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. 1991 Apr;154(4):427–441.

Congestive heart failure. New frontiers.

W W Parmley 1, K Chatterjee 1, G S Francis 1, B G Firth 1, R A Kloner 1
PMCID: PMC1002791  PMID: 1678903

Abstract

Congestive heart failure is a common syndrome with high mortality in its advanced stages. Current therapy includes the use of vasodilator drugs, which have been shown to prolong life. Despite current therapy, mortality remains high in patients with severe heart failure. Potent new inotropic vasodilators have improved ventricular performance but have not prolonged life in patients with end-stage heart failure. Serious arrhythmias are implicated in the sudden deaths of 30% to 40% of patients with severe heart failure, but the benefits of antiarrhythmic therapy have not been established. Upcoming trials will address this question. Ventricular remodeling and progressive dilatation after myocardial infarction commonly lead to congestive heart failure; early unloading of the ventricle with an angiotensin-converting enzyme inhibitor may attenuate these events. These findings support the concept that angiotensin-converting enzyme inhibitors may be useful in managing heart failure of all degrees of severity, including left ventricular dysfunction and end-stage heart failure. Part of the damage that may occur with acute myocardial infarction, particularly in this era of thrombolysis therapy, is reperfusion injury, which may be mediated by oxygen-derived free radicals. Better knowledge of the mechanisms and treatment of myocardial infarction, the leading cause of congestive heart failure, may help prevent or attenuate the development of this syndrome.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ambrosio G., Becker L. C., Hutchins G. M., Weisman H. F., Weisfeldt M. L. Reduction in experimental infarct size by recombinant human superoxide dismutase: insights into the pathophysiology of reperfusion injury. Circulation. 1986 Dec;74(6):1424–1433. doi: 10.1161/01.cir.74.6.1424. [DOI] [PubMed] [Google Scholar]
  2. Arnold J. M., Antman E. M., Przyklenk K., Braunwald E., Sandor T., Vivaldi M. T., Schoen F. J., Kloner R. A. Differential effects of reperfusion on incidence of ventricular arrhythmias and recovery of ventricular function at 4 days following coronary occlusion. Am Heart J. 1987 May;113(5):1055–1065. doi: 10.1016/0002-8703(87)90912-4. [DOI] [PubMed] [Google Scholar]
  3. Awan N. A., Needham K., Evenson M. K., Hermanovich J., Joye J. A., DeMaria A. N., Mason D. T. Therapeutic efficacy or oral pirbuterol in severe chronic congestive heart failure: acute hemodynamic and long-term ambulatory evaluation. Am Heart J. 1981 Sep;102(3 Pt 2):555–563. doi: 10.1016/0002-8703(81)90744-4. [DOI] [PubMed] [Google Scholar]
  4. Bhatia S. J., Swedberg K., Chatterjee K. Acute hemodynamic and metabolic effects of ICI 118,587 (Corwin), a selective partial beta 1 agonist, in patients with dilated cardiomyopathy. Am Heart J. 1986 Apr;111(4):692–696. doi: 10.1016/0002-8703(86)90101-8. [DOI] [PubMed] [Google Scholar]
  5. Blaustein A. S., Schine L., Brooks W. W., Fanburg B. L., Bing O. H. Influence of exogenously generated oxidant species on myocardial function. Am J Physiol. 1986 Apr;250(4 Pt 2):H595–H599. doi: 10.1152/ajpheart.1986.250.4.H595. [DOI] [PubMed] [Google Scholar]
  6. Bolli R. Oxygen-derived free radicals and postischemic myocardial dysfunction ("stunned myocardium"). J Am Coll Cardiol. 1988 Jul;12(1):239–249. doi: 10.1016/0735-1097(88)90381-6. [DOI] [PubMed] [Google Scholar]
  7. Bolli R., Patel B. S., Jeroudi M. O., Lai E. K., McCay P. B. Demonstration of free radical generation in "stunned" myocardium of intact dogs with the use of the spin trap alpha-phenyl N-tert-butyl nitrone. J Clin Invest. 1988 Aug;82(2):476–485. doi: 10.1172/JCI113621. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Boveris A. Mitochondrial production of superoxide radical and hydrogen peroxide. Adv Exp Med Biol. 1977;78:67–82. doi: 10.1007/978-1-4615-9035-4_5. [DOI] [PubMed] [Google Scholar]
  9. Braunwald E., Kloner R. A. Myocardial reperfusion: a double-edged sword? J Clin Invest. 1985 Nov;76(5):1713–1719. doi: 10.1172/JCI112160. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Braunwald E., Kloner R. A. The stunned myocardium: prolonged, postischemic ventricular dysfunction. Circulation. 1982 Dec;66(6):1146–1149. doi: 10.1161/01.cir.66.6.1146. [DOI] [PubMed] [Google Scholar]
  11. Brodsky M. A., Allen B. J., Baron D., Chesnie B. M., Abate D., Thomas R., Henry W. L. Enhanced survival in patients with heart failure and life-threatening ventricular tachyarrhythmias. Am Heart J. 1986 Dec;112(6):1166–1172. doi: 10.1016/0002-8703(86)90345-5. [DOI] [PubMed] [Google Scholar]
  12. Brückner R., Meyer W., Mügge A., Schmitz W., Scholz H. Alpha-adrenoceptor-mediated positive inotropic effect of phenylephrine in isolated human ventricular myocardium. Eur J Pharmacol. 1984 Apr 6;99(4):345–347. doi: 10.1016/0014-2999(84)90144-4. [DOI] [PubMed] [Google Scholar]
  13. Chakko C. S., Gheorghiade M. Ventricular arrhythmias in severe heart failure: incidence, significance, and effectiveness of antiarrhythmic therapy. Am Heart J. 1985 Mar;109(3 Pt 1):497–504. doi: 10.1016/0002-8703(85)90554-x. [DOI] [PubMed] [Google Scholar]
  14. Christensen D. J., Ford M., Reading J., Castle C. H. Effect of hypertension on myocardial rupture after acute myocardial infarction. Chest. 1977 Nov;72(5):618–622. doi: 10.1378/chest.72.5.618. [DOI] [PubMed] [Google Scholar]
  15. Cleland J. G., Dargie H. J., Hodsman G. P., Ball S. G., Robertson J. I., Morton J. J., East B. W., Robertson I., Murray G. D., Gillen G. Captopril in heart failure. A double blind controlled trial. Br Heart J. 1984 Nov;52(5):530–535. doi: 10.1136/hrt.52.5.530. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Cohn J. N., Archibald D. G., Ziesche S., Franciosa J. A., Harston W. E., Tristani F. E., Dunkman W. B., Jacobs W., Francis G. S., Flohr K. H. Effect of vasodilator therapy on mortality in chronic congestive heart failure. Results of a Veterans Administration Cooperative Study. N Engl J Med. 1986 Jun 12;314(24):1547–1552. doi: 10.1056/NEJM198606123142404. [DOI] [PubMed] [Google Scholar]
  17. Cohn J. N., Levine T. B., Olivari M. T., Garberg V., Lura D., Francis G. S., Simon A. B., Rector T. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med. 1984 Sep 27;311(13):819–823. doi: 10.1056/NEJM198409273111303. [DOI] [PubMed] [Google Scholar]
  18. Daly P. A., Chatterjee K., Viquerat C. E., Parmley W. W., Curran D., Scheinbaum M., Anderson S. RO13-6438, a new inotrope-vasodilator: systemic and coronary hemodynamic effects in congestive heart failure. Am J Cardiol. 1985 Jun 1;55(13 Pt 1):1539–1544. doi: 10.1016/0002-9149(85)90969-5. [DOI] [PubMed] [Google Scholar]
  19. De Marco T., Kwasman M., Lau D., Chatterjee K. Dopexamine hydrochloride in chronic congestive heart failure with improved cardiac performance without increased metabolic cost. Am J Cardiol. 1988 Aug 11;62(5):57C–62C. [PubMed] [Google Scholar]
  20. DeBoer L. W., Ingwall J. S., Kloner R. A., Braunwald E. Prolonged derangements of canine myocardial purine metabolism after a brief coronary artery occlusion not associated with anatomic evidence of necrosis. Proc Natl Acad Sci U S A. 1980 Sep;77(9):5471–5475. doi: 10.1073/pnas.77.9.5471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Dean J. W., Lab M. J. Arrhythmia in heart failure: role of mechanically induced changes in electrophysiology. Lancet. 1989 Jun 10;1(8650):1309–1312. doi: 10.1016/s0140-6736(89)92697-4. [DOI] [PubMed] [Google Scholar]
  22. Dell'Italia L. J., Starling M. R., Blumhardt R., Lasher J. C., O'Rourke R. A. Comparative effects of volume loading, dobutamine, and nitroprusside in patients with predominant right ventricular infarction. Circulation. 1985 Dec;72(6):1327–1335. doi: 10.1161/01.cir.72.6.1327. [DOI] [PubMed] [Google Scholar]
  23. DiBianco R., Shabetai R., Kostuk W., Moran J., Schlant R. C., Wright R. A comparison of oral milrinone, digoxin, and their combination in the treatment of patients with chronic heart failure. N Engl J Med. 1989 Mar 16;320(11):677–683. doi: 10.1056/NEJM198903163201101. [DOI] [PubMed] [Google Scholar]
  24. Eaton L. W., Weiss J. L., Bulkley B. H., Garrison J. B., Weisfeldt M. L. Regional cardiac dilatation after acute myocardial infarction: recognition by two-dimensional echocardiography. N Engl J Med. 1979 Jan 11;300(2):57–62. doi: 10.1056/NEJM197901113000202. [DOI] [PubMed] [Google Scholar]
  25. Eddy L. J., Stewart J. R., Jones H. P., Engerson T. D., McCord J. M., Downey J. M. Free radical-producing enzyme, xanthine oxidase, is undetectable in human hearts. Am J Physiol. 1987 Sep;253(3 Pt 2):H709–H711. doi: 10.1152/ajpheart.1987.253.3.H709. [DOI] [PubMed] [Google Scholar]
  26. Engler R., Covell J. W. Granulocytes cause reperfusion ventricular dysfunction after 15-minute ischemia in the dog. Circ Res. 1987 Jul;61(1):20–28. doi: 10.1161/01.res.61.1.20. [DOI] [PubMed] [Google Scholar]
  27. Erlebacher J. A., Weiss J. L., Eaton L. W., Kallman C., Weisfeldt M. L., Bulkley B. H. Late effects of acute infarct dilation on heart size: a two dimensional echocardiographic study. Am J Cardiol. 1982 Apr 1;49(5):1120–1126. doi: 10.1016/0002-9149(82)90035-2. [DOI] [PubMed] [Google Scholar]
  28. Fennell W. H., Taylor A. A., Young J. B., Brandon T. A., Ginos J. Z., Goldberg L. I., Mitchell J. R. Propylbutyldopamine: hemodynamic effects in conscious dogs, normal human volunteers and patients with heart failure. Circulation. 1983 Apr;67(4):829–836. doi: 10.1161/01.cir.67.4.829. [DOI] [PubMed] [Google Scholar]
  29. Flaherty J. T., Weisfeldt M. L. Reperfusion injury. Free Radic Biol Med. 1988;5(5-6):409–419. doi: 10.1016/0891-5849(88)90115-3. [DOI] [PubMed] [Google Scholar]
  30. Francis G. S., Goldsmith S. R., Levine T. B., Olivari M. T., Cohn J. N. The neurohumoral axis in congestive heart failure. Ann Intern Med. 1984 Sep;101(3):370–377. doi: 10.7326/0003-4819-101-3-370. [DOI] [PubMed] [Google Scholar]
  31. Francis G. S., Parks R., Cohn J. N. The effects of bromocriptine in patients with congestive heart failure. Am Heart J. 1983 Jul;106(1 Pt 1):100–106. doi: 10.1016/0002-8703(83)90446-5. [DOI] [PubMed] [Google Scholar]
  32. Francis G. S. Should asymptomatic ventricular arrhythmias in patients with congestive heart failure be treated with antiarrhythmic drugs? J Am Coll Cardiol. 1988 Jul;12(1):274–283. doi: 10.1016/0735-1097(88)90388-9. [DOI] [PubMed] [Google Scholar]
  33. Gheorghiade M., St Clair J., St Clair C., Beller G. A. Hemodynamic effects of intravenous digoxin in patients with severe heart failure initially treated with diuretics and vasodilators. J Am Coll Cardiol. 1987 Apr;9(4):849–857. doi: 10.1016/s0735-1097(87)80241-3. [DOI] [PubMed] [Google Scholar]
  34. Goldberg L. I. Dopamine--clinical uses of an endogenous catecholamine. N Engl J Med. 1974 Oct 3;291(14):707–710. doi: 10.1056/NEJM197410032911405. [DOI] [PubMed] [Google Scholar]
  35. Goldberg L. I., Rajfer S. I. Dopamine receptors: applications in clinical cardiology. Circulation. 1985 Aug;72(2):245–248. doi: 10.1161/01.cir.72.2.245. [DOI] [PubMed] [Google Scholar]
  36. Goldberg M. R., Robertson D. Evidence for the existence of vascular alpha 2-adrenergic receptors in humans. Hypertension. 1984 Jul-Aug;6(4):551–556. doi: 10.1161/01.hyp.6.4.551. [DOI] [PubMed] [Google Scholar]
  37. Goldstein R. A., Passamani E. R., Roberts R. A comparison of digoxin and dobutamine in patients with acute infarction and cardiac failure. N Engl J Med. 1980 Oct 9;303(15):846–850. doi: 10.1056/NEJM198010093031503. [DOI] [PubMed] [Google Scholar]
  38. Greenfield D. T., Greenfield L. J., Hess M. L. Enhancement of crystalloid cardioplegic protection against global normothermic ischemia by superoxide dismutase plus catalase but not diltiazem in the isolated, working rat heart. J Thorac Cardiovasc Surg. 1988 May;95(5):799–813. [PubMed] [Google Scholar]
  39. Guerci A. D., Gerstenblith G., Brinker J. A., Chandra N. C., Gottlieb S. O., Bahr R. D., Weiss J. L., Shapiro E. P., Flaherty J. T., Bush D. E. A randomized trial of intravenous tissue plasminogen activator for acute myocardial infarction with subsequent randomization to elective coronary angioplasty. N Engl J Med. 1987 Dec 24;317(26):1613–1618. doi: 10.1056/NEJM198712243172601. [DOI] [PubMed] [Google Scholar]
  40. Hale S. L., Kloner R. A. Left ventricular topographic alterations in the completely healed rat infarct caused by early and late coronary artery reperfusion. Am Heart J. 1988 Dec;116(6 Pt 1):1508–1513. doi: 10.1016/0002-8703(88)90736-3. [DOI] [PubMed] [Google Scholar]
  41. Hammerman H., Kloner R. A., Briggs L. L., Braunwald E. Enhancement of salvage of reperfused myocardium by early beta-adrenergic blockade (timolol). J Am Coll Cardiol. 1984 Jun;3(6):1438–1443. doi: 10.1016/s0735-1097(84)80282-x. [DOI] [PubMed] [Google Scholar]
  42. Hammerman H., Kloner R. A., Hale S., Schoen F. J., Braunwald E. Dose-dependent effects of short-term methylprednisolone on myocardial infarct extent, scar formation, and ventricular function. Circulation. 1983 Aug;68(2):446–452. doi: 10.1161/01.cir.68.2.446. [DOI] [PubMed] [Google Scholar]
  43. Hammermeister K. E., DeRouen T. A., Dodge H. T. Variables predictive of survival in patients with coronary disease. Selection by univariate and multivariate analyses from the clinical, electrocardiographic, exercise, arteriographic, and quantitative angiographic evaluations. Circulation. 1979 Mar;59(3):421–430. doi: 10.1161/01.cir.59.3.421. [DOI] [PubMed] [Google Scholar]
  44. Hammond B., Hess M. L. The oxygen free radical system: potential mediator of myocardial injury. J Am Coll Cardiol. 1985 Jul;6(1):215–220. doi: 10.1016/s0735-1097(85)80278-3. [DOI] [PubMed] [Google Scholar]
  45. Herlitz J., Elmfeldt D., Holmberg S., Málek I., Nyberg G., Pennert K., Rydén L., Swedberg K., Vedin A., Waagstein F. Göteborg Metoprolol Trial: mortality and causes of death. Am J Cardiol. 1984 Jun 25;53(13):9D–14D. [PubMed] [Google Scholar]
  46. Hohnloser S. H., Raeder E. A., Podrid P. J., Graboys T. B., Lown B. Predictors of antiarrhythmic drug efficacy in patients with malignant ventricular tachyarrhythmias. Am Heart J. 1987 Jul;114(1 Pt 1):1–7. doi: 10.1016/0002-8703(87)90299-7. [DOI] [PubMed] [Google Scholar]
  47. Hutchins G. M., Bulkley B. H. Infarct expansion versus extension: two different complications of acute myocardial infarction. Am J Cardiol. 1978 Jun;41(7):1127–1132. doi: 10.1016/0002-9149(78)90869-x. [DOI] [PubMed] [Google Scholar]
  48. Jeremy R. W., Becker L. C. Neutrophil depletion does not prevent myocardial dysfunction after brief coronary occlusion. J Am Coll Cardiol. 1989 Apr;13(5):1155–1163. doi: 10.1016/0735-1097(89)90278-7. [DOI] [PubMed] [Google Scholar]
  49. Jeremy R. W., Hackworthy R. A., Bautovich G., Hutton B. F., Harris P. J. Infarct artery perfusion and changes in left ventricular volume in the month after acute myocardial infarction. J Am Coll Cardiol. 1987 May;9(5):989–995. doi: 10.1016/s0735-1097(87)80298-x. [DOI] [PubMed] [Google Scholar]
  50. Kannel W. B., Sorlie P., McNamara P. M. Prognosis after initial myocardial infarction: the Framingham study. Am J Cardiol. 1979 Jul;44(1):53–59. doi: 10.1016/0002-9149(79)90250-9. [DOI] [PubMed] [Google Scholar]
  51. Kennedy J. W., Ritchie J. L., Davis K. B., Fritz J. K. Western Washington randomized trial of intracoronary streptokinase in acute myocardial infarction. N Engl J Med. 1983 Dec 15;309(24):1477–1482. doi: 10.1056/NEJM198312153092402. [DOI] [PubMed] [Google Scholar]
  52. Kenny J., Plappert T., Doubilet P., Salzman D., Sutton M. G. Effects of heart rate on ventricular size, stroke volume, and output in the normal human fetus: a prospective Doppler echocardiographic study. Circulation. 1987 Jul;76(1):52–58. doi: 10.1161/01.cir.76.1.52. [DOI] [PubMed] [Google Scholar]
  53. Kereiakes D. J., Viquerat C., Lanzer P., Botvinick E. H., Spangenberg R., Buckingham M., Parmley W. W., Chatterjee K. Mechanisms of improved left ventricular function following intravenous MDL 17,043 in patients with severe chronic heart failure. Am Heart J. 1984 Nov;108(5):1278–1284. doi: 10.1016/0002-8703(84)90754-3. [DOI] [PubMed] [Google Scholar]
  54. Kereiakes D., Chatterjee K., Parmley W. W., Atherton B., Curran D., Kereiakes A., Spangenberg R. Intravenous and oral MDL 17043 (a new inotrope-vasodilator agent) in congestive heart failure: hemodynamic and clinical evaluation in 38 patients. J Am Coll Cardiol. 1984 Nov;4(5):884–889. doi: 10.1016/s0735-1097(84)80047-9. [DOI] [PubMed] [Google Scholar]
  55. Kino M., Hirota Y., Yamamoto S., Sawada K., Moriguchi M., Kotaka M., Kubo S., Kawamura K. Cardiovascular effects of a newly synthesized cardiotonic agent (TA-064) on normal and diseased hearts. Am J Cardiol. 1983 Mar 1;51(5):802–810. doi: 10.1016/s0002-9149(83)80137-4. [DOI] [PubMed] [Google Scholar]
  56. Kitamura S., Kay J. H., Krohn B. G., Magidson O., Dunne E. F. Geometric and functional abnormalities of the left ventricle with a chronic localized noncontractile area. Am J Cardiol. 1973 Jun;31(6):701–707. doi: 10.1016/0002-9149(73)90003-9. [DOI] [PubMed] [Google Scholar]
  57. Klein M. D., Herman M. V., Gorlin R. A hemodynamic study of left ventricular aneurysm. Circulation. 1967 Apr;35(4):614–630. doi: 10.1161/01.cir.35.4.614. [DOI] [PubMed] [Google Scholar]
  58. Kloner R. A., Alker K., Campbell C., Figures G., Eisenhauer A., Hale S. Does tissue-type plasminogen activator have direct beneficial effects on the myocardium independent of its ability to lyse intracoronary thrombi? Circulation. 1989 May;79(5):1125–1136. doi: 10.1161/01.cir.79.5.1125. [DOI] [PubMed] [Google Scholar]
  59. Lampert S., Lown B., Graboys T. B., Podrid P. J., Blatt C. M. Determinants of survival in patients with malignant ventricular arrhythmia associated with coronary artery disease. Am J Cardiol. 1988 Apr 1;61(10):791–797. doi: 10.1016/0002-9149(88)91068-5. [DOI] [PubMed] [Google Scholar]
  60. Langer S. Z. Presynaptic regulation of catecholamine release. Biochem Pharmacol. 1974 Jul 1;23(13):1793–1800. doi: 10.1016/0006-2952(74)90187-7. [DOI] [PubMed] [Google Scholar]
  61. Lefkowitz R. J., Stadel J. M., Caron M. G. Adenylate cyclase-coupled beta-adrenergic receptors: structure and mechanisms of activation and desensitization. Annu Rev Biochem. 1983;52:159–186. doi: 10.1146/annurev.bi.52.070183.001111. [DOI] [PubMed] [Google Scholar]
  62. Leier C. V., Heban P. T., Huss P., Bush C. A., Lewis R. P. Comparative systemic and regional hemodynamic effects of dopamine and dobutamine in patients with cardiomyopathic heart failure. Circulation. 1978 Sep;58(3 Pt 1):466–475. doi: 10.1161/01.cir.58.3.466. [DOI] [PubMed] [Google Scholar]
  63. Lo H. M., Kloner R. A., Braunwald E. Effect of intracoronary verapamil on infarct size in the ischemic, reperfused canine heart: critical importance of the timing of treatment. Am J Cardiol. 1985 Oct 1;56(10):672–677. doi: 10.1016/0002-9149(85)91033-1. [DOI] [PubMed] [Google Scholar]
  64. Ludmer P. L., Wright R. F., Arnold J. M., Ganz P., Braunwald E., Colucci W. S. Separation of the direct myocardial and vasodilator actions of milrinone administered by an intracoronary infusion technique. Circulation. 1986 Jan;73(1):130–137. doi: 10.1161/01.cir.73.1.130. [DOI] [PubMed] [Google Scholar]
  65. McCord J. M. Oxygen-derived free radicals in postischemic tissue injury. N Engl J Med. 1985 Jan 17;312(3):159–163. doi: 10.1056/NEJM198501173120305. [DOI] [PubMed] [Google Scholar]
  66. McKay R. G., Pfeffer M. A., Pasternak R. C., Markis J. E., Come P. C., Nakao S., Alderman J. D., Ferguson J. J., Safian R. D., Grossman W. Left ventricular remodeling after myocardial infarction: a corollary to infarct expansion. Circulation. 1986 Oct;74(4):693–702. doi: 10.1161/01.cir.74.4.693. [DOI] [PubMed] [Google Scholar]
  67. McKee P. A., Castelli W. P., McNamara P. M., Kannel W. B. The natural history of congestive heart failure: the Framingham study. N Engl J Med. 1971 Dec 23;285(26):1441–1446. doi: 10.1056/NEJM197112232852601. [DOI] [PubMed] [Google Scholar]
  68. Minardo J. D., Heger J. J., Miles W. M., Zipes D. P., Prystowsky E. N. Clinical characteristics of patients with ventricular fibrillation during antiarrhythmic drug therapy. N Engl J Med. 1988 Aug 4;319(5):257–262. doi: 10.1056/NEJM198808043190501. [DOI] [PubMed] [Google Scholar]
  69. Moss A. J., Davis H. T., Conard D. L., DeCamilla J. J., Odoroff C. L. Digitalis-associated cardiac mortality after myocardial infarction. Circulation. 1981 Dec;64(6):1150–1156. doi: 10.1161/01.cir.64.6.1150. [DOI] [PubMed] [Google Scholar]
  70. Mullins L. J. The generation of electric currents in cardiac fibers by Na/Ca exchange. Am J Physiol. 1979 Mar;236(3):C103–C110. doi: 10.1152/ajpcell.1979.236.3.C103. [DOI] [PubMed] [Google Scholar]
  71. Nejima J., Knight D. R., Fallon J. T., Uemura N., Manders W. T., Canfield D. R., Cohen M. V., Vatner S. F. Superoxide dismutase reduces reperfusion arrhythmias but fails to salvage regional function or myocardium at risk in conscious dogs. Circulation. 1989 Jan;79(1):143–153. doi: 10.1161/01.cir.79.1.143. [DOI] [PubMed] [Google Scholar]
  72. Neri R., Mestroni L., Salvi A., Pandullo C., Camerini F. Ventricular arrhythmias in dilated cardiomyopathy: efficacy of amiodarone. Am Heart J. 1987 Mar;113(3):707–715. doi: 10.1016/0002-8703(87)90711-3. [DOI] [PubMed] [Google Scholar]
  73. Nolan S. E., Mannisi J. A., Bush D. E., Healy B., Weisman H. F. Increased afterload aggravates infarct expansion after acute myocardial infarction. J Am Coll Cardiol. 1988 Nov;12(5):1318–1325. doi: 10.1016/0735-1097(88)92616-2. [DOI] [PubMed] [Google Scholar]
  74. O'Neill P. G., Charlat M. L., Michael L. H., Roberts R., Bolli R. Influence of neutrophil depletion on myocardial function and flow after reversible ischemia. Am J Physiol. 1989 Feb;256(2 Pt 2):H341–H351. doi: 10.1152/ajpheart.1989.256.2.H341. [DOI] [PubMed] [Google Scholar]
  75. Petein M., Levine T. B., Cohn J. N. Hemodynamic effects of a new inotropic agent, piroximone (MDL 19205), in patients with chronic heart failure. J Am Coll Cardiol. 1984 Aug;4(2):364–371. doi: 10.1016/s0735-1097(84)80227-2. [DOI] [PubMed] [Google Scholar]
  76. Pfeffer J. M., Pfeffer M. A., Braunwald E. Influence of chronic captopril therapy on the infarcted left ventricle of the rat. Circ Res. 1985 Jul;57(1):84–95. doi: 10.1161/01.res.57.1.84. [DOI] [PubMed] [Google Scholar]
  77. Pfeffer M. A., Lamas G. A., Vaughan D. E., Parisi A. F., Braunwald E. Effect of captopril on progressive ventricular dilatation after anterior myocardial infarction. N Engl J Med. 1988 Jul 14;319(2):80–86. doi: 10.1056/NEJM198807143190204. [DOI] [PubMed] [Google Scholar]
  78. Pfeffer M. A., Pfeffer J. M., Steinberg C., Finn P. Survival after an experimental myocardial infarction: beneficial effects of long-term therapy with captopril. Circulation. 1985 Aug;72(2):406–412. doi: 10.1161/01.cir.72.2.406. [DOI] [PubMed] [Google Scholar]
  79. Przyklenk K., Ghafari G. B., Eitzman D. T., Kloner R. A. Nifedipine administered after reperfusion ablates systolic contractile dysfunction of postischemic "stunned" myocardium. J Am Coll Cardiol. 1989 Apr;13(5):1176–1183. doi: 10.1016/0735-1097(89)90281-7. [DOI] [PubMed] [Google Scholar]
  80. Przyklenk K., Kloner R. A. "Reperfusion injury" by oxygen-derived free radicals? Effect of superoxide dismutase plus catalase, given at the time of reperfusion, on myocardial infarct size, contractile function, coronary microvasculature, and regional myocardial blood flow. Circ Res. 1989 Jan;64(1):86–96. doi: 10.1161/01.res.64.1.86. [DOI] [PubMed] [Google Scholar]
  81. Przyklenk K., Kloner R. A. Acute effects of hydralazine and enalapril on contractile function of postischemic "stunned" myocardium. Am J Cardiol. 1987 Oct 1;60(10):934–936. doi: 10.1016/0002-9149(87)91059-9. [DOI] [PubMed] [Google Scholar]
  82. Przyklenk K., Kloner R. A. Effect of verapamil on postischemic "stunned" myocardium: importance of the timing of treatment. J Am Coll Cardiol. 1988 Mar;11(3):614–623. doi: 10.1016/0735-1097(88)91540-9. [DOI] [PubMed] [Google Scholar]
  83. Przyklenk K., Kloner R. A. Superoxide dismutase plus catalase improve contractile function in the canine model of the "stunned myocardium". Circ Res. 1986 Jan;58(1):148–156. doi: 10.1161/01.res.58.1.148. [DOI] [PubMed] [Google Scholar]
  84. Rae A. P., Spielman S. R., Kutalek S. P., Kay H. R., Horowitz L. N. Electrophysiologic assessment of antiarrhythmic drug efficacy for ventricular tachyarrhythmias associated with dilated cardiomyopathy. Am J Cardiol. 1987 Feb 1;59(4):291–295. doi: 10.1016/0002-9149(87)90801-0. [DOI] [PubMed] [Google Scholar]
  85. Rajfer S. I., Anton A. H., Rossen J. D., Goldberg L. I. Beneficial hemodynamic effects of oral levodopa in heart failure. Relation to the generation of dopamine. N Engl J Med. 1984 May 24;310(21):1357–1362. doi: 10.1056/NEJM198405243102105. [DOI] [PubMed] [Google Scholar]
  86. Rajfer S. I., Rossen J. D., Douglas F. L., Goldberg L. I., Karrison T. Effects of long-term therapy with oral ibopamine on resting hemodynamics and exercise capacity in patients with heart failure: relationship to the generation of N-methyldopamine and to plasma norepinephrine levels. Circulation. 1986 Apr;73(4):740–748. doi: 10.1161/01.cir.73.4.740. [DOI] [PubMed] [Google Scholar]
  87. Reimer K. A., Jennings R. B. Verapamil in two reperfusion models of myocardial infarction. Temporary protection of severely ischemic myocardium without limitation of ultimate infarct size. Lab Invest. 1984 Dec;51(6):655–666. [PubMed] [Google Scholar]
  88. Reimer K. A., Lowe J. E., Rasmussen M. M., Jennings R. B. The wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs duration of coronary occlusion in dogs. Circulation. 1977 Nov;56(5):786–794. doi: 10.1161/01.cir.56.5.786. [DOI] [PubMed] [Google Scholar]
  89. Renard M., Jacobs P., Dechamps P., Dresse A., Bernard R. Hemodynamic and clinical response to three-day infusion of sulmazol (AR-L 115 BS) in severe congestive heart failure. Chest. 1983 Oct;84(4):408–413. doi: 10.1378/chest.84.4.408. [DOI] [PubMed] [Google Scholar]
  90. Serruys P. W., Simoons M. L., Suryapranata H., Vermeer F., Wijns W., van den Brand M., Bär F., Zwaan C., Krauss X. H., Remme W. J. Preservation of global and regional left ventricular function after early thrombolysis in acute myocardial infarction. J Am Coll Cardiol. 1986 Apr;7(4):729–742. doi: 10.1016/s0735-1097(86)80330-8. [DOI] [PubMed] [Google Scholar]
  91. Sharma B., Goodwin J. F. Beneficial effect of salbutamol on cardiac function in severe congestive cardiomyopathy. Effect on systolic and diastolic function of the left ventricle. Circulation. 1978 Sep;58(3 Pt 1):449–460. doi: 10.1161/01.cir.58.3.449. [DOI] [PubMed] [Google Scholar]
  92. Sharpe N., Murphy J., Smith H., Hannan S. Treatment of patients with symptomless left ventricular dysfunction after myocardial infarction. Lancet. 1988 Feb 6;1(8580):255–259. doi: 10.1016/s0140-6736(88)90347-9. [DOI] [PubMed] [Google Scholar]
  93. Simonton C. A., Daly P. A., Kereiakes D., Modin G., Chatterjee K. Survival in severe left ventricular failure treated with the new nonglycosidic, nonsympathomimetic oral inotropic agents. Chest. 1987 Jul;92(1):118–123. doi: 10.1378/chest.92.1.118. [DOI] [PubMed] [Google Scholar]
  94. Simpson P. J., Mickelson J. K., Lucchesi B. R. Free radical scavengers in myocardial ischemia. Fed Proc. 1987 May 15;46(7):2413–2421. [PubMed] [Google Scholar]
  95. Smith T. W., Antman E. M., Friedman P. L., Blatt C. M., Marsh J. D. Digitalis glycosides: mechanisms and manifestations of toxicity. Part III. Prog Cardiovasc Dis. 1984 Jul-Aug;27(1):21–56. doi: 10.1016/0033-0620(84)90018-5. [DOI] [PubMed] [Google Scholar]
  96. Sonnenblick E. H., Frishman W. H., LeJemtel T. H. Dobutamine: a new synthetic cardioactive sympathetic amine. N Engl J Med. 1979 Jan 4;300(1):17–22. doi: 10.1056/NEJM197901043000105. [DOI] [PubMed] [Google Scholar]
  97. Stamato N. J., O'Connell J. B., Murdock D. K., Moran J. F., Loeb H. S., Scanlon P. J. The response of patients with complex ventricular arrhythmias secondary to dilated cardiomyopathy to programmed electrical stimulation. Am Heart J. 1986 Sep;112(3):505–508. doi: 10.1016/0002-8703(86)90514-4. [DOI] [PubMed] [Google Scholar]
  98. Stevenson L. W., Laks H., Terasaki P. I., Kahan B. D., Drinkwater D. C. Cardiac transplantation. Selection, immunosuppression, and survival. West J Med. 1988 Nov;149(5):572–582. [PMC free article] [PubMed] [Google Scholar]
  99. Swedberg K., Hjalmarson A., Waagstein F., Wallentin I. Prolongation of survival in congestive cardiomyopathy by beta-receptor blockade. Lancet. 1979 Jun 30;1(8131):1374–1376. doi: 10.1016/s0140-6736(79)92010-5. [DOI] [PubMed] [Google Scholar]
  100. Thomas J. A., Marks B. H. Plasma norepinephrine in congestive heart failure. Am J Cardiol. 1978 Feb;41(2):233–243. doi: 10.1016/0002-9149(78)90162-5. [DOI] [PubMed] [Google Scholar]
  101. Thompson M. J., Huss P., Unverferth D. V., Fasola A., Leier C. V. Hemodynamic effects of intravenous butopamine in congestive heart failure. Clin Pharmacol Ther. 1980 Sep;28(3):324–334. doi: 10.1038/clpt.1980.169. [DOI] [PubMed] [Google Scholar]
  102. Unverferth D. V., Magorien R. D., Lewis R. P., Leier C. V. Long-term benefit of dobutamine in patients with congestive cardiomyopathy. Am Heart J. 1980 Nov;100(5):622–630. doi: 10.1016/0002-8703(80)90226-4. [DOI] [PubMed] [Google Scholar]
  103. Uraizee A., Reimer K. A., Murry C. E., Jennings R. B. Failure of superoxide dismutase to limit size of myocardial infarction after 40 minutes of ischemia and 4 days of reperfusion in dogs. Circulation. 1987 Jun;75(6):1237–1248. doi: 10.1161/01.cir.75.6.1237. [DOI] [PubMed] [Google Scholar]
  104. Velebit V., Podrid P., Lown B., Cohen B. H., Graboys T. B. Aggravation and provocation of ventricular arrhythmias by antiarrhythmic drugs. Circulation. 1982 May;65(5):886–894. doi: 10.1161/01.cir.65.5.886. [DOI] [PubMed] [Google Scholar]
  105. Wahr D. W., Swedberg K., Rabbino M., Hoyle M. J., Curran D., Parmley W. W., Chatterjee K. Intravenous and oral prenalterol in congestive heart failure. Effects on systemic and coronary hemodynamics and myocardial catecholamine balance. Am J Med. 1984 Jun;76(6):999–1005. doi: 10.1016/0002-9343(84)90848-9. [DOI] [PubMed] [Google Scholar]
  106. Warren S. E., Royal H. D., Markis J. E., Grossman W., McKay R. G. Time course of left ventricular dilation after myocardial infarction: influence of infarct-related artery and success of coronary thrombolysis. J Am Coll Cardiol. 1988 Jan;11(1):12–19. doi: 10.1016/0735-1097(88)90159-3. [DOI] [PubMed] [Google Scholar]
  107. Watanabe A. M. Recent advances in knowledge about beta-adrenergic receptors: application to clinical cardiology. J Am Coll Cardiol. 1983 Jan;1(1):82–89. doi: 10.1016/s0735-1097(83)80013-8. [DOI] [PubMed] [Google Scholar]
  108. Webster M. W., Fitzpatrick M. A., Nicholls M. G., Ikram H., Wells J. E. Effect of enalapril on ventricular arrhythmias in congestive heart failure. Am J Cardiol. 1985 Sep 15;56(8):566–569. doi: 10.1016/0002-9149(85)91186-5. [DOI] [PubMed] [Google Scholar]
  109. Weisman H. F., Bush D. E., Mannisi J. A., Bulkley B. H. Global cardiac remodeling after acute myocardial infarction: a study in the rat model. J Am Coll Cardiol. 1985 Jun;5(6):1355–1362. doi: 10.1016/s0735-1097(85)80348-x. [DOI] [PubMed] [Google Scholar]
  110. White H. D., Norris R. M., Brown M. A., Brandt P. W., Whitlock R. M., Wild C. J. Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation. 1987 Jul;76(1):44–51. doi: 10.1161/01.cir.76.1.44. [DOI] [PubMed] [Google Scholar]
  111. Woosley R. L. Pharmacokinetics and pharmacodynamics of antiarrhythmic agents in patients with congestive heart failure. Am Heart J. 1987 Nov;114(5):1280–1291. doi: 10.1016/0002-8703(87)90217-1. [DOI] [PubMed] [Google Scholar]
  112. Yusuf S., Wittes J., Bailey K., Furberg C. Digitalis--a new controversy regarding an old drug. The pitfalls of inappropriate methods. Circulation. 1986 Jan;73(1):14–18. doi: 10.1161/01.cir.73.1.14. [DOI] [PubMed] [Google Scholar]
  113. Zipperle G., Butzer F., Dieterich H. A., Heinrich F. A double-blind dose response comparison of oral enoximone and placebo for congestive heart failure. Am J Cardiol. 1987 Aug 14;60(5):72C–74C. doi: 10.1016/0002-9149(87)90530-3. [DOI] [PubMed] [Google Scholar]

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