Search PubMed⌕ Search

Biomedical subjects

R R Brandt

Publications and source records attributed to R R Brandt.

21 records · Page 2Linked to original sources

Atrial natriuretic peptide in heart failure.

Atrial natriuretic peptide hormone of cardiac origin, which is released in response to atrial distension and serves to maintain sodium homeostasis and inhibit activation of the renin-angiotensin-aldosterone system. Congestive heart failure is a clinical syndrome characterized by increased cardiac volume and pressure overload with an inability to excrete a sodium load, which is associated with increased activity of systemic neurohumoral and local autocrine and paracrine mechanisms. Circulating atrial natriuretic peptide is greatly increased in congestive heart failure as a result of increased synthesis and release of this hormone. Atrial natriuretic peptide has emerged as an important diagnostic and prognostic serum marker in congestive heart failure. In early heart failure, it may play a key role in preserving the compensated state of asymptomatic left ventricular dysfunction. Despite increased circulating atrial natriuretic peptide in heart failure, the kidney retains sodium and is hyporesponsive to exogenous and endogenous atrial natriuretic peptide. The mechanism for the attenuated renal response is multifactorial and includes renal hypoperfusion, activation of the renin-angiotensin-aldosterone and sympathetic nervous systems. Therapeutic strategies to potentiate the biologic actions of atrial natriuretic peptide may prolong the asymptomatic phase and delay progression to overt congestive heart failure.

Animals↗

Dextran 70 embolization. Another cause of pulmonary hemorrhage, coagulopathy, and rhabdomyolysis.

Thirty-two percent dextran 70 is a highly viscous polysaccharide liquid used for uterine distention during hysteroscopy. Although generally safe, this agent has been recognized recently to cause noncardiogenic pulmonary edema, renal insufficiency, and intravascular coagulopathy. We report a case of acute 32 percent dextran 70 embolization, associated with intravascular coagulopathy, bilateral lung infiltrates, and rhabdomyolysis, recognized initially by hemoptysis and pleuritic chest pain while the patient was in the recovery room following a hysteroscopic procedure. Pulmonary, anesthesiology, and critical care physicians should be aware of these potential complications of hysteroscopic surgery.

Adult↗

Intracardiac extension of a lung tumor causing left ventricular inflow obstruction.

A patient with the diagnosis of small cell lung cancer had syncopal episodes. The tumor was found to invade the right upper pulmonary vein with extension into the left atrium. The mass was protruding across the mitral valve producing ball-valve blockade. In this report the echocardiographic signs of a primary lung tumor with intraatrial extension causing left ventricular inflow tract obstruction are described.

Aged↗