intravenous acute amrinone administration, 14 patients with chronic cardiac failure were studied by quantitative M-mode and cross-sectional echocardiography. Six patients had idiopathic dilated cardiomyopathy and 8 patients had severe chronic aortic insufficiency. Myocardial contractility (evaluated as peak arterial systolic pressure/end-systolic volume ratio: PAP/ESV) did not change in patients with idiopathic cardiomyopathy, a significant increase of myocardial contractility occurred in patients with aortic regurgitation only if the control value of PAP/ESV was greater than 1. Mean systolic wall stress decreased significantly in all patients, independent of aetiology of cardiac failure and was the factor determining the improvement of left ventricular performance (evaluated as fractional shortening) in patients without changes in myocardial contractility. Maximum improvement in left ventricular performance occurred 10 minutes after amrinone administration. It is concluded that the possibility of detecting the positive inotropic properties of amrinone in man depends on the aetiology of the cardiac failure and on the basal level of myocardial contractility.
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PMID:Variability of positive inotropic response to acute amrinone administration in chronic cardiac failure. 375 94

Although it is well known that the pulmonary circulation is altered in patients with pulmonary arterial or venous hypertension, the resultant hemodynamic behavior has not been systematically studied. We undertook to do so in a group of patients with pulmonary hypertension of diverse etiology. We measured pulmonary arterial (PAP) and occlusive wedge pressures and cardiac output at rest (i.e., standing) and during progressive upright treadmill exercise in 51 patients. Forty-two had chronic, stable, cardiac failure secondary to ischemic, myopathic or valvular heart disease and were grouped according to whether their mean PAP was less than (normotensive) or greater than (hypertensive) 19 mm Hg, and nine had pulmonary vascular disease of diverse etiology and were considered separately. In the majority of patients, we found that irrespective of whether the hypertension was arterial or venous in origin or etiology: the mean PAP-flow relationship was linear; pulmonary capillary wedge pressure was greater than or equal to the average closure pressure of the pulmonary vascular bed and could therefore be used as the downstream pressure in calculating pulmonary vascular resistance; and pulmonary vascular resistance declined with exercise. Notable exceptions to the third observation were patients with valvular heart disease or a resting pulmonary vascular resistance greater than 800 dyne-sec-cm-5.
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PMID:The pressure-flow response of the pulmonary circulation in patients with heart failure and pulmonary vascular disease. 406 71

The influences of pregnancy on the pulmonary circulation in mitral stenosis (MS), were studied. 1) Twenty-two cardiac patients underwent serial right heart catheterization with the use of flow-directed catheter without X-ray fluoroscopy during the course of pregnancy. 2)In 23 cases of MS, in whom cardiac catheterization had been performed before pregnancy, clinical courses during the pregnancy were studied. In the 26-32 weeks' gestation: in MS (Group I), an elevation of peak systolic pulmonary arterial pressure (s-PAP) (mean + 14.9 mmHg, P less than 0.001) was seen; in contrast, in atrial septal defect (Group II), s-PAP remained constant. Right atrial pressure rose in the 26-32 weeks, gestation in both the groups. Infusion of 200 ml of dextran in 12-16 weeks, gestation induced an elevation of s-PAP in Group I, especially in those who fell into heart failure in the succeeding courses of pregnancy; but not in Group II. In MS, in 12 cases, whose s-PAP before the pregnancy was below 35 mmHg, no heart failure occurred during the pregnancy; in 6 of 8 cases with s-PAP between 35 and 50 mmHg, mild heart failure occurred; and in 2 cases with s-PAP over 50 mmHg, severe heart failure occurred during the pregnancy. In conclusion, in MS, PAP rises during pregnancy, and S-PAP before pregnancy and the reaction to dextran infusion can give suggestions for allowing pregnancy.
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PMID:Intracardiac pressures in pregnant patients with mitral stenosis. 617 76

Thirteen patients with chronic congestive cardiac failure and refractory oedema were treated by haemodialysis. All patients had severe cardiac failure (Class IV NYHA) due to primary myocardial disease (5 cases), ischaemic heart disease (4 cases) or valvular heart disease (4 cases). Haemodialysis was performed via a Shaldon Y-shaped catheter in the internal jugular vein, with input and output through the same catheter using an alternating clamp. Filtration was carried out through a highly permeable membrane by a simple hydrostatic pressure gradient without a dialysis bath. The sessions were monitored haemodynamically by measuring the pulmonary artery pressures. The mean weight loss was 4.9 +/- 0.4 kg obtained after 3 three hour dialysis sessions with 24 hour intervals between each session (mean filtration flow = 12 ml/min). Hypotension was observed in one patient with low initial pulmonary artery pressures; two patients with severe valvular stenosis (1 mitral stenosis; 1 aortic stenosis) failed to lose weight. In the 10 remaining cases, there was a clearcut symptomatic improvement (5 patients Class III; 5 patients Class II NYHA) with total regression of oedema. There was a significant fall in pulmonary artery (mean PAP 40.5 +/- 6.5 mmHg to 34.6 +/- 6.5 mmHg; p less than 0.001) and pulmonary capillary pressure (27.6 +/- 6.9 mmHg to 22.5 +/- 5.8 mmHg; p less than 0.05) in these 10 cases. Cardiac output did not change significantly (cardiac index 2.2 +/- 0.5 l/m2/min compared to 2.3 +/- 0.4 l/m2/min after dialysis).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of cardiac failure with refractory edema using extracorporeal ultrafiltration]. 643 80

Balloon-induced distention of the main pulmonary artery causes acute pulmonary hypertension and reflex pulmonary vasoconstriction in animals. Pulmonary artery pressure responses caused by MPA balloon inflation were measured in ten human newborn infants with cardiac failure (n = 5) or persistent fetal circulation (n = 5). During balloon inflation distal mean PAP increased significantly while cardiac rate remained unchanged. MPA distention caused greater increases of PAP in those infants with lower resting PAP. The greatest balloon-induced increases of PAP were observed in infants recovering from PFC. The existence of a pulmonary artery reflex and its possible role in the regulation of the human fetal and neonatal pulmonary circulation is discussed.
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PMID:Main pulmonary artery distention: a potential mechanism for acute pulmonary hypertension in the human newborn infant. 735 56

Perioperative hemodynamic changes following mitral valve replacement using the porcine heterograft prosthesis were measured in 21 patients with acquired mitral valve disease. Preoperatively, a state of compensatory cardiac failure was suggested by the following: an increased heart rate (HR) (96 beats per minute); low cardiac and stroke volume (SVI) indices (2.3 +/- 0.10 L/min/m2 and 25 +/- 2 ml/beat/m2); and increased systemic vascular resistance (SVR) (1,626 +/- 116 DYNE SEC CM-5). Bothe the mean pulmonary artery PAP) and pulmonary capillary wedge pressures (PCWP) were elevated as well (32 +/- 3 and 22 +/- 2 torr). Immediate hemodynamic improvement followed valve replacement. HR, SVR, PAP, and PCWP all decreased significantly. Twenty-four hours after valve replacement, PAP (23 +/- 1 torr) and PCWP (13 +/- 1 torr) demonstrated marked declines, SVR was reduced by one-third (1,173 +/- 87 dyne sec cm-5), HR had decreased by 10 beats per minute, and SVI had increased to 30 +/- 2 ml/beat/m2. The prompt circulatory improvement of patients soon after mitral valve replacement using the porcine heterograft compares favorably with studies in which other valve types were employed and in which postoperative cardiovascular depression was encountered frequently.
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PMID:Acute hemodynamic alterations after mitral valve replacement with the glutaraldehyde-treated porcine heterograft prosthesis. 737 85


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