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)

In order to limit the spread of myocardial infarction, 56 patients with acute myocardial infarction, admitted to hospital within 10 hours after the attack, for two days received continuous intravenous drip infusion of glucose-insulin-potassium mixture (GIP) containing: 300 ml glucose, 50 U common insulin, 60 meqv potassium chloride per 1 1 of the solution, at the rate of 1 ml/kg/hour. A control group of 48 patients were given saline solution at the rate of 20 drops/minute for the same duration of time. In the GIP-treated group, the frequency of cardiac rhythm disorders and clinical signs of heart failure was significantly lower. In spite of a certain improvement in the clinical pattern of the disease, hospital mortality rates did not differ statistically between the treated and control patients. GIP treatment did not reduce the spread of myocardial infarction, as evidenced by electrocardiographic charting and routine assays of serum CPK activity.
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PMID:[Effect of a glucose-insulin-potassium mixture on the size and clinical course of myocardial infarct]. 633 81

Many metabolic and hormonal changes are observed during the acute phase of myocardial infarction (glucose metabolism, lipoproteins...). Mineralocorticoid function may also be disturbed but there have been few studies of this problem. The aim of this study was to confirm the elevation of serum aldosterone during the acute phase of myocardial infarction and to determine the effects of antialdosterone treatment in these patients. Hyperaldosteronism was confirmed in 74% of 72 consecutive patients admitted for acute myocardial infarction, in 85% if patients previously treated by an antialdosterone drug or admitted after the acute phase are excluded, and in 96% if patients with cardiac failure are included. One thousand consecutive patients admitted for myocardial infarction were given an antialdosterone agent systematically (intravenous potassium canrenoate , 600 mg daily for 5 days). The serum and red blood cell potassium concentrations rose, the number of ventricular extrasystoles and the administration of anti-arrhythmic drugs fell, and, above all, the prevalence of ventricular fibrillation decreased significantly: 0,8% (p less than 0,001), compared with comparable previously reported series.
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PMID:[Hyperaldosteronism in the acute phase of myocardial infarction. Effects of its treatment on the prevention of ventricular fibrillation]. 642 61

The following studies were carried out to examine energy metabolites and cardiac performance of the failing heart (hereditary cardiomyopathy) of the Syrian hamster (strain UM-X7.1) perfused either by normal or stress conditions, and to determine whether cyclical changes in energy-related metabolites occurred in the glucose-perfused hearts of both normal and heart failure animals. Hamster hearts from 250-day-old animals with moderate heart failure were removed and perfused either as nonworking hearts (Langendorff method, an afterload pressure of 90 mm Hg and 2.5 mM calcium in the perfusate) or as working hearts with stress conditions [an afterload of 110 mm Hg, high calcium concentrations in the perfusate (3.5 mM), and 10(-8) M isoproterenol]. Mechanical parameters (developed pressure and max dP/dt) and measurements of oxygen consumption indicated that both contractility and oxygen consumption had fallen 50% in myopathic hearts, compared with those of normal hamsters perfused with either of the two conditions. By means of a specially designed stimulator-triggered freeze clamp, hearts were terminated at systole and diastole, and tissue content of ATP, ADP, AMP, adenosine, phosphocreatine, creatine, pyruvate, lactate, and inorganic phosphate were analyzed. A 50% reduction in cardiac performance of the cardiomyopathic hamster hearts was associated with a corresponding reduction in systolic ATP, adenosine, and phosphocreatine values, while inorganic phosphate and lactate increased. With glucose as the sole substrate, the high energy phosphates, ATP and phosphocreatine, reached maximum values during diastole and minimum values during systole.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Energy levels at systole vs. diastole in normal hamster hearts vs. myopathic hamster hearts. 664 Aug 62

Diabetes mellitus (DM) was induced in 10 lambs by giving alloxan (150 mg/kg). Two to 4 days later, mean values for glucose were 748 mg/dl, and for arterial pH 7.25 (acute group). Two additional lambs were studied after 3 mo of DM (chronic group). Data were compared with 7 controls (glucose 128 mg/dl, pH 7.36). Left ventricular (LV) performance was assessed from function curves and measurements of LV dP/dtmax. Stroke volume ejected at LV end-diastolic pressure of 5 cmH2O (SV5) was calculated from regression analysis of each curve. SV5 averaged 2.83 +/- 0.34 ml in controls and 2.90 +/- 0.23 ml in the acute diabetics (not significant). Mean values for LV dP/dtmax also did not differ. A significant correlation was found between SV5 and LV weight (P less than 0.001). SV5 was normalized as ml/100 g LV, and average values for the three groups were identical. Insulin (10 U/kg) caused a progressive fall in SV5 in diabetics with severe acidosis (pH 7.00), but not in those with less acidosis (pH 7.28). In nondiabetics given lactic acid (pH 7.01), SV5 fell to 60% of initial values 1 h after insulin. Acidemic animals not given insulin showed no reduction in LV performance in the same time interval. Adrenergic support is necessary to prevent cardiac failure associated with acidosis. The present findings are ascribed to inhibition by insulin of catecholamine inotropic action on myocardium.
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PMID:Effects of insulin on ventricular function in diabetic lambs with acidosis. 679 34

Nineteen ambulant patients in cardiac insufficiency stages III to IV, eleven of them concomitantly presenting hypertension, were treated with Osyrol 50-Lasix for a period of three months. With a maintenance dose consisting on average of one capsule Osyrol 50-Lasix daily, effective and reliable elimination of edema and adequate recompensation of the heart was achieved by way of reduction of the body weight, decrease in ankle circumference, congestion of the liver and improvement of dyspnoea. In the eleven patients with hypertension grade I, the systolic and diastolic blood pressure was normalized under Osyrol 50-Lasix medication, whilst the blood pressure values of normotensive patients were practically unchanged. The serum potassium values at the beginning of the study were 4.29 mmol/l on average and increased moderately to 4.83 mmol/l after three months' therapy. Compared to pre-trial controls the serum values of creatinine and uric acid showed no changes attributable to the drug after three months' therapy with Osryol 50-Lasix. No significant change of the fasting blood glucose values was ascertained either in the nondiabetic or in the diabetic patients. Based on the clinical and laboratory-chemical parameters the success of therapy was considered to be good in 18 patients and satisfactory in one case. Tolerability was also considered to be good in 18 cases. Transient side effects were observed in two patients. Hypotension was diagnosed in one case after four weeks' treatment and in a further patient an increased serum potassium level was found. After reducing the dose the values reverted to normal in both cases.
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PMID:[Long term experiences with a solid spironolactone-furosemide combination in heart insufficiency and hypertension]. 680 28

Between November 1975 and June 1977, 49 children underwent repair of complicated cardiac defects with the aid of deep hypothermia. Circulatory arrest was used in 28 cases. Nine children died (18%) due to early postoperative heart failure. A decisive cause of death in terms of important cardiovascular defects, which were either unknown or not correctable at the time of repair, was found in 6 patients. Children with complicated forms of congenital heart disease requiring an extensive repair were overrepresented among those who died. Hence, there was an excess in the duration of bypass among nonsurvivors (p less than 0.01) whereas the patient's age at operation, the use of circulatory arrest and the duration of aortic occlusion had no bearing on operative mortality. Cerebral blood flow (CBF) and cerebral metabolism were studied in 9 survivors. A negative correlation (r = -0.67) was found between the duration of circulatory arrest and CBF measured directly after surgery. CBF was reduced to values below 0.2 ml . g-1 . min-1 in 3 children with long periods of circulatory arrest. The cerebral uptake of oxygen and glucose was normal both before and after surgery. Two separate interviews with the parents were performed, the first one 3-22 months and the second one about 3 years after surgery. No serious neurological symptoms or psychomotor disturbances were reported. However, in 3 children operated with circulatory arrest, difficulties in performing more delicate motor activities were noted by the parents. The findings indicate that circulatory arrest should be used with caution and total arrest periods exceeding 60 min avoided.
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PMID:Cerebral blood flow and cerebral metabolism in children following cardiac surgery with deep hypothermia and circulatory arrest. Clinical course and follow-up of psychomotor development. 682 May 74

The hemodynamic, hormonal and electrolyte effects of prenalterol, a synthetic selective beta 1 agonist, were studied in six patients with New York Heart Association functional class II and III heart failure. Prenalterol was infused incrementally at 60, 120 and 240 nmol/min, each rate for 24 hours, producing steady-state plasma prenalterol levels of 52 +/- 3, 121 +/- 6 and 194 +/- 9 nmol/1, respectively (mean +/- SEM). Hemodynamic and hormonal measurements were performed before, during and after prenalterol administration under conditions of constant body posture and a regulated intake of dietary sodium and potassium. Prenalterol induced a statistically significant increase in cardiac index (from 2.6 +/- 0.2 to 3.1 +/- 0.3 1/min/m2), with parallel increases in stroke index (from 28 +/- 2 to 34 +/- 2 ml/beat/m2). Forearm blood flow measurements increased (from 2.9 +/- 0.5 to 4.1 +/- 0.6 ml/min/100 g), while calculated systemic vascular resistance fell, as did pulmonary capillary wedge pressure (from 13.7 +/- 1.6 to 10.5 +/- 1.7 mm Hg). The drug did not alter heart rate, arterial pressure, right heart pressures or the frequency of ventricular premature beats. Prenalterol increased plasma renin activity (from 2.9 +/- 0.8 to 6.6 +/- 1.8 nmol/1/hour), angiotensin II (from 59 +/- 12 to 89 +/- 22 pmol/1), urinary aldosterone excretion (from 41 +/- 10 to 78 +/- 34 nmol/day) and plasma insulin (from 10.6 +/- 2.2 to 19.8 +/- 3.9 mU/1). Circulating catecholamines, cortisol, glucose, glucagon or pancreatic polypeptide did not change. Dose-response studies in five patients showed dose-dependent increments in hemodynamic variables, while hormonal changes plateaued at the second dose level. We conclude that prenalterol infusion augments myocardial contractility, reduces systemic vascular resistance, and stimulates insulin release and the renin-angiotensin-aldosterone system.
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PMID:Hemodynamic, hormonal and electrolyte responses to prenalterol infusion in heart failure. 682 3

The microorganisms associated with the undiseased human colon wall were examined in material obtained from four sudden-death victims. In traffic accident subjects (aged 45 and 16 years) the anaerobe-aerobe ratio was about 10(4):1 in all areas of the colon examined, whereas in acute heart failure subjects (aged 74 and 46 years) the ratio was as low as 1.2:1. The flora of each individual was distinct and complex. Although the predominant anaerobes isolated were Bacteroides and Fusobacterium spp., which composed over 50% of the flora in some samples, the species isolated (indicated by morphology and glucose fermentation products) varied between individuals. Other major types observed were gram-positive nonsporing rods, including Bifidobacterium spp., and anaerobic cocci (between 8 and 20% of isolates). Clostridia were only isolated in significant numbers from one individual. Scanning electron microscopy showed that most of the organisms were present below the top surface of the mucin layer overlying the mucosa. The use of several different preparative procedures for microscopy showed a complex microbial structure within the mucus, but major variations in the bacterial populations in different areas of the colon were not found. Spiral-shaped organisms up to 60 mum long in the form of double helices were found in two subjects by scanning electron microscopy but were not isolated during the parallel bacteriological investigation. The differences between this and previous studies are discussed in relation to experimental procedures and also in contrast to results with animals that showed a particularly specialized flora associated with the colon wall.
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PMID:Bacterial populations associated with different regions of the human colon wall. 684 78

We gave sodium nitroprusside by intravenous infusion to 163 randomly selected patients during the first 24 hours after hospitalization for typical acute myocardial infarction, and we studied its effects on mortality at one week, on the incidence of cardiogenic shock, on clinical signs of left ventricular failure, and on peak levels of creatine kinase isoenzyme MB. A control group of 165 patients received standard medical treatment and infusion of 5 per cent glucose. The end point of the study was a significant reduction in mortality in the nitroprusside group; this was reached when five deaths had occurred in this group, as compared with 18 among the controls (P less than 0.05). The incidence of cardiogenic shock, clinical signs of left-heart failure, and mean peak levels of creatine kinase isoenzyme MB were all reduced (P less than 0.05). The results indicate that infusion of nitroprusside in the early phase of acute infarction limits complications, possibly by reducing infarct size. The drug was particularly effective in anterior-wall infarction.
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PMID:Effect of sodium nitroprusside on mortality in acute myocardial infarction. 704 Sep 55

Clinical pattern and complications of the disease were studied in 62 heparin-treated patients with large-focal myocardial infarction as compared to a control group of 59 patients treated with a polarizing mixture of glucose, insulin, potassium, analgetics and tranquilizers. The changes of the necrotic area and lesion were assessed on the basis of precardiac charting. The results obtained were correlated to the data on central hemodynamics, heart contractility and pumping function, gaseous exchange and acid-base balance. Heparin-treated patients showed a smaller rate of fatal outcomes, although primary ventricular fibrillation and heart failure prevailed in the mortality pattern in both groups. Heparin treatment improved central hemodynamics, contractility and pumping function of the heart, and gaseous exchange, while prestress decreased simultaneously, which is the optimum effect for patients with acute myocardial infarction. Precardiac charting data showed heparin treatment to be associated with a more rapid reduction in the depth of the ischemic lesion. The advantages of continuous intravenous heparin infusion are demonstrated.
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PMID:[Effectiveness of heparin in patients with acute myocardial infarction]. 716 20


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