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PubMed1985

The effects of piretanide, a potassium stable diuretic, on serum electrolytes in patients with congestive heart failure.

In a randomized double-blind, parallel group study, the effects of piretanide on serum electrolytes and on symptoms of congestive heart failure were compared with those of the combination piretanide plus triamterene in out-patients with mild to severe congestive heart failure. A total of 60 patients entered the study; 13 patients were excluded from the statistical analysis (4 due to premature end of the study, 2 due to dose increase, 7 due to concomitant medication (antihypertensive or antihypotensive agents), so that the results of 47 patients were statistically analyzed, 26 of them in the piretanide and 21 of them in the piretanide plus triamterene group. Piretanide (6 mg once daily) and piretanide plus triamterene (6 mg + 50 mg once daily) both produced a significant reduction in certain symptoms of congestive heart failure which was evident at 2 weeks and was maintained and further enhanced over the ensuing 12-week trial period. Improvement in a number of symptoms of congestive heart failure was attained in 54% of the patients in the piretanide group and 67% in the piretanide plus triamterene group. This difference, however, was not clinically relevant, since the symptoms which are expected to improve in this short time showed no great difference between the two groups. There were no significant changes in serum potassium and serum magnesium within groups or differences between the groups. There were decreases in serum sodium, calcium and inorganic phosphorus in the piretanide plus triamterene group. In the piretanide group, only a temporary drop in inorganic phosphorus was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2003

[Clinical study on effect of shengmai injection on serum concentration and pharmacokinetic parameters of digoxin in patients with congestive heart failure].

OBJECTIVE: To investigate the effect of Shengmai Injection (SMI) on serum concentration and pharmacokinetic parameters of digoxin in patients with congestive heart failure. METHODS: Forty in-patients with congestive heart failure were selected and randomly divided into 4 groups, the three treated groups I, II and III treated with digoxin combined with 20 ml, 40 ml and 60 ml of SMI respectively, and the control group, 10 patients in each group. The serum concentration of digoxin at different time points was determined with radioimmunoassay and the pharmacokinetical parameters were calculated with 3P97 pharmacokinetic software. RESULTS: The serum concentration of digoxin in the treated group I was significantly lower than that in the control group (P < 0.05), with the pharmacokinetical parameters, including the elimination half-life time (T1/2), elimination rate constant (Ke), apparent volume of distribution (Vd), plasma clearance (CL) and area under curve (AUC), significantly different to those in the control group (P < 0.05 or P < 0.01). But the serum concentration of digoxin with its pharmacokinetical parameters in the other two treated groups were not different significantly to those in the control group respectively (P > 0.05). CONCLUSION: SMI could influence the metabolism of digoxin in patients with congestive heart failure. This study has provided an important reference for safe and rational combined use of digoxin and SMI in clinical practice.

Adult↗

PubMed1999

Evaluating Health-related quality-of-life outcomes in patients with congestive heart failure. A review of recent randomised controlled trials.

Congestive heart failure (CHF) is a chronic disorder characterised by fatigue, shortness of breath and congestion. Treatment is designed to relieve symptoms, halt or delay progression of the disease, prolong life and, ultimately, improve quality of life. The purpose of this paper is to identify recent trends in the assessment of health-related quality-of-life (HR-QOL) outcomes in randomised, controlled trials evaluating treatment effectiveness in patients with CHF. 41 studies using HR-QOL as an explicit outcome and published in English between 1990 and September 1998 were reviewed. Trends in the measurement of HR-QOL and evidence of treatment effectiveness are presented followed by a discussion of the implications for future research. Results suggest that pharmacological and nonpharmacological treatment regimens can have a positive impact on HR-QOL. However, treatment-related improvement in exercise capacity in patients with CHF was not consistently associated with improvement in all domains of HR-QOL. The primary HR-QOL domain affected by treatment appears to be the performance of daily activities, which may or may not be accompanied by enhanced well-being. This suggests that functional status should be considered a primary HR-QOL end-point in clinical intervention trials. Preference-based or utility assessment, ethnic group differences in treatment effectiveness, caregiver burden and cost effectiveness are understudied outcomes in CHF research.

Heart Failure↗

PubMed1981

Hemodynamic comparison of intravenous amrinone and dobutamine in patients with chronic congestive heart failure.

Amrinone, a new inotropic agent, has been shown to be beneficial in patients with congestive heart failure. However, its hemodynamic effects have not been compared with those those of currently useful catecholamines. In this study, the effects of intravenously administered dobutamine and amrinone were compared in eight patients with severe chronic congestive heart failure. Dobutamine was infused with a maximal increase in cardiac index was reached for undesirable effects were produced. This dose was then continued for 8 hours. After a return of hemodynamic values to baseline level, amrinone was infused at a rate of 40 microgram/kg per min for 1 hour and then 10 microgram/kg per min for 24 hours. Both drugs significantly improved cardiac index while simultaneously decreasing systemic vascular resistance and right atrial and pulmonary wedge pressures (p less than 0.05). Initially no differences could be found between the drugs. However, with prolonged infusion amrinone produced a sustained improvement whereas dobutamine had a decreased effectiveness. Thus, amrinone is comparable in effect with the optimal dose of dobutamine and would appear to be an extremely promising drug in the acute treatment of severe congestive heart failure.

Adolescent↗

PubMed1990

Long-term prognosis of patients with congestive heart failure.

Factors determining prognosis in 100 patients with recent onset of congestive heart failure (CHF) were evaluated. The 1 year, 3 year, 5 year, and 10 year survival rates in the entire CHF group were 78.5%, 59.8%, 50.4% and 14.7%, respectively. No correlations between age, sex, heart rate and cardiothoracic ratio, and the cumulative survival rate were found. The prognosis of patients with CHF due to underlying coronary artery disease or primary cardiomyopathy was poor compared with that of patients with other types of heart disease. Patients whose NYHA classification was class III or VI had a significantly lower survival rate than those in class II. Patients with lower left ventricular stroke work and consecutive ventricular premature depolarization also had a significantly lower survival rate. These results suggest that functional status, underlying heart disease, left ventricular stroke work, and the presence of ventricular tachycardia provide important information regarding the long-term prognosis in patients with congestive heart failure.

Adolescent↗

PubMed2006

Congestive heart failure: Diagnosis, pathophysiology, therapy, and implications for respiratory care.

Congestive heart failure (CHF) is a common clinical disorder that results in pulmonary vascular congestion and reduced cardiac output. CHF should be considered in the differential diagnosis of any adult patient who presents with dyspnea and/or respiratory failure. The diagnosis of heart failure is often determined by a careful history and physical examination and characteristic chest-radiograph findings. The measurement of serum brain natriuretic peptide and echocardiography have substantially improved the accuracy of diagnosis. Therapy for CHF is directed at restoring normal cardiopulmonary physiology and reducing the hyperadrenergic state. The cornerstone of treatment is a combination of an angiotensin-converting-enzyme inhibitor and slow titration of a beta blocker. Patients with CHF are prone to pulmonary complications, including obstructive sleep apnea, pulmonary edema, and pleural effusions. Continuous positive airway pressure and noninvasive positive-pressure ventilation benefit patients in CHF exacerbations.

Aged↗

PubMed1988

Preservation of the end-systolic pressure/end-systolic dimension relation following pindolol in congestive heart failure.

Beta blockade may adversely affect inotropic state of the ventricle, resulting in exacerbation of congestive heart failure in subjects with reduced ventricular function. In normal subjects, ventricular contractility appears to be preserved following administration of beta blockers with intrinsic sympathomimetic activity (ISA). The inotropic state of the ventricle was assessed in seven subjects with congestive heart failure (mean ejection fraction = 23 +/- 5%) before and after administration of the ISA beta blocker, pindolol, with the use of the noninvasively derived end-systolic pressure/end-systolic dimension (ESP/ESD) relation. The mean slope of the ESP/ESD relation was 36.3 +/- 20.4 mm Hg/cm at baseline and increased to 45.0 +/- 25.2 mm Hg/cm following five consecutive 10 mg oral doses of pindolol (p = ns). Other simultaneously derived inotropic indices that included percent fractional shortening, mean delta P/delta T, velocity of circumferential fiber shortening, and preejection period-to-left ventricular ejection time ratio showed directionally similar changes toward a mild increase in contractility. These results indicate that the slope of the left ventricular ESP/ESD relation is not altered following repeated dosing with pindolol in subjects with congestive heart failure. This reflects a preservation of inotropic state following administration of this ISA beta blocker in a population with severely compromised ventricular function.

Echocardiography↗

PubMed2000

Intravenous nesiritide, a natriuretic peptide, in the treatment of decompensated congestive heart failure. Nesiritide Study Group.

BACKGROUND: Intravenous infusion of nesiritide, a brain (B-type) natriuretic peptide, has beneficial hemodynamic effects in patients with decompensated congestive heart failure. We investigated the clinical use of nesiritide in such patients. METHODS: Patients hospitalized because of symptomatic congestive heart failure were enrolled in either an efficacy trial or a comparative trial. In the efficacy trial, which required the placement of a Swan-Ganz catheter, 127 patients with a pulmonary-capillary wedge pressure of 18 mm Hg or higher and a cardiac index of 2.7 liters per minute per square meter of body-surface area or less were randomly assigned to double-blind treatment with placebo or nesiritide (infused at a rate of 0.015 or 0.030 microg per kilogram of body weight per minute) for six hours. In the comparative trial, which did not require hemodynamic monitoring, 305 patients were randomly assigned to open-label therapy with standard agents or nesiritide for up to seven days. RESULTS: In the efficacy trial, at six hours, nesiritide infusion at rates of 0.015 and 0.030 microg per kilogram per minute decreased pulmonary-capillary wedge pressure by 6.0 and 9.6 mm Hg, respectively (as compared with an increase of 2.0 mm Hg with placebo, P<0.001), resulted in improvements in global clinical status in 60 percent and 67 percent of the patients (as compared with 14 percent of those receiving placebo, P<0.001), reduced dyspnea in 57 percent and 53 percent of the patients (as compared with 12 percent of those receiving placebo, P<0.001), and reduced fatigue in 32 percent and 38 percent of the patients (as compared with 5 percent of those receiving placebo, P<0.001). In the comparative trial, the improvements in global clinical status, dyspnea, and fatigue were sustained with nesiritide therapy for up to seven days and were similar to those observed with standard intravenous therapy for heart failure. The most common side effect was dose-related hypotension, which was usually asymptomatic. CONCLUSIONS: In patients hospitalized with decompensated congestive heart failure, nesiritide improves hemodynamic function and clinical status. Nesiritide is useful for the treatment of decompensated congestive heart failure.

Atrial Natriuretic Factor↗

PubMed2000

[Pericardial extravasation as an indicator of congestive heart failure due to thiamine deficiency in a young adult].

INTRODUCTION: Thiamine (B1) deficiency is one of the classical causes of congestive heart failure. Although in the western world and in other developed regions this disorder is generally associated with chronic alcoholism, it may also only occur as a result of a deficient diet. EXEGESIS: A young patient was admitted for electrocardiographic examination, and pericardial extravasation was recorded. The etiological assessment showed a case of congestive heart failure due to thiamine (B1) deficiency. A hemodynamic examination and investigation of thiamine blood levels confirmed this diagnosis. The patient's health status improved following thiamine administration, with complete and rapid regression of symptoms of congestive heart failure. CONCLUSION: Although cardiomyopathic beriberi is infrequent, it should systematically be taken into account in the etiology of congestive heart failure. The present study also notes that a dietary thiamine deficiency is uncommon, but should nevertheless be considered when other symptoms of denutrition are present.

Adult↗

PubMed1986

Hemodynamic effects of digoxin on congestive heart failure.

To assess the hemodynamic effects of digoxin (0.01 mg/kg) on congestive heart failure, we evaluated 19 patients with decreased contraction force of left ventricle (old myocardial infarction n = 9, and dilated cardiomyopathy n = 10, group 1) and 8 patients with mechanical impaired left ventricular filing (mitral stenosis n = 8, group 2). In groups 1 and 2, heart rate and pulmonary capillary pressure significantly decreased (p less than 0.05). In group 1, stroke volume increased, but not significantly. In group 2, stroke volume increased significantly (p less than 0.05). There were no significant changes in blood pressure and systemic vascular resistance in either group. We divided group 1 into two groups (group 1A: cardiac index increased more than 15%, group 1B: cardiac index increased less than 15%). In group 1A, cardiac index and % fractional shortening before digoxin administration were lower than in group 1B (1.97 + 0.27 vs 2.80 + 0.481/min/m2, p less than 0.001, and 10.9 + 8.0 vs. 19.5 +11.9%, p less than 0.05, respectively). These data suggested that digoxin exerted a positive inotropic effect with decreased pulmonary capillary pressure but cardiac index did not always increase in congestive heart failure.

Digoxin↗

PubMed1999

Induction of functional inducible nitric oxide synthase in monocytes of patients with congestive heart failure. Link with tumour necrosis factor-alpha.

AIMS: We studied the induction of monocytic inducible nitric oxide synthase expression and the tumour necrosis factor-alpha system in patients with congestive heart failure. METHODS AND RESULTS: Forty-three congestive heart failure patients and 15 healthy subjects were studied. Antigenic tumour necrosis factor-alpha and its soluble receptors, measured by ELISA, were increased in chronic heart failure and the increase was related to the clinical severity of the syndrome (tumour necrosis factor-alpha from 8.2+/-5.2 in NYHA class II to 18.2+/-7.2 in class III and 26.9+/-13.2 pg. ml(-1)in class IV, P<0.0001 classes III and IV vs class II; soluble tumour necrosis factor receptor I from 1.0+/-0.2 in class II to 2.3+/-1.1 in class III and 5.5+/-3.2 ng. ml(-1)in class IV, P<0.0001 classes III and IV vs class II; soluble tumour necrosis factor receptor II from 2.7+/-0.7 in class II to 4.9+/-1.9 in class III and 8.4+/-5.0 ng. ml(-1)in class IV, P<0.002 classes III and IV vs class II). Monocytic inducible nitric oxide synthase assessed by Western blot, was expressed only in congestive heart failure patients (13 out of 43). The association among monocytic inducible nitric oxide synthase expression, tumour necrosis factor-alpha system activation, neurohormones and other clinical parameters was studied. The univariate logistic regression showed that inducible nitric oxide synthase expression was strictly associated with NYHA class (P<0.05), antigenic tumour necrosis factor-alpha (P<0.01) and its soluble receptors (P<0.05). The multivariate analysis showed that antigenic tumour necrosis factor-alpha was the only predictor for monocytic inducible nitric oxide synthase expression (P<0.05, RR=2.75, CI 1. 34-5.43). CONCLUSIONS: Inducible nitric oxide synthase is expressed in circulating monocytes of patients with severe congestive heart failure. This phenomenon is linked to the activation of the tumour necrosis factor-alpha system.

Adult↗

PubMed1991

Elevated plasma beta-endorphin levels in patients with congestive heart failure.

Recent experimental studies show that the opioid system is important to the pathophysiology of cardiovascular impairment in congestive heart failure. Plasma beta-endorphin levels were measured in 37 patients with congestive heart failure and compared with those of 21 age- and gender-matched normal subjects. The relation of plasma beta-endorphin levels and cardiac function at rest and exercise capacity was assessed in 17 of the patients with dilated cardiomyopathy. Exercise capacity was determined by symptom-limited maximal treadmill exercise with expired gas analysis. Plasma beta-endorphin levels were elevated and correlated with the patients' New York Heart Association functional cardiac status (control: 14.0 +/- 4.4 pg/ml; class II: 17.9 +/- 3.6 pg/ml; class III: 28.3 +/- 8.8 pg/ml; class IV: 46.7 +/- 14.6 pg/ml, mean +/- SD). No relation was found between plasma beta-endorphin levels and left ventricular systolic performance as assessed by M-mode and Doppler echocardiography. Plasma beta-endorphin levels were negatively correlated with cardiac output determined by Doppler echocardiography and positively correlated with systemic vascular resistance (r = -0.733, r = 0.747, respectively, both p less than 0.001), but not correlated with calf blood flow as measured by a plethysmography. A good correlation was found between plasma beta-endorphin levels at rest and exercise capacity. The correlations with peak oxygen consumption, anaerobic threshold, and peak rate-pressure product were r = -0.721, -0.672, and -0.674, respectively (p less than 0.01). The data show that plasma beta-endorphin levels are elevated in patients with congestive heart failure and reflect, to some degree, the severity of the disease.

Echocardiography↗

PubMed1979

[Therapeutic experience with osyrol 100/Lasix in the treatment of congestive heart failure (author's transl)].

Under general practice conditions 18 patients with congestive heart failure which did not respond satisfactorily to digitalization and saluretic therapy were treated with Osyrol 100/Lasix for a period of 3 months while retaining the digitalis medication. The application gave good to satisfactory results in over 90% of the cases. This very good result in patients with previously unsatisfactory response underlines the high therapeutic efficacy of this preparation. The findings of this study confirm that Osytol 100/Lasix is a reliably effective, well tolerated preparation with a low risk and is particularly suitable for the ambulant treatment of patients with congestive heart failure.

Digitalis Glycosides↗

PubMed1981

Bioavailability of quinidine in congestive heart failure.

1 The oral bioavailability of quinidine was evaluated in eight patients with moderate to severe congestive heart failure. Each patient was given a 400 mg dose of quinidine gluconate by intravenous infusion and orally in solution. Serial plasma samples and total urine for drug analysis were collected for 24 and 48 h after drug administration, respectively. 2 When compared to control cardiac patients, the rate of quinidine absorption was slower in the heart failure patients. The mean value for the apparent absorption half-life and time to achieve peak plasma quinidine concentration was 38 +/- 18 min and 2.4 +/- 1.5 h respectively. The corresponding values observed in the control subjects were 18 +/- 6 min and 1.0 +/- 0.6 h. 3 The extent of quinidine absorption when evaluated by the AUC and urinary excretion methods was about 72% of the administered dose in the congestive heart failure patients. This value was similar to the extent of quinidine absorption (approximately 73%) observed in the control subjects. 5 When compared with non-heart failure cardiac patients, the results of this study suggest that patients with congestive heart failure may require smaller oral quinidine dosages to achieve therapeutic drug concentrations in the plasma or serum.

Aged↗

PubMed1984

Restoration of normal reflex responses to orthostatic stress during felodipine therapy in congestive heart failure.

The mechanisms underlying the abnormal responses to orthostatic stress in congestive heart failure are ill defined and little is known about the effects of specific therapy. In the present study intravascular pressures and plasma noradrenaline levels were measured in nine patients with heart failure subjected to 45 degrees and 90 degrees upright tilt. Studies were repeated during 4 weeks of vasodilator therapy with felodipine and again after felodipine withdrawal. Before the introduction of vasodilator therapy, tilt did not activate orthostatic reflexes despite significant reductions in left ventricular filling pressure and cardiac output. Thus, plasma noradrenaline, heart rate and systemic vascular resistance were unaffected and blood pressure fell. Felodipine resulted in a rapid and sustained improvement in left ventricular function but restoration of orthostatic reflexes was delayed and could be detected only after 48 h therapy. At this time, and during the subsequent 4 weeks, tilt-induced reductions in ventricular filling and cardiac output produced a normal rise in plasma noradrenaline and heart rate. A postural drop in blood pressure, however, was not averted because the direct action of felodipine on vascular smooth muscle prevented adrenergically-mediated increments in systemic vascular resistance. Felodipine withdrawal led to a prompt deterioration in left ventricular function. Orthostatic reflexes, however, were still intact 48 h later when tilt elicited a completely normal pattern of responses. These observations confirm that the abnormal responses to orthostatic stress in congestive heart failure are due principally to impairment of autonomic control mechanisms and are not related to the absence of venous pooling. Importantly the autonomic dysfunction is reversible with felodipine therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2002

[Autoantibodies: new upstream targets of paroxysmal atrial fibrillation in patients with congestive heart failure].

OBJECTIVES: The clinical implications of autoantibodies (Abs) were investigated as upstream indicators of paroxysmal atrial fibrillation in patients with congestive heart failure. METHODS: Circulating Abs against myosin (M-Abs) detected by immunofluorescence, Abs against beta 1-adrenergic receptors (Beta 1-Abs) detected by enzyme-linked immunosorbent assay (ELISA), and Abs against NA-K-ATPase (NKA-Abs) detected by ELISA were screened in 95 congestive heart failure patients with < or = 45% left ventricular ejection fraction (coronary artery disease, n = 48; dilated cardiomyopathy, n = 47) and 48 age-matched control patients with hypertension. No patient received antiarrhythmic therapy. All patients were enrolled with angiotensin converting enzyme inhibitors in the chronic stable state. Relationship of the presence of paroxysmal atrial fibrillation to other clinical variables were assessed by 48-hour Holter monitoring. RESULTS: No control patient had Abs. However, M-Abs, Beta 1-Abs, and NKA-Abs were detected in 22%, 26% and 16% of patients with congestive heart failure (coronary artery disease; 8%, 10%, and 4%, dilated cardiomyopathy; 36%, 43%, and 28%, respectively). Paroxysmal atrial fibrillation was more frequent in patients with dilated cardiomyopathy than in those with coronary artery disease (47% vs 15%, p < 0.01). Multivariate analysis suggested that NKA-Abs was an independent risk factor for the occurrence of paroxysmal atrial fibrillation (p < 0.01), although there were no differences in other clinical factors: age, sex, New York Heart Association functional class, concomitant medication, left ventricular ejection fraction, left atrial diameter, severity of mitral regurgitation, serum potassium, plasma norepinephrine, and atrial natriuretic peptide concentration. CONCLUSIONS: Autoantibodies against sarcolemmal Na-K-ATPase were closely related to the occurrence of paroxysmal atrial fibrillation in patients with congestive heart failure, so an autoimmune process may be an upstream factor in atrial fibrillation.

Atrial Fibrillation↗

PubMed1993

[Prevalence of congestive heart failure after ventriculomectomy in patients with obstructive hypertrophic cardiomyopathy].

PURPOSE: To assess the prevalence of congestive heart failure in the late post-operative follow-up in patients with hypertrophic obstructive cardiomyopathy (HOCM) submitted to ventriculomectomy (VM). METHODS: Thirty six patients with HOCM, all of them with basal intraventricular systolic pressure gradient (BPG) > or = 50 mmHg, were studied. Sixteen (group I) were submitted to VM and 20 (group II) remained under clinical treatment. At group I the ages were 1 month to 61 years (28.25 +/- 15.39), 10 male (62.5%); BPG ranged from 50 to 192 mmHg (98.09 +/- 42.76) with mean follow-up of 13.06 +/- 7.19 years. At group II the age ranged from 2 months to 58 years (31.01 +/- 18.61); 12 male (60%); BPG ranged from 52 to 185 mmHg (83.47 +/- 35.08) with mean follow-up of 9.6 +/- 4.93 years. RESULTS: At group I the follow-up was good in 4 patients (25%), stable in 2 (12.5%) and poor in 3 (18%). Seven patients (43.75%) developed congestive heart failure at mean time of 7.53 +/- 8.44 years; there was one operative death and the follow-up control was lost in 7 patients. In group II, the follow-up was good in 3 patients (15%), stable in a 6 (30%) and poor in a 9 (45%); no deaths occurred. Two patients had heart failure within 3 years after the onset of the disease. The follow-up control was lost in 8 patients (40%). CONCLUSION: 1) congestive heart failure was more frequent in patients submitted to VM rather than the non-operated ones (p < 0.05); 2) the short-term follow-up was better in operated patients rather than in non-operated ones.

Adolescent↗

PubMed2001

Fetal congestive heart failure: correlation of Tei-index and Cardiovascular-score.

INTRODUCTION: Congestive heart failure (CHF) may be present in fetuses with hydrops fetalis (HF) and the severity is difficult to quantitate. Differential ventricular dysfunction may be present in the fetus with CHF. A non-geometric measure of ventricular function that is not afterload dependent would be useful to measure the severity of myocardial dysfunction. METHODS: Tei-index (isovolumetric time/ejection time) was measured prenatally in 23 normals (24-34 weeks gestational age-GA) and in 7 with HF (24-34 weeks GA). Prenatal CHF severity was graded by a 10 point cardiovascular (CV) score (2 points each for absence of hydrops, normal venous Doppler, heart function, arterial Doppler, and heart size, and 10/10 = normal). A paired student t-test was used to compare RV and LV and non-paired t-test compared HF and normals. Tei-index and CV score were correlated. RESULTS: Tei-index normals were 0.38 +/- 0.04 in the right ventricle (RV) and 0.41 +/- 0.05 in the left ventricle (LV) and there were no significant RV-LV or gestational age (GA) differences. Among HF fetuses, RV and LV Tei-indices were both significantly increased (0.54 and 0.92) and not significantly different. CV score ranged from 2 to 8 (mean 5.43 out of 10) and correlated inversely with Tei-index (r = -0.52, r = -0.68). CONCLUSION: Hydrops fetalis is associated with biventricular dysfunction and congestive heart failure. Tei-index correlates with CV score obtained within two weeks of delivery or intrauterine death. Tei-index may be useful in the serial assessment of myocardial dysfunction in the fetus with hydrops.

Adult↗