PN 200-110 (isradipine), a dihydropyridine derivative, is a newly available calcium antagonist with potent vasodilatory properties. To determine if PN 200-110 might benefit patients with congestive heart failure (CHF), its acute hemodynamic effects were evaluated in a group of 12 patients with severe CHF. Measurements of cardiac performance were obtained ...

Several clinical studies have demonstrated beneficial hemodynamic effects of calcium antagonist drugs when used as arterial vasodilators in the treatment of certain patients with moderate to severe congestive heart failure. These drugs usually decrease systemic vascular resistance and improve ejection phase indexes of left ventricular function in such patients. However, ...

The literature available on the use of nitrates (glyceryl trinitrate, isosorbide dinitrate and isosorbide 5-mononitrate) as various formulations (oral, buccal, sublingual, transdermal and intravenous) in the treatment of acute and chronic congestive heart failure is reviewed. There are adequate data on the acute haemodynamic effects of these preparations, but little ...

A variety of cerebrovascular abnormalities may become manifest in the first years of life. We present our recent experience with 7 children, ages 1 week to 7 months of age, who presented with congestive heart failure and progressive head enlargement (3), heart failure alone (1) and head enlargement alone (2). ...

This article reviews the cardiovascular effects of the standard tricyclic antidepressants and what is known of the cardiovascular effects of the newer antidepressants. The cardiovascular effects of the standard tricyclics are orthostatic hypotension, conduction delay and a potent antiarrhythmic effect. Patients who have congestive heart failure and are on cardiac ...

Microbubble contrast visualization within the right heart is almost always due to intravenous injections containing microbubbles. In the absence of immediate administration of agitated solutions, several other mechanisms for the occurrence of echo contrast spontaneously in the cardiovascular system have been postulated. Often overlooked as a source of contrast are ...

Cardiac abnormalities have been reported in 25% to 73% of adult patients with acquired immunodeficiency syndrome (AIDS). We are reporting the clinical course of a child with congenital AIDS who developed similar cardiac complications. He presented with congestive heart failure three months after the diagnosis of AIDS. He had cardiomegaly ...

Chylothorax associated with congestive cardiomypathy was diagnosed in a 10-year-old male castrated domestic shorthair cat via analysis of pleural fluid. The triglyceride concentration in the pleural fluid was high (579 mg/dl), compared with that in serum (87 mg/dl), and the fluid cleared with ether. Evidence of atrial and left ventricular ...

To examine the effect of daily treatment with taurine on improving the status of congestive heart failure (CHF), we used rabbits with artificially induced aortic regurgitation. Ten rabbits were treated daily with taurine (100 mg/kg by mouth) and eight with guanidinoethyl sulfonate (GES) (100 mg/kg by mouth) immediately after induction ...

To alter the natural history of congestive heart failure and change the poor prognosis for patients with this condition will require new insights into its pathogenesis as well as the development of strategies to alter the neurohumeral and serum electrolyte abnormalities associated with congestive heart failure, which are often exaggerated ...

Congestive cardiomyopathy was diagnosed during post mortem examination in eight of 149 adult woodchucks from New York. The eight woodchucks, four males and four females, died spontaneously without clinical signs of heart failure having been detected. The primary lesion was a grossly enlarged and dilated heart. Histologic lesions consisted of ...

Cardiac involvement is common in systemic amyloidosis. The most frequent cardiovascular manifestations are congestive heart failure and arrhythmias. Embolic complications often occur after the onset of these symptoms. We report a 46-year-old woman with systemic amyloidosis, who sustained two middle cerebral artery strokes and shortly after developed symptoms of cardiac ...

A congestive cardiomyopathy (CCM) model occurs in inbred broad-breasted turkeys and is manifested by reduced hatchability and a high mortality within a week of hatching. In the survivors, cardiac dilation begins by 3-4 weeks of age and further mortality occurs from chronic congestive heart failure. The mechanisms behind these changes ...

Intravenous nitroglycerin is frequently used in the treatment of acute myocardial infarction for its vasodilating effect on lowering both preload and afterload and in the control of ischemic heart pain. The end point for doses of nitroglycerin infusion is either relief of persistent or recurrent angina or controlling congestive heart ...

The short- and long-term hemodynamic effects of encainide, a new class IC antiarrhythmic agent, were studied in 25 patients (mean age 61 +/- 11) with complex symptomatic ventricular arrhythmia and left ventricular dysfunction. Ninety-two percent had previous myocardial infarction and 8% had dilated cardiomyopathy. Seventy-five percent had congestive heart failure, ...

The pharmacological properties of SK&F 94120 on the cardiovascular system have been studied in laboratory animal species. The compound was shown to have positive inotropic activity on hearts from guinea-pig, cat, dog and marmoset in-vitro and in cat and dog in-vivo. These responses in-vivo occurred in association with minimal changes ...

The diuretic effect of the supine position was evaluated in six patients with cirrhosis and ascites and six with congestive cardiac failure. After fasting overnight in bed the patients received bumetanide 1 mg intravenously and were then immediately randomly assigned to either bed rest in the supine position or normal ...

Abnormal procainamide pharmacokinetics (prolonged half-life and decreased volume of distribution) and pharmacodynamics (decreased threshold for the suppression of premature ventricular complexes) have been suggested in patients with acute myocardial infarction or congestive heart failure, or both. To better define procainamide kinetics, 37 patients in the acute care setting received intravenous ...

The increasingly frequent use of endomyocardial biopsies for diagnosis has provided the opportunity to study myocardial metabolism in patients with cardiac diseases. The authors have tested microassays of the hexose monophosphate shunt, glycolytic pathway, and Krebs cycle and demonstrated that they are easily and reproducibly performed on small pieces of ...

The effects of acute intravenous administration of ICI 118,587 (Corwin), a partial beta 1 agonist, were studied in nine patients with dilated cardiomyopathy and symptomatic congestive heart failure. Hemodynamic and metabolic parameters were measured using Swan-Ganz, arterial, and coronary sinus catheters. Repeated doses of Corwin produced no significant change in ...

Over a six-month period, 106 admissions of 94 patients for acute pulmonary edema were identified and their charts were reviewed. Precipitating factors for acute pulmonary edema included progressively worsening congestive heart failure in 25.5% of cases, coronary insufficiency in 20.8%, subendocardial myocardial infarction in 16.0%, acute transmural myocardial infarction in ...

The incidence of congestive heart failure was studied in the Beta Blocker Heart Attack Trial in which postmyocardial infarction patients between the ages of 30 and 69 years, with no contraindication to propranolol, were randomly assigned to receive placebo (n = 1921) or propranolol 180 or 240 mg daily (n ...

The positive inotropic/vasodilator agent MDL 17,043 was evaluated to determine its usefulness for both short-term support of the failing circulation and long-term treatment of patients with congestive heart failure. Both intravenous and oral administration of MDL 17,043 significantly increased cardiac output, stroke volume, stroke work index, and heart rate, and ...

A middle-aged patient with new-onset congestive heart failure, a loud precordial systolic murmur, and a widened mediastinum on chest radiography is described. Noninvasive studies in addition to the clinical examination suggested an unusual complication of atherosclerotic aortic disease, which was demonstrated at aortography and confirmed at surgery. This case stresses ...

The effects of the extracorporeal ultrafiltration method were studied in an experimental canine model of advanced congestive heart failure with mitral regurgitation, coronary artery occlusion and overhydration. With the application of this technique, cardiac output, stroke work, systemic vascular resistance and left ventricular dp/dt increased significantly associated with reduction in ...

The reduced and intrinsic viscosities of myocardial Straub F-actin from the left ventricle of a practically healthy man were equal to 3.05 +/- 0.2 and 2.4 +/- 0.32 and from the right ventricle were 2.37 +/- 0.2 and 2.1 +/- 0.3 dl/g, respectively (the difference between ventricles was not significant). ...

Chronic heart failure results from two processes, i.e., myocardial and congestive failure. Myocardial failure is clinically silent, most often progresses slowly, and is documented by a depressed left ventricular ejection fraction. Multiple etiologic factors include systolic and diastolic overloads, myocardial necrosis and/or ischemia, and, perhaps, microvascular spasm. Myocardial failure ultimately ...

Chronic congestive heart failure is a frequently occurring disease associated with an impaired quality of life and significant mortality rate. Progress has been made in dissecting the pathophysiologic changes of congestive failure and in using vasodilators, newer positive inotropic agents, and other treatment modalities. Despite these advances, the overall mortality ...

A patient presented with hypernatremia (plasma sodium level equals 171 mEq/L), marked congestive heart failure, and fluid retention. A high-salt intake and an inappropriate lack of thirst in this patient with poor cardiac function resulted in hypernatremia accompanied by edema. Hypertonic salt intake may have been due, in part, to ...

Intraarterial digital subtraction arteriography (DSA) was performed in a 39-year-old man with multiple myeloma, high-output congestive heart failure unresponsive to correction of anemia, and a pelvic bruit suspicious for an arteriovenous malformation. DSA revealed extensive neovascularity of all the visualized skeletal structures with rapid arteriovenous shunting in the pelvis. Temporary ...

Eleven patients with acute left ventricular failure following acute myocardial infarction (mean pulmonary capillary wedge pressure [PCW] greater than 20 mmHg) were entered into an open, haemodynamic study of oral isosorbide-5-mononitrate (ISMN). Left ventricular failure was resistant to intravenous diuretic therapy. No patient received concurrent cardioactive drugs nor further diuretic ...

A case study is presented of a premature infant delivered at 32 weeks' gestation by cesarean section. At birth the infant had massive cardiomegaly with extreme left ventricular dilatation as well as severe congestive heart failure and respiratory distress. The findings at autopsy suggest that the cardiac dysfunction was secondary ...

The occurrence of heart disease in uraemic patients was evaluated from study of 94 autopsied cases of chronic renal failure. The most common autopsy-ascertained causes of death were congestive heart failure (37%), acute myocardial infarction (13%) and tamponading pericarditis (8%). Death from congestive heart failure was significantly more common among ...

Eight patients with NYHA Class II congestive heart failure were studied before and after captopril with right heart catheterization, cycloergometric stress tests and radionuclide 99Tc cineventriculography. Acute administration of captopril increased stroke volume and cardiac index and reduced left ventricular filling pressure. Similar changes though less marked were seen after ...

Hyperthyroidism was diagnosed in 4 cats with congestive heart failure. Dyspnea and anorexia were observed in 3 of the 4 cats. In each cat, a holosystolic left and/or right apical heart murmur was auscultated. In 3 cats, a prominent extra heart sound (gallop rhythm) was auscultated. All cats had a ...

Amiodarone is a cardiac antiarrhythmic agent now undergoing clinical trials in the United States. Its most important side effect is pulmonary toxicity, which may present radiographically in two forms. One is similar to eosinophilic pneumonia with peripheral alveolar opacities but without any of the laboratory or pathologic findings. A second ...

Bisantrene is a newer anthracycline derivative currently being investigated in phase 2 trials. One presumed advantage of bisantrene is that it is purportedly free of cardiotoxic effects. However, bisantrene apparently precipitated congestive heart failure after a single intravenous infusion in a young boy, prompting our study of a second child ...

On two separate occasions, a 78-year-old obese man suffering from congestive cardiac failure and peripheral vascular disease, required epidural anaesthesia for surgery to his leg. The dosage requirement on the first occasion was large and much greater than on the second occasion. Reasons for the difference in dosage are discussed. ...

Cardiac hemochromatosis usually presents with clinical congestive heart failure and an enlarged heart. A woman with secondary hemochromatosis and features of both restrictive and congestive cardiomyopathy with a normal sized heart is described. Despite all interventions she had progressive cardiac impairment and expired eight days following presentation. The clinical and ...

Since the initial introduction of digitalis 200 years ago by Withering, its low therapeutic ratio has limited the use of this agent. The utility of digitalis in patients with congestive heart failure and a recent myocardial infarction has been questioned recently. Findings of rigorously controlled clinical studies suggest a small ...

Milrinone is a potent non-catecholamine, non-glycoside inotropic agent that can improve hemodynamic performance and functional capacity in patients with severe congestive heart failure. However, the potential effect of chronic inotropic stimulation on ventricular arrhythmias in patients with heart failure requires evaluation. We compared 24-hour ambulatory ECGs before and 2 to ...

Two mature Nubian does with signs of congestive heart failure were found at necropsy to have a large anterior mediastinal mass diagnosed histologically as thymoma. Lesions attributable to congestive heart failure were also present.

Superprecipitation (SP) of artificial actomyosin, obtained by hybridization of Straub actin from the human myocardium with myosin of normal animal hearts was studied. Actin was prepared from the myocardium of persons who died of congestive heart failure and various non-cardiac diseases, as well as of infants whose death resulted from ...

I confirmed the existence of an additional isozyme band of lactate dehydrogenase (LD) (EC 1.1.1.27) cathodic to LD-5 utilizing agarose gel isozyme electrophoresis in seven patients. Three of the patients died of circulatory failure within three weeks after the isozyme was identified. Four patients survived after successful therapy for heart ...

The clinician must appreciate unique aspects of equine cardiovascular physiology in order to distinguish normal variation from a pathophysiologic state. Cardiovascular problems in the horse include auscultation of cardiac murmurs, identification of cardiac arrhythmias, and recognition of congestive heart failure. A cardiac data base including history, general and cardiovascular examination, ...

One hundred consecutive female patients with active systemic lupus erythematosus (SLE) were studied from the cardiovascular point of view by means of non invasive methods. Seventy percent of the cases presented some type of cardiovascular anomaly. Seventy four percent of the resting electrocardiograms were abnormal as well as 72% of ...

Nitroglycerin and other organic nitrates exert a number of favorable effects on the circulation of patients with severe congestive heart failure, and these effects mediate the short- and long-term hemodynamic and clinical improvement that follows treatment with these drugs. Although these agents are potent dilators of systemic venous capacitance vessels, ...

Unless there is unequivocal evidence of a congenital anomaly incompatible with life, expeditious delivery should be offered to the patient whose potentially viable fetus is showing evidence of severe distress. The patient should be informed of the difficulties in interpreting diagnostic testing as well as both the immediate risks and ...

Hypocalcemia is a relatively uncommon but reversible cause of congestive heart failure. A 39-year-old woman with hypocalcemia due to untreated hypoparathyroidism presented with congestive heart failure and a left ventricular ejection fraction of 25 percent. She had no evidence of underlying cardiac disease. The serum calcium level was normalized within ...

A 39-year-old woman had suffered from congestive heart failure of unknown cause for 3.5 years before a phaeochromocytoma was diagnosed. After pretreatment with phenoxybenzamine, the tumour was removed by surgery resulting in disappearance of signs of heart disease. The patient was followed for 16 years: at that time she was ...