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Diastolic hear failure

J E Varney, T J Weiland, W J Inder, G A Jelinek
BACKGROUND: Failure to achieve treatment targets is common among people with type 2 diabetes. Cost-effective treatments are required to delay the onset and slow the progression of diabetes-related complications. AIMS: This study aimed to measure the effect of a 6-month telephone coaching intervention on glycaemic control, risk factor status and adherence to diabetes management practices at the intervention's conclusion (6 months) and at 12 months. METHOD: This randomised controlled trial recruited 94 adults with type 2 diabetes and an HbA1C > 7% from the Diabetes Clinic of St Vincent's Hospital Melbourne...
September 2014: Internal Medicine Journal
David H MacIver, Mark J Dayer, Andrew J I Harrison
Current concepts of heart failure propose multiple heterogeneous pathophysiological mechanisms. Recently a theoretical framework for understanding chronic heart failure was suggested. This paper develops this framework to include acute heart failure syndromes. We propose that all acute heart failure syndromes may be understood in terms of a relative fall in left ventricular stroke volume. The initial compensatory mechanism is frequently a tachycardia often resulting in a near normal cardiac output. In more severe forms a fall in cardiac output causes hypotension or cardiogenic shock...
April 30, 2013: International Journal of Cardiology
Akira Mima, Fumihiko Shiota, Takeshi Matsubara, Noriyuki Iehara, Taro Akagi, Hideharu Abe, Kojiro Nagai, Motokazu Matsuura, Taichi Murakami, Seiji Kishi, Toshikazu Araoka, Fumi Kishi, Naoki Kondo, Reiko Shigeta, Kazuhiro Yoshikawa, Toru Kita, Toshio Doi, Atsushi Fukatsu
A 50-year-old man who underwent hemodialysis (HD) at local outpatient HD center due to end-stage renal disease (ESRD) was transferred to our hospital because of pneumonia. He had severe emaciation and past history of congestive heart failure. Presenting symptoms almost consistently involved difficulty in hearing and recurrent attacks of migraine-like headaches. He was diagnosed with dilated cardiomyopathy, showing diastolic mechanical dyssynchrony by tissue Doppler echocardiography. On the day of death, he had hematemesis and hemorrhagic shock...
2011: Renal Failure
Hsien-Kuo Wang, Min-Shan Tsai, Jia-How Chang, Tzung-Dau Wang, Wen-Jone Chen, Chien-Hua Huang
INTRODUCTION: The aim of this study was to evaluate the role of cardiac ultrasound in diagnosing acute heart failure (AHF) in patients with acute dyspnea with available plasma B-type natriuretic peptide (BNP) level. METHODS: Patients with acute dyspnea presenting to the emergency department (ED) of a tertiary medical center were prospectively enrolled. The enrolled 84 patients received both BNP tests and cardiac ultrasound studies and were classified into AHF and non-heart failure groups...
November 2010: American Journal of Emergency Medicine
Gabriela Vazquez, M Fareed K Suri, Kamakshi Lakshminarayan, Muhammad Zeeshan Memon, Mustapha Ezzeddine, Adnan I Qureshi
BACKGROUND AND PURPOSE: For unclear reasons the blood pressure in acute stroke patients is elevated and falls over next few days. Stress in emergency department has been suggested as an etiology. To study this, we compared the prevalence of elevated blood pressure in adult patients presenting to the emergency department (ED) with hypertension related diseases. METHODS: We used data from the 2003 National Hospital Ambulatory Medical Care Survey (NHAMCS). Patients with clinical conditions requiring specific management of elevated blood pressure, namely, stroke, acute coronary syndrome, heart failure and traumatic brain injury were selected using ICD-9CM primary codes...
April 2008: Journal of Vascular and Interventional Neurology
Fatih Bayrak, Gokhan Kahveci, Muzaffer Degertekin, Bulent Mutlu
BACKGROUND: Symptoms in hypertrophic cardiomyopathy (HC) appear to be caused by diastolic dysfunction, myocardial ischemia, left ventricle (LV) outflow obstruction, and atrial fibrillation. However, clinical deterioration and severe heart failure symptoms can be observed in patients without any of these factors. Thus, the aim of this study is to determine the echocardiographic predictors of severe heart failure symptoms in patients with HC. METHODS AND RESULTS: 86 HC patients were compared according to symptomatic status...
2008: Trials
Ali Ahmed, Michael W Rich, Jerome L Fleg, Michael R Zile, James B Young, Dalane W Kitzman, Thomas E Love, Wilbert S Aronow, Kirkwood F Adams, Mihai Gheorghiade
BACKGROUND: About half of the 5 million heart failure patients in the United States have diastolic heart failure (clinical heart failure with normal or near-normal ejection fraction). Except for candesartan, no drugs have been tested in randomized clinical trials in these patients. Although digoxin was tested in an appreciable number of diastolic heart failure patients in the Digitalis Investigation Group ancillary trial, detailed findings from this important study have not previously been published...
August 1, 2006: Circulation
Stefan Klotz, Ilan Hay, Geping Zhang, Mathew Maurer, Jie Wang, Daniel Burkhoff
The impact of hypertension on left ventricular (LV) structure, pump function, and heart failure in Dahl salt-sensitive rats is poorly characterized but hypothesized to yield insights into the pathophysiology of heart failure with normal or preserved ejection fraction. Eighty Dahl salt-sensitive rats were fed either a high-salt (HS) or low-salt (LS, controls) diet starting at age 7 weeks. Ventricular properties were measured by echocardiography, hemodynamics and end-systolic and end-diastolic pressure-volume relationships (ESPVR and EDPVR, respectively)...
May 2006: Hypertension
Robyn A Clark, Skye McLennan, Anna Dawson, David Wilkinson, Simon Stewart
BACKGROUND: Australia, like other countries, is experiencing an epidemic of heart failure (HF). However, given the lack of national and population-based datasets collating detailed cardiovascular-specific morbidity and mortality outcomes, quantifying the specific burden imposed by HF has been difficult. METHODS: Australian Bureau of Statistics (ABS data) for the year 2000 were used in combination with contemporary, well-validated population-based epidemiologic data to estimate the number of individuals with symptomatic and asymptomatic HF related to both preserved (diastolic dysfunction) and impaired left ventricular systolic (dys)function (LVSD) and rates of HF-related hospitalisation...
September 2004: Heart, Lung & Circulation
Luigi Tarantini, Gianfranco Alunni, Rita Mariotti
The diagnosis of heart failure in the elderly frequently represents a clinical challenge. Atypical symptoms and signs and confounding comorbid conditions are common situations in old patients with heart failure and may obscure the clinical picture, complicating the diagnostic evaluation. Furthermore in the elderly, especially in female gender with a long-lasting history of hypertension, heart failure commonly may ensue as a consequence of a predominating impairment of the diastolic function with normal or near-normal preserved systolic function...
December 2004: Italian Heart Journal: Official Journal of the Italian Federation of Cardiology
Roberto Sciagrà, Marzia Giaccardi, Maria Cristina Porciani, Andrea Colella, Antonio Michelucci, Paolo Pieragnoli, Gianfranco Gensini, Alberto Pupi, Luigi Padeletti
UNLABELLED: Cardiac resynchronization therapy (CRT) by biventricular pacing is indicated in patients with severe heart failure and left bundle branch block who remain symptomatic despite optimal medical therapy. The relationship between baseline resting perfusion pattern and hemodynamic response to CRT has not been fully investigated. We tested the usefulness of perfusion gated SPECT for baseline evaluation and follow-up of these patients. METHODS: In 20 patients, we performed gated SPECT before CRT and at the 3-mo follow up...
February 2004: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Paola A Lanfranchi, Virend K Somers, Alberto Braghiroli, Ugo Corra, Ermanno Eleuteri, Pantaleo Giannuzzi
BACKGROUND: The prevalence and characteristics of sleep-disordered breathing in patients with asymptomatic left ventricular (LV) dysfunction are unknown. Therefore, we evaluated the prevalence of sleep-disordered breathing in patients with LV dysfunction without overt heart failure and tested the hypothesis that sleep-disordered breathing is linked to greater hemodynamic and autonomic impairment. METHODS AND RESULTS: We studied 47 patients with LV ejection fractions <or=40% without any history of heart failure...
February 11, 2003: Circulation
M Ceresa, S Capomolla, G D Pinna, O Febo, A Caporotondi, G P Guazzotti, M T La Rovere, G Francolini, A Olivares, M Gnemmi, A Mortara, R Maestri, F Cobelli
UNLABELLED: The stroke volume response to exercise is a critical determinant in meeting peripheral metabolic demands in patients with chronic hear failure. The Left atrium, by its position, is important in coupling right and left ventricles, to left preload reserve and to modulate sympathetic activity. We performed this study to investigate the relationship between exercise capacity and diastolic and systolic left atrium function in patients with chronic heart failure. METHODS: We considered 128 consecutive patients with severe chronic heart failure (EF < 35%) due to ischemic or idiopathic dilated cardiomyopathy...
September 2002: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
A Perrot, M B Ranke, R Dietz, K J Osterziel
Treatment with human recombinant growth hormone (GH) has yielded conflicting results in patients with congestive heart failure. We analyzed the baseline somatotrophic axis in 50 patients with dilated cardiomyopathy. Then, a double-blind, randomized, placebo-controlled study of GH was performed. We randomly allocated these patients to treatment with subcutaneous GH (2 IU daily) or placebo for a minimum of 12 weeks. The primary end-points were the effect on left ventricular (LV) mass and systolic wall stress...
March 2001: Journal of Cardiac Surgery
J G Cleland, M Tendera, J Adamus, N Freemantle, C S Gray, M Lye, D O'Mahony, L Polonski, J Taylor
BACKGROUND: The prevalence of chronic heart failure (CHF) rises with increasing age, from < 1% in those below 65 years of age to > 5% in those over 65 years of age and is a major cause of morbidity and mortality in older people. Recent European guidelines point to a major deficiency in our knowledge of how to treat diastolic chronic heart failure, and a lack of information on treatment for heart failure in the elderly in general. AIMS: The aims of this trial are to assess the potential benefits of the ACE inhibitor perindopril to treat chronic heart failure in elderly people, in the absence of any major left ventricular systolic dysfunction...
August 1999: European Journal of Heart Failure
A G Fried, A B Parker, G E Newton, J D Parker
BACKGROUND: The rate of left ventricular (LV) pressure increase (LV + dP/dt) may be related to QRS duration, as well as to a number of hemodynamic parameters. METHODS AND RESULTS: We studied the relation between basal LV + dP/dt and QRS duration in 43 patients with normal LV function and 81 patients with heart failure undergoing diagnostic catheterization. We also examined the relationship between LV + dP/dt and heart rate, as well as measures of both LV preload and afterload...
March 1999: Journal of Cardiac Failure
P A Majid, R Wardeh, P J De Feyter, J P Roos
We studied 9 men with antero-apical left ventricular aneurysms. All suffered from incapacitating angina pectoris without heart failure. Aneurysmectomy was done in 4 patients as the sole procedure while it was combined with revascularisation of the residual myocardium in the other 5. Haemodynamic measurements were made at rest and during submaximal supine-leg exercise before and approximately 6 mth after operation in each patient. Compared to the preoperative levels, we observed a significant increase in respiratory rate at rest (P less than 0...
1981: European Journal of Cardiology
P Hamosh, J N Cohn
Left ventricular catheterization was carried out in 40 patients with acute myocardial infarction. Left ventricular end-diastolic pressure (LVEDP) was elevated in 85% of the patients studied. In 14 patients with apparently uncomplicated infarcts, LVEDP averaged 15 mm Hg, and cardiac index (2.98 liter/min/m(2)), stroke volume (38.3 ml/m(2)), and stroke work (49.2 g-m/m(2)) were within normal limits. In 12 patients with clinical signs of left ventricular failure, LVEDP averaged 29.9 mm Hg, cardiac index was at the lower limit of normal (2...
March 1971: Journal of Clinical Investigation
N Reifart, A D Schmidt-Moritz, M Nadj, M Kaltenbach, W D Bussmann
Long-term treatment of congestive heart failure with prazosin is disputed. Only few controlled trials have been reported so far. Our study is the first randomized double-blind placebo controlled trial over several months that also takes haemodynamic measurements into account. 25 patients with congestive heart failure classes III and IV (NYHA) received either prazosin 20 mg/d orally (n = 12) or placebo (n = 13) and were followed up closely. Before treatment, after 6 and after 12 months we performed echocardiography, heart volume (estimated by chest X-ray) and right heart catheterization at rest and during exercise...
April 1985: Zeitschrift Für Kardiologie
I Aursnes, J B Osnes, E S Platou
Today it is considered a primary goal to reduce morbidity and mortality from stroke. It will probably also be possible to reduce other pressure-related illnesses, such as heart failure and renal failure. Coronary morbidity is influenced to some extent only, and involves risk of over-treatment. There is most probably a J-shaped relationship between achieved reduction of pressure and mortality. Treatment with drugs is considered when diastolic pressures exceed 90 mm Hg, provided that the patient has been observed when treated in other ways than by drugs for several months...
January 10, 1992: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
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