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

The autopsy findings in 41 patients with University of Cape Town aortic valve prostheses were studied. Twenty patients died within 1 month of operation and 21 patients died later, up to 141 months after operation. The most important postoperative complications which were common to both groups of patients were arrhythmias, myocardial failure and infection. Systemic embolism was the most important late complication. The type of coronary arterial perfusion or ventricular rhythm during bypass did not influence the myocardial pathology. Patients who died of myocardial failure did not show more severe myocardial alterations than did those who died of other causes.
S Afr Med J 1977 Sep 24
PMID:Pathology of aortic valve replacement. 91 Jan 95

Comparing cardial and extracardial effects of digitalis with corresponding digoxin blood concentrations, we determine the therapeutic range of glycosides. These studies are based on 1109 determinations in 317 patients with heart failure. The clear intoxication limit is above 2.0 ng/ml.
Int J Clin Pharmacol Biopharm 1977 Sep
PMID:Digitalis effect and blood concentration. 91 5

The clinical manifestations of glycoside toxicosis were compared with the character of myocardial ultrastructural changes and the electrolyte shifts outside the infarction zone. Accumulation of glycogen in the cytoplasm of the muscle cells with simultaneous gross destruction of the myocardial ultrastructure in the pre-infarction zones are morphological manifestations of glycoside toxicosis on the ultrastructural level. The administration of strophanthin to patients with extremely severe cardiac insufficiency due to myocardial infarction may lead to disturbance in the mitochondrial energy-producing activity and the development of nodes of myofibril over-contractility with subsequent death of the cell, even to the development of smallfocal necrosis in the myocardium. The use of lidocaine and panangin in sufficiently high doses is an effective measure in the prevention and elimination of extrasystolic arrhythmias caused by glycoside toxicosis.
Kardiologiia 1977 Sep
PMID:[Clinico-electrocardiographic, morphological and biochemical manifestations of glycoside poisoning in patients with myocardial infarct]. 92 96

There were 29 patients with rheumatic heart disease and early stages of cardiac insufficiency under observation. Spiroergometry with the "Ergotest" device was conducted in dynamics to check whether the proper dose of the cardiac glycoside had been chosen. The results attest to the considerable improvement in the spiroergometric indices in patients with early stages of cardiac insufficiency who had been treated with digitalis. Spiroergometry yielded important additional criteria of the effectiveness of digitalization, particularly in individuals with normal or diminished rate of cardiac contractions.
Kardiologiia 1977 Sep
PMID:[Spiroergometric evaluation of the effectiveness of treatment of cardiac insufficiency with cardiac glycosides]. 92 1

In this study, the effects of forearm static exercise were determined on local blood flow and oxygen consumption in 15 normal individuals (NL) and their responses were compared with ten patients in congestive heart failure (CHF). Forearm blood flow was determined by a plethysmographic technique before and during 15% of maximum voluntary contraction of the forearm. Regional arterial and venous oxygen contents were sampled and forearm oxygen consumption calculated by the Fick principle. At rest, forearm blood flow was less in patients with heart failure than in normal individuals; however, this was compensated for by an increased oxygen extraction, thus maintaining forearm oxygen consumption at a normal level. In contrast, during static exercise, forearm blood flow failed to rise normally with heart failure (NL 9.31; CHF 4.35 ml/min-100 ml, P less than 0.001) and the increased oxygen extraction was not sufficient to maintain a normal forearm oxygen consumption (NL .82; CHF .44 ml/min-100 ml, P less than 0.01). Therefore, patients with congestive heart failure demonstrate regional circulatory and metabolic abnormalities during static exercise that are comparable to those present during dynamic exercise. Because of a limited ability of their skeletal muscle resistance vessels to respond to dilator stimuli, they have an attenuation of their exercise hyperemia which leads to an earlier shift to anaerobic metabolism.
Circulation 1976 Sep
PMID:Impaired forearm oxygen consumption during static exercise in patients with congestive heart failure. 94 78

Following an episode of rheumatic carditis, severe mitral incompetence developed in a 9-year-old girl. A mitral annuloplasty succeeded for a short time in ameliorating her symptoms of cardiac failure. However, mitral incompetence recurred and was accompanied by severe anemia and hemosiderinuria. Distortion of erythrocytes was evident on a peripheral blood smear. A second mitral annuloplasty resulted in resolution of the hemolytic anemia.
Can Med Assoc J 1976 Sep 04
PMID:Cardiac hemolytic anemia resolving after second mitral annuloplasty. 95 16

The transcapillary escape rate of albumin (TERalb), i.e., the fraction of intravascular mass of albumin that passes to the extravascular space per unit of time, was determined from the disappearance of intravenously injected 125I-labeled human serum albumin during the first 60 minutes after injection in 10 subjects with chronic right heart failure. The investigation was repeated after sodium and water depletion. Before treatment TERalb was significantly elevated (mean 8.3 +/- 1.6% (SD)/hour, in comparison to values for normal subjects (mean 5.4 +/- 1.1%/hour, P less than 0.001). With treatment TERalb decreased significantly (mean 5.9 +/- 1.2%/hour, P less than 0.01). Right atrial pressure decreased from an average of 10 mm Hg to 6 mm Hg during treatment. A statistically significant, positive correlation was found between TERalb and right atrial pressure (r = 0.77, P less than 0.001). Our results best can be explained by increased filtration, mainly through the venous end of the microvasculature, due to the increased venous pressure in heart failure.
Circ Res 1976 Sep
PMID:Transcapillary escape rate of albumin and right atrial pressure in chronic congestive heart failure before and after treatment. 95 65

In 395 consecutively investigated patients with cardiac failure of varying aetiologythe platelet ocurt in venous blood was less than 100 000/mm(3) in 5.3% and below the 2s devaition (less than 136 000/mm (3)) in 19.2. The average platelet count of the whole group was 197 500 +/- 70 800/mm (3) which was significantly lower (P less than 0.001) than in normal controls (n = 128). In 6 patients a (51)Cr study of platelet kinetics was performed; the results support the conclusion that the faculatative thrombocytopenia in cardiac failure is mainly,but not exclusively, due to an increased uptake of platelets in the congested spleen.
Dtsch Med Wochenschr 1976 Sep 17
PMID:[Frequency and pathogenis of thrombocytopenia in cardiac failure]. 95 98

Protein-losing enteropathy, documented by 51Cr-labeled albumin excretion studies, was demonstrated in a 24-month-old girl following the Mustard operation for complete transposition. Apparent postoperative inferior vena cava obstruction had been diagnosed by angiocardiograms and both caval pressure were found to be elevated. There was no evidence of primary renal or hepatic disease or cardiac failure. This problem may occur more frequently than has been recognized.
J Thorac Cardiovasc Surg 1976 Sep
PMID:Transient protein-losing enteropathy secondary to elevated caval pressures and caval obstruction after the Mustard procedure. 95 55

Sodium nitroprusside is a potent, effective, and readily reversible direct vasodilating agent. It is broken down by hemoglobin into cyanide, which is in part detoxified by liver and kidney to thiocyanate. Some cyanide, especially in nitroprusside- "resistant" individuals who need large amounts of the drug, appears to remain free to cause cyanide poisoning. Patients requiring inordinate amounts probably should not continue to receive the drug, although maximum dosage limits for long-term therapy are not established. Blood thiocyanate levels do not indicate the extent to which free cyanide is limiting oxygen utilization in essential tissue, nor do blood cyanide levels. Metabolic acidosis, elevated lactate levels, elevated lactate/pyruvate ratios, and elevated mixed venous blood oxygen content are at present the best indications of the presence of cyanide poisoning during nitroprusside administration. Nitroprusside appears useful for induction of hypotension during surgery, and for treatment of hypertensive emergencies from all causes, although continuance for more than a few days is probably unwise. The reductions of cardiac afterload and ventricular filling pressure by nitroprusside appear useful in treatment of severe myocardial failure or infarction, but studies of myocardial cyanide toxicity are needed before complete acceptance of this therapy is warranted. Initial dose rates between 0.5 and 1.5 mug/kg/min are recommended only as starting points for very careful titration. Total projected intra-operative dosage should be calculated as quickly as possible and should not exceed 3-3.5 mg/kg. It is hoped that future studies will reveal the maximum dose of nitroprusside that can safely be metabolized in a 24-hour period, and may indicate that cofactors of rhodanase such as thiosulfate, or cobalamins such as hydroxocobalamin, can be administered with nitroprusside to prevent cyanide poisoning.
Anesthesiology 1976 Sep
PMID:Sodium nitroprusside: pharmacology, toxicology and therapeutics. 96 81


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