Congestive cardiomyopathy

Congestive cardiomyopathy, arrhythmias, hemolysis, and increased risk of infection can also occur. 

Sinus arrest with hypotension has been reported in a patient with a congestive cardiomyopathy when diltiazem was added to amiodarone (255). 

Congestive cardiomyopathy has been attributed to tumor necrosis factor alfa in isolated patients (SED-13, 1110) (6). 

Hyperphosphatemia, often seen in renal failure, produces no specific signs or symptoms. In contrast, chronic hypophosphatemia can produce weakness, bone pain, congestive cardiomyopathy, dizziness, and hemolytic anemia. 

Like radionuclide assessment, contrast angiography, and ECHO, CT scanning can be used to calculate ejection fraction, left ventricular volume, and stroke volume. The blood pool is defined with intravenous iodinated contrast material. Ventricular volumes, ejection fraction, and stroke volume are determined directly from the blood pool on each image. Values obtained with CT scanning are more accurate and reproducible than those obtained on angiography and ECHO. The three-dimensional image of a CT scan also allows determination of the extent and distribution of LVH in patients with hypertrophic or congestive cardiomyopathy. 

Cardiac muscle function has been reported to be impaired in the setting of hypophosphatemia and has resulted in congestive cardiomyopathy. This has been reported in alcoholics, and postoperative and intensive care patients. A depletion in cardiac ATP stores has been hypothesized as the cause of this syndrome. Arrhythmias have also been reported in patients with hypophosphatemia. Because hypophosphatemia is a potentially reversible cause of heart failure, it should be considered in patients who experience an acute deterioration in ventricular function. 

Cardiac toxicity congestive cardiomyopathy, usually reversible with medical management infusion reactions... 

Oster O, Prellwitz W, Kasper W, et al. 1983. Congestive cardiomyopathy and the selenium content of serum. Clin Chim Acta 128 125-132. 

Kawai, C., Yoshiki, Y., Hoshino, T., Sasayama, S., Matsumori, A., 1983. Myocardial catecholamines in hypertrophic and dilated (congestive) cardiomyopathy a biopsy study. J. Am. Coll. Cardiol. 2, 834-840. 

McLaran, C. J., Bett, J. H., Nye, J. A. and Halliday J. W. Congestive cardiomyopathy and haemochromatosis — rapid progression possibly accelerated by excessive ingestion of ascorbic acid. Australia New Zealand Journal of Medicine 12 187-188 1982. 

Bull, 33, 2549 (1985). Binding affinity and selectivity K. Naito et al> Japan, J, Pharmacol 38. 235 (1985), Clinical efficacy in congestive cardiomyopathy J. Thormann et al. Am. Heart X 110, 426 (1985), Series of articles on pharmacokinetics, metabolism and disposition in animals Arznei-miUel-Forsch. 36t 643-667 (1986). 

Epi and other catecholamines may cause myocardial cell death, particularly after intravenous infusions. Acute toxicity is associated with contraction band necrosis and other pathological changes prolonged sympathetic stimulation of the heart, such as in congestive cardiomyopathy, may promote apoptosis of cardiomyocytes. 

Sulmazole (AR-L 115) (37), an imidazopyridine derivative, increased dp/dt max. by 58% and heart rate by 12 beats/min in anesthetized cats after 1 mg/kg i.v. Systolic blood pressure was decreased by 13 mm Hg.l42 Oral administration augmented dp/dt max. up to 92% for 5 to 12 hours in conscious dogs.143 Despite similar PDE-inhibitory activity of 37 and theophylline, it seems likely that effects other than PDE-inhibi-tion contribute to the positive inotropic action.144 Measurement of the effect of 21 on relations between free Ca++, bound Ca ", and ATPase activity of dog cardiac myofibrils indicates that the positive inotropic actions may involve direct activation of myofibrils by an increased affinity of thin filament receptors for Ca++.145 Several clinical studies in heart failure showed that in patients with congestive cardiomyopathy and with coronary artery disease, 22 improved hemodynamics and regional wall motion via decrease in pre- and afterload and Increase in contractility, myocardial oxygen consumption and coronary sinus flow, with no myocardial ischemia.14 149... 

Cardiovascular effects. In severe cases, extensive tissue third spacing of fluids combined with fluid loss from gastroenteritis may lead to hypotension, tachycardia, shock, and death. Metabolic acidosis and rhabdomyoly-sis may be present. After a delay of 1-6 days, there may be a second phase of congestive cardiomyopathy, cardiogenic or noncardiogenic pulmonary edema, and isolated or recurrent cardiac arrhythmias. Prolongation of the QT interval may be associated with torsade de pointes ventricular arrhythmia. 

Diuretics and pressor support may be required in patients with congestive cardiomyopathy. 

Chronic ipecac abuse by anorexic or bulimic individuals has been associated with cardiac toxicity characterized by PR prolongation, T-wave abnormalities, QRS abnormalities, congestive cardiomyopathy, and atrial and ventricular dysrhythmia. Generalized muscle weakness, myopathy, diarrhea, mild tremors, edema, dehydration, metabolic disturbances (hypokalemia, hypochloremic acidosis, elevation of creatinine phosphokinase), shock, and death have also been reported after chronic use (Manno and Manno 1977 Quang and Woolf 2000). 

C22H34O7, Mr 410.51, cryst., mp. 230-232 °C, [a]u -26.2 (CHCI3). Cardioactive diterpenoid (" labdane type) from the Indian medicinal plant Coleusforskolii (Lamiaceae). F. has a positive inotropic effect, it lowers blood pressure and has general vasodilatatory activity, especially on intravenous administration. The activity results from a direct stimulation of adenylate cyclase. F. is the archetype for all substances with this mechanism of action. In laboratory experiments it has been used successfully in therapy of congestive cardiomyopathy, glaucoma, or asthma. Several F. derivatives with improved solubility in water have been prepared. ... 

Gotsman MS, Lewis BS, Mitha AS, Bakst A (1973) Left ventricular performance in congestive cardiomyopathy. In Bajuz E, Rona Co. (eds), Cardiomyopathies Vol. 2 of Recent Advances in Cardiac Structure Metabolism, pp 677-698, University Park Press, Baltimore... 

A dinuclear zinc complex 26 of a novel chiral ligand is a very efficient chiral catalyst system to promote asymmetric Henry reaction. It is employed as the key step in the synthesis of (-)-denopamine, a selective Pi-adrenoceptor agonist, clinically effective in treating congestive cardiomyopathy. Aldehyde 27 condenses with nitromethane in the presence of 10% catalyst 26 in THF to afford vincinal nitroalcohol 28 in 88% yield with 90% ee. Hydrogenation of 28 catalyzed by palladium on carbon in ethanol furnishes aminoalcohol 29, which is then converted into the final product 30. 

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