Chronic Circulatory Failure Research Articles

Acceptance of the disease by patients over 70 with chronic heart failure

Introduction: Chronic circulatory failure is a very serious and complex problem, constituting a significant health problem not only in Poland, but also worldwide. Treated patients with chronic circulatory failure in everyday life experience many limitations and requirements from the disease, which in many respects is difficult to accept. Aim: Diagnosing the disease acceptance rate and understanding the impact of sociodemographic variables, variables specific to clinical parameters, on the degree of disease acceptance by patients with chronic heart failure hospitalized in the hospital. Materials and methods: The research was carried out using the diagnostic survey method, using the author's own questionnaire and the AIS disease acceptance scale. The study was conducted among 98 patients of the Cardiology Department of the Railway Hospital in Wilkowice-Bystra. Results: The analysis of the degree of acceptance of the disease gives an average value of 21.49. The obtained result is in the lower limit of the reference range, indicating an average level of disease acceptance and adaptation to functioning in everyday life with its presence, while the obtained minimum value (8) and Q1 (17) indicate a low disease acceptance rate. Conclusions: On the basis of the conducted research, it is found that the average and low rate of accepting the disease by the subjects and adapting to it with a sense of psychological discomfort resulting from its presence in everyday life.

Study of the effect of Unifuzol on cognitive impairment and damage to the hippocampus and cerebral cortex during course administration to rats with bilateral stenosis of the common carotid arteries, causing chronic circulatory failure

To study the effect of Unifuzol (L-arginine sodium succinate) on cognitive impairment, cerebral blood flow, and damage to the tissues of the hippocampus and cerebral cortex during a 10-day course of administration to rats with chronic cerebral ischemia (CCI) caused by bilateral stenosis of the common carotid arteries (CCA). The study was conducted on male rats with CCI caused by bilateral stenosis of the CCA by 60%. 40 days after surgery, rats received Unifusol (21, 42 and 84 ml/kg), nicergoline (10 mg/kg), citicoline (500 mg/kg) or placebo (0.9% NaCl) for 10 days. Next, cognitive impairments were assessed in the Morris Water Maze and the New Object Recognition (NOR) test, as well as the level of motor and exploratory activity in the Open Field test. The level of cerebral blood flow was determined immediately after the CCA stenosis and at the end of the experiment. Animals were euthanized in a CO2 incubator, after which the brain was removed and subjected to morphometric analysis. In animals that were modeled with CCA stenosis, pronounced behavioral and cognitive impairments occurred as a result of a decrease in blood flow in the vessels of the brain and subsequent changes in the tissues of the hippocampus and the cerebral cortex. Intravenous course administration of Unifuzol at doses of 42 and 84 ml/kg to animals with CCI was comparable in efficiency to nicergoline and citicoline, which was expressed in greater preservation of the cognitive abilities of animals in the Morris Water Maze and NOR tests. In the Open Field test, animals injected with Unifusol at doses of 42 and 84 ml/kg performed more acts of motor and exploratory activity than animals from the placebo group, and had a higher level of cerebral blood flow (compared to animals that were injected with citicoline). Based on the results of a morphological study, it was found that the most significant neuroprotective effect was provided by nicergoline and Unifuzol (at doses of 42 and 84 ml/kg). Unifuzol at a course of administration at doses of 42 and 84 ml/kg, comparable to the reference drugs nicergoline and citicoline, reduces the severity of psychoneurological deficit in animals with CCI, comparable to them improves the microcirculation of brain tissues, preventing damage to brain tissues.

The experience of using the infusion of European clefthoof leaves in chronic circulatory failure

Копытень европейский Asarum europaeum многолетнее растение семейства кирказоновых, широко распространен не только в СССР, но и в Западной Европе, Америке и Азин, где он пользовался широкой популярностью в народной медицине и в течение многих столетий применялся в качестве отхаркивающего, рвотного, жаропонижающего, противовоспалительного, мочегонного, желчегонного (С. Смирнов, 1858; М. А. Алуф с соавторами, 1943; Д. М. Российский, 1944; С. С. Станков, 1955; Г. С. Оголевец, 1951).

Correct diagnostic conclusion in patients with chronic heart failure: a reality or a pipe dream?

The authors of this article have analyzed the problem of diagnostic conclusion unification in patients with chronic heart failure (CHF). The root of this problematic situation in which practitioners find themselves is that, despite the large number of different regulatory documents, there is no consensus on what is considered correct and what is wrong when formulating a diagnostic conclusion in a patient with CHF. The many-faced syndrome is designated differently: CHF, congestive heart failure, chronic circulatory failure. There are difficulties in determining the stage of CHF in patients receiving optimal drug therapy or in those who are in a state of compensation after a successful surgical correction. When assessing the functional status in a patient with CHF, a distinct subjectivity should be taken into account in determining which limited physical activity is slight or, conversely, marked, as well as what kind of physical exertion is normal for the patient. This subjectivity naturally leads to low reproducibility of the assessment results of the CHF functional class in the same patient by different doctors. CHF should also be classified according to the value of a left ventricular ejection fraction. The diagnosis should also take into account the state characteristics of a diastolic function of the left ventricle (especially in patients with CHF and preserved left ventricular ejection fraction). The authors give examples of diagnostic conclusions, including cases of comorbid pathology.

Biogenic Monoamines, Their Precursors, and Metabolites in the Brain of Rats under Experimental Circulatory Failure

Abstract—The aim of the study was to establish the effect of experimental chronic circulatory failure on the levels of biogenic monoamines, their precursors, and their metabolites in rat brain structures. Thirteen weeks after experimental narrowing of the abdominal aorta to 1 or 0.7 mm, the levels of biogenic monoamines, their precursors, metabolites, kynurenine, and kynurenic acid were measured by reverse phase HPLC in rat brain structures. It was found that circulatory failure is accompanied by a decrease in the synthesis and functional activity of a mediator in the serotonergic system, which was evaluated using the level of the final metabolite 5-hydroxyindoleacetic acid. In the cerebral hemispheres, this may be partially related to deficiency of the precursor. The activation of kynurenic acid synthesis in the cerebral hemispheres and the brain stem is also likely. Changes in the indices that characterize central catecholaminergic systems were less pronounced.

The relationship of the brainstem ischemia and chronicity of lumboischialgia

We analyzed 60 patients aged from 30 up to 75 years with any of low-lumbar herniated intervertebral disks. Pain intensity was compared with the concomitant presence of chronic circulatory failure in the vertebral-basilar basin as a result of clinically significant abnormalities of blood vessels in the form of hypoplasia of vertebral artery and its tortuosity. We investigated dynamics of patient's pain under the influence of low-dose treatment by Cortexin (neurocytoprotector). In patients with chronic brainstem ischemia the herniated discs cause more intense and prolonged pain (radicular and local). More effective in these patients is a treatment with inclusion of Cortexin 20 mg intramuscularly within 10 days.

Supportive and palliative care for adults dying from congenital heart defect

Adult survivors with congenital heart disease (CHD) are a novel group of adults with chronic disease. Due to the nature of their surgical repair, the majority is not cured. This review focuses on changing demographics and mortality of adults with CHD, available knowledge and data on end-of-life (EOL) and palliative care in this patient group and outlines needs for future clinical practice and research. Recent findings underscore that survival to adulthood has become the rule for the majority of patients born with CHD. Many remain at increased risk of premature death from their disease. Chronic circulatory failure has been identified as one of the leading causes of death and, thus, patients may benefit from incorporation of palliative care principles in their management. Recent studies show that this practice has not yet been widely adopted. Nonetheless a survey of adult outpatients has shown that many patients prefer to be involved in EOL decisions early in the course of their disease. More research is needed to learn how we can best implement principles of palliative care in the growing population of adult survivors with CHD. This includes improved communication about EOL issues and a more comprehensive approach for symptom control.

CARNITINE ESTERS PREVENT OXIDATIVE STRESS DAMAGE AND ENERGY DEPLETION FOLLOWING TRANSIENT FOREBRAIN ISCHAEMIA IN THE RAT HIPPOCAMPUS

1. The present study investigated whether propionyl-L-carnitine (PLC) has neuroprotective effects, similar to those reported for acetyl-L-carnitine (AC), against transient forebrain ischaemia-induced neuronal damage and biochemical derangement in the rat hippocampal CA1 region. 2. In total, 105 adult male Wistar albino rats were divided into seven groups of 15 animals each. The first three groups were injected i.p. with normal saline, AC (300 mg/kg) or PLC (300 mg/kg) for 7 successive days. The next three groups were injected i.p. with the same doses of normal saline, AC or PLC immediately after the induction of 10 min forebrain ischaemia and i.p. injections were continued for 7 successive days. Rats in the seventh group were subjected to sham-operated ischaemia and injected with normal saline for 7 successive days. 3. Seven days after treatment, animals were killed and their brains isolated for histopathological examination and biochemical studies. 4. Forebrain ischaemia resulted in a significant decrease in the number of intact neurons (77%), ATP concentration (51%) and glutathione content (32%), whereas there was a significant increase in the production of thiobarbituric acid-reactive substances (TBARS; 71%) and total nitrate/nitrite (NOx; 260%) in hippocampal tissues. 5. Administration of either AC or PLC attenuated forebrain ischaemia-induced neuronal damage, manifested by a greater number of intact neurons, ATP and glutathione, as well as a decrease in TBARS and NOx in hippocampal tissues. 6. Results from the present study suggest, for the first time, that PLC attenuates forebrain ischaemia-induced neuronal injury, oxidative stress and energy depletion in the hippocampal CA1 region. Propionyl-L-carnitine has neuroprotective effects similar to AC and could have a potential use in the treatment of neurodegenerative diseases. 7. The results of the present study will open up new perspectives for the use of PLC in the treatment of neurodegenerative diseases associated with, or secondary to, myocardial ischaemia-reperfusion injury and chronic circulatory failure.

Influence of L-carnitine and its derivatives on myocardial metabolism and function in ischemic heart disease and during cardiopulmonary bypass.

Carnitine and its derivatives have recently been shown to protect cardiac metabolism and function in ischemic heart disease and other clinical conditions of myocardial ischemia. Potential mechanisms of this effect include an increase in glucose metabolism, a reduction of toxic effects of long-chain acyl-CoA and acyl-carnitine in myocytes, an increase in coronary blood flow and anti-arrhythmic effect. It has also been shown that propionyl-L-carnitine which penetrates faster than carnitine into myocytes is effective in inhibiting production of free radicals. Beneficial effects of carnitine supplementation have been demonstrated under a variety of clinical conditions such as acute cardiac ischemia, during extracorporeal circulation, in carnitine-dependent cardiomyopathy as well as in patients with chronic circulatory failure and in cardiogenic shock. However, further studies are required before carnitine administration could be recommended as a routine procedure in ischemic heart disease or before cardiopulmonary bypass.

A study of the clinical usefulness of dobutamine administered orally.

Dobutamine 300 mg was administered orally to both healthy volunteers and to patients with circulatory failure. After the 300 mg dose of dobutamine, subjects were found to have a higher concentration of the drug in their plasma than the effective levels of 37.5 (SD 2.9) ng/ml (n = 5) normally seen during intravenous infusion of the clinically effective (5 micrograms/kg/min) dose. This increased concentration waned within 90 minutes. A clinical effect of dobutamine on the circulation was observed in both the healthy volunteers and the patients. An increase in the cardiac index of the patients continued longer than 90 minutes. An unidentified substance was noticed on chromatography measuring plasma dobutamine concentrations, which may have contributed to the increased cardiac index, although its chemical formula could not be determined. The results suggest that the oral administration of dobutamine may be expected to have a long-lasting and significant therapeutic effect on patients with chronic circulatory failure.

Influence of complex therapy with strophanthin, curantil and heparin on the state of central hemodynamics and microcirculation in patients with chronic circulatory insufficiency

Under the influence of treatment with a combination of strophanthin, curantil and heparin in patients with chronic circulatory insufficiency, indicators of central hemodynamics, tissue blood flow and microcirculation improved. The research results give reason to consider the proposed drug combination as an effective means for the course treatment of patients with chronic circulatory failure.

Changes in central hemodynamics during treatment with strophanthin in combination with non-steroidal anabolizers

The data on changes in some parameters of central hemodynamics in 176 patients with chronic circulatory failure under the influence of treatment with strophanthin in combination with non-steroidal anabolizers: potassium orotate and methyluracil are presented.

MECHANISM AND TREATMENT OF EXPERIMENTAL SHOCK

DEFINITION Many syndromes are grouped by investigators and clinicians under the general term Since the word has various connotations for different persons, it might well be discarded from medical nomenclature. However, no satisfactory synonym is available, and the widespread clinical use of the term seems to warrant its retention. Throughout this and subsequent publications, shock is used to denote a condition of acute circulatory failure characterized by prostration, apathy or stupor, tachycardia with feeble, regular pulse and, in many instances, diminished blood pressure. The temperature of the body is often subnormal. Pallor and slight cyanosis are usually present. Edema, visceral congestion and accumulations of fluid in the serous cavities do not occur in shock. The latter signs are characteristics of chronic circulatory failure (cardiac decompensation, congestive failure, etc.). Much confusion has resulted from a lack of complete differentiation between these two general conditions, which not only are different as