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

Left ventricular systolic time intervals (LVSTI) were measured several times daily during 10 days in 47 patients with acute myocardial infarction without major complications. Left ventricular ejection time (LVET) and the interval between the beginning of depolarization and the aortic component of the second heart sound (Q-A2) decreased progressively during the first 72 hr. Shortening of Q--A2 and LVET was most marked in patients with heart failure and persisted till the end of the observation period. Q-upstroke (Q-U) prolonged progressively during the first 3 days, mainly in patients with heart failure. After 10 days, Q-U tended to return to normal except in decompensated patients. Definite diurnal variation in LVSTI were observed; LVET and Q--A2 were longest in the morning hours. Multiple regression analysis of LVSTI with a series of clinical variables revealed that R-R interval, age, sex, digitalis administration, day after infarction, hour of the day, peak of SGOT, and survival are significantly and independently correlated with the changes in LVSTI.
Eur J Cardiol 1975 Apr
PMID:Left ventricular systolic time intervals during acute myocardial infarction. 109 48

Complications after heart valve replacement remain a substantial source of morbidity and mortality despite continuing advances in surgical care and prosthetic design. Infectious endocarditis occurs in about 4 percent of patients and may appear early (within 60 days) or late after operation. Endocarditis of early onset is commonly due to staphylococcal, fungal or gram-negative organisms and is fatal in 70 percent or more of cases. Infection of late onset is more often of streptococcal origin and the mortality rate is lower, about 35 percent. With either type, prompt recognition, vigorous and appropriate antimicrobial therapy and early consideration of surgical intervention are crucial. The postperfusion and postpericardiotomy syndromes are relatively common and relatively benign syndromes associated with postoperative fever. Their recognition is important to prevent confusion with endocarditis or sepsis and thus to reassure the patient and physician. Treatment is primarily symptomatic. Intravascular hemolysis occurs with most prosthetic heart valves but is more common with certain prostheses and with paraprosthetic valve regurgitation, with significant hemolytic anemia in 5 to 15 percent. Oral iron replacement therapy is effective in the majority of patients, but occasionally blood transfusion or reoperation for leak around the prosthesis is necessary. Prosthesis dysfunction due to thrombus may be recognized clinically by recurrence of heart failure, syncope, cardiomegaly and altered prosthetic valve sounds or new murmurs. Hemodynamic studies verify the diagnosis, and prompt reoperation is indicated for this potentially lethal problem. Systemic embolization has decreased markedly with the introduction of cloth-covered prostheses and is frequently related to erratic or ineffective anticoagulant therapy. We continue to recommend anticoagulant therapy for all patients with prosthetic heart valves unless there is a major contraindication.
Am J Cardiol 1975 Jun
PMID:Diagnosis and management of complications of prosthetic heart valves. 109 75

A 25 year old asymptomatic man with a past history of pulmonary tuberculosis presented with a continuous murmur. Selective arteriography revealed a left internal mammary arteriovenous malformation in communication with vessels in the left upper pulmonary lobe. No significant hemodynamic abnormalities were detected. This is the 26th reported case of internal mammary arteriovenous fistula and the 6th with a pulmonary communication. Review of the data in previous cases suggests that surgical indications are limited to symptomatic relief, heart failure during infancy or the possible risk of endarteritis, proximal arterial degeneration or rupture.
Am J Cardiol 1975 Jan
PMID:Internal mammary arteriovenous malformation with communication to the pulmonary vessels. 110 39

Seventeen year old identical twin brothers with no family history of cardiopathy began experiencing palpitations almost simultaneously. In both, examination revealed marked cardiomegaly and hypokinesia of the ventricular walls, and clinical and radiologic signs of progressive cardiac failure developed a few days later. Both boys died suddenly, 49 days and 5 months, respectively, after the initial examination. Electrocardiographic and vectorcardiographic studies revealed a severe intraventricular conduction disturbance that coincided with histologic changes in the myocardial tissue, including profuse interstitial fibrosis, hypertrophy and degeneration of the myocardial fibers, aberrant arrangement of the muscular fibers and considerable alteration of the structure of cardiac tissue. In the absence of hereditary and chromosomal factors, and excluding possible viral intervention during fetal life, it is believed that a teratogenic factor can produce the structural alterations of the tissue and derangement of the fibers observed in these hearts. The irregular contractions of the heart at the level of the net-like meshwork, disarrangement of myocardial fibers, and adaptative mechanisms of the heart inherent in the destruction of the contractile tissue contributed to the functional cardiac disorders that resulted in congestive heart failure and sudden death in these twins.
Am J Cardiol 1975 Jan
PMID:Primary cardiomyopathy in identical twins. 110 51

The rate of survival, the evolution of functional cardiac status and the incidence of major complications during a 5 year period were studied in 410 patients with rheumatic mitral or aortic valve disease, of whom 200 were treated medically and 210 by surgery. The 5 year survival rates in patients with various types of rheumatic mitral valve disease were similar (45 percent for those with mitral stenosis and 46 percent for those with mitral insufficiency or mixed mitral insufficiency and stenosis). The survival rate in patients with aortic valve disease was somewhat more favorable (64 percent). Mitral valvulotomy had the most positive influence on mortality. The 85 percent 5 year survival rate of patients who underwent this procedure was significantly higher than that of patients with medically treated mitral stenosis. In patients submitted to mitral and aortic valve replacement, the survival rate was also improved in comparison with data in the corresponding medically treated group, but to a lesser degree (70 percent for aortic valve replacement and 60 percent for mitral valve replacement). In all surgically treated groups, initial operative mortality was the primary determinant of the rate of survival at the end of 5 years. Survivors of all surgical groups had appreciable improvement in cardiac functional classification and a remarkable reduction in the incidence of heart failure and atrial fibrillation. The incidence of infectious endocarditis was significantly reduced after mitral valvulotomy, as compared with the incidence in patients with medically treated mitral stenosis. Mitral and aortic valve replacement did not reduce the incidence of infectious endocarditis. The incidence of thromboembolic phenomena was favorably influenced by mitral valvulotomy and aortic valve replacement, but not by mitral valve replacement.
Am J Cardiol 1975 Feb
PMID:Influence of surgery on the natural history of rheumatic mitral and aortic valve disease. 111 83

As a prelude to a study of severe ischemic heart failure, the therapeutic response of the ischemic ventricle to epinephrine and acetylstrophanthidin in nontoxic doses was determined in 24 intact anesthetized dogs undergoing a first episode of acute regional ischemia. A thrombotic obstruction was produced in the left ventricular dysfunction. The elevation of end-diastolic pressure and reduced stroke volume in control dogs were not significantly altered by administration of strophanthidin. Epinephrine (0.05 mug/kg per min) elicited a significant reduction in end-diastolic pressure and increase in stroke volume. The latter was not attended by an increased incidence of ventricular fibrillation, whereas fibrillation occurred in half of the group given strophantihidin. Thus, the catecholamine was selected to study pump failure. Severe ischemic heart failure was assessed in two groups with scar from previous infarction for up to 4 hours. By 60 minutes of ischemia the increase in end-diastolic pressure and volume and decrease in stroke volume and ejection fraction were comparable in both groups. Thereafter, alternate animals received small doses of epinephrine (0.05 to 0.15 mug/kg per min) with graded increments at 60 minute intervals to counter tachyphylaxis and findings were compared with those in control dogs. Over the subsequent 3 hours, there was progressive deterioration of left anterior descending coronary artery, affecting ventricular function in the untreated group with an increase in end-diastolic pressure from 10 plus or minus 1 to 33 plus or minus 2.4 mm Hg. End-diastolic volume increased by 63 percent; stroke volume and ejection fraction decreased by 48 and 66 percent, respectively. The infusion of epinephrine was attended by a significantly lower end-diastolic pressure of 20 plus or minus 2.5 mm Hg, whereas end-diastolic volume, stroke volume and ejection fraction were restored to control levels after 4 hours of ischemia. Mortality in the untreated group was 62 percent by 4 hours; all seven animals in the treated group survived.
Am J Cardiol 1975 Apr
PMID:Ischemic heart failure: sustained inotropic response to small doses of I-epinephrine without toxicity. 111 1

A survey is made of present-day methods proving myocardial failure, and a new indirect method is set forth based on apex-cardiography. After consideration of the physiological variations of the 'a' wave and OF interval, they are checked in an after-exercise state. It is established that the slow normalization of 'a' wave, which follows the restoration of the pulse rate initial values, is an indication of incipient myocardial failure. This regularity is observed for all diseases involving some failure of the myocardial functions.
Bibl Cardiol 1975
PMID:Apex-cardiographic approaches applicable to incipient myocardial failure in preclinical periods. 113 Nov 66

After Mustard operation for transposition of the great arteries, hemodynamic and angiocardiographic changes were evaluated in 25 patients. In 19 patients, postoperative studies were done electively and, in 6 patients, they were required to investigate symptoms of heart failure, these symptoms were temporary in 4 patients and progressive in 2. Both of the latter had pulmonary venous obstruction which was later relieved successfully by reoperation. After operation, systemic arterial oxygen saturation and blood pressure increased and polycythemia disappeared in every patient. However, several complications-some of them unsuspected clinically-were identified by cardiac catheterization: (a) patch detachment in 5 patients; (b) obstruction of superior vena caval return in 10 patients; (c) obstruction of inferior vena return in 1 patient; and (d) pulmonary venous obstruction in 2 patients. The incidence of pulmonary or systemic venous obstruction was higher in patients who had a Dacron intraatrial baffle (8 of 19 patients). Comparison of 21 sets of preoperative and postoperative right ventricular angiograms demonstrated an increase in right ventricular trabeculations in each patient, poorer right ventricular contractility in 12 patients, and development of tricuspid insufficiency in nine patients. None of the patients with poor right ventricular contractility had had surgical ventriculotomy. Although Mustard operation for transposition of the great arteries is effective in relieving cyanosis, it may be followed by obstruction to systemic or pulmonary venous return, intraatrial patch detachment, tricuspid insufficiency and angiocardiographic evidences of poor right ventricular contractility.
Eur J Cardiol 1975 Jun
PMID:Hemodynamic and angiographic changes after Mustard operation for transposition of the great arteries. 113 8

1. The authors present 86 children and adolescents with rheumatic heart disease of the Pediatric Cardiology Service of the Instituto Nacional de Cardiologia who received valve replacements in the period between September, 1964 and April, 1973, a series which is more numerous and of longer follow-up than any published up to the present 2. In order to obtain comparable results, patients with mitral heart disease of other origen and aortic replacement as well as those subjected to double or triple exchange, were omitted from the study. 3. The symptomatology, the presence of compensated heart failure, the progression of cardiomegaly, the radiologic and electrocardiographic changes, the presence of atrial fibrillation, the mean venocapilary, pulmonary arter, and left right ventricle telediastolic pressures, the pulmonary resistence figures and the results of cineangiocardiography were the fundamental elements used to establish the surgical indication. 4. None were operated with clinic or laboratory data suggesting rheumatic activability. The shortest period between the last bout of rheumatic fever and surgery was 10 months. 5. The clinic improvement was remarkable. Half of the cases receiving digitalis and diuretics were released without this prescription and only 10% continue to take digitalis. With the exception of five patients, the physical capacity is normal and most play sports. The postoperatory radiologic and electrocardiographic changes were remarkable, most were obtained a few months after surgery. With the exception of one case, atrial fibrillation disappeared (in 58% before six months in a group of 31 patients). 6. The later complications attributed to the valve replacement as well as the 15 deaths in the total lot were analyzed. It was pointed out that the hospital death rate was 12.6% and the later was 5.3%, extraordinarily low figures if it is taken into account that the material corresponds to nine years of work and the problems inherent to the initial period are included. It gains still greater importance if compared to the series published up to the date. The global mortality rate of 17.9% is small in relation to the only comparable publication, -30 and if only the results of the last three years are compiled (61 cases equals 70 of the series), the global death rate was 9.8%. 7. It was noted that the results are due to the system adopted for establishing the surgical indication, to the good state of the myocardial fiber...
Arch Inst Cardiol Mex
PMID:[Mitral valve replacement in children and in adolescents. Surgical indication and long-term results in 86 cases]. 113 59

Eleven elderly patients with idiopathic pericarditis are reported. All but one were older than 60 yr. Evidence of ischemic cardiovascular disease was present in 8 patients. The initial diagnosis was heart failure with pulmonary complications in 4 cases and myocardial infarction in 3. Respiratory infection preceded the onset of pericarditis in 5 cases. Presenting symptoms were typical precordial pain, fever and dyspnea. Pericardial friction was found in 7 cases and transient rhythm disturbances in 5. Four patients had ST elevation and 3 had ST depression in their electrocardiograms. Other findings included an increased sedimentation rate, leukocytosis, elevated venous pressure and normal SGOT levels. Antibiotics were of no avail but prednisone had a dramatic effect. Two patients had a relapsing course lasting 2 yr or more. One patient, who died at the age of 75 from bleeding ulcer, had patent coronary arteries and mild perimyocardial fibrosis. The diagnosis of idiopathic pericarditis in the aged is difficult because the disease simulates ischemic heart disease in patients who frequently have evidence of arteriosclerotic cardiovascular involvment.
Eur J Cardiol 1975 Jan
PMID:Acute idiopathic pericarditis in the aged. 114 70


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