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At least 1,117 records · Page 62Linked to original sources
PubMed1992

A model of left ventricular dysfunction caused by intracoronary adriamycin.

Experimental evaluation of new therapy for congestive heart failure has been hampered by the lack of a simple and reliable animal model of heart failure. This study was undertaken to develop a canine model of chronic left ventricular dysfunction. A left thoracotomy was performed in 9 adult mongrel dogs. A 1.5-mm Silastic (Dow Corning) catheter with an attached subcutaneous access port was positioned in the left main coronary artery. Six animals received five weekly infusions of Adriamycin (doxorubicin hydrochloride) (10 mg/wk), and 3 received saline solution. Hemodynamic studies were performed before insertion of the catheter and 2 weeks after completion of the infusions. In animals that received Adriamycin, rest ejection fraction declined from 0.54 +/- 0.03 to 0.35 +/- 0.03, cardiac output fell from 5.6 +/- 0.6 to 3.9 +/- 0.5 L/min, and left ventricular end-diastolic volume increased from 76 +/- 9 to 99 +/- 12 mL (p less than 0.05). There was a small increase in right atrial pressure (2.7 +/- 1 versus 5.7 +/- 1 mm Hg) but no change in right ventricular ejection fraction (0.31 +/- 0.04 versus 0.30 +/- 0.03). In no animal did alopecia, weight loss, neutropenia, or anemia develop. Histological changes consistent with Adriamycin-induced cardiac toxicity were found in each dog. No significant hemodynamic or histological changes occurred in the control animals. Administration of Adriamycin into the left main coronary artery causes left ventricular dysfunction without resulting in systemic side effects or compromising right ventricular function. This animal model could be used to evaluate the effects of new possible therapy, such as cardiomyoplasty, on left ventricular failure.

Animals↗
PubMed1985

Mechanisms in cardiomyopathies.

The three main clinical types of cardiomyopathy are: hypertrophic cardiomyopathy; dilated cardiomyopathy; and restrictive cardiomyopathy. In each case the basic cellular mechanisms still remain to be defined.

Adrenergic beta-Antagonists↗
PubMed1985

Calcium and catecholamines: relevance to cardiomyopathies and significance in therapeutic strategies.

There are marked differences between human cardiomyopathies, especially of the hypertrophic variety, and animal models. There is no simple way in which a hyperadrenergic state can explain the contractile abnormalities, although additional effects of calcium overload or marked hypertrophy come somewhat closer to linking animal and human diseases. One of the best links between excess catecholamine stimulation and myocardial damage lies in the enhanced sarcolemmal permeability which is mediated by beta-adrenergic stimulation and calcium ions in an isolated rat heart model. The therapeutic success of beta-adrenergic blockade and especially calcium antagonists in no way provide firm evidence for a hyperadrenergic state nor for intracellular calcium overload. In human hypertrophic cardiomyopathy, these agents may be acting merely by enlarging cavity size. In dilated cardiomyopathy, the use of beta-adrenergic blockers is still highly controversial and calcium antagonists are not well tested. It is the lack of appropriate models for both hypertrophic cardiomyopathy and dilated cardiomyopathy which is holding up research in this important area.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Residuae, sequelae, and complications of surgery for congenital heart disease.

Definitive, if not curative surgery is available for the eight most common congenital cardiac defects-ductus arteriosus, ASD, coarctation, pulmonary valve stenosis, aortic valve stenosis, tetralogy of Fallot, and transposition. The results of surgery for uncomplicated cases of DA, ASD, VSD, and coarctation usually can be determined by clinical means (including chest radiogram and ECG). Postoperative heart catheterization is recommended for evaluation of the patient who has had surgery for pulmonary valve stenosis or artic stenosis and is necessary after tetralogy of Falot or transposition of the great arteries repair to identify the important postoperrative residua and sequelae. The term "curative" surgery probably shoud be reserved for operation for divion of ductus arteriosus unassociated with pulmonary hypertension and performed in childhood. After closure of ASD, patients should continue to be observed for late development of arrhythmias and persistent cardiac enlargement, although the incidence of these problems is low. After VSD closure the patient is still followed at intervals for possible ill effects of the ventriculotomy scar, manifest as arrhythmias, ventricular aneurysm or myocardial insufficiency. The patient with coarctation repair must be observed for a possible late complication from one of the several clinically silent cardiovascular or cerebrovascular anomalies as well as for the change of restenosis or unrelieved hypertension...

Aortic Coarctation↗
PubMedDate not supplied

Diabetic cardiomyopathy.

Diabetes mellitus is associated with a specific cardiomyopathy. This is evident from the clinical-pathological work and the epidemiologic data from the Framingham study. Noninvasive studies of diabetics have shown alterations in systolic and diastolic function that may ultimately lead to clinical heart failure. The relationship of these cardiac changes to the type of diabetes, its duration, and its severity is not settled. However, a correlation between changes in heart function and other complications of diabetes has been demonstrated. Insufficient prospective data is available from noninvasive studies to establish the frequency of progression from subclinical cardiac dysfunction to overt congestive failure. The pathogenesis of this disorder is still uncertain. Pathological studies have shown changes in the intramural arteries, arterioles, and capillaries but their functional significance is uncertain. Experimental studies have shown interstitial changes leading to an apparently less compliant left ventricle in the diabetic dog and monkey. In the diabetic rat reversible changes were found in myocardial function, related to changes in contractile proteins and intracellular calcium metabolism. In both species, the response to anoxia or ischemia was altered in the presence of diabetes. However, irreversible depression of the contractile element was not found in most animal studies of isolated diabetes. In contrast, the combination of hypertension and diabetes leads to substantial cardiac damage and circulatory congestion, both in clinical and experimental investigations. Clearly much more work must be carried out to understand the pathogenesis, treatment, and ultimately the prevention of diabetic cardiomyopathy.

Adult↗
PubMed1988

Detection of valvar obstruction by intracardiac masses using Doppler echocardiography.

The purpose of this paper was to examine valvar involvement in patients with intracardiac masses. Seven patients with intracardiac masses were studied by cross-sectional and Doppler echocardiography. In one, a candida vegetation on a mitral Starr-Edwards prosthesis obstructed the aortic valve with a peak transvalvar velocity of 2 m/sec and aortic regurgitation. Another patient with endocarditis demonstrated mitral stenosis as did two patients with left atrial myxomata. Tricuspid stenosis was demonstrated in three patients with right ventricular intracardiac masses (primary and secondary tumour and thrombus). By Doppler, the mitral and tricuspid stenosis was similar to from that seen in rheumatic heart disease with increased peak transvalvar velocity and prolonged pressure half-time. Because of the hazards associated with cardiac catheterisation in intracardiac masses, we conclude that Doppler ultrasound allows for the adequate assessment of the haemodynamic alterations so as to complement the images obtained by cross-sectional echocardiography.

Adult↗
PubMed1992

Multichamber intracardiac thrombi in a patient without any predisposing cardiac or non-cardiac disease.

A patient who developed multichamber (left ventricle, right ventricle, right atrium) intracardiac thrombi without having any predisposing cardiac or non-cardiac disease is discussed. The thrombi were diagnosed echocardiographically and confirmed histopathologically. The occurrence of multichamber mural thrombi without any predisposing disease is extremely rare. Risk factors for their development have been reviewed.

Blood Coagulation Tests↗