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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 61 patients with chronic cor pulmonale with compensation and decompensation of circulation, the stroke and minute heart volume were studied as well as the indices, characterizing the blood-gas contents and acid-base blood state. The minute heart volume in the patients examined proved to be with normal values. Stroke heart volume is decreased in all patients examined with chronic cor pulmonale. The acceleration of heart activity enables the maintenance of normal minute volume. Hypoxemia has a cardiac depressive effect as regards minute volume and heart rate. The moderate hypercapnia has a certain stimulating effect on heart. A direct proportional correlation exists between the hypercapnia degree and the tendency of minute volume increase and especially of heart rate. The campaign against hypoxemia is an essential element in the prophylaxis and early treatment of chronic cor pulmonale.
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PMID:[Cardiac output, blood gas analysis and the acid-base state of the blood in chronic cor pulmonale]. 1 45

With a radionuclide technique, left ventricular ejection fraction and stroke volume index were measured in the basal state and after the stress of a methoxamine-induced increase in afterload in 10 men with severe chronic obstructive pulmonary disease. The resting mean left ventricular ejection fraction was normal in all 10 patients. After an acute increase in resistance to left ventricular ejection with methoxamine, the left ventricular ejection fraction and the stroke volume index did not decrease significantly, even in the presence of cor pulmonale in 5 patients. Mean pulmonary capillary wedge pressure was normal before, and did not change significantly after, methoxamine infusion. The data suggest that latent left ventricular dysfunction is not present in this group of patients with severe chronic obstructive pulmonary disease.
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PMID:Methoxamine-induced increase in afterload. Effect on left ventricular performance in chronic obstructive pulmonary disease. 65 92

The essential implication of the notion of risk factor is that preventive action should be undertaken if certain factors, predisposing to cardiovascular diseases are present in an individual or in a group. Risk factors are thus categorized from the pragmatic point of view, according to the relative ease and practicability of prophylactic intervention -- and their justification. A brief review of the risk factors of the major cardiovascular diseases (coronary heart disease, hypertension, chronic pulmonary heart disease, stroke, rheumatic heart disease and congenital malformations) shows that the risk factor concept is the basis of preventive cardiology.
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PMID:[Use of the risk factor concept in cardiovascular diseases (author's transl)]. 100 56

Red cell mass and plasma volume were simultaneously measured by Cr51 and J125-albumine, respectively, in 36 patients with chronic obstructive lung disease and cor pulmonale. Additionally, pulmonary function tests and arterial blood gas analyses as well as pulmonary circulatory and right ventricular hemodynamic measurements were performed the same day. Patients were divided into 3 clinical subgroups: 1. a predominantely emphysematous A-type (n =12), 2. a predominantly bronchial B-type (n = 12), and 3. an intermediate type (n = 12) with about equal scores for A and B. With regard to the cardiac state, A-patients were clinically characterized by small ptotic hearts on chest x-ray and the absence of overt cardiac failure during the whole course of illness whereas B-patients generally showed radiological evidence of heart dilatation associated with recurrent episodes of manifest right ventricular failure. Patients of the intermediate type mostly had recovered from cardiac failure. The following results were obtained: 1. Red cell volume, plasma volume, and total blood volume were within normal limits in A-patients and in patients of the intermediate type. A marked hypervolemia in B-patients was almost entirely due to an increased red cell volume. 2. Close correlations of the red cell volume and total blood volume, respectively, to the arterial PO2 as well as to the arterial PCO2 could be established. 3. Total blood volume was significantly correlated to certain hemodynamic parameters, including cardiac output, stroke volume, pulmonary artery pressure, and right ventricular enddiastolic pressure. 4. The quotient body hematocrit/venous hematocrit was lowered to a significant degree as compared to normal subjects. As a consequence, indirect determination of red cell volume and total blood volume from plasma volume and venous hematocrit leads to a consistent overestimation of both parameters, amounting to 28% in the mean for the red cell mass and to 12% for the total blood volume in the present series.
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PMID:[Red cell mass and plasma volume in chronic cor pulmonale (author's transl)]. 119 61

Investigations of the hemodynamics of pulmonary circulation, right and left heart venticle and ventilatory function of the lungs were carried out in a group of 12 patients with primary pulmonary hypertension. The results were discussed in the light of data obtained in a group of 16 patients with chronic cor pulmonale syndrome and 16 healthy subjects. It was found that patients with primary pulmonary hypertension show a markedly raised pressure in the pulmonary artery mean pressure x = 60.3 +/- 24.2 mm Hg, in the right ventricle (systolic pressure x = 90.6 +/- 27.9 mm Hg, end-diastolic pressure x = 11.7 +/- 4.3 mm Hg), very high total pulmonary vascular resistance (x = 1571 +/- dynes. sec. cm-5) and increased work of right ventricle (x = 2.3 +/- 1.5 kgm/min/m2). In patients with chronic cor pulmonale syndrome the load on the right ventricle was much lower. The indices determining left ventricle function as a pump indicated that this function was impaired, with lower cardiac index (x = 2.1 +/- 0.8 1/min/m2), stroke volume (x = 41.7 +/- 17.2 ml) and left ventricular work (x = 2.7 +/- 1.1 kgm/min/m2). These changes might, however, be due also to impaired blood flow into the left ventricle. In contrast to patients with chronic cor pulmonale syndrome, the indices of ventilatory function of the lungs were normal or only slightly decreased. No significant correlations were observed between hemodynamic indices of pulmonary circulation and right ventricle and the parameters of the ventilatory function of the lungs.
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PMID:Primary pulmonary hypertension--a study of disturbances in circulatory hemodynamics and ventilatory function of the lungs. 122 28

The hemorheologic properties are obviously abnormal in patients with cor pulmonale (CP), presenting as high hematocrit (HCT), hyperviscosity and hyper-viscoelasticity. Twenty patients suffering from CP with polycythemia were randomized into either an isovolemic hemodilution (IHD) group or control group. In the IHD group, 10 patients were treated by routine therapy combined with IHD. The other 10 patients in the control group were treated by routine therapy only. The results demonstrated that after treatment in IHD group, all viscoelasticity property parameters except eta p were decreased significantly. Oxygen delivery, oxygen transport capacity, and stroke volume and cardiac output were increased. Mean pulmonary artery pressure and total pulmonary resistance were decreased. However, in the control group only HCT and eta 0.512 were decreased after treatment. The viscosity and eta' of the whole blood in IHD group were decreased more markedly than those in the control group. IHD was well tolerated in most of the patients. There were no complications or side effects. Thus, IHD is a safe, effective and acceptable therapy, and it may play a role in the treatment of cor pulmonale.
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PMID:[A randomized control trial of isovolemic hemodilution therapy in cor pulmonale]. 128 45

Amrinone was given intravenously combined with the routine treatment to 10 patients with late chronic cor pulmonale in exacerbation stage. The initial loading dose was 1.5-2 mg/kg followed by the maintenance dose of 15 micrograms/kg. min for 6 hours. Hemodynamic and blood gas monitoring showed that pulmonary artery pressure, pulmonary vascular resistance index, right atrial pressure and pulmonary capillary wedge pressure decreased significantly and maintained the level markedly below baseline after amrinone administration (the extents decreased were 0.53-1.1 kPa, 80-140 dyn.s.m2.cm-5, 0.27-0.40 kPa and 0.40-0.67 kPa respectively. P < 0.05 for each parameter) and that cardiac index and stroke volume index increased identically (the extents increased were 0.3-0.6 L/min.m2 and 2-4 ml/beat.m2 respectively, P < 0.05 for each parameter). There were no significant changes in systemic artery pressure, arterial blood gas analysis and blood platelet count after amrinone administration. We suggest that amrinone may be effective in the treatment of cardio-pulmonary decompensated chronic cor pulmonale.
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PMID:[Hemodynamic effects of amrinone on cardiopulmonary decompensated chronic cor pulmonale]. 133 21

Cigarette smoking is the most preventable cause of cardiovascular morbidity and mortality. Smoking has been associated with a two-to fourfold increased risk of coronary heart disease, a greater than 70% excess rate of death from coronary heart disease, and an elevated risk of sudden death. These risks are compounded in the presence of hypertension, hypercholesterolemia, glucose intolerance, and diabetes, all of which exhibit a synergistic effect with smoking. The relationship between smoking and the risk of peripheral vascular disease has also been well documented. Smokers account for approximately 70% of patients with atherosclerosis obliterans and virtually all those with thromboangiitis obliterans. An association between smoking and cerebrovascular disease remains a matter of debate, although a higher risk of stoke and stroke-related mortality has been observed in smokers than in nonsmokers. Smoking has also been implicated in the development of cor pulmonale, but a direct association with congestive heart failure has not been established. Nicotine and carbon monoxide appear to play major roles in the cardiovascular effects of smoking. Both components adversely alter the myocardial oxygen supply/demand ratio and have been shown to produce endothelial injury, leading to the development of atherosclerotic plaque. Adverse effects on the lipid profile have been noted as well, but the relationship between these changes and the risk of cardiovascular disease remains to be confirmed. Notably, smoking cessation results in a dramatic reduction in the risk of mortality from both coronary heart disease and stroke. In light of the fact that the incidence of smoking has declined primarily among educated sectors of the U.S. population, future efforts must focus on providing effective education, including smoking cessation techniques, to the less-educated groups.
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PMID:Smoking and cardiovascular disease. 149 5

Clinical and autopsy records of 100 elderly patients were analyzed. The most common cause of death in this series was malignant tumors (39%). The second leading cause of death was diseases of the circulatory system (37%), in which cerebrovascular accident alone accounted for 21%. Cor pulmonale and myocardial infarction were also common causes of death. In addition, infective diseases, especially pneumonia and septicemia were often fatal to elderly patients. The discrepancy between clinical and post-mortem diagnoses in this series was 24.7%. The causes of incorrect and missed diagnoses are discussed. The results suggest that extensive autoptic study still has vital practical significance.
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PMID:[Autopsy study of 100 elderly patients]. 161 44

Cor pulmonale is present in 54-64% of patients with respiratory failure (mean PaO2: 52-54 Torr) receiving home oxygen therapy in Japan. This may imply that the development of clinical symptoms of cor pulmonale in the course of the disease more strongly reflects far advanced stage than the presence of respiratory failure. In this paper, clinical data from subjects with various forms of precapillary pulmonary hypertension were analysed with respect to correlation between the prognosis and the pulmonary vascular response to various therapeutic modalities such as acute administration of oxygen, vasodilator drugs, and surgery. The results were as follows: 1) In subjects with COPD, there was a significant correlation between mean pulmonary arterial pressure (PPA) and prognosis. Patients who showed decreased pulmonary vascular resistance (% delta PVR less than -10) after 100% oxygen inhalation had a good prognosis. 2) In subjects with sequelae of pulmonary tuberculosis, there was no apparent correlation between the prognosis and % delta PVR after 100% oxygen inhalation. 3) In subjects with both COPD and sequelae of pulmonary tuberculosis, the lowest value of desaturation during sleep was significantly correlated to the PPA during wake. 4) Analysis of 232 cases with primary pulmonary hypertension revealed the following prognostic factors: PPA, cardiac output, stroke volume index, pulmonary vascular resistance, mixed venous oxygen tension, right atrial pressure, total bilirubin, and total protein.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical aspects of precapillary pulmonary hypertension]. 162 93


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