عنوان

Acute and chronic heart failure :

(Number (ISBN

3642648908

(Number (ISBN

9783642648908

Number

b544268

Title Proper

Acute and chronic heart failure :

General Material Designation

[Book]

Other Title Information

diagnosis and therapy

First Statement of Responsibility

by Wulf-Dirk Bussmann.

Place of Publication, Distribution, etc.

New York

Name of Publisher, Distributor, etc.

Springer-Verlag

Date of Publication, Distribution, etc.

2011

Specific Material Designation and Extent of Item

286 pages

Text of Note

2011 reprint of 1986 content.

Text of Note

Acute Heart Failure.- A. Overview.- I. Recent Developments.- II. Systematic Use of Vasodilating Agents.- 1. Milestones.- 2. Present State of the Art.- Literature.- B. Pathophysiology of Heart Failure With Respect to Vasodilation.- I. Definition of Heart Failure.- 1. Acute and Chronic Heart Failure.- 2. Clinical Presentations.- a) Acute Heart Failure.- b) Chronic Heart Failure.- c) New York Heart Association Functional Classification.- II. Hemodynamics in Heart Failure.- 1. Intracardiac Pressures in Heart Failure.- 2. Technique of Measurement.- a) Swan-Ganz Catheter.- b) Left Ventricular Filling Pressure.- c) Right Atrial Pressure.- d) Cardiac Output.- e) Arterial Blood Pressure.- f) Systemic Vascular Resistance.- III. Pathophysiology.- 1. Pumping Performance as a Function of Ejection Impedance.- 2. Sympathetic Adrenergic Mechanisms of Regulation.- 3. Influence of the Renin-Angiotensin-Aldosterone System.- 4. Venoconstriction.- 5. Preload and Afterload.- a) Preload.- b) Afterload.- IV. Therapeutic Concepts in Heart Failure.- 1. Increase of Myocardial Contractility.- a) Digitalis.- b) Catecholamines.- 2. Vasodilating Agents.- a) Unloading Mechanism.- b) Spectrum of Activity.- 3. Regulation of Venous Vasculature in Heart Failure.- a) Significance of the Venous System.- b) Intrinsic Venous Pooling Capacity.- 4. Hemodynamic Effects of Venodilation.- a) Venous Return.- b) Reduction of Filling Pressure.- c) Subendocardial Perfusion.- d) Diastolic Wall Tension.- e) Intrinsic Counterregulation.- 5. Arterial Vasodilation.- 6. Agents with Activity on the Venous and Arterial Side.- 7. Attenuation of Action with Long-Term Treatment.- a) Non-Responders.- b) Intrinsic Counterregulation.- c) Genuine Tolerance.- d) Differences in Response.- Literature.- C. Acute Left Sided Heart Failure.- I. Conventional Therapy.- 1. Is there still an Indication for Digitalis in Acute Heart Failure?.- 2. Diuretics in Acute Heart Failure.- Literature.- D. Therapy of Acute Pulmonary Edema.- I. Etiology of Pulmonary Edema.- II. Hemodynamics in Pulmonary Edema.- III. Clinical Classification of Pulmonary Edema.- IV. Treatment of Pulmonary Edema.- 1. Action of Nitroglycerin.- a) Hemodynamics.- b) Clinical Presentation.- c) Clinical and Practical Experiences.- d) Ease of Administration.- e) Dosage of Nitroglycerin.- f) Non-Responders in Cardiogenic Shock.- g) Influence on Peripheral Edema.- h) Intravenous Administration of Nitroglycerin in Pulmonary Edema.- i) Sequence of Therapeutic Interventions in the Management of Pulmonary Edema.- 2. Role of Diuretics in the Treatment of Pulmonary Edema.- 3. Digitalis in Pulmonary Edema?.- 4. Morphine.- 5. Drug of Choice.- 6. Other Vasodilators for the Treatment of Pulmonary Edema.- a) Sodium Nitroprusside.- b) Phentolamine.- c) Nifedipine.- 7. Positive Pressure Ventilation.- Literature.- E. Left-Sided Heart Failure in Acute Myocardial Infarction.- I. Clinical Presentation.- 1. Physical Findings.- 2. Radiologic Signs.- 3. Hemodynamics.- II. Treatment with Nitroglycerin and Nitrates.- 1. Reasons for Contraindications in the Past.- 2. Origins of Nitroglycerin Therapy in Acute Myocardial Infarction.- 3. Hemodynamic Effects of Nitroglycerin.- a) Sublingual Nitroglycerin.- b) Continuous Intravenous Infusion of Nitroglycerin.- 4. Oral and Intravenous Administration of Isosorbide Dinitrate.- 5. Clinical Effects of Nitrates.- a) Influence on Pain.- b) Reduction of Dyspnea.- 6. Influence on Myocardial Ischemia.- 7. Reduction of Infarct Size.- a) CK and CK-MB Infarct Size.- b) Electrocardiographic Signs of Necrosis.- 8. Indications for Potential Influence on Prognosis.- 9. Influence of Nitrates on Ventricular Ectopy.- 10. Decrease in Bradyarrhythmias.- 11. Dilation of Functionally Narrowed Coronary Artery Stenosis.- 12. Long-Term Follow-Up: Increased Incidence of Angina Pectoris.- 13. Side Effects.- 14. Summary.- III. Therapeutic Intervention in Acute Myocardial Infarction with Left Ventricular Failure Outside the Hospital.- IV. Mechanism of Action of Sodium Nitroprusside.- 1. History.- 2. Pharmacology and Hemodynamics.- 3. Release of Cyanide.- 4. Effects on Acute Myocardial Infarction.- a) Profile of Action in Specific Subgroups.- b) Recommendations for Use.- c) Potential Side Effects.- 5. Role of Sodium Nitroprusside Therapy Today.- a) Side Effects.- b) Microcirculation: Nonhomongenous Perfusion.- V. Isosorbide Dinitrate in Patients with Acute Myocardial Infarction and Left-Sided Heart Failure.- 1. Comparison with Nitroglycerin.- 2. Sustained Action after Oral Administration.- 3. Prognostic Aspects.- VI. Isosorbide-5-Mononitrate Efficacy Compared to Isosorbide Dinitrate.- 1. Pharmacokinetics.- 2. Hemodynamic Effects.- 3. Absence of Sublingual Efficacy.- VII. Molsidomine in Left Ventricular Failure.- 1. Pharmacology and Mechanism of Action.- 2. Hemodynamics.- 3. Myocardial Ischemia and Necrosis.- VIII. Xanthine Derivatives.- IX. Calcium Antagonists for the Treatment of Patients with Myocardial Infarction and Left-Sided Heart Failure.- 1. Nifedipine.- a) Hemodynamic Effects.- b) Effects on Pulmonary Edema.- c) Myocardial Ischemia.- d) Side Effects.- e) Therapeutic Role of Nifedipine.- 2. Verapamil for the Treatment of Acute Myocardial Infarction.- a) Negative Inotropic Effect.- b) Anti-Ischemic Mechanism of Action.- c) Hemodynamic Effects of Verapamil in Patients with Myocardial Infarction.- d) Reduction of Infarct Size.- e) Antiarrhythmic Effects.- f) Side Effects.- g) Pharmacokinetics of Verapamil.- Literature.- F. Left-Sided Heart Failure and Papillary Muscle Dysfunction.- I. Etiology and Clinical Signs of Mitral Regurgitation.- 1. Case Report 1.- 2. Case Report 2.- II. Hemodynamics.- III. Therapy.- 1. Sodium Nitroprusside.- 2. Nitroglycerin.- IV. Papillary Muscle Dysfunction with Cardiogenic Shock.- Literature.- G. Heart Failure Following Rupture of the Ventricular Septum.- I. Incidence.- II. Clinical Manifestations.- 1. Verification of Diagnosis.- 2. Clinical Course.- III. Treatment.- a) Drugs.- b) Surgery.- Literature.- H. Cardiogenic Shock.- I. Definition.- 1. Etiology of Cardiogenic Shock.- 2. Clinical Presentation.- 3. Hemodynamics.- 4. Mortality.- II. Treatment of Cardiogenic Shock.- 1. Goals of Treatment.- a) Mild Increase in Blood Pressure.- b) Mild Reduction of Filling Pressure.- 2. Dopamine.- 3. Dobutamine.- 4. Comparison between Dopamine and Dobutamine.- 5. Epinephrine.- 6. Norepinephrine.- 7. Combination Therapy with Dobutamine and Nitroglycerin.- a) Patients with Valvular Defects.- b) Patients with Myocardial Lesions.- 8. Combination Therapy with Dobutamine and Sodium Nitroprusside.- 9. Volume Replacement?.- 10. Cardiogenic Shock without Increased Filling Pressures.- III. Mechanical Therapeutic Modalities: Intra-Aortic Balloon Counterpulsation.- 1. Technique.- 2. Mechanism.- 3. Influence on Mortality.- 4. Therapeutic Guidelines.- Literature.- I. Left-Sided Heart Failure Associated with Rheumatic Valvular Defects or Cardiomyopathies.- I. Effects of Nitroglycerin on Acute Decompensation with Left Ventricular Failure and Pulmonary Congestion.- II. Vasodilating Agents in Aortic Stenosis.- Literature.- J. Left-Sided Heart Failure in Hypertensive Crisis.- I. Etiology.- II. Treatment.- 1. Recommendations of the League.- 2. Sodium Nitroprusside.- 3. Nitroglycerin.- 4. Nifedipine.- 5. Urapidil.- III. Treatment of Postoperative Hypertension.- Comparison between Nitroglycerin and Sodium Nitroprusside.- Literature.- K. Acute Right-Sided Heart Failure.- I. Pulmonary Thromboembolism.- 1. Etiology.- 2. Clinical Presentation.- 3. Diagnostic Procedures.- a) Shock Symptoms.- b) Less Severe Pulmonary Embolism.- c) Hemodynamics.- d) Pulmonary Scintigraphy.- e) Digital Subtraction Angiography.- f) Echocardiography.- 4. Treatment.- a) Embolectomy.- b) Fibrinolysis.- c) Other Therapeutic Agents.- II. Right Ventricular Infarction.- 1. Incidence of Right Ventricular Infarction.- 2. Hemodynamics.- 3. Treatment.- III.

Text of Note

Right Heart Failure in Chronic Obstructive Lung Disease.- Literature.- L. Pharmacokinetics of Vasodilating Agents.- I. Nitroglycerin.- 1. Sublingual Nitroglycerin.- 2. Intravenous Administration of Nitroglycerin.- a) Accumulation in the Vascular Wall.- b) Dose-Response Curve in the Venous and Arterial Beds.- c) Loss of Active Substance through Plastic Material.- 3. Oral Nitroglycerin.- 4. Transdermal Nitroglycerin.- II. Isosorbide Dinitrate.- 1. Sublingual and Oral Administration.- 2. Pharmacokinetics During Acute and Chronic Administration.- III. Sodium Nitroprusside.- Literature.- Chronic Heart Failure.- A. Pathophysiologic Mechanisms of Chronic Heart Failure.- I. Frank-Starling Mechanism.- II. Sympathetic Adrenergic Stimulation.- 1. Reduction of Beta-Adrenergic Receptor Density.- 2. Decrease of Myocardial Norepinephrine Stores.- III. Stimulation of the Renin-Angiotensin-Aldosterone System.- IV. Reactivity of Vessel Walls in Chronic Heart Failure.- V. Renal Vasoconstriction.- Literature.- B. New Aspects in the Treatment of Chronic Heart Failure.- I. Digitalis and Diuretics.- II. Vasodilators.- 1. Critical Evaluation of the Therapeutic Concept.- 2. The Classic Therapeutic Concept.- 3. Restrictions on Therapy for Patients with Severe Heart Failure.- Literature.- C. Role of Digitalis.- I. Mechanism of Action of Digitalis Glycosides.- 1. Molecular Mechanism.- 2. Hemodynamic Effects.- II. Contraindications.- III. Dosage of Digoxin and Digitoxin.- 1. Blood Levels.- 2. Interactions.- IV. Long-Term Effects.- 1. Excessive Prescribing of Digitalis by Physicians in West Germany.- 2. Rate of Intoxication, 3 Percent.- 3. Significance of Discontinuation Trials.- Literature.- D. Role of Diuretic Therapy.- I. Renal Function in Heart Failure.- II. Sites of Action for Various Diuretics.- III. Hemodynamic Changes after Diuretic Therapy in Acute Left Ventricular Failure.- IV. Activity of Furosemide in the Venous System.- V. Long-Term Effects of Diuretics.- VI. Side Effects of Diuretics.- Literature.- E. Clinical Role of Vasodilator Therapy.- I. The Ideal Vasodilating Agent.- II. Spectrum of Side Effects.- III. Effect on Acute Decompensation.- IV. Goals of Chronic Treatment.- V. Therapeutic Agents.- F. The Use of Nitrates in Chronic Heart Failure.- I. Acute Effects in Chronic Heart Failure.- 1. At Rest.- a) Sustained Action.- b) Increase in Cardiac Output.- 2. During Physical Exercise.- II. Chronic Action of Nitrates.- 1. Nitrate Tolerance.- 2. Side Effects.- 3. Combination with Hydralazine.- 4. Pharmacokinetics of Isosorbide Dinitrate in Chronic Heart Failure.- Literature.- G. Hydralazine for Chronic Heart Failure.- I. Pharmacokinetics of Hydralazine.- II. Mechanism of Action of Hydralazine.- 1. Hemodynamic Effects.- a) Renal Blood Flow.- b) Coronary Blood Flow.- c) Increased Blood Flow in Other Vascular Beds.- III. Acute and Chronic Effects of Hydralazine.- 1. Improved Function at Rest.- a) Long-Term Effects.- b) Attenuation of Effects.- c) Clinical Improvement.- 2. Hydralazine Effects During Exercise.- a) Acute and Chronic Effects.- b) Absence of Increase in Oxygen Extraction.- 3. Hydralazine in the Treatment of Mitral and Aortic Regurgitation.- a) Mitral Regurgitation.- b) Aortic Insufficiency.- 4. Hydralazine: Influence on Prognosis.- 5. Side Effects of Hydralazine.- a) Lupus Erythematosus Syndrome.- b) Neuropathy.- c) Febrile Condition.- d) Reflex Tachycardia.- e) Fluid Retention.- f) Flushing.- 6. Hydralazine in Combination with Nitrates.- a) Long-Term Effects.- b) Side Effects.- Literature.- H. Prazosin in Chronic Heart Failure.- I. Mechanism of Action of Prazosin.- 1. Alpha-Adrenergic Blocking Agents.- 2. Plasma Renin Activity with Prazosin.- 3. Myocardial Oxygen Consumption.- II. Pharmacokinetics of Prazosin.- 1. Kinetics in Patients with Hypertension.- 2. Kinetics in Patients with Heart Failure.- 3. Elimination.- 4. Prazosin in Renal Failure.- 5. Dosage.- III. Acute and Chronic Effects of Prazosin in Heart Failure.- 1. Acute Effects of Prazosin.- a) Regional Blood Flow.- 2. Chronic Effect of Prazosin.- a) Follow-Up Studies.- b) Placebo-Controlled Trials.- c) Prazosin Influence on Exercise Tolerance.- IV. Attenuation of Prazosin Effects with Chronic Therapy.- 1. Repetitive Single Dosing.- 2. Temporary Withdrawal of Prazosin.- V. Role of Prazosin in the Treatment of Chronic Heart Failure.- VI. Side Effects of Prazosin.- 1. `First-Dose Phenomenon'.- 2. Weight Gain.- 3. Other Side Effects.- Literature.- I. Converting Enzyme Inhibition: Therapy for Chronic Heart Failure.- I. Mechanism of Action.- 1. Renin-Angiotensin-Aldosterone System.- 2. Special Mechanism of Action of Converting Enzyme Inhibitors.- a) Influence of Converting Enzyme Inhibitors on the Renin-Angiotensin-Aldosterone System.- b) Local Inhibition of the Renin-Angiotensin-System in the Vascular Wall.- c) Inhibition of Sympathetic Regulation in Resistance Vessels.- d) Inhibition of Bradykinin Metabolism.- e) Influence of Vasoactive Prostaglandins.- f) Hormonal Factors.- g) Conclusion: Mechanism of Action.- II. Pharmacokinetics of Captopril.- 1. Absorption.- 2. Elimination.- III. Other Agents.- 1. Specific Angiotensin II Inhibitor: Saralasin.- 2. Converting Enzyme Inhibitor: Teprotide.- IV. Clinical Use of Captopril in Hypertension.- V. Captopril in Heart Failure.- 1. Acute Effects of Captopril.- 2. Long-Term Effects of Captopril.- a) Repetitive Single Dosing.- b) Sustained Action.- 3. Regional Flow Changes During Captopril Therapy.- a) Renal Blood Flow.- b) Coronary Blood Flow.- c) Splanchnic and Extremity Blood Flow.- 4. Effects of Captopril During Exercise.- 5. Influence on Prognosis.- 6. Captopril for Acute Myocardial Infarction.- 7. Captopril for Acute Left Ventricular Failure.- 8. Captopril Dosage.- VI. Side Effects of Captopril.- 1. Hematologic Side Effects.- 2. Renal Side Effects.- 3. Cutaneous Side Effects.- 4. Alterations in Taste Sensation.- 5. Drug Interactions.- 6. Side Effects in Patients with Heart Failure.- 7. Summary of Side Effects.- Literature.

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by Wulf-Dirk Bussmann.

Wulf-Dirk Bussmann

Electronic name

[Book]

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