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

The study of fluid and electrolyte disturbances by isotope radiodilution method is carried out in 22 patients with chronic respiratory insufficiency and cardiac failure. The simultaneous measurements of hydro-ionic compartments have been carried out with tritiated water (HTO), labelled sodium (22Na), labelled potassium (42K) and labelled bromine (82Br). From these measurements, the various water spaces are calculated: total water (ET) and extracellular fluids (LEC), also exchangeable electrolytes: sodium (NaE), potassium (KE), chlorine (ClE) and derived values. Results are compared to corresponding values in controls with the same obesity index. Patients with respiratory insufficiency show a fluid and sodium rise, similar to that found in cardiac failure and denutrition. The (NaE + KE)/ET ratio is not significantly decreased and the natremia is only slightly lower. There is no real potassium depletion in most patients.
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PMID:[Isotopic study of fluid and electrolyte disturbances in decompensated chronic respiratory insufficiency (author's transl)]. 0 42

Because of the close anatomic and physiologic relationship between the heart and lungs, patients with chronic obstructive lung disease are at special risk of arrhythmias. Effective therapy hinges on identifying the mechanisms of the arrhythmias--hemodynamic, metabolic, or drug-induced. Impulsive use of antiarrhythmic agents may result only in a more complex and dangerous rhythm disorder. Extremes of pH are a major cause of arrhythmias in these patients. Respiratory alkalemia usually originates with inappropriate ventilation, often during mechanical respiration, while metabolic alkalemia generally can be traced to diuretic or bicarbonate therapy. Lidocaine or diphenylhydantoin are of little use, since the alkaline pH inside and outside heart muscle cells hampers drug distribution and activity. At the other extreme, the arrhythmias of acidemia strike patients who have severe respiratory failure with carbon dioxide retention or severe cardiac failure with shock and lactic acidemia. Arrhythmias may develop if vagal restraint is lost, which is especially likely in patients with potassium depletion. Irritant receptors along the bronchopulmonary tree can trigger arrhythmias if stimulated by cough, microembolism, or mechanical irritation, which is a hazard with endotracheal or tracheostomy tubes.
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PMID:Mechanisms of arrhythmias in chronic obstructive lung disease. 1 Feb 30

Body potassium status of patients with cardiac failure may be estimated by a number of methods, but increasing reliance is being placed upon radioisotope dilution with 42K which measures the total exchangeable potassium. Total exchangeable potassium comprises between 86 per cent and 97 per cent of whole body potassium in healthy subjects. We have measured total exchangeable potassium in 22 oedema-free elderly patients with stable cardiac failure and compared the results with simultaneously determined measurements of whole body potassium obtained by whole body counting. The mean whole body potassium was 2360 +/- 640 mmol. The mean value of total exchangeable potassium measured at 24 hours was 1820 +/- 610 mmol (77% of whole body potassium) and increased further to 2000 +/- 600 mmol (84%) when measured after 48 hours. In patients with cardiac failure and, perhaps, also other patients with a history of fluid retention, the mixing of a tracer dose may be significantly delayed, which if not appreciated may lead to an overestimate of potassium depletion.
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PMID:Whole body potassium and total exchangeable potassium in elderly patients with cardiac-failure. 11 19

The effect of the aldosterone-antagonist Spironolacton in decompensated hydropic cardiac insufficiency is explored with patients not re-compensated under a glycosid-diuretica-therapy. This analysis is based on the clinical records and other documents of 34 patients with most serious oedematous cardiac insufficiency of different genesis. For elucidation of the result of the clinical treatment two casuistic cases are described. The probability of mortality or survival-rate is calculated, periods of observation could be achieved up to more than nine years. It is endeavoured to compare the results with observations of patients-collectives, that are known from the literature. Statistically significant decreases in weight are objectified. When examining the reactions of blood-pressure at the Spironolacton-therapy no statistically significant alterations of blood-pressure could be observed with those cardiac-decompensated patients. 6.25 per cent of the considered serum-potassium-data were underneath the limitations of lower standard, at 1.875 per cent of the measured values a hyperkalemia existed. No clinical side-effects could be observed except the incidence of a gynaecomastia with two male patients. A protracted therapy with Spironolacton for patients with decompensated hydropical myocardial insufficiency is appropriated to support recompensation in addition to the hitherto conventional possibilities of therapy, and to maintain this achieved re-compensation.
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PMID:[Long term therapy over nine years with Spironolacton in hydropic cardiac insufficiency]. 13 20

A study of 44 Nigerians with heart muscle disease defined as congestive cardiac failure and cardiac enlargement of unknown cause with a presenting diastolic blood pressure of not more than 100 mm Hg has shown 20 were alcoholics. 12 of these belonged to the high socioeconomic class. 17 were thiamine deficient; 11 of these consumed alcohol excessively and 8 of the 11 belonged to the high socioeconomic class. Only 3 alcoholics were identified in 52 controls. None of the 3 patients was thiamine deficient but 10 others were. Only 1 patient with heart muscle disease had a reversible high output cardiac failure. The mean serum albumin of the patients with heart muscle disease was significantly lower than controls. There was no significant difference between the mean levels of serum potassium in the study group and controls. It is concluded that chronic alcoholism is not rare among Nigerians with heart muscle disease. Although there is no convincing evidence to show that malnutrition or thiamine deficiency could in themselves cause the chronic myocardial failure seen in heart muscle disease, they could be conditioning factors which increase the susceptibility of the heart to other injurious agents.
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PMID:Heart muscle disease among adult Nigerians: role of nutritional factors in its aetiology. 15 80

A salt-free diet is usually useless or dangerous in the elderly subject. It has at present only rare indications, such as after acute pulmonary oedema or congestive heart failure during initial treatment. In all other cases, it may be replaced by a reasonable diet; sodium intake remains permitted, but naturally one should not fall in the opposite extreme. As in younger subjects, and provided one takes into consideration the subjacent renal condition, properly prescribed diuretics have transformed the situation in the treatment of heart failure as in essential hypertension. Naturally the patient still requires regular clinical supervision and laboratory tests which may in practice be limited to periodical estimation of blood urea and serum potassium, less regularly, blood sugar and uric acid.
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PMID:[Salt-free diet and diuretics in the elderly (author's transl)]. 21 98

Data derived from clinical, electro- and polycardiographic observations of 68 patients subjected to electric stimulation therapy are presented. The evaluation of late results of the treatment showed that clinical factors such as the patients' age, the nature of the affection, the degree of cardiac insufficiency, the standing of auricular fibrillation are not decisive in determining indications and contraindication for electric stimulation therapy. A considerable worsening of the cardiac dynamics with developing fibrillation arrhythmia, especially in patients suffering from cardiosclerosis, and a distinct improvement of the polycardiographic indices after defibrillation point to the need of attempting, whenever this is possible, to bar the auricular fibrillation. A pretreatment with potassium preparations and lengthy maintenance therapy with quinidine or quinidine-like agents is recommended. An analysis of the ECG findings after the electric stimulation therapy (heart rate, and its regularity, the state of the intraatrial and atrioventricular conduction) enable it to foresee the retention time of the re-established rhythm.
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PMID:[Electroimpulse therapy of auricular fibrillation]. 23 37

Direct cardiac and vascular effects of the antikaliuretic diuretic potassium-canrenoate were measured in cardio-surgical patients during extracorporal circulation and immediatly after operations, each time in neuroleptanalgesia. During "steady state" extracorporeal circulation (aorta cross-clamped, constant flow rate of heart-lung-machine, constant hypothermia), in 13 patients no significant influence on peripheral circulation was found after i.v.-injection of 800 mg potassium-canrenoate. Neither arterial perfusion pressure (representing an arterial vascular reaction) nor changes in oxygenator-volume (indicating venous vasodilation or contraction) demonstrated significant differences in comparison to a control group. After cardiac surgery haemodynamic measurements were performed for a period of 60 minutes in 10 patients given 800 mg potassium-canrenoate. In comparison with a control group (n = 6), no significant differences in arterial pressure, heart rate, cardiac index and pulmonary arterial pressure were found. Left ventricular measurements, using a catheter tip manometer, revealed no direct positive inotropic effect of a single i.v.-injection of potassium-canrenoate. In acute myocardial failure during anaesthesia or in "low cardiac ouptut" following open heart surgery no improvement in myocardial contractility is obtained by i.v.-application of potassium-canrenoate; at the present there seems no alternative to other positive inotropic agents such as calcium, glucagon, dopamine, orciprenaline and epinephrine.
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PMID:[Extrarenal effects of potassium-canrenoate. Haemodynamic investigations during neuroleptanalgesia in cardiosurgical patients (author's transl)]. 31 42

There have been many studies which suggest that patients with heart failure were potassium depleted. This depletion has been attributed to the use of potent diuretics, and these are now given with either potassium supplements or potassium-retaining diuretics. A detailed examination of the studies suggests that the reported decrease in body potassium compared with the results in healthy persons is not due to the diuretics. It can be partly explained by a failure to match patients and controls in terms of age, and the remaining difference can be explained by muscle wasting. There is therefore no evidence of a potassium depletion in these patients with heart failure.
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PMID:Potassium depletion in heart failure and its relation to long-term treatment with diuretics: a review of the literature. 34 54

Electrocardiograms before and during lithium treatment were evaluated. In both 12 healthy volunteers who were given lithium for 7 days as well as in 20 out-patients, who had received lithium treatment for many years similar results were found: 1. Disturbances of the cardiac rhythm or heart failure did not occur. 2. Unspecific variations of the repolarisation were indicated in 75% of the long-term patients and 50% of the healthy volunteers during lithium treatment; these changes were dose-related. 3. The potassium concentrations in the serum remained within normal limits and showed no significant variations. 4. During therapy the long-term patients experienced a significant drop in the pulse-rate. This effect was apparently not dose-related, byt seemed to be conditioned by an incipient tachycardia caused by an additional psychotropic medication administered before the lithium application. In the healthy volunteers the pulse-rate remained stable during the experiment. These results are discussed in the context of the current literature of the subject.
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PMID:[ECG changes under acute and chronic lithium application (author's transl)]. 36 Feb 46


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