We investigated whether the quality of myocardial collagen associates with elevated left-sided filling pressures in 38 hypertensive patients with stage C chronic heart failure. Filling pressures were assessed invasively measuring pulmonary capillary wedge pressure. Left ventricular chamber stiffness constant was calculated from the deceleration time of the early mitral filling wave. The fractio...

BACKGROUND Prior investigations suggest that superimposing continuous flow on aortic flow (continuous aortic flow augmentation) produces vasodilation, cardiac unloading, and improved cardiac performance. METHODS AND RESULTS We compared percutaneous continuous aortic flow augmentation (flow <or=1.5 L/min for up to 96 hours) plus medical therapy versus medical therapy alone by randomizing 168 p...

Continuous arteriovenous hemofiltration (CAVH) was carried out in 8 patients with refractory congestive heart failure. All these patients had heart failure and oliguria for over 24 hours and intensive treatment with digitalis, diuretics, catecholamines and vasodilators was prescribed. Hemodynamics were followed closely during CAVH. During CAVH, pulmonary arterial pressure and pulmonary capillar...

The constant (C= 3I) in the hydraulicformulafor calculation of mitral valve area was originally empirically determined by comparison of measured valve area at operation or necropsy with right heart catheterization data. This constant corrects, among other things, for overestimation of the diastolic filling and mitral valve gradient derived from a peripheral arterial tracing and pulmonary capill...

BACKGROUND AND OBJECTIVES There are no studies associating ventilation-induced effects and hemodynamic changes during pneumoperitoneum. This study aimed at evaluating hemodynamic changes determined by pneumoperitoneum in dogs under volume and pressure controlled ventilation. METHODS The study involved 16 dogs anesthetized with sodium thiopental and fentanyl, divided in group 1: volume control...

tory distress syndrome; CI cardiac index; CPB cardiopulmonary bypass; CPDA citrate phosphate dextrose adenine; EF = ejection fraction; IMA internal mammary artery; LAD = left anterior descending artery; LE lung edema; LVSWI = left ventricular stroke work index; PCWP pulmonary capillary wedge pressure; PVR pulmonary vascular resistance; RCA right coronary artery; RVSWI right yentricular stroke w...

BACKGROUND Blocking the tubuloglomerular feedback mechanism with adenosine A1 receptor antagonists seems to improve diuresis and sodium excretion without compromising the glomerular filtration rate in patients with heart failure. However, the direct cardiac effects of this compound class have not been investigated to date. METHODS AND RESULTS In total, 111 patients (109 men and 2 women) recei...

BACKGROUND Doppler echocardiography is currently applied for the assessment of left ventricular and right ventricular hemodynamics in patients with cardiovascular disease. However, there are conflicting reports about its accuracy in patients with unstable decompensated heart failure. The objective of this study was to evaluate the accuracy of the technique in patients with unstable heart failur...

BACKGROUND Patients with heart failure are frequently hospitalized for fluid overload. A reliable method for chronic monitoring of fluid status is therefore desirable. We evaluated an implantable system capable of measuring intrathoracic impedance to identify potential fluid overload before heart failure hospitalization and to determine the correlation between intrathoracic impedance and standa...

The phosphodiesterase inhibitor milrinone is usually preferred in patients with pulmonary hypertension and myocardial dysfunction after cardiopulmonary bypass. We investigated the effects of low-dose milrinone on pulmonary hypertension in the immediate pre- and postoperative period. Forty-seven patients were randomized to the control and milrinone groups. All patients had mean pulmonary artery ...