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

Early mobilisation after acute myocardial infarction is said to increase the risk of ventricular aneurysm and -rupture, reinfarction, sudden death, and heart failure. In order to evaluate these possible negative effects, we run a prospective and controlled study: 2 X 100 consecutive patients with acute myocardial infarction were mobilized conventionally (A) and according to an early mobilisation programme (B) respectively-the two groups were comparable according to age, sex, CHD-history, infarction transmural/non transmural and coronary prognostic index (Norris). There was a significant reduction in the average hospital stay from 31.4 days in group A to 25.8 in group B. The patients were followed up for 32 (A) and 46 days (B) respectively. In the early mobilized group we found no increased risk for heart failure, reinfarction, or sudden death. On the other side, early mobilisation has many psychological, oeconomic and social advantages for patients and hospital.
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PMID:[Early mobilisation after myocardial infarction. A prospective and controlled study (author's transl)]. 83 19

Bicycle exercise stress tests of 39 patients with coronary heart disease are compared to those of 33 healthy persons. The difference in enddiastolic pulmonary artery pressure (PAEDP) of the patients compared to the healthy is low at rest (PAEDPhec healthy = 8.49 +/- 2.80, PAEDPCHD = 10.51 +/- 5.09, p = 0.05). Stress testing (50 Watts) brings significant differences of the average enddiastolic pressures (PAEDP healthy = 12.76 +/- 3.61, PAEDPCHD = 19.38 +/- 7.96, p = 0.001). More important than this (already well known difference) is the wide divergence of results within the group of patients with CHD. For this reason this type of investigation seems to be a good "screening method" regarding selection for coronary arteriography. The reason for the pathological rise of PAEDP can be found in a decrease of compliance due to ischaemia ("coronary factor"), or in exercise induced temporary heart failure ("myocardial factor"), or both.
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PMID:[Behavior of pulmonary artery pressure in the egometric exercise test in chronic coronary disease]. 86 59

The study was undertaken to examine central hemodynamic and carbohydrate metabolic parameters in patients with coronary heart disease (with or without signs of chronic heart failure, Stages I and IIA). The changes in carbohydrate metabolism in CHD patients were detected earlier than those in central hemodynamics. In patients with Stage I heart failure, who had normal resting hemodynamic parameters, metabolic parameters were indicative of abnormalities in carbohydrate metabolism: there was a reduction in carbohydrate tolerance and red blood cell release of insulin in response to glucose load and an increase in blood immunoreactive insulin, erythrocytic glucose-6-phosphate dehydrogenase activity and greater adrenalin- and insulin-containing erythrocytes. It is suggested that it is advisable to determine the above parameters of carbohydrate metabolism in patients with coronary heart disease.
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PMID:[Correlation of some parameters of carbohydrate metabolism and central hemodynamics in the early stages of circulatory insufficiency in patients with ischemic heart disease]. 175 10

Since January 1988 till June 1990 145 patients with combined coronary and vascular pathology have been operated on. Concomitant damage of aortic arch branches was observed in 54 patients (37.2%), and aortocoronary bypass surgery was performed in 40 patients without correction of the carotid vascular bed pathology. These patients comprised the basic group, which was divided into two subgroups depending on the clinical pattern of the disease: subgroup I--18 asymptomatic patients (45.0%), subgroup II--22 patients (55.0%) with clinical signs of the disease. The basic group comprised 257 patients with CHD alone and no damages of the aortic arch branches. In the postoperative period 10 out of 40 patients of the basic group developed neurological complications: brain hypoxia, delirious syndrome (3 patients); brain hypoxia, pre-comatose condition (3 patients); brain hypoxia, comatose condition (2 patients); transitory ischemic attack (2 patients). No significant differences in the development of complications have been observed in patients of both subgroups. In the control group neurological complications developed in 9 out of 257 patients (3.5%). The comparison of reasons responsible for the onset of complications in both groups has shown that acute heart failure was significantly predominant (10%) in the basic group, as compared to control group (1.9%). It has been concluded that after aortocoronary bypass surgery the risk of neurological complications was higher in patients with the accompanying damage of the aortic arch branches than in patients with CHD alone; the onset of acute heart failure in the early postoperative period increases the risk of neurological complications in such patients.
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PMID:[The risk of neurological complications following aortocoronary bypass in patients with multifocal atherosclerosis]. 178 76

Risk of cardiovascular events was determined over 24 years of surveillance in relation to general adiposity reflected by relative weight and by regional obesity estimated by skinfolds and waist girth per inch of height. Upper quintile values of relative weight, subscapular skinfolds and waist girth were each associated with increased risks of cardiovascular disease in both sexes. Risk of total cardiovascular events increased with the degree of regional, central or abdominal obesity. Mortality from cardiovascular disease was also increased. Increased relative weight and central obesity were both associated with increased risk factors including cholesterol, blood pressure, glucose and uric acid. Changes in weight were mirrored by changes in risk factors with linear trends over a 15 lb range of weight fluctuations. Subscapular skinfold and the ratio of subscapular-to-triceps skinfold, measures of central obesity, were in either sex also associated with an increased probability of coronary attacks in particular. The subscapular skinfold contributed to CHD risk independent of body mass index (BMI). Multivariate analyses taking all the risk factors into account indicate an independent effect of abdominal obesity on stroke, cardiac failure and cardiovascular and all-cause mortality in men. In women, only the subscapular-to-triceps skinfold ratio independently contributes to CHD, cardiovascular and all cause mortality. Regional obesity appears to be an independent contributor to cardiovascular disease at a given level of general adiposity, its effect only partially mediated through promotion of other known risk factors. These data suggest that cardiovascular disease is as closely linked to abdominal as to general adiposity.
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PMID:Regional obesity and risk of cardiovascular disease; the Framingham Study. 199 75

In the present study, the Ca2(+)-sensitivity and myosin light chain patterns of skinned fibers of right atrium and left papillary muscles of 27 patients suffering from mitral valve disease (MVD, moderate heart failure), ischemic cardiomyopathy (ICM, severe heart failure), dilated cardiomyopathy (DCM, severe heart failure), and coronary heart disease (CHD, no heart failure, no atrial hypertrophy) were investigated. Myosin light chains of both chemically skinned and intact samples were studied by two-dimensional gel electrophoresis (2D-PAGE). Ca2(+)-sensitivity of ventricular fibers was about 0.14 pCa-units higher than that of atrial fibers in all groups except dilated cardiomyopathy where this difference was markedly diminished (only 0.06 pCa-units). Generally, Ca2(+)-sensitivity of skinned ventricular fibers was the same among the different heart diseases. Skinned atrial fibers from patients with dilated cardiomyopathy, however, were significantly (about 0.08 pCa-units) more sensitive for Ca2+ than those of the other groups (coronary heart disease, mitral valve disease or ischemic cardiomyopathy) which showed similar Ca2(+)-tension relationships. Ventricle-specific P-light chain forms could be observed in atrial samples from patients of all groups, whereas no atrium-specific light chain forms were detectable in any ventricular sample. It is concluded that there is no difference in Ca2(+)-sensitivity of the ventricular contractile elements of the human heart in different heart diseases. In atrial myocardium, there is an increased Ca2(+)-sensitivity of skinned fibers from hearts with dilated cardiomyopathy which is probably related to an elevation of right atrial pressure.
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PMID:Calcium sensitivity and myosin light chain pattern of atrial and ventricular skinned cardiac fibers from patients with various kinds of cardiac disease. 208 58

To elucidate the nature of lipid defects in patients with diabetes mellitus (DM) concurrent with acute myocardial infarction (MI), the study was undertaken to examine the serum concentrations of total cholesterol, triglycerides, alpha- and beta-lipoproteins with DM in the presence of acute MI. 40 non-diabetic patients with acute MI, 23 diabetics with postinfarct cardiosclerosis, and 17 non-insulin-dependent diabetics without signs of coronary atherosclerosis. Urinary epinephrine and norepinephrine excretion was additionally determined in the acute period and 3-4 weeks after therapy. Homogeneous lipid metabolic parameters were found in CHD patients with and without DM and when transient hyperglycemia developed. The patients with acute MI exhibited some increase in lipid consumption to satisfy the energy need for the cardiovascular system, this being true for triglycerides in DM patients. The DM patients who showed low triglyceride levels had more frequently transmural MI and MI complicated with heart failure. Obesity and familial histories of DM and CHD in DM patients with acute MI were ascertained to be accompanied by reduced serum alpha-lipoprotein concentrations.
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PMID:[The nature of changes in lipid metabolism in patients with diabetes mellitus associated with ischemic heart disease]. 227 41

The study was undertaken to examine a random representative sample from the nonorganized male and female population from on of the Moscow districts. The survey covered 1238 males and 1241 females; the response-rate was 71% and 74%, respectively. Routine epidemiological tools and consistent criteria for their assessment were applied to the survey of the population. The authors examined the following risk factors: arterial hypertension, hypercholesterolemia, hypertriglyceridemia, hypoalphacholesterolemia, and cigarette smoking in relation to a particular CHD: acute myocardial infarction, heart failure, etc.
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PMID:[Comparative characteristics of the incidence of ischemic heart disease and its risk factors among men and women aged 20-69 years (epidemiological study)]. 259 71

Management of CHD depends on the type, severity, natural history of the specific malformation, age and the secondary effect of the defect. Management includes diagnostic, regular follow-ups, preventive and therapeutic management. Prevention measures should be taken against infective endocarditis, brain abscess, pulmonary vascular obstructive disease (PVOD). Therapeutic measures include treatment for cardiac failure, infective endocarditis, common infections, arrhythmia, cyanotic spells, cerebro vascular complications. Early correction is indicated for CHD with large pulmonary blood flow to prevent PVOD, and for CHD with pressure overloading to prevent fibrosis of the myocardium. Cyanotic CHD should have early palliative or corrective surgery in order to minimise the secondary effect of prolonged cyanosis.
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PMID:Management of congenital heart disease. 281 22

The results of large epidemiological studies dealing with the prognosis and unfavourable outcome of essential hypertension, clearly show that the pharmacological reduction of the elevated blood pressure of hypertensive patients significantly reduces the risk of at least some major cardiovascular complications. Satisfactory antihypertensive efficacy reflects, nevertheless, merely a minimal requirement for a modern antihypertensive drug. Additional pharmacological properties, which counteract the typical concomitant diseases like CHD, heart failure and other cardiovascular complications would be desirable. In this respect, the oral CE-inhibitors captopril and enalapril offer an exciting new approach to the treatment of arterial hypertension. As the most predictive international studies on prevention of hypertension were conducted before CE-inhibitors were available, the present review evaluates the pharmacological profile of this new class of antihypertensive compounds in the light of previously available baseline drugs, including the calcium channel antagonists. Until now, captopril and enalapril have been the best investigated and documented representatives. Besides new experimental results concerning the molecular mechanism of these drugs, clinical and experimental approaches to verify protective effects on the cardiovascular and the renal system are addressed. These offer a rational basis for the preferential treatment of hypertensive patients with reduced renal function, diabetes and chronic heart failure. In addition, some distinct advantages of enalapril over captopril, resulting mainly from the long-term reduction of high blood pressure, are discussed.
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PMID:[Differential therapeutic topics in antihypertensive therapy. What can angiotensin-converting enzyme inhibitors accomplish?]. 285 Jun 83


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