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)

Although sarcoid may involve the myocardium, there is little information on its incidence or significance. We studied 84 consecutive autopsied patients with sarcoidosis. The patients ranged in age from 18--80 years (average 46 years) and 61% were women; 23 (27%) of them had myocardial granulomas. In eight (35%) these were clinically silent, and in 15 (65%) there was a history of heart failure and/or arrhythmias and conduction defects. Of the 23 patients, only four (17%) had grossly evident, widespread myocardial lesions: three of these four (75%) had documented arrhythmias. All four had sudden, unexpected death at an average age of 36 years; in only two had sarcoid been suspected during life. The other 19 patients (83%) had microscopically evident granulomatous involvement. Of these, eight (42%) had a thythm or conduction disturbance and three (16%) sudden death, although none of those who suffered sudden death had a recognized rhythm or conduction disturbance. Nine (15%) of those without cardiac sarcoidosis had a rhythm or conduction disturbance and eight (13%) suffered a sudden death. The results show that although myocardial involvement occurs in at least 25% of patients with sarcoid, it most often involves a small portion of myocardium and is clinically silent. Since some of the 61 patients in whom myocardial lesions were not identified may still have had small microscopic granulomas, the true incidence of myocardial sarcoid may be even greater than suggested here. Rhythm and conduction disturbances are more common in the cardiac sarcoid group, but the findings suggest that only the small subset of patients with severe, grossly evident myocardial sarcoid are at increased risk for sudden death.
Circulation 1978 Dec
PMID:Cardiac sarcoid: a clinicopathologic study of 84 unselected patients with systemic sarcoidosis. 70 77

Ten patients in severe cardiac failure were treated with dopamine (4 microgram/kg . min) and dobutamine (7.5 microgram/kg.min). Both drugs brought about a similar increase in stroke volume and cardiac output of about 50% and 60%, respectively, accompanied by a fall in peripheral vascular resistance of about 33%. On dopamine the heart rate increased by 12%, but remained unaltered on dobutamine. There was a significant fall in the preload of both ventricles with dobutamine, while ventricular filling pressure during dopamine infusion was only slightly decreased, unchanged or even increased. The pulmonary (wedge) pressure during dopamine infusion averaged 9 mm Hg higher than during dobutamine (P less than 0.001). There is thus the potential danger with dopamine of aggravating pulmonary congestion. Furthermore, the improvement in cardiac function due to dopamine is at the expense of a higher oxygen demand than with dobutamine. Dobutamine is, therfore, preferable to dopamine in the treatment of advanced myocardial failure.
Dtsch Med Wochenschr 1978 Dec 01
PMID:[Dopamine and dobutamine in the treatment of severe cardiac failure (author's transl)]. 71 Mar 19

Amrinone, a new bipyridine derivative, exerts a positive inotropic action in experimental preparations and is effective when administered orally to dogs. To assess its immediate effects in man, we studied by cardiac catheterization the hemodynamic responses to amrinone (1.85 to 3.5 mg per kilogram given intravenously) in eight patients with congestive heart failure already receiving full doses of digitalis. the following statistically significant (P less than 0.01) effects were noted: cardiac index increased from a mean +/- 1 S.D. of 1.8 +/- 0.3 to 2.6 +/- 0.3 liters per minute per square meter; peak rate of left ventricular pressure rise rose from 849 +/- 233 to 1206 +/- 456 mm Hg per second; left ventricular end-diastolic pressure fell from 25 +/- 9 to 14 +/- 7 mm Hg; pulmonary-capillary pressure fell from 28 +/- 8 to 15 +/- 4 mm Hg; and right atrial pressure fell from 12 +/- 6 to 7 +/- 5 mm Hg. Mean heart rate was unchanged, and aortic mean pressure declined slightly (86 +/- 10 to 80 +/- 7 mm Hg, P less than 0.025). No toxicity was observed. Amrinone, whose mechanism of action has not yet ben defined, warrants further study as a possible treatment for heart failure.
N Engl J Med 1978 Dec 21
PMID:Hemodynamic assessment of amrinone. A new inotropic agent. 71 15

The case is presented of a 27-year old male with typical Reiter's sundrome (RS) and cardiac lesions. Eight months after the initial onset of the joint and mucosal symptoms, atrial fibrillation and signs of cardiac failure suddenly supervened. Rheumatic fever, hyperthyroidism and myocardial infarction were ruled out. Digitalization and Valsalva maneuvers produced a return to normal sinus rhythm. At the same time a diastolic murmur was heard and the diastolic pressure fell to 40 mm Hg, suggesting acute aortic insufficiency. This carditis was attributed to RS. The evolution was favourable, although a mild degree of aortic insufficiency persisted.
Schweiz Med Wochenschr 1978 Dec 02
PMID:[Auricular fibrillation and acute aortic insufficienncy in Reiter's syndrome]. 71 26

In a group of 29 patients treated with digoxin for cardiac failure, only 16 showed increased calcium and potassium concentrations in saliva. There was no correlation in the 29 patients between serum digoxin levels and concentrations of salivary electrolytes. On the other hand, in 4 normal subjects treated with digoxin no change in salivary electrolytes was noted. It is concluded that modifications in salivary electrolytes seen in patients with cardiac failure treated with digitalis are not due to this drug. However, a retrospective clinical study showed a good correlation between clinical signs of cardiac failure and increased levels of salivary calcium, potassium and CaX Kproduct. It is suggested that this phenomenon is due to the well-known adrenergic stimulation in patients with cardiac failure.
Schweiz Med Wochenschr 1978 Dec 02
PMID:[Salivary electrolytes, digitalis glycosides and cardiac insufficiency]. 71 27

The effect of intermediate coronary care, with and without ECG monitoring, was compared with general medical ward care on the basis of mortality, resuscitation, and detection and treatment of arrhythmias from days 3 to 14 after admission in 2,095 cases of acute coronary heart disease. Mortality was significantly reduced (P less than .02), and number of successful resuscitations for ventricular fibrillation was increased (P less than .05) but only in the unit with monitoring. Number of arrhythmias detected was significantly increased, particularly incidence of ventricular ectopics and heart block (P less than .02). Number of arrhythmias corrected to sinus rhythm was increased, but not significantly. Death from pulmonary embolism fell (P less than .01). Review of causes of death and autopsies showed an increased proportion of deaths due to intractable heart failure and cardiogenic shock. Not only specially trained nurses, but also ECG monitoring, were necessary to obtain the benefits of this treatment.
Arch Intern Med 1978 Dec
PMID:An assessment of intermediate coronary care. 71 43

Serum activity of creatine kinase and creatine kinase-MB have been investigated in 129 patients of various etiology in overt heart failure. Elevations in CK-MB were found in 19 patients, most frequently in patients with inflammatory heart disease. We found no correlation between CK-MB activity in serum and the severity of heart failure. CK-MB elevation in patients with chronic heart failure may be interpreted as a sign of progressive as well as regressive processes in the myocardium.
Med Klin 1978 Dec 22
PMID:[Determination of creatine kinase and CK-MB in heart failure (author's transl)]. 72 68

A 2-day-old female infant was presented with severe cyanosis without cardiac failure. The ECG revealed a normal axis and left ventricular hypertrophy. Chest X-ray examination showed a slightly but uncharacteristically enlarged heart. Cardiac catheterization and angiography showed isolated right ventricular hypoplasia with atrial septal defect. A large right to left shunt at atrial level produced marked systemic arterial desaturation. Up to the age of now nine months the patient remained in good health without cardiac failure. The clinical findings and surgical treatment of this rare malformation are discussed. Differential diagnosis with clinically similar malformations such as tricuspid atresia type 1 B or pulmonary atresia type 1 (with intact ventricular septum) is impossible without angiography.
Helv Paediatr Acta 1978 Dec
PMID:[Isolated right ventricular hypoplasia]. 73 6

Two patients with arteriovenous malformations draining into the deep venous system of the brain are presented. Both were diagnosed in infancy. One of the patients required a ventriculo-peritoneal shunt to control his obstructive hydrocephalus. Six months later, the AVM was surgically attacked in an attempt to control the progressive heart failure. The other, treated without a shunt, required digitalis to control the progressive heart failure. The clinical presentation and the characteristics of arteriovenous malformations of the vein of Galen and treatment are discussed.
Surg Neurol 1978 Dec
PMID:Deep seated giant arteriovenous malformations in infancy. 74 58

Three cases of persistent pulmonary hypertension in newborn infants are reported. One patient developed this syndrome following a normal pregnancy and uneventful delivery, whilst the others had a history of fetal or perinatal distress. Cardiac catheterization showed pulmonary hypertension in two cases in the absence of cardiac or pulmonary disease or metabolic disorders; one of these babies died unexpectedly following initial improvement. The second infant died from massive cardiac failure before cardiac catheterization could be carried out. The surviving infant was reinvestigated at the age of 7 months and showed normal pulmonary pressure and no evidence of cardiac disease. Aetiology, haemodynamics and clinical picture of this syndrome are discussed in relation to the varying clinical features manifested by our patients and the course taken.
Wien Klin Wochenschr 1978 Dec 08
PMID:[Persistent pulmonary hypertension in newborn infants (author's transl)]. 74 50


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