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

One thousand two hundred and thirty-five haemodialyses have been performed on 92 patients with renal failure. The mean number of dialyses per patient was 13.42 and the survival rate was 60.9%. One hundred and six arteriovenous shunts (98 of arm, 7 of ankle, and one of groin) were created. Three arteriovenous fistulae of arm were created in 2 patients with chronic renal failure. All the operations were performed under local or regional block anaesthesia. The mean shunt complications were clotting (27.4%), bleeding (17.9%) and infection (13.2%). The complications associated with the fistulae were non-function, heart failure, infection, aneurysmal dilatation and bleeding. One death from heart failure was attributable to arteriovenous fistula. It is recommended that patients with renal failure requiring haemodialysis in developing countries should have shunts or fistulae created under regional anaesthesia to avoid the problems of general anaesthesia in uraemic patients.
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PMID:Vascular access for haemodialysis for renal failure in a developing country. 711 69

Using Inokuchi's vascular stapler, arteriovenous fistulas with an end-to-end fashion for hemodialysis were constructed in 80 patients (82 limbs) with chronic renal failure. In 76 patients and 76 limbs (95%) of a total of 80 patients, the fistulas were patent and hemodialysis could be effectively carried out. Use of Inokuchi's vascular stapler facilitated a rapid construction of subcutaneous end-to-end arteriovenous fistulas, and no particular training in vascular surgery was required for the operator. Since the anastomosis was constructed in an end-to-end fashion, complications such as swollen hand, peripheral steal syndrome and cardiac failure were nil.
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PMID:Construction of internal arteriovenous fistulas for hemodialysis using Inokuchi's vascular stapler. 712 Jul 5

Therapy of chronic renal failure requires individual management in diet and vigorous treatment of disorders of fluid and electrolyte metabolism and renal acidosis. Concomitant diseases such as renal hypertension, arrhythmia, cardiac insufficiency, pulmonary complications, gastrointestinal disorders, renal anaemia, affection of central nervous system, disturbance in glucose, uric acid and lipid metabolism and infections, demand careful medication Selection of drugs and doses related to impaired renal functions, is indicated.
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PMID:[Therapy in chronic renal insufficiency (author's transl)]. 724 18

A case of metastatic myocardial calcification is reported in a patient with chronic renal failure. The characteristic features are failure to take phosphate-binding antacids on a regular basis, intractable congestive heart failure, atrioventricular block, a calcium phosphate product consistently greater than 60, and sudden irreversible cardia arrest. Arteriovenous fistulae created for haemodialysis appear to be an unlikely cause of cardiac failure.
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PMID:Metastatic myocardial calcification. 724 27

The cardiac function in Hegglin syndrome (HS; prolonged QT interval and shortened QS2) remains unclear. In order to estimate cardiac function of HS, left ventricular echocardiographic parameters and systolic time intervals (STI) were analyzed, and compared with those of normal subjects (N) (n = 20). Forty-six patients (pts) of HS are constituted of 23 pts with chronic renal failure, 7 with cardiomyopathy, 5 with ischemic heart disease, 5 with essential hypertension, 4 with acquired valvular disease, 1 with effusive pericarditis and 1 with Romano-Ward syndrome. Corrected preejection period (PEPc) and PEP/ET were significantly larger (0.15 +/- 0.02 vs 0.13 +/- 0.01, p less than 0.001; 0.48 +/- 0.13 vs 0.35 +/- 0.04, p less than 0.001, respectively) in HS. Corrected ejection time (ETc) was significantly smaller (0.37 +/- 0.02 vs 0.41 +/- 0.01, p less than 0.001) in HS. Mitral EF slope (DDR), ejection fraction (EF), and mean ventricular circumferential fiber shortening (mVCF) were significantly decreased (58 +/- 29 vs 92 +/- 25, p less than 0.001; 0.52 +/- 0.15 vs 0.62 +/- 0.07; p less than 0.005; 0.98 +/- 0.33 vs 1.18 +/- 0.20; p less than 0.05, respectively) in HS, but cardiac index (C.I.) did not differ. Thus, patients with Hegglin syndrome showed heart failure pattern in STI and hypodynamic cardiac function in echocardiographic parameters, and our data suggest that hypodynamic cardiac function of HS is caused by both lowered pump function and decreased myocardial contractility.
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PMID:[Systolic time intervals and echocardiographic parameters in Hegglin syndrome (author's transl)]. 732 May 60

33 patients with chronic renal failure were divided into two groups. Group I consisted of 8 non-dialysed patients without any clinical or biochemical sign of liver disturbance nor any iron supplementation. Group II consisted of 25 maintenance hemodialysis (MHD) patients treated from 2 to 13 years. 19 subjects had chronic B hepatitis. Total exogenous iron load parenteral iron and/or blood transfusions) was calculated. Body iron overload (hemosiderosis) was assessed by liver iron concentration (LIC) in needle biopsy specimens according to Barry's method (less than 200 microgram/100 mg dry weight) and serum ferritin levels (less than 360 ng/ml). 4 patients whose serum ferritin was increased with or without hepatic fibrosis and with or without any organ dysfunction due to hemochromatosis received i.v. infusions of desferrioxamine in doses of 2 g at each dialysis. Serum ferritin levels were correlated with LIC (p less than 0.001) and iron load (p less than 0.001). Hemosiderosis was noted in 16 MHD patients (group II) and correlated with iron load. Hemochromatosis was noted in 4 patients (group II). 4 hemodialysed patients with iron overload were treated by desferrioxamine from 6 to 18 months. During this therapy, body iron stores fell and organ dysfunction (heart failure, hepatic cytolysis, anaemia, diabetes mellitus improved. Long-term chelation therapy by desferrioxamine was effective and the chelated iron was readily removed by dialysis. These data show the importance of precise evaluation of iron stores in MHD patients.
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PMID:[Iron-overload in patients on maintenance hemodialysis: diagnostic criteria, indications and treatment by desferrioxamine (author's transl)]. 732 1

The responses in the left ventricular systolic time intervals following digoxin administration (0.5 mg i.v.) were studied in 11 patients with chronic renal failure and hypertension. The control group comprised 11 patients with mild essential hypertension. There were no clinical signs of congestive heart failure in any of the patients. Before digoxin administration total electromechanical systole (QS2), the pre-ejection period (PEP) and the PEP/LVET ratio were greater, while the left ventricular ejection time (LVET) was shorter than in the control group (P < 0.001). In patients with chronic renal failure digoxin administration induced a reduction in QS2, PEP and PEP/LVET ratio and a prolongation of LVET (P < 0.001). These data suggest latent heart failure in the group of patients studied with chronic renal failure. It seems to be advisable to use digitalis preparations in patients with chronic renal failure despite the absence of clinical signs of heart failure.
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PMID:The left ventricular systolic function after digoxin administration in patients with chronic renal failure. 739 45

A 68-year-old female on two-year chronic hemodialysis for chronic renal failure due to chronic pyelonephritis, was admitted to hospital for weakness, dulled sensorium and dizziness. On examination the patient was in a state of circulatory collapse, the electrocardiogram showed an accelerated idioventricular rhythm and laboratory analysis revealed extreme hyperkalemia (K+ 10.1 mmol/l). There were no common causes of shock, such as hypovolemia, sepsis, heart failure and presence of vasodilator drugs. The patient was treated with calcium gluconate, sodium bicarbonate and sodium chloride (to oppose the effects of hyperkalemia on the cell membrane to minimize cardiac and neuromuscular toxicity), insulin and dextrose (to increase the transport of K+ from the extracellular to the intracellular compartment), and hemodialysis (to remove K+ from the body). At the end of the hemodialysis session, the patient was in a clinically good condition, blood pressure was 160/90 mm Hg and the serum K+ concentration was normal. The case appeared to suggest that extreme hyperkalemia may have direct effects on vascular resistance, causing hypotension and shock.
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PMID:A life-threatening complication of extreme hyperkalemia in a patient on maintenance hemodialysis. 748 41

The efficacy and side effects of the combination therapy of thiazide and furosemide administered to patients with refractory heart failure, for a prolonged period of time, were assessed. Thirty-two patients were hospitalized during the years 1985-1991. Left heart failure (left ventricular ejection fraction (LVEF = 22.4% +/- 6.6%) was present in 26 patients, right heart failure in 3 patients, chronic renal failure, cirrhosis and bilateral pleural effusion were present each in one patient. Chlorothiazide 0.5 g daily was added to conventional therapy. Patients were monitored closely during hospitalization and later as outpatients. During hospitalization, addition of chlorothiazide caused a reduction of 4.8 +/- 4.0 kg in patients' weight, serum potassium decreased from 4.4 +/- 0.6 to 4.0 +/- 0.5 mmol/l (P < 0.005) and serum sodium from 139.0 +/- 4.7 to 136.8 +/- 5.5 mmol/l (P < 0.05). The duration of the combined therapy was 17.2 +/- 19.1 months. Thirteen patients had short treatment (1.6 +/- 0.8 months) and 19 patients had prolonged treatment (26.5 +/- 19.0 months). No specific characteristics distinguished patients in both groups. Thiazides were discontinued in 19 patients, 10 of which had side effects. In only 5 of the 19 patients treated for the prolonged period had thiazides to be discontinued because of side effects. Addition of thiazides to furosemide is efficacious in severe heart failure. The combination should be started during hospitalization. Many patients can be maintained on this combination for a prolonged period of time on an ambulatory basis.
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PMID:Prolonged therapy by the combination of furosemide and thiazides in refractory heart failure and other fluid retaining conditions. 759 35

A 39-year-old woman with the diagnosis of mitral regurgitation was admitted to our hospital for surgical treatment. Cerebral thromboembolism and spontaneous abortion had been repeated in her past history. She was suffered from chronic renal failure associated with systemic lupus erythematosus (SLE) and anti-phospholipid syndrome (APS). An operative procedure was recommended because of the progressive heart failure due to mitral regurgitation. For renal failure, continuous ambulatory peritoneal dialysis (CAPD) was introduced at one month before operation. As the operative procedure, valve replacement using Carpentier-Edwards bioprosthesis (27 mm) was done rather than valve reconstruction, because chordal rupture of posterior leaflet and severe hypertrophy of both leaflets were recognized. During operation, uncontrollable bleeding was not observed. However, platelet transfusion was needed. We use warfarin and antiplatelet agents jointly as postoperative anticoagulant therapy. Thromboembolic episodes have not been observed 4 years postoperatively. Relationship between SLE with APS and cardiac valvular lesions has been focused. The present case was considered to be the interesting case which various devices were necessary to operative management including chronic renal failure, cardiopulmonary bypass, selection of prosthetic heart valve, and postoperative anticoagulant therapy for preventing thrombus formation.
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PMID:[Successful surgical treatment of mitral regurgitation associated with anti-phospholipid syndrome and systemic lupus erythematosus]. 759 55


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