pituitrin and Heart-Diseases

Topics: Arteriosclerosis; Catecholamines; Chronic Disease; Endothelium, Vascular; Heart Diseases; Humans; Inflammation; Kidney Diseases; Oxidative Stress; Renin-Angiotensin System; Risk Factors; Vasopressins

Cardiovascular failure in critically ill patients carries a high mortality. Identification and treatment of the underlying etiology simultaneously with prompt therapy are indicated to avoid the consequences of prolonged shock. Physicians should assess patients using all available clinical, radiologic, and laboratory data to avoid the pitfalls associated with use of single measures of regional or global perfusion. Continued evidence of inadequate perfusion despite fluid resuscitation warrants consideration of placement of a pulmonary artery catheter or pharmacologic support of the cardiovascular system. Finally, the dynamic nature of physiology in critically ill patients requires constant patient reassessment and flexibility in treatment to tailor therapy individually as the pathologic state evolves.

Topics: Algorithms; Blood Vessels; Catheterization, Swan-Ganz; Glucocorticoids; Heart; Heart Conduction System; Heart Diseases; Heart Failure; Humans; Myocardial Infarction; Oxygen Consumption; Shock, Cardiogenic; Vasoconstrictor Agents; Vasodilator Agents; Vasopressins

Topics: Bethanechol; Bethanechol Compounds; Calcium Channel Blockers; Chest Pain; Diagnosis, Differential; Edrophonium; Ergonovine; Esophageal Achalasia; Esophageal Diseases; Gastroesophageal Reflux; Heart Diseases; Humans; Isosorbide Dinitrate; Mental Disorders; Nitroglycerin; Pentagastrin; Vasopressins

Topics: Age Factors; Animals; Ascites; Blood; Body Water; Heart Diseases; Humans; Kidney Failure, Chronic; Liver Cirrhosis; Osmolar Concentration; Rats; Renal Dialysis; Ultrafiltration; Vasopressins

Various rhythm disturbances occur in the postoperative patient. Proper management requires an awareness of clinical circumstances in which they are most likely to happen. Often, the appearance of new arrhythmias in the postoperative period is a manifestation of underlying remediable medical problems. Direct antiarrhythmic therapy is unnecessary in many patients when these precipitating conditions are properly treated.

Topics: Arrhythmias, Cardiac; Atrial Fibrillation; Atrial Flutter; Bradycardia; Bundle-Branch Block; Electrocardiography; Heart Diseases; Humans; Surgical Procedures, Operative; Tachycardia; Tachycardia, Paroxysmal; Vasopressins

Topics: Adrenal Glands; Aldosterone; Diagnosis, Differential; Edema; Extracellular Space; Female; Heart Diseases; Humans; Kidney; Kidney Diseases; Liver Cirrhosis; Male; Parasitic Diseases; Pituitary Gland; Posture; Pre-Eclampsia; Pregnancy; Pulmonary Edema; Sodium; Vasopressins; Water-Electrolyte Balance

Topics: Animals; Digitalis Glycosides; Heart Diseases; Humans; Infusions, Parenteral; Injections, Intravenous; Shock; Vasodilator Agents; Vasopressins

Topics: Acetylcholine; Adjuvants, Anesthesia; Adrenal Cortex Hormones; Anesthesia; Blood Circulation; Cardiac Output; Cardiovascular Diseases; Cardiovascular Physiological Phenomena; Cardiovascular System; Epinephrine; Heart; Heart Diseases; Humans; Myocardium; Norepinephrine; Thyroid Hormones; Vasopressins

As part of a large pragmatic study, the authors investigated heart rate, blood pressure, dysrhythmic and ischemic responses to lidocaine 2% with a combination vasoconstrictor (noradrenaline 1:50,000 and vasopressin 0.25 IU/mL), and midazolam sedation in a medically compromised population. There were anesthesia-induced physiological changes to both hemodynamics and the electrocardiogram. The use of midazolam significantly ameliorated the sympathoadrenal response to stress, and the greatest hemodynamic and electrocardiographic changes were observed during surgery.

Topics: Anesthesia, Dental; Anesthetics, Local; Arrhythmias, Cardiac; Blood Pressure; Conscious Sedation; Electrocardiography; Epinephrine; Female; Follow-Up Studies; Heart Diseases; Heart Rate; Hemodynamics; Humans; Hypnotics and Sedatives; Lidocaine; Male; Midazolam; Middle Aged; Myocardial Ischemia; Oral Surgical Procedures; Single-Blind Method; Statistics as Topic; Statistics, Nonparametric; Stress, Physiological; Vasoconstrictor Agents; Vasopressins

Immersion pulmonary edema (IPE) is a misdiagnosed environmental illness caused by water immersion, cold, and exertion. IPE occurs typically during SCUBA diving, snorkeling, and swimming. IPE is sometimes associated with myocardial injury and/or loss of consciousness in water, which may be fatal. IPE is thought to involve hemodynamic and cardiovascular disturbances, but its pathophysiology remains largely unclear, which makes IPE prevention difficult. This observational study aimed to document IPE pathogenesis and improve diagnostic reliability, including distinguishing in some conditions IPE from decompression sickness (DCS), another diving-related disorder.Thirty-one patients (19 IPE, 12 DCS) treated at the Hyperbaric Medicine Department (Ste-Anne hospital, Toulon, France; July 2013-June 2014) were recruited into the study. Ten healthy divers were recruited as controls. We tested: (i) copeptin, a surrogate marker for antidiuretic hormone and a stress marker; (ii) ischemia-modified albumin, an ischemia/hypoxia marker; (iii) brain-natriuretic peptide (BNP), a marker of heart failure, and (iv) ultrasensitive-cardiac troponin-I (cTnI), a marker of myocardial ischemia.We found that copeptin and cardiac biomarkers were higher in IPE versus DCS and controls: (i) copeptin: 68% of IPE patients had a high level versus 25% of DCS patients (P < 0.05) (mean ± standard-deviation: IPE: 53 ± 61 pmol/L; DCS: 15 ± 17; controls: 6 ± 3; IPE versus DCS or controls: P < 0.05); (ii) ischemia-modified albumin: 68% of IPE patients had a high level versus 16% of DCS patients (P < 0.05) (IPE: 123 ± 25 arbitrary-units; DCS: 84 ± 25; controls: 94 ± 7; IPE versus DCS or controls: P < 0.05); (iii) BNP: 53% of IPE patients had a high level, DCS patients having normal values (P < 0.05) (IPE: 383 ± 394 ng/L; DCS: 37 ± 28; controls: 19 ± 15; IPE versus DCS or controls: P < 0.01); (iv) cTnI: 63% of IPE patients had a high level, DCS patients having normal values (P < 0.05) (IPE: 0.66 ± 1.50 μg/L; DCS: 0.0061 ± 0.0040; controls: 0.0090 ± 0.01; IPE versus DCS or controls: P < 0.01). The combined "BNP-cTnI" levels provided most discrimination: all IPE patients, but none of the DCS patients, had elevated levels of either/both of these markers.We propose that antidiuretic hormone acts together with a myocardial ischemic process to promote IPE. Thus, monitoring of antidiuretic hormone and cardiac biomarkers can help to make a quick and reliable diagnosis of IPE.

Topics: Adult; Aged; Biomarkers; Decompression Sickness; Diagnosis, Differential; Diving; Female; Heart Diseases; Humans; Male; Middle Aged; Prospective Studies; Pulmonary Edema; Vasopressins; Young Adult

Long-term survival after cardiac arrest (CA) due to shock-refractory ventricular fibrillation (VF) is low. Clearly, there is a need for new pharmacological interventions in the setting of cardiopulmonary resuscitation (CPR) to improve outcome. Here, hemodynamic parameters and cardiac damage are compared between the treatment group (milrinone, esmolol and vasopressin) and controls (vasopressin only) during resuscitation from prolonged CA in piglets.. A total of 26 immature male piglets were subjected to 12-min VF followed by 8-min CPR. The treatment group (n=13) received i.v. (intravenous) boluses vasopressin 0.4 U/kg, esmolol 250 μg/kg and milrinone 25 μg/kg after 13 min, followed by i.v. boluses esmolol 375 μg/kg and milrinone 25 μg/kg after 18 min and continuous esmolol 15 μg/kg/h infusion during 180 min reperfusion, whereas controls (n=13) received equal amounts of vasopressin and saline. A 200 J monophasic counter-shock was delivered to achieve resumption of spontaneous circulation (ROSC) after 8 min CPR. If ROSC was not achieved, another 200 J defibrillation and bolus vasopressin 0.4 U/kg would be administered in both groups. Direct current shocks at 360 J were applied as one shot per minute over maximally 5 min. Hemodynamic variables and troponin I as a marker of cardiac injury were recorded.. Troponin I levels after 180 min reperfusion were lower in the treatment group than in controls (P<0.05). The treatment group received less norepinephrine (P<0.01) and had greater diuresis (P<0.01). There was no difference in survival between groups.. The combination of milrinone, esmolol and vasopressin decreased cardiac injury compared with vasopressin alone.

Topics: Acid-Base Equilibrium; Adrenergic beta-Antagonists; Animals; Cardiopulmonary Resuscitation; Cardiotonic Agents; Fluid Therapy; Heart Arrest; Heart Diseases; Male; Milrinone; Myocardium; Propanolamines; Survival Analysis; Swine; Troponin I; Vasoconstrictor Agents; Vasopressins

The present study was conducted to identify the protective effect of vasopressin (AVP) and milrinone on cardiovascular function, mitochondrial complex activities, cellular ATP reserve, oxidative stress, and apoptosis in rats poisoned by aluminum phosphide (AlP). Rats were divided into five groups (n = 12) including control, AlP (12.5 mg/kg), AlP + AVP (2.0 Units/kg), AlP + milrinone (0.25 mg/kg) and AlP + AVP + milrinone. After treatment, the animals were connected to an electronic cardiovascular monitoring device to monitor electrocardiographic (ECG) parameter. Finally, oxidative stress biomarkers, mitochondrial complex activities, ADP/ATP ratio and apoptosis were evaluated on the heart tissues. Results indicated that AlP administration induced ECG abnormalities along with a decline in blood pressure and heart rate. AVP and milrinone significantly ameliorated these changes in all treated groups. Considerable protective effects on oxidative stress biomarkers, complex IV activity, ADP/ATP ratio and caspase-3 and -9 activities in treated groups were also found. These findings were supported by flow cytometry assay of cardiomyocytes. In conclusion, administration of AVP and milrinone, not only improve cardiovascular functions in AlP poisoned rats in the short time, but after a long time can also restore mitochondrial function and ATP level and reduce the oxidative damage, which prevent cardiomyocytes from entering the apoptotic phase.

Topics: Adenosine Diphosphate; Adenosine Triphosphate; Aluminum Compounds; Animals; Apoptosis; Biomarkers; Cardiotonic Agents; Caspase 3; Caspase 9; Electrocardiography; Heart Diseases; Lethal Dose 50; Milrinone; Mitochondria, Heart; Myocytes, Cardiac; Necrosis; Oxidative Stress; Oxygen Consumption; Phosphines; Rats; Vasoconstrictor Agents; Vasopressins

Milrinone is a phosphodiesterase type III inhibitor with positive inotropic and vasodilatory effects. A common side effect of milrinone is hypotension from the peripheral vasodilation. Although mild elevations in serum creatinine have been described previously in the setting of milrinone-induced hypotension, acute oligoanuric renal failure requiring renal replacement therapy has not yet been described. This case report is the first to document such a result and to report the successful use of peritoneal dialysis in this setting. Previous case reports documented vasopressin as an effective alternative to catecholamines in the treatment of milrinone-induced hypotension. This report documents the use of four vasopressor agents (including vasopressin) in this patient, with only vasopressin resulting in improvement in systemic vascular resistance and blood pressure. Vasopressin may be the most effective vasopressor agent in the treatment of milrinone-induced hypotension.

Topics: Acute Kidney Injury; Adrenergic beta-Agonists; Amyloidosis; Cardiotonic Agents; Dobutamine; Drug Administration Schedule; Drug Therapy, Combination; Heart Diseases; Humans; Hypotension; Male; Middle Aged; Milrinone; Norepinephrine; Peritoneal Dialysis; Phenylephrine; Vasoconstrictor Agents; Vasodilator Agents; Vasopressins

The authors analyze the results of measuring the content of vasopressin, renin, angiotensin II and aldosterone coupled with the results of studying hemodynamics, acid-base state, and lactate in the arterial blood during operations on the heart in 32 patients with different acquired heart diseases. The main attention was concentrated on studies into the nature of humoral changes during extracorporeal circulation in three types of anesthesia. In group I, anesthesia was maintained by fentanyl given in a dose of 5-6 micrograms/kg/h, diazepam (0.1 mg/kg/h), and arduan (0.02 mg/kg/h). In the second observation group, at the beginning of perfusion the patients were administered trimetotan (artonad) (0.2 mg/kg), and in group III, the dose of fentanyl was raised during perfusion to 10-12 micrograms/kg/h. It is concluded that during extracorporeal circulation, it is desirable that the dose of fentanyl be increased to attain more adequate anesthesia in that period of heart surgery. The magnitude of humoral changes occurring in the body during extracorporeal circulation served as a criterion for anesthesia adequacy.

Topics: Adult; Anesthesia, General; Dose-Response Relationship, Drug; Extracorporeal Circulation; Female; Fentanyl; Heart Diseases; Hemodynamics; Humans; Ketamine; Male; Middle Aged; Renin-Angiotensin System; Stimulation, Chemical; Vasopressins

Thirty-three insulin-dependent diabetic patients were separated into two groups from the results of three different tests for cardiac vagal neuropathy: heart rate response to deep breathing, Valsalva manoeuvre and heart rate response to postural change. Seventeen patients were considered as without ('intact' patients) and 16 as with ('denervated' patients) cardiac autonomic dysfunction. One patient with a transplanted heart was also studied. Plasma antidiuretic hormone (ADH), plasma aldosterone and plasma renin activity (PRA) were measured immediately before and 60 min after intravenous administration of frusemide and passage from lying to standing. The kinetics of hormonal responses were analysed more precisely (five blood collections) in six patients of each group who were studied again. Heart rate and blood pressure were recorded before each blood collection. Volume depletion estimated from the rise in plasma protein (+ 11.9 and + 12.2% in 'denervated' and 'intact' patients respectively) and heart rate response (+ 1.06 and + 14.7%) were similar in both groups. Mean blood pressure was unchanged in the 'intact' patients whereas it fell in the 'denervated' patients (-13.5%). PRA (+ 161.5 and + 231.2% in 'denervated' and 'intact' patients respectively) and plasma aldosterone (+ 318.2 and 279%) increased in both groups whereas plasma ADH was stimulated only in 'intact' patients (+ 55.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aldosterone; Autonomic Nervous System Diseases; Blood Pressure; Blood Volume; Diabetic Neuropathies; Female; Furosemide; Heart Diseases; Heart Rate; Heart Transplantation; Humans; Male; Middle Aged; Renin; Vasopressins

Topics: Anesthesia, Dental; Anesthetics; Heart; Heart Diseases; Humans; Lidocaine; Norepinephrine; Vasopressins

Plasma antidiuretic hormone (ADH) was greater in patients with cardiac failure than in healthy subjects. Plasma ADH increased significantly with age in both groups. Covariance analysis showed that the difference between patients and controls occurred whatever the age. Plasma sodium and plasma osmolality were lower in cardiac patients than in healthy subjects. This showed that increase in plasma ADH observed in patients was inappropriate since it coexisted with inhibitory levels of plasma osmolality. Plasma creatinine was greater in cardiac patients than in healthy subjects and for each group in elderly than in young people. But there was no significant correlation between plasma ADH and creatinine. This suggested that increase in plasma ADH observed in cardiac failure was due more to an augmented release than to a diminished catabolism. No clear influence of etiology, severity, length of the disease and treatment with diuretics could be demonstrated.

Topics: Adolescent; Adult; Aged; Aging; Blood; Creatinine; Female; Heart Diseases; Humans; Male; Middle Aged; Osmolar Concentration; Sodium; Vasopressins

Topics: Acute Disease; Animals; Blood Pressure; Dogs; Glomerular Filtration Rate; Heart Diseases; Male; Osmolar Concentration; p-Aminohippuric Acid; Pulmonary Artery; Vasopressins; Water

Topics: Acid-Base Imbalance; Adult; Alcoholism; Beer; Heart Diseases; Humans; Hyponatremia; Liver Diseases; Male; Nutrition Disorders; Vasopressins

Topics: Animals; Blood Pressure; Body Fluids; Cardiovascular Physiological Phenomena; Dogs; Heart; Heart Diseases; Humans; Hyponatremia; Immersion; Plasma Volume; Pressoreceptors; Reflex; Sodium; Thirst; Vasopressins; Water-Electrolyte Balance

Topics: Animals; Diuresis; Glomerular Filtration Rate; Heart Diseases; Humans; Kidney; Vasopressins

Topics: Edema; Heart Diseases; Humans; Vasopressins; Water-Electrolyte Balance

Topics: Diuretics; Extracellular Space; Heart Diseases; Hepatitis; Homeostasis; Humans; Hypothalamo-Hypophyseal System; Pericarditis, Constrictive; Pituitary Diseases; Polyuria; Vasopressins

Topics: Adult; Aged; Aldosterone; Arteriosclerosis; Blood Pressure; Blood Volume; Cardiac Output; Chronic Disease; Digitalis Glycosides; Diuretics; Electrocardiography; Female; Heart Diseases; Heart Failure; Humans; Hypertension; Kidney; Male; Middle Aged; Mitral Valve Insufficiency; Mitral Valve Stenosis; Regional Blood Flow; Serum Albumin, Radio-Iodinated; Vasopressins

Topics: Adult; Diagnosis, Differential; Female; Heart Diseases; Humans; Hyponatremia; Kidney Diseases; Male; Middle Aged; Obesity; Potassium; Potassium Isotopes; Radioisotope Dilution Technique; Sodium; Sodium Isotopes; Vasopressins

Topics: Dipyridamole; Heart Diseases; Humans; Promazine; Stress, Physiological; Stress, Psychological; Vasopressins

Topics: Abdomen; Anemia; Angiotensins; Antihypertensive Agents; Blood Circulation; Bradykinin; Coronary Vessels; Ganglionic Blockers; Heart Diseases; Hypertension; Hyperthyroidism; Hypothyroidism; Liver Circulation; Niacin; Pharmacology; Polycythemia; Serotonin; Shock; Vasopressins; Xanthines

Topics: Arginine Vasopressin; Heart Diseases; Psychotropic Drugs; Stress, Physiological; Stress, Psychological; Vasodilator Agents; Vasopressins

Topics: Animals; Arginine Vasopressin; Dogs; Heart; Heart Diseases; Vasopressins