pituitrin and Cardiomyopathy--Dilated

Topics: Benzazepines; Cardiomyopathy, Dilated; Diuretics; Heart Failure; Humans; Tolvaptan; Vasopressins

A number of vasoactive mediators have been identified in plasma and in the heart. Some of them may be liberated in inflammatory heart disease. The action of mediators on coronary vasculature in various animal models and their potential role in inflammatory heart disease is reviewed. Their role in patients remains to be determined.

Topics: Adrenal Glands; Animals; Atrial Natriuretic Factor; Cardiomyopathy, Dilated; Coronary Circulation; Coronary Vessels; Eicosanoids; Endothelium, Vascular; Humans; Myocarditis; Neuropeptides; Renin-Angiotensin System; Sympathetic Nervous System; Vasopressins

In the present review, an attempt has been made to describe the modern concept of circulatory shock (Part I). The shock inducing insults (low circulatory volume/vascular capacity equation, heart failure, or disturbance of cellular metabolism induce physiological defense mechanisms, which result in peripheral vasoconstriction in order to maintain adequate blood pressure and perfusion of vital organs (compensatory phase). However, when the insult is too aggressive or too prolonged, deterioration of the cardiovascular system and cellular function ensues as a result of anaerobic metabolism, loss of vascular tone, reperfusion injury, depression of the reticuloendothelial system, disseminated intravascular coagulation, and myocardial failure (decompensatory phase). This leads to widespread cellular destruction, autodigestion, and finally death of the patient. Recent features of shock therapy will be discussed in part II of this review.

Topics: Animals; Carbohydrate Metabolism; Cardiomyopathy, Dilated; Disseminated Intravascular Coagulation; Energy Metabolism; Hemodynamics; Lipid Metabolism; Mononuclear Phagocyte System; Neurotransmitter Agents; Oxygen Consumption; Proteins; Shock; Shock, Septic; Vasopressins

We report the quantification of a hemodynamic profile sufficient to support consciousness during cardiopulmonary resuscitation. A 62-yr-old man experienced cardiac arrest while being evaluated for heart failure after heart transplantation. During the emergency, hemodynamic data were obtained from bedside monitors and reviewed at regular intervals. His mean arterial blood pressure and heart rate were correlated with consciousness during cardiopulmonary resuscitation. A mean arterial blood pressure of 50 mm Hg with a heart rate of 100 bpm supported consciousness during cardiac arrest. This case helps to validate the recent emphasis on hard, fast, basic life support.

Topics: Blood Pressure; Cardiomyopathy, Dilated; Cardiopulmonary Resuscitation; Consciousness; Epinephrine; Fatal Outcome; Heart Arrest; Heart Failure; Heart Rate; Heart Transplantation; Humans; Male; Middle Aged; Monitoring, Physiologic; Time Factors; Vasoconstrictor Agents; Vasopressins; Withholding Treatment

Topics: Adult; Cardiomyopathy, Dilated; Fasciitis, Necrotizing; Female; Humans; Vasopressins

To evaluate plasma concentrations and urinary excretion of vasopressin and cortisol and urinary excretion of catecholamines in dogs with dilated cardiomyopathy (DCM).. 15 dogs with clinical signs of DCM, 15 dogs with preclinical DCM, and 15 control dogs.. Physical examinations, thoracic radiography, ECG, and echocardiography were performed on all dogs. Blood and urine samples were collected.. Plasma concentration of vasopressin and the urine cortisol-to-urine creatinine ratio were significantly increased in dogs with clinical signs of DCM and dogs with preclinical DCM, compared with control dogs. Plasma vasopressin concentration was significantly higher in dogs with clinical signs of DCM, compared with dogs with preclinical DCM. Urine vasopressin-to-urine creatinine ratio was significantly increased in dogs with clinical signs of DCM, compared with dogs with preclinical DCM and control dogs. Urine epinephrine-to-urine creatinine ratio and urine norepinephrine-to-urine creatinine ratio were significantly increased in dogs with clinical signs of DCM, compared with control dogs. Plasma concentration of cortisol and urine dopamine-to-urine creatinine ratio did not differ significantly among groups.. According to this study, the neuroendocrine pattern is changed in dogs with preclinical DCM. These changes are even more pronounced in dogs with clinical signs of DCM. Analysis of concentrations of vasopressin, cortisol, and catecholamines may aid in identification of the clinical stages of DCM. These findings may also provide a basis for additional studies of the possible beneficial effects of vasopressin antagonists and beta-adrenergic receptor antagonists in the treatment of dogs with congestive heart failure and DCM.

Topics: Analysis of Variance; Animals; Cardiomyopathy, Dilated; Catecholamines; Creatine; Dog Diseases; Dogs; Electrocardiography; Hydrocortisone; Norepinephrine; Radiography, Thoracic; Vasopressins

Topics: Adult; Aldosterone; Angiotensin II; Cardiomyopathies; Cardiomyopathy, Dilated; Heart Transplantation; Hemodynamics; Humans; Middle Aged; Postoperative Period; Renin; Renin-Angiotensin System; Tissue Donors; Vasopressins; Ventricular Function, Right