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

A haemodynamic study was conducted in 96 patients with acute myocardial infarction. The method of right heart catheterization at the bedside using the Swan-Ganz floating balloon-tipped catheter is safe and feisible. An elevation of pressure in the pulmonary circulation was revealed in patients with transmural myocardial infarction and in those without clinical signs of heart failure. The pressure elevation is detected the more often the sooner after the onset of infarction the examination is conducted. To evaluate fast pressure changes heart catheterization is essential and cannot be substituted by any other technique of examination Digoxin administration during the acute phase of myocardial infarction fails to produce any significant reduction of the pulmonary circulation pressure, but a prompt reduction of the pulmonary circulation pressure can be achieved by way of Phentolamine infusion. The pulmonary circulation pressure measurements during the acute phase of myocardial infarction are believed to be an indispensable component of examinations for the heart failure therapy.
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PMID:[Hemodynamic observations in acute myocardial infarct]. 85 47

Ten infants who had paroxysmal atrial tachycardia in utero or at birth are reported. Because of apparent fetal distress, caesarean section was performed in 4 cases and labour was induced in 1. Birthweight was generally large for gestational age. Severe ascites and hydrops at birth were manifestations of cardiac failure. Atrial flutter was recorded in 4 infants and supraventricular tachycardia in 5. The WoLff-Parkinson-White syndrome became evident later in 2. Digoxin was given to all 10 infants, and cardioversion was required and was effective in 4. Known recurrences in childhood have occurred in only 1 patient. Congenital atrial tachyarrhythmias may be commoner than generally believed, and fetal electrocardiography may help to avoid unnecessary termination of pregnancy. Blood sugar determinations are important, since neonatal hypoglycaemia was found. Cardioversion should be performed promptly in severely ill infants or if there is no response to digoxin. Care is required to avoid digoxin toxicity.
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PMID:Congenital paroxysmal atrial tachycardia. 96 71

1. Tritiated (12alpha-3H) digoxin (0-05 mg/kg body weight) was administered intravenously to conscious dogs with circulatory volume overload induced by previous creation of aorto-caval fistulae. Dogs were killed after 5 min, 1, or 4 h, and the myocardium sampled. Digoxin was extracted and counted and results compared to those in normal dogs. 2. At each time, myocardial digoxin concentration of all cardiac chambers in test dogs was greater than normal. Plasma digoxin concentration measured 5 min after administration was greater in dogs with fistulae but the subsequent levels were not different. 3. Anaesthetized and open-chest dogs with fistulae studied 5 min after digoxin administration had greater myocardial concentrations than similarly studied normal dogs. Although myocardial concentrations of digoxin were higher in anaesthetized than in conscious dogs the group with fistulae had higher values than did the normal group, as was the case for unanaesthetized dogs. 4. The basis for the effect of fistula is probably multifactorial. Diminised peripheral blood flow and peripheral digoxin delivery and uptake, resulting initially in higher digoxin levels in plasma perfusing the myocardium, may play a role. Increased myocardial mechanical and metabolic activity almost certainly are important. Cardiac hypertrophy, cardiac failure per se and plasma electrolyte changes are probably not. 5. The results are consistent with previously demonstrated reduced digitalis tolerance in the dog with circulatory volume overload.
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PMID:Increase in myocardial digoxin content associated with circulatory volume overload in the dog. 97 23

It was established by means of radioimmunoassay that the blood concentration of Digoxin in patients with congestive heart failure depends not only on the dose of the drug given, but also on the stage of cardiac insufficiency. With equal daily doses, higher Digoxin concentrations were observed in patients with more severe cardiac insufficiency. The analysis of the obtained data has demonstrated that in 75% of the patients with signs of digitalis intoxication the concentration of Digoxin in blood exceeded 2.5 ng/ml. In animal experiments it was established that a distinct reduction of the toxic threshold took place in rabbits with acute myocardial infarction, acute pulmonary embolism, congestive cardiac failure, this threshold being determined by the amount of intravenously injected Strophantin that causes persistent ventricular tachycardia.
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PMID:[Digitalis poisoning, risk factors and digitalis intolerance]. 101 87

Digoxin concentrations were studied in the blood serum of 128 patients with cardiac insufficiency of different etiology (acute myocardial infarction, postinfarction cardiosclerosis, mitral valve disease). Radioimmunoassay with standard kits was employed, the kits containing 125 I-labelled Digoxin. Mean concentrations of Digoxin were determined in the blood serum corresponding to different maintenance doses of the drug. It was found that signs of overdosage usually appear with concentrations exceeding 2.5 ng/ml. Disorders in the renal excretory function in patients with severe edematous syndrome help a prompt cumulation of Digoxin and the development of glucoside intoxication. Some patients demonstrated a reduced Digoxin tolerance in the acute period of their myocardial infarction. The advantages of the radioimmunoassay, especially in severely ill patients with cardiac pathology are emphasized.
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PMID:[Radioimmune method of determining the concentration of digoxin in the blood during treatment of patients with cardiac insufficiency]. 101 88

The study was conducted in 80 patients with moderate compensatid mitral valve diseases without any signs of active rheumatic disease and preserved sinus rhythm. On the basis of a clinical examination two groups of patients were singled out: those without clinical manifestations of circulatory insufficiency, and those with Stage 1 circulatory insufficiency. In both groups of patients, at rest and following exercises, a reduced tolerance of physical exercises was observed, as well as a reduction of the minute and stroke indices. Better tolerance of exercises and improved haemodynamic parameters were noted in both groups following Digoxin therapy. The results of the study prompt the presence of a latent cardiac insufficiency in patients without clinical manifestations of the latter, and permit to recommend its therapy with cardiotonic doses of cardiac glycosides.
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PMID:[Study of the adaptation to physical exertion in patients with mitral valve defects]. 101 25

Serum digoxin estimations were done in 98 patients receiving digoxin for heart failure of varied aetiology. Digoxin toxicity or the lack of it was determined on the basin of established electrocardiographic criteria. Fifty-two patients were classified as 'toxic' and 46 as 'non-toxic'. The difference is the mean digoxin levels between the two groups was highly significant (P less than 0.001). The mean serum digoxin level in 'non-toxic' patients was slightly higher than that found by other investigators. Fairly good correlations have been noted between different dosage schedules and various rhythm disturbances. Death was attributed to digoxin toxicity in only 2 patients who showed electrocardiographic evidence of intoxication at the time of death.
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PMID:Radioimmunoassay of serum digoxin in relation to digoxin intoxication. 114 59

The radioisotope method with Rb86 was used for determining in vitro the serum concentration of Digoxin. The study was conducted in 57 patients with cardiac insufficiency in the acute period of myocardial infarction and with post infarction cardiosclerosis. The mean values of Digoxin concentration depending on the daily maintenance dose were obtained. The direct correlation between the amount of the drug taken and the content of the drug in the blood serum was proved. Digoxin intoxication was found to develop in cases of its content exceeding the mean level for the given dosage (4 patients), however, in 2 patients signs of intoxication developed with a low concentration of Digoxin. The causes favouring the development of intoxication are discussed.
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PMID:[Treatment of circulatory insufficiency in patients with ischemic heart disease with digoxin and determination of its concentration in the blood serum by radioisotope method]. 120 42

Digoxin absorption was investigated in 7 patients suffering from severe right cardiac failure. After successful treatment and disappearance of the symptoms of right cardiac failure, the study was repeated in the same patients. Tritium-labelled digoxin in a dose of 0.1 mg as a solution, and non-labelled digoxin as a 0.25 mg tablet, were given to the patients in the fasting state. Blood samples were taken at specified time intervals up to 120 h and the urine was collected during the same period. The concentrations of digoxin in plasma and urine were measured in a liquid scintillation counter. The unlabelled digoxin was estimated by radioimmunoassay. The concentrations obtained in the plasma and urine were used to compute pharmacokinetic parameters. There was no significant difference in the plasma concentration curves in severe right cardiac failure and after successful treatment, nor did the calculated pharmacokinetic parameters differ significantly. Inhibition of digoxin absorption in severe right cardiac failure therefore seems unlikely.
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PMID:[Proceedings: Studies on the digoxin resorption in patients with decompensated right cardiac insufficiency]. 121 78

Beta-adrenergic stimulants (Dobutamine and Dopamine) and recently introduced phosphodiesterase inhibitors (PDI) such as Amrinone, Milrinone, Enoximone and Piroximone are the principal inotropic agents for the treatment of acute cardiac failure. Most of the hemodynamic effects of these drugs are comparable, but peripheral vasodilatation is more marked with PDI. A potential advantage of the latter group is the lack of development tolerance, which occurs within 48 to 72 hours after beta-stimulants. On simultaneous administration, additive effects can be observed. Short term clinical results with PDI are good, especially in patients with postoperative cardiocirculatory failure, including cardiogenic shock. In contrast, long-term oral treatment with Amrinone, Milrinone and Enoximone in recent studies was disappointing. Efficacy was not superior to Digoxin, and unwanted side effects were frequent. Intermittent instead of continuous administration of positive inotropic agents should be evaluated in patients with severe congestive heart failure not responding to vasodilators and diuretics.
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PMID:[New positive inotropic drugs in acute and chronic heart failure]. 135 9


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