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

We have studied retrospectively 18 infants who have received captopril for treatment of severe heart failure due to left-to-right shunts with pulmonary hypertension. Captopril has been administered in doses of up to 3.5 mg/kg/day (mean 2.47 mg/kg/day). Maintenance treatment with digoxin and frusemide was continued but potassium-sparing diuretics were stopped in most patients. The mean period of assessment was 19 days before and 27 days after commencing captopril. The mean daily weight gain before captopril was -7 g and after its introduction was + 13 g (P less than 0.001). There were statistically significant (P less than 0.05) falls in mean heart rate and respiratory rate and rises in plasma sodium concentration and feeding score. Plasma urea concentration fell but this did not reach statistical significance. Two patients suffered hypotension after increments in captopril dosage and subsequently had a rise in plasma urea and creatinine values. This adverse reaction may be linked to the presence of hyponatraemia. This preliminary report shows captopril may be useful in the control of severe heart failure in infancy.
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PMID:Captopril in treatment of infant heart failure: a preliminary report. 330 15

During 1981 - 1986 3 women with similar complaints were seen. Their symptoms were tetany and congestive cardiac failure (CCF) without a previous history of cardiac disease or alcohol abuse. One patient did have a history of cataract removal and epilepsy and all 3 had ECGs showing prolonged Q-T intervals and echocardiograms consistent with the diagnosis of cardiomyopathy. Biochemical profiles were similar: hypocalcaemia, hyperphosphataemia and normal serum urea levels. Parathyroid hormone levels were inappropriately low in all 3 cases. The tetany and CCF responded to calcium +/- magnesium infusions together with diuretics and in 2 cases, digoxin therapy. All 3 patients are well at present, and are controlled on 1-alpha-hydroxyvitamin D3 and calcium supplements.
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PMID:Cardiac dysfunction in primary hypoparathyroidism. A report of 3 cases. 334 Sep 68

We have studied the efficiency of urea in the treatment of hyponatremia and hydrosaline retention in a 76-year-old man with chronic ischemic congestive heart failure. Since increase of furosemide worsened the hyponatremia (120 mmol/l), 30 g/day of urea was added and induced the following changes: progressive weight loss (6.5 kg in one week), increased diuresis (from 0.750 to 1.950 l/day), increased salt excretion (from 40 to 165 mmol sodium/day) and correction of the hyponatremia (120 to 136 mmol/l). Blood urea and creatinine serum concentrations rose moderately without significant change in creatinine clearance (32 to 38 ml/min). No adverse effects related to urea administration were observed. Urea intake seems to be useful in the management of hyponatremia in our patient with cardiac failure.
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PMID:Urea treatment for water retention in hyponatremic congestive heart failure. 366 93

Nine patients, six men and three women, 40 to 73 years of age, were included in the study. All of the patients had severe heart failure refractory to aggressive therapy including digitalis, diuretics, and vasodilators. Eight patients underwent one treatment of peritoneal dialysis while the remaining patient received two dialyses. The urine output was measured by an indwelling catheter; glomerular filtration rate (GFR) was determined by creatinine and inulin clearance, and renal blood flow (RBF) was determined by sodium paraamino hippurate (PAH) clearance. Following one peritoneal dialysis, the mean fluid loss/patient was 3,995 ml (range 3,200 to 5,100 ml). Dialysis was generally well tolerated. One patient, who had underlying hepatic cirrhosis and underwent two dialyses, developed hepatic failure and died 10 days after the second dialysis. At postmortem, peritonitis was discovered. All of the patients showed a marked subjective and objective clinical improvement. The mean plasma urea decreased from 154 to 71 mg/dl (P less than 0.005), and mean plasma creatinine decreased from 1.83 to 1.13 mg/dl (P less than 0.005). Blood pH was 7.30 before dialysis and increased to 7.37 (P less than 0.0125) after treatment. Mean urine output predialysis was 955 ml and increased to 1,472 ml post dialysis (P less than 0.0005). Creatinine clearance increased from 35 to 73 ml/min (P less than 0.0005). The mean inulin clearance increased from 33 ml/min predialysis to 69 ml/min post dialysis (P less than 0.0005), and mean PAH clearance increased from 96.7 to 362.5 ml/min (P less than 0.0005). Acute peritoneal dialysis is a safe and effective means for removing large quantities of excess fluid from patients with intractable heart failure.
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PMID:Improved renal function following acute peritoneal dialysis in patients with intractable congestive heart failure. 369 51

A total of 75 patients with rheumatic fever, 49 acute (ARF) and 26 acute-on-chronic (A-C-RF), registered in the Zimbabwean Midlands during a 7 year period [1973-1980], followed up for 1-12 years where each one had a potential of follow-up of at least 5 years, were reviewed. Their mean age at diagnosis was 13.2 +/- 7.9 (range 3-39) years and 5 of them were over thirty years old. Thirty five percent were followed up regularly although only 20% realised the full potential. 12% of ARF who initially had no carditis, developed it on a recurrence. The disease was more florid among defaulters than among regulars; chronic valvular lesions being clinically established in 2.8 +/- 1.8 (range 1-6) years; chronic heart failure developing in 5.2 years and death occurring in relatively young patients aged 10.9 +/- 3.0 years old. There were more recurrences among defaulters than among regulars (p less than 0.001). The follow-up was better in those with clinically established valvular lesions, worse in the asymptomatic ones and it was unrelated to age or residence. In addition to improving social-economic conditions, parenteral penicillin prophylaxis should be continued until one is at least 40 years old.
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PMID:Experience on follow-up of registered rheumatic fever patients in the Zimbabwean Midlands. 375 Mar 95

To estimate the frequency of diuretic-related electrolyte disorders in the elderly, 561 consecutive admissions to three acute geriatric units were studied. For the 287 admissions to one unit, discharge/death diagnoses were also examined in relation to admission diuretic therapy. Sodium concentrations were significantly lower, and urea and creatinine significantly higher, in patients on diuretics, though the size of the differences was small. Comparing different preparations sodium concentrations were significantly lower on Moduretic than on Dyazide or Navidrex K and on frusemide when combined with a potassium-retaining diuretic rather than a potassium supplement. Potassium concentrations were significantly lower on Bendrofluazide alone compared to Navidrex K or Moduretic. Diuretics were positively associated with cardiac failure, ischaemic heart disease, airflow obstruction and obstructive large bowel disorders but negatively with Parkinson's disease. No significant association was found with falls, immobility or confusion. Major electrolyte disorders on diuretics appear to be unusual but important differences exist between preparations. Similarly major illness resulting from diuretic therapy is rare but minor morbidity may be more common.
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PMID:Biochemical and clinical correlates of diuretic therapy in the elderly. 379 65

Relationships between clinical status, haemodynamic measurements, hormone and biochemical indices, and maintenance diuretic dose in patients with chronic cardiac failure, are not clear. This study assessed such relationships and their stability under standardized conditions in 21 hospitalized patients. The daily maintenance dose of frusemide correlated closely and in a positive fashion with plasma levels of renin activity, angiotensin II and aldosterone (P less than 0.001), and to a lesser extent with plasma noradrenaline. Although there was some overlap, patients most incapacitated by their heart failure had the highest circulating levels of renin activity, angiotensin II, aldosterone and noradrenaline. Plasma aldosterone correlated closely with concomitant angiotensin II levels (r = 0.70, P less than 0.001) but not with its other secretagogues ACTH (as reflected by plasma cortisol) or plasma potassium. Close positive correlations between angiotensin II and plasma levels of urea and creatinine (P less than 0.01) were observed. Both renin and angiotensin II showed positive relationships with right heart pressures, but were inversely related to cardiac index and arterial pressure. These results show close relationships between clinical and haemodynamic indices on one hand, and hormones on the other. The renin-angiotensin system appears to be the primary regulator of aldosterone under these conditions, and its activity relates closely to haemodynamic measurements and to the degree of azotaemia.
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PMID:Stability and inter-relationships of hormone, haemodynamic and electrolyte levels in heart failure in man. 389 Nov 72

In a series of 604 adults operated on for cardiac surgery with cardiopulmonary bypass (CPB), 21 (3.5%) underwent circulatory assistance by intra-aortic balloon pump (IABP); in 5 of them (24%), acute renal failure (ARF) was observed. ARF occurred in only 26 (4.4%) of the other patients who did not require IABP. Evolution of ARF and its factors were therefore investigated in those patients having received IABP. ARF was defined as serum blood urea nitrogen (BUN) greater than or equal to 16 mmol X 1(-1), urinary urea/BUN less than 10, creatinine clearance less than 40 ml X min-1 X 1.73 m-2. Some perioperative features were compared between patients with postoperative ARF and those without ARF. ARF occurred in the 5 patients with IABP during, or immediately after, weaning from IABP. ARF was more frequent in patients operated on for mechanical complications of myocardial infarction with a significant more severe haemodynamic status. They had significantly longer CPB and aortic clamping times. The prognosis depended on the cardiac failure and not on the ARF. In patients with mechanical complications of infarction, early IABP seemed to be the predominant preventive measure. Other therapeutic implications are suggested, particularly the use of dopamine (1 to 3 micrograms X kg-1 X min-1) because of its renal vasodilating action which can contribute to the maintenance of urinary flow.
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PMID:[Acute renal failure after extracorporeal circulation with aortic counterpulsation in surgically treated patients]. 401 97

The biochemistry laboratory records of a 400-bed general hospital serving a population of about 120,000 showed that during the three-year period 1966-8 inclusive 487 patients had at some stage during their admission a blood urea of 100 mg/100 ml or more. Ninety per cent. were aged 50 or over, 79% were 60 or over, and 52% were 70 or over.The case notes of all patients with renal failure admitted during 1966 and 1967 were examined together with those of patients under 60 admitted during 1968. Three observers agreed about the most likely cause of the renal failure in 90% of patients whose case notes were available, or 74% of the total. The raised blood urea was thought to be due to "prerenal" factors in 60% of the patients, to acute tubular necrosis in 80%, to obstructive uropathy in 12%, and to "intrinsic" renal disease in 20%. Renal failure precipitated by such factors as cardiac failure, chest infections, cerebrovascular accidents, and shock was particularly common in old people.The hospital survey and replies to a questionnaire sent to all general practitioners in the area suggest that in the three-year period 14 patients may have been suitable for treatment by maintenance haemodialysis or renal transplantation. This represents a rate of about 39 per million per year under the age of 60 and 28 per million per year under 50.
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PMID:Incidence of uraemia and requirements for maintenance haemodialysis. 521 79

We report a case of acute interstitial nephritis (AIN) after a six weeks' therapy with sulphinpyrazone (Anturane, Ciba-Geigy, Wien). The patient presented with acute renal failure requiring hemodialysis. He died from acute cardiac failure three days after admission. According to our available information, it seems to be the first case of histologically proven acute interstitial nephritis with renal failure requiring hemodialysis after sulphinpyrazone therapy. Our observation underlines the suggestions made by Butler (7) and Mayrhofer et al. (19): During sulphinpyrazone therapy, serum creatinine and urea concentrations should be controlled regularly; the drug must be discontinued immediately when renal function is worsening; and the drug should not be administered in patients with even slightly impaired renal function.
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PMID:[Acute interstitial nephritis and kidney failure requiring dialysis after sulfinpyrazone therapy]. 623 42


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