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)

Dopamine is a direct-acting catecholamine with a short half-life that has many advantages in treating visceral hypoperfusion states such as shock and refractory heart failure. Unlike other inotropic drugs, dopamine directly dilates the mesenteric, renal, and cerebral vessels and redirects blood flow to essential viscera. This dopaminergic effect is prominent with doses of 100-700 mug/min in adults and is attenuated by phenothiazines and haloperidol. At doses of 700-1400 mug/min, dopamine also has a significant beta-adrenergic, inotropic effect, increasing myocardial contractility. The inotropic effect is equivalent to that of isoproterenol, epinephrine, and norepinephrine, but tachycardia, tachyarrhythmias, and angina may be less frequent with dopamine. In doses greater than 1400 mug/min, dopamine is a vasoconstrictor with pressor effects usually equivalent to that of norepinephrine. Dopamine dilates pupils, does not dilate bronchi, and does not shunt blood from viscera to skeletal muscles as does isoproterenol. Because dopamine increases myocardial contractility, selectively redistributes perfusion to essential viscera and allows a pharmacologic titration of effect, it is a logical first-choice catecholamine for treatment of shock and refractory heart failure.
Johns Hopkins Med J 1975 Dec
PMID:The clinical use of dopamine in the treatment of shock. 0 63

The effects of the cardioselective beta-blocker, metoprolol, were evaluated under double-blind conditions in eighteen patients with angina pectoris. During an introductory run-in period of eight weeks, a placebo was given single-blindly. Thereafter two double-blind crossover periods each of four weeks followed, either 20 mg metroprolol or placebo being given t.i.d. Metoprolol gave a significant reduction in the number of anginal attacks and in nitroglycerin consumption. The patients' subjective assessments of their daily angina pectoris symptoms also showed a significant improvement compared with the placebo. At the end of each period, a standardized exercise test was performed. In comparison with placebo, metoprolol gave a significant increase of total work performed until the appearance of 1 mm ST-segment depression and until the end of exercise. The heart rate was significantly reduced at rest and during exercise. The blood pressure was significantly reduced only during exercise. None of the patients reported any severe unwanted effects. The complaints reported were mild to moderate, and the frequency during metoprolol treatment was even lower than during placebo treatment. No signs or symptoms of cardiac failure were seen in any of these patients on any occasion. It is concluded that 20 mg metoprolol t.i.d. is of benefit in the treatment of angina pectoris but further benefit might be obtained with higher doses.
Ann Clin Res 1975 Dec
PMID:Effects of the cardioselective beta-blocker metoprolol in angina pectoris. A subacute study with exercise tests. 0 92

The development of heart failure in the cardiomyopathic hamster is associated with a decrease in norepinephrine stores and parallel increases in cardiac sympathetic tone and tyrosine hydroxylase activity. Despite the increase in tyrosine hydroxylase, cardiac norepinephrine synthesis does not increase in heart failure. In this study, we have shown that an accumulation of cardiac dopamine accompanies the decline of cardiac norepinephrine. The abnormal content of norepinephrine and of dopamine in the decompensating hamster heart is restored to normal by peripheral ganglionic blockade. The acute increase in cardiac sympathetic tone induced by immobilization stress in control hamsters mimics the alterations in cardiac catecholamine distribution found in heart failure. Other investigators have demonstrated similar alterations in the catecholamine content of the rat submaxillary gland and adrenal medulla following an increase in sympathetic input to these organs. We conclude that the increase in cardiac sympathetic tone in the late stages of hamster cardiomyopathy appears to lead to a shift in the rate-limiting step for norepinephrine synthesis from the hydroxylation of tyrosine to the hydroxylation of dopamine. There is evidence that this shift which results in an accumulation of dopamine in the noradrenergic nerve terminals of the heart is a general manifestaion of augmented sympathetic nerve traffic rather than a peculiarity of hamster cardiomyopathy.
Circ Res 1977 Dec
PMID:A possible change in the rate-limiting step for cardiac norepinephrine synthesis in the cardiomyopathic Syrian hamster. 2 58

Left ventricular force-generating capacity was determined in 19 anesthetized dogs with heart failure (HF) from aortocaval fistula. At the time of study all dogs had ascites, edema, and elevated pulmonary wedge pressure. Length-contractile force (CF) curves recorded from the left ventricle (LV) with a modified Walton-Brodie arch indicated that the LV was operating on the ascending limb of the length-CF curve at 62.4 +/- 0.1% Lmax in the normal group and in the HF group at 83.4 +/- 2.7% Lmax. In HF the length-CF curve was depressed when compared to normal and was further depressed when CF in grams was normalized for changes in LV wall thickness and expressed as g/cm2. Additionally, dose-response curves of CF in response to injected norepinephrine, isoproterenol, glucagon, and calcium were depressed when compared to the normal group while the response of heart rate and blood pressure was not different. These findings indicate that volume overload HF is associated with depressed ventricular muscle function and a depressed response to inotropic drugs.
Am J Physiol 1978 Dec
PMID:Volume overload heart failure: length-tension curves, and response to beta-agonists, Ca2+, and glucagon. 3 75

The heart of the old hemiplegic patient is examined as follows: 1. The preapoplectic situation of the heart which often induces in a conclusive manner the beginning of a stroke, 2. the occurrence of heart troubles with the stroke itself and 3. the influence of rehabilitation measures and the heart function. Preexistent heart troubles are very frequent (in ca. 80%). Thereby the hypertension with a left ventricular hypertrophy and later with heart failure play an important role. The stroke itself especially in subarachnoidal bleedings can cause severe electrocardiographic anomalies. The telemetric controlled heart shows specially while rehabilitation more extrasystoles and alterations of repolarisation but usually do not impair the rehabilitation. With a systematic rehabilitation (training) the heart is most favourably influenced.
Aktuelle Gerontol 1978 Dec
PMID:[The heart of the old hemiplegic patient (author's transl)]. 3 57

Systemic hemodynamic changes and noradrenaline concentrations in coronary sinus blood were studied at rest and during work before and after acute beta-receptor blockade. Patients with congestive cardiomyopathy were compared to patients with primary valvular diseases and to healthy subjects. Noradrenaline concentrations were higher in coronary sinus blood than in arterial blood and increased after beta blockade and during work. Noradrenaline concentrations were more increased in patients with more pronounced myocardial failure and did not seem to separate patients with congestive cardiomyopathy from those with valvular disease. Patients with congestive cardiomyopathy showed a good hemodynamic tolerance toward acute beta blockade.
Clin Cardiol 1979 Dec
PMID:Effects of work and acute beta-receptor blockade on myocardial noradrenaline release in congestive cardiomyopathy. 4 91

Nine Cooperstown beagles of known DL-A genotypes were exposed to supralethal total-body irradiation and received bone-marrow allografts from DL-A-identical donors. Four to 5 months later, the resulting chimeras received orthotopic cardiac allografts from their corresponding donors of marrow. Six chimeras died of operative complications in the immediate postoperative period. The other 3 chimeras survived from 173 to 547 days; 1 dog died at 173 days as a result of right-sided heart failure, secondary to stenosis at the site of the pulmonary artery anastomosis. The other two recipients continue to be active and healthy at 545 and 547 days. The results indicate that dogs can be rendered specifically tolerant to orthotopic cardiac allografts by supralethal total-body irradiation and the transplantation of marrow obtained from the prospective allograft donor.
Transplant Proc 1975 Dec
PMID:Allogeneic unresponsiveness to orthotopic cardiac transplants in DL-A-identical radiation chimeras. 5 25

Eight patients with diuretic-resistant ascites due to cirrhosis were treated by reinfusion of concentrated ascitic fluid. In 11 procedures, with a mean duration of 21.9 hours, weight loss averaged 14.8 kg. Complications during reinfusion included septicemia in 1 procedure, left-sided heart failure in 5, pyrexia in 7 and coagulation abnormalities in 10. Ascites recurred within 2 months after reinfusion in all but one patient. Although this technique is an efficient and inexpensive method of treatment of ascites, it does not appear indicated in patients with cirrhosis and resistant ascites in view of the possibly serious complications associated with reinfusion and the poor long-term results.
Can Med Assoc J 1977 Dec 03
PMID:Treatment of resistant ascites by continuous ultrafiltration--reinfusion of ascitic fluid. 7 94

A mechanism is outlined to explain why oedema forms so readily in hot climates. A continual cutaneous vasodilation produces a low total peripheral resistance so that the mean arterial pressure cannot be raised except by increasing cardiac output. This inability to raise the arterial pressure as efficiently as usual will lead to difficulties in dealing with excess sodium and water loads, because the mean arterial pressure is the major determinant of urinary output. Anything which favours the retention of sodium and water in hot climates must therefore make things worse. This mechanism will also explain the post-partum cardiac failure syndrome which occurs in Northern Nigeria, since Hausa women take high-sodium diets and lie on heated beds during the post-partum period. The necessity for a further increase of cardiac output to excrete excess sodium and water in hot climates causes stress in persons with vulnerable myocardia and produces the symptoms and signs of cardiac failure more rapidly.
Lancet 1977 Dec 03
PMID:Oedema and heart-failure in the tropics. 7 65

Ten patients with severe myxoedema were treated with regular increments of thyroxine. The urine aldosterone excretion rate and plasma-aldosterone level increased with each increasing dose of thyroxine. Two patients in whom the serum-aldosterone rose to abnormally high levels had cardiac failure which resolved when the thyroxine dose was reduced.
Lancet 1978 Dec 16
PMID:Aldosterone in myxoedema. 8 81


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