There is no uniformly accepted clinical definition for congestive heart failure (CHF), although criteria have been published by various groups. There is also no reference standard for CHF, although left ventricular ejection fraction (LVEF) gives a quantitative assessment of systolic function and is useful in predicting prognosis. To determine the relationship between LVEF and clinically diagnos...

To the Editor: Anemia has recently become an important issue in patients with heart failure, and in the January 21, 2003 issue of Circulation, 3 studies relating to this subject were published.1–3 In one of these studies, Ezekowitz et al1 showed that anemia is common and is an independent prognostic marker for mortality in community-based patients with congestive heart failure (CHF). To determi...

The interaction of the renin-angiotensin system and the sympathetic nervous system in patients with congestive heart failure is not well understood. We tested the hypothesis that angiotensinconverting enzyme inhibitors can resensitize the fJ-adrenergic receptor system. Guinea pigs were given captopril, isoproterenol, or both for 2 weeks. At death, cardiac sarcolemmal and light vesicle fractions...

BACKGROUND The vasodilatory response to intra-arterial administration of acetylcholine is reduced in patients with congestive heart failure compared with that of normal subjects. The reduced response to acetylcholine may be related to decreased endothelial release of nitric oxide, interaction with peripheral alpha-adrenergic transmission, or production of cyclooxygenase-dependent vasoconstricti...

The immediate haemodynamic effects of peruvoside, a cardiac glycoside obtained from the Indian plant Thevetia neriifolia Juss, were studied in six patients with congestive heart failure. The drug was found to have an immediate and powerful positive inotropic and negative chronotropic effect, like ouabain, on the failing human heart. Oral peruvoside was also effective in the treatment of congest...

Congestive heart failure (CHF) is the most devastating cardiac sequella of long-standing hypertension. Recent data from the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) have shown the risk of CHF to be twice as high with doxazosin than with chlorthalidone. Although some questions remain regarding the diagnosis and mortality of CHF in the doxazosin arm and...

The cardinal symptoms of heart disease are dyspnea, edema, and pain. The recent important publication of Keefer and Resnik (1928) has done much to remove the subject of cardiac pain from the realm of controversy, and to lead to a better understanding of the mechanism by which it is produced, and hence, to a clearer clinical concept of its significance. Unlike cardiac pain, edema and dyspnea are...

A 50-year-old male was found on the street confused. He had little recollection about the event but thought he might have passed out. Recently he has had progressive exertional dyspnea and fatigue but no other specific complaints. He was admitted to the hospital for further evaluation and treatment. Physical examination revealed blood pressure of 120/80 without orthostatic changes. Carotid mass...

Deranged magnesium concentrations in serum and cardiovascular structures have been implicated in the pathophysiology of hypertension, ischemic heart disease, arrhythmias, and sudden death. This study was conducted to determine the status and interrelation of serum and tissue concentrations of magnesium in patients with congestive heart failure, a clinical setting purportedly predisposed to the ...