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

The results of renal transplantation for end-stage diabetic nephropathy in 17 patients--11 receiving cadaver (CD) grafts and 6 related living donor (RLD) grafts--are reported. The transplants were rejected in 5 cases, in 4 acutely, and these patients were returned to haemodialysis; 3 of them subsequently died. One patient died of heart failure, but the graft was still functioning. The remaining 11 patients enjoy good renal function. The outcome was superior to results on dialysis, particularly for RLD grafts, and was comparable to results of transplantation for non-diabetic renal failure. Visual acuity tended to stabilize or improve after transplantation, but peripheral vascular disease progressed. Blood glucose control was suboptimal and requires more attention. Lipoproteins did not differ from those in non-diabetic patients. Renal transplantation is feasible and probably the preferred method of treatment for end-stage diabetic nephropathy.
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PMID:Transplantation for diabetic nephropathy. 389 12

Haemodynamic effects of pharmacological doses of insulin during acute ischaemic heart failure were studied in 8 dogs. Severe depression of left ventricular function was induced by the injection of 50 micron plastic microspheres into the left main coronary artery. This was demonstrated by a significant increase in left ventricular end-diastolic pressure and a significant decrease in the maximum rate of left ventricular pressure rise (LVdP/dtmax), stroke volume and cardiac output. Eighty-five minutes after the embolization procedure, 300 IU of insulin free of glucagon and calcium was injected as a bolus. This was followed by infusion of glucose and potassium to maintain physiological levels of these factors. Five minutes after insulin administration, there was a significant improvement in left ventricular performance as shown by decreased left ventricular end-diastolic pressure (P less than 0.01) and increased LVdP/dtmax (P less than 0.01), stroke volume (P less than 0.05) and cardiac output (P less than 0.05). A significant reduction in heart rate occurred. A non-significant increase in mean aortic blood pressure and reduction in total peripheral resistance were seen. In conclusion, pharmacological doses of insulin significantly improve cardiac pump function during acute ischaemic left ventricular failure in dogs.
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PMID:Haemodynamic effects of high doses of insulin during acute left ventricular failure in dogs. 389 50

Metabolic effects of pharmacological doses of insulin were studied during acute ischaemic heart failure in 7 dogs. Severe depression of left ventricular performance was induced by embolization of the left main coronary artery with 50 micron plastic microspheres. This was followed by a significant reduction in myocardial blood flow and oxygen consumption. After a period of stabilization of the haemodynamic and metabolic variables, 300 IU of insulin free of glucagon and calcium was injected as a bolus dose. Glucose and potassium were given to maintain their plasma concentrations. Insulin significantly improved performance of the failing left ventricle. Myocardial blood flow was significantly increased, whereas myocardial oxygen consumption was unchanged. Insulin significantly reduced arterial concentrations and myocardial uptake of free fatty acids, while myocardial uptake of glucose and lactate showed a non-significant increase. In conclusion, pharmacological doses of insulin significantly improve cardiac pump function without increasing myocardial oxygen consumption during acute ischaemic left ventricular failure in dogs. This may be partly related to reduced myocardial uptake of free fatty acids relative to that of glucose.
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PMID:Metabolic effects of high doses of insulin during acute left ventricular failure in dogs. 389 51

The effect of muzolimine (initial dose 60 mg followed by 30 mg/day for 14 days) on 15 patients with aortic and mitral incompetence and chronic cardiac failure, functional class 3, was analyzed on the basis of repeated clinical observations, metabolic studies as well as mono and bidimensional echo changes 2, 24 hours and 15 days after the initial dose. An important variation was a reduction in body weight by 3-4% after the first day and by a further 1-2% after 2 weeks. No significant variations were observed regarding heart rate and blood pressure at rest. Plasma level of electrolytes as well as other important biochemical parameters in the serum (BUN, glucose and creatinine) were uninfluenced. A small increase was observed in both the plasma level of chloride and in the red cell count. Urine volume increased by two to threefold after the first day; this increase was still present after 2 weeks. Changes in the left ventricular end-diastolic and end-systolic volumes were not significant after the first day; however a slight but significant reduction was observed after 2 weeks and was in parallel with the improvement of the functional class of the patients. Data, in particular the possible mode of action of muzolimine after acute administration and after short-term therapy, are discussed.
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PMID:Effect of muzolimine in aortic insufficiency with different levels of left ventricular function. 400 87

Self-limited edema is a well-recognized complication of insulin therapy. However, progression to overt cardiac failure has only recently been reported in one patient with pre-existing heart disease. This report describes the first case of insulin-induced cardiac failure in a patient without underlying heart disease. Current trends toward intensive insulin therapy for rapid near-normalization of blood glucose levels will increase the recognition of this entity. Careful follow-up of so-called "self-limited" insulin edema is encouraged, and the early institution of diuretic therapy is advocated in elderly patients to prevent the development of overt cardiac failure.
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PMID:Insulin-induced cardiac failure. 401 1

Both risk factors and the incidence of cardiovascular disease are higher in diabetic patients. Total serum cholesterol has the same impact on coronary heart disease (CHD) incidence in diabetic patients as in nondiabetic individuals. Abnormal blood lipids in diabetic patients include elevated very low-density lipoproteins (VLDL) and triglyceride and reduced levels of high-density lipoproteins (HDL). These are associated with obesity and precede the onset of diabetes. Diabetes increases the risk of all clinical manifestations of CHD, has a greater impact in women, and predisposes to cardiac failure and fatal outcome. In men, it predisposes to silent myocardial infarctions. CHD risk reduction in the diabetic patient requires multifactorial control. In evaluating the lipid-induced CHD risk, the level of low-density lipoprotein (LDL) cholesterol is not as valuable as the LDL/HDL cholesterol ratio, which is the most reliable criterion. Triglyceride levels make no independent contribution. Most CHD preventive measures, including weight control, exercise, avoidance of cigarettes, and improvement of glucose tolerance also increase HDL cholesterol, reduced levels of which are chiefly responsible for the poor LDL/HDL ratio in diabetics. Weight control merits a high priority because of its favorable influence on the lipid profile, glucose tolerance, and blood pressure.
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PMID:Lipids, diabetes, and coronary heart disease: insights from the Framingham Study. 406 Dec 65

Myocardial function and peripheral hemodynamic alterations were measured through the late stages of canine endotoxin shock. 60 min postendotoxin paired animals were given infusions of either 5 ml/kg per hr of 5% dextrose or dextrose plus isoproterenol (0.25 mug/kg per min). Comparable blood lactic and pyruvic acid levels were determined, the excess lactic acid calculated, and pH values were obtained. During the initial stages the classic pattern of hemodynamic alterations was observed; an excess of lactic acid appeared and the pH decreased. Outstanding was evidence of markedly reduced myocardial function in the late stages of shock with progressive rise in left ventricular end diastolic pressure (LVEDP), low cardiac index, rise of central venous pressure, increased central blood volume, tachycardia, and declining arterial pressure. Analyses of left ventricular function curves also indicated myocardial failure. Infusion of dextrose alone failed to decrease mortality rate (10 of 18 dying), whereas the rate was significantly decreased with isoproterenol (2 of 18). Dextrose infusion did not benefit myocardial function. Isoproterenol resulted in a marked improvement in myocardial action with a significant increase in heart work associated with, yet very minor, increments of LVEDP. In addition, tachycardia subsided, peripheral resistance decreased, and the blood pressure stabilized. The prognostic value of excess lactic acid was doubtful but a progressive fall in later stages was associated with survival.
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PMID:Hemodynamic effects of isoproterenol in canine endotoxin shock. 567 17

Cardiac muscle hearts of Atlantic hagfish continuously function under hypoxic conditions that would lead to cardiac failure in most other vertebrates. Contractile performance of hagfish systemic hearts is resistant to anoxia and respiratory poisons but shows a significant decrement when carbohydrate catabolism is blocked by 0.5 mM iodoacetic acid. Enzyme activity profiles of hagfish ventricle reveal a robust capacity for glycolysis of carbohydrate in comparison to that for general aerobic metabolism and catabolism of alternate metabolic fuels. Isolated working hagfish ventricles preferentially oxidize radiolabeled glucose even when fatty acid fuels are present in the incubation medium. Work output of the isolated ventricular preparation is maintained only in the presence of exogenous glucose. The results indicate that energy metabolism of the hagfish myocardium is predominantly carbohydrate-based and that energy demand of the tissue can be sustained by anaerobic glycolysis during extended periods of extreme hypoxia. Cardiac metabolism of this primitive species is compared with that of hearts from higher vertebrates and an evolutionary hypothesis relating cardiac workload to preferred metabolic fuel is discussed.
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PMID:Cardiac metabolism in the Myxinidae: physiological and phylogenetic considerations. 613 23

Measurement of lactate dehydrogenase (LDH), glucose and protein was performed in ascites fluid of 44 patients in addition to bacteriological and cytological examinations. In patients with cirrhosis of the liver protein content of ascites was low, LDH normal, and the ascites/serum ratio of glucose concentration was higher than 1. These values were statistically significant different from the values in patients with tumorous or inflammatory disease of the peritoneum - protein and LDH in the ascites fluid being high and the ascites/serum ratio of glucose concentration being below 1. Cirrhosis however and tumors of the liver could not be differentiated by this method. Ascites from patients with cardiac failure had high protein content. In patients with liver cirrhosis high concentrations of protein in ascitic fluid may mean possibly a better survival time.
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PMID:[Diagnostic value of laboratory examination of ascites fluid (author's transl)]. 616 37

The chest X-rays of 15 hypoglycaemic small-for-gestational-age infants showed cardiomegaly in 10 infants, 4 had heart failure. None of the infants had respiratory distress syndrome, congenital heart disease, septicaemia, anaemia or polycythaemia; infants of diabetic mothers were excluded. Cardiomegaly disappeared with the normalization of blood glucose in most of the cases. The cause of the cardiomegaly and heart failure might be related to insufficient cardiac energy substrates in small-for-gestational-age infants. This condition should also be considered in the differential diagnosis of cardiomegaly and heart failure.
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PMID:Cardiomegaly in hypoglycaemic small-for-gestational-age infants. 621 92


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