Abnormal pulmonary function specifically related to congestive heart failure: Comparison of patients before and after cardiac transplantation

OBJECTIVE: To evaluate the magnitude and dose-relatedness of the effect of clarithromycin on the pharmacokinetics of digoxin, and to compare the effects of clarithromycin with those of P-glycoprotein inhibitors. METHODS: Eight Japanese inpatients with congestive heart failure participated in this study. Each patient received oral digoxin therapy for at least 7 days and were coadministered oral clarithromycin to prevent or treat pneumonia. To evaluate the effects of clarithromycin on the pharmacokinetics of digoxin, digoxin concentrations were compared before and after coadministration of clarithromycin. RESULTS: Digoxin concentrations were higher after coadministration of clarithromycin in all patients (before, 0.838 ± 0.329 ng/mL; after, 1.36 ± 0.619 ng/mL); (p < 0.005). A significant correlation was observed between the dose of clarithromycin and the percentage of increase in the digoxin concentration. CONCLUSIONS: Digoxin concentrations increased during concomitant administration of clarithromycin, and this effect was dose-dependent on clarithromycin. The percentage increase in digoxin concentrations after the usual oral dose of clarithromycin (400 mg/d) is approximately 70%. Therefore, digoxin concentrations must be monitored carefully after coadministration of clarithromycin, and the doses of digoxin may need readjustment in patients who are concomitantly receiving clarithromycin.

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The Role of Lymphatics in Atherogenesis, Myocardial Infarction, Congestive Heart Failure, and Cardiac Transplantation

The Cardiac Lymphatic System ◽

10.1007/978-1-4614-6774-8_4 ◽

2013 ◽

pp. 45-62

Author(s):

Shin Lin ◽

Stanley G. Rockson

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Congestive Heart Failure ◽

Cardiac Transplantation

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Impact of Medical Therapy on Pulmonary Hypertension in Patients With Congestive Heart Failure Awaiting Cardiac Transplantation

The American Journal of Cardiology ◽

10.1016/s0002-9149(96)00334-7 ◽

1996 ◽

Vol 78 (4) ◽

pp. 440-443 ◽

Cited By ~ 16

Author(s):

T.Barry Levine ◽

Arlene B Levine ◽

A.David Goldberg ◽

Barbara Narins ◽

Sidney Goldstein ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Pulmonary Hypertension ◽

Medical Therapy ◽

Cardiac Transplantation

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Baro- and ventricular reflexes in conscious dogs subjected to chronic tachycardia

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1992.263.4.h1084 ◽

1992 ◽

Vol 263 (4) ◽

pp. H1084-H1089 ◽

Cited By ~ 9

Author(s):

J. S. Chen ◽

W. Wang ◽

K. G. Cornish ◽

I. H. Zucker

Keyword(s):

Heart Failure ◽

Heart Rate ◽

Congestive Heart Failure ◽

Clinical Signs ◽

Chronic Congestive Heart Failure ◽

Ventricular Pacing ◽

Arterial Baroreflex ◽

Failure State ◽

Before And After ◽

Blood Pressure Responses

It has been well documented that the arterial baroreflex is depressed in chronic congestive heart failure. Furthermore, cardiopulmonary reflexes have also been shown to be depressed in heart failure. Because cardiac reflexes can be mediated by both mechanical and chemical stimuli, we undertook the current study to determine whether chemically activated cardiac reflexes (Bezold-Jarisch) are abnormally depressed in dogs with chronic heart failure at a point in time when arterial baroreflexes were clearly depressed. We studied heart rate and arterial pressure responses in 13 conscious instrumented dogs before and after chronic ventricular pacing at 250 beats/min for 4-5 wk. At the time the study was done each dog showed both hemodynamic and clinical signs of congestive heart failure. The arterial baroreflex was evaluated by analyzing the heart rate response to acute injections of phenylephrine and nitroglycerin. The Bezold-Jarisch reflex was assessed in nine dogs by determining the heart rate and blood pressure responses to intracoronary injections of various doses of veratridine. Arterial baroreflex responses were uniformly depressed following ventricular pacing. The phenylephrine slope was reduced by 55.8 +/- 6.9% (P < 0.001), and the nitroglycerin slope was reduced by 67.9 +/- 5.0% (P < 0.0001) in the heart failure state. Significant bradycardia and hypotension were seen at each dose of veratridine given (0.01, 0.1, and 0.4 microgram/kg). When compared with the prepaced control state, the magnitude of the hypotension was no different in the heart failure state in response to any dose of veratridine.(ABSTRACT TRUNCATED AT 250 WORDS)

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P1278DIALYSIS IN TREATMENT OF CONGESTIVE HEART FAILURE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1278 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Vesna Ristovska

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Renal Failure ◽

Body Weight ◽

Extracellular Volume ◽

The Body ◽

Oedema Formation ◽

Water Excretion ◽

Before And After ◽

Sodium And Potassium

Abstract Background and Aims The advanced congestive heart failure (CHF), may provoke functional kidney disturbances with insufficient and resistant to conservative therapy water excretion. The treatment of the chronic renal failure (CRF) with active dialysis related to ultrafiltration (UF), may overcome the renal diuretics resistance with diuresis restoration and oedema elimination. The aim of the study was to define the indications for active, discontinued UF in setting of the CHF refractory to drugs, especially in the treatment of oedema. Method We investigated 12 patients, mean age 62,4+/-5,3 years, with incipient renal failure, but advanced congestive heart failure. Seven of them were males and 5 females. The indication for discontinued UF, was the severe expressed heart failure, reduced diuresis and initial renal insufficiency. In all investigated patients, before and after each UF procedure, the serum sodium and potassium, blood urea nitrogen (BUN), creatinin and osmolality were detected. The body weight, abdominal and crural parameters were noted before and after dialysis. Results The recovery was achieved in 10 patients with CHF, but 2 patients out of 12 have not demonstrated satisfactory response to UF. The biochemical features encountered to CHF patients suggest chronic hyponatriemia, hypokalemia and hypovolemia. Proteinuria range 1,2 to 3,6 g/l, was present in 6 patients. The clinical data were performed with oedema formation, reduced diuresis and dispnea. Mean UF rate achieved after several dialysis was 12,4+/- 7,6, lit. Conclusion Chronic heart failure in chronic renal patients, with severe oedemas is an indication for UF therapy, even if the values of BUN and creatinin are not increased. Reduction of the body weight and the extracellular volume, contribute for improved survival in these patients. However the risk of complications is high and not always with successful treatment.

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