Low Cardiac Output

A state of subnormal or depressed cardiac output at rest or during stress. It is a characteristic of CARDIOVASCULAR DISEASES, including congenital, valvular, rheumatic, hypertensive, coronary, and cardiomyopathic. The serious form of low cardiac output is characterized by marked reduction in STROKE VOLUME, and systemic vasoconstriction resulting in cold, pale, and sometimes cyanotic extremities.

Also Known As:

Networked: 979 relevant articles (56 outcomes, 56 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Heart Failure
2.	Myocardial Ischemia (Ischemic Heart Diseases)
3.	Aortic Valve Stenosis (Aortic Stenosis)
4.	Coronary Artery Disease (Coronary Atherosclerosis)
5.	Hypotension (Low Blood Pressure)

Experts

1.	Chang, Anthony C: 7 articles (09/2010 - 01/2002)
2.	Mohr, Friedrich W: 6 articles (05/2015 - 11/2003)
3.	Walther, Thomas: 5 articles (05/2015 - 11/2003)
4.	Ranucci, Marco: 5 articles (08/2013 - 02/2005)
5.	Atz, Andrew M: 5 articles (04/2012 - 01/2002)
6.	Wernovsky, Gil: 5 articles (03/2007 - 01/2002)
7.	Pagano, Domenico: 4 articles (03/2015 - 06/2005)
8.	Sabzi, Feridoun: 4 articles (01/2015 - 04/2013)
9.	Frigiola, Alessandro: 4 articles (08/2013 - 02/2005)
10.	Falk, Volkmar: 4 articles (06/2005 - 11/2003)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Low Cardiac Output:

1.	DobutamineFDA LinkGeneric 08/01/1988 - "Dobutamine seems to be an effective agent for the treatment of low cardiac output in asphyxiated neonates." 02/01/2013 - "The resulting data suggest that a careful literature review did not supply evidence for the systematic use of BB in patients with low cardiac output syndrome who require dobutamine for inotropic support." 09/01/2003 - "Dobutamine stress echocardiography is a useful tool for assessing low cardiac output AS. " 01/01/2001 - "Treatment with dobutamine is indicated in patients in whom low cardiac output rather than elevated pulmonary pressure is the primary hemodynamic aberration. " 11/01/1999 - "We re-analysed data from 22 patients after cardiac surgery who were randomized to receive either dobutamine or placebo, and a separate group of patients who received dobutamine for low cardiac output (n = 6). "
2.	simendan (Levosimendan)IBA 06/01/2014 - "These preliminary results show that timely perioperative levosimendan treatment is feasible, has a favourable safety profile safe and may help to prevent low cardiac output syndrome. " 06/01/2006 - "The efficacy of levosimendan treatment for a low cardiac output status following cardiac surgery has not been established. " 05/01/2006 - "Levosimendan was safely used in a small number of pediatric patients with established low cardiac output state who demonstrated improved hemodynamics and tissue perfusion, with a tendency to reduced conventional inotrope usage, and this warrants its evaluation as an inotrope in the pediatric population." 10/01/2013 - "In conclusion, the above studies were in favour of levosimendan as a safe and feasible drug providing potential clinical benefit in low cardiac output syndrome (LCOS) and post-cardiac surgeries when other vasoactive drugs were insufficient to maintain stable haemodynamics. " 04/01/2009 - "This study was performed to evaluate the efficacy and safety of levosimendan (LEVO) in pediatric patients with low cardiac output syndrome. "
3.	Amrinone (Amrinon)FDA Link 01/01/1991 - "The efficacy of amrinone was assessed in the treatment of low cardiac output states occurring within 24 h after mitral valve replacement in an open prospective trial. " 01/01/1991 - "[Hemodynamic effects of amrinone in low cardiac output after mitral valve replacement]." 08/01/1990 - "Amrinone in perioperative low cardiac output syndrome." 12/01/1989 - "Amrinone: contemporary management of the low cardiac output syndrome. " 07/01/1988 - "[Clinical and hemodynamic multicenter study of the effect of intravenous amrinone in the treatment of low cardiac output after valvular replacement]."
4.	Milrinone (Primacor)FDA LinkGeneric 02/01/2001 - "This is a preliminary study for evaluating the efficacy of a slow induction of milrinone, so patients in low cardiac output state were excluded. " 04/01/2012 - "Administration of milrinone to neonates with low cardiac output may lead to improved postoperative stability." 09/01/2005 - "We assessed the effect of milrinone on myocardial function in pediatric patients with postoperative low cardiac output syndrome by index of myocardial performance in a prospective, open-label, nonrandomized, consecutive study. " 02/01/2004 - "The data used for pharmacokinetic analysis were collected in a prospective, randomized, placebo-controlled multi-center trial of milrinone as prophylaxis for the development of low cardiac output syndrome after surgery for repair of complex congenital cardiac defects. " 01/01/1992 - "Haemodynamic and biological effects of intravenous milrinone in patients with a low cardiac output syndrome following cardiac surgery: multicentre study."
5.	dopexamineIBA 10/01/1992 - "Titration of dopexamine, 1 to 4 micrograms/kg/min, was efficacious in producing circulatory improvement in patients with a low cardiac output after cardiac surgery." 01/01/1999 - "Dopexamine is a synthetic catecholamine used for the management of low-cardiac-output states. " 05/01/1997 - "Dopexamine has a hemodynamic profile suited to treatment of low cardiac output in anesthetized horses; however, at the dosage rate studied (4 micrograms/kg/min), its administration was associated with a number of undesirable adverse effects which could preclude its clinical use." 06/01/1994 - "Dopexamine hydrochloride (Dopacard) is the novel synthetic catecholamine designed for use in the acute management of a low cardiac output status. " 10/01/1993 - "Recently, dopexamine (DX), which acts via adrenergic beta 2 and dopaminergic DA1 receptors, has been introduced in the treatment of low cardiac output states. "
6.	EnoximoneIBA 06/01/1997 - "[Enoximone in the treatment of postoperative low cardiac output syndrome in pediatric heart surgery. " 12/01/1995 - "In turn, the PDE III-inhibitor enoximone has been used for several years to treat low cardiac output syndrome. " 03/01/1991 - "We conclude that enoximone, single or in association with other inotropics, should be considered a drug of choice in patients undergoing cardiac surgery who develop a low cardiac output syndrome." 11/01/1990 - "Low cardiac output and enoximone." 05/01/1990 - "Management of low cardiac output syndrome after cardiac surgery using enoximone."
7.	Epinephrine (Adrenaline)FDA LinkGeneric 03/01/1991 - "In this patient, adrenaline perfusion improved the low cardiac output syndrome but resulted in poorly tolerated side effects. " 04/01/1966 - "Experimental study and clinical use of epinephrine for treatment of low cardiac output syndrome." 01/01/2014 - "Pharmacokinetics, hemodynamic and metabolic effects of epinephrine to prevent post-operative low cardiac output syndrome in children." 04/01/1996 - "In patients with direct femoral artery cannulation risk factors appear to be: arteriopathy (p<0.001), prolonged extra corporeal circulation (p<0.001), low cardiac output syndrome (p<0.001), continuous i.v. infusion of epinephrine (p<0.0001). " 01/01/1985 - "[High-dosage adrenaline therapy in low cardiac output syndrome following aortic valve replacement]."
8.	Carbon MonoxideIBA 05/01/2008 - "This study was undertaken to validate the transpulmonary thermodilution cardiac output measurement (CO(TPTD)) in a controlled newborn animal model under various hemodynamic conditions with special emphasis on low cardiac output. " 11/01/2014 - "Although CHF is commonly associated with low cardiac output (CO), it may also occur in high CO states. " 01/01/2012 - "Low cardiac output (LCO) was defined as CO lower than 2.5 Llminlm². " 06/01/2009 - "Three (5.4%) patients had low Cardiac Output (CO) after operation. " 10/01/2007 - "The utility of CVA-CO2 and SVA-CO2 tension gradient appeared to be limited to their negative predictive value to exclude a low cardiac output state when CVA-CO, or SVA-CO, tension gradient was normal (< or =5 mmHg)."
9.	glucuronyl glucosamine glycan sulfate (Vessel)IBA 04/01/1996 - "Although the Q-wave MI rate, the peak CPK level and the reperfusion rate were no different, the low cardiac output condition, multi vessel disease and short-term mortality were significantly greater in the older group. " 12/01/2007 - "In the right ventricular outlet reconstruction patients, the McGoon index for patients with low cardiac output syndrome (LCOS) was 1.36 +/- 0.51, and 1.97 +/- 0.58 for patients without LCOS (t = 2.347, P < 0.05), the Nakata index for patients with LCOS was 164 +/- 106 mm(2)/m(2) and 269 +/- 124 mm(2)/m(2) for patients without LCOS (t = 2.218, P < 0.05), the PVI for patients with LCOS was 152 +/- 77 mm(2)/m(2) and 273 +/- 125 mm(2)/m(2) for patients without LCOS (t = 2.936, P < 0.01), pulmonary vessel index of patients with LCOS was less than that of those without LCOS. " 01/01/2003 - "CHF is associated with abnormalities of flow (low cardiac output, dilated cardiac chambers), vessel wall (endothelial dysfunction), and abnormalities of blood constituents (abnormalities of platelets and haemorrheology). " 04/01/1999 - "In addition to "abnormal flow" through low cardiac output, dilated cardiac chambers and poor contractility, patients with heart failure also demonstrate abnormalities of hemostasis and platelets (that is "abnormal blood constituents") and endothelial dysfunction ("vessel wall abnormalities"). " 05/01/1977 - "The published reports of this type of gangrene indicate that it may result from (1) va sospastic conditions, (2) small vessel obstruction, or (3) conditions producing a very low cardiac output. "
10.	Atrial Natriuretic Factor (ANF)IBA 11/01/2011 - "Determination of the plasma ANP and hs-CRP level may be helpful for decisions related to early diagnosis of patient with low cardiac output." 09/01/1992 - "In addition, we sought to determine whether this model of low cardiac output would show a full vasoconstrictive response to exogenous ET infusion and whether atrial natriuretic factor (ANF) infused acutely to achieve pathophysiological concentrations would modulate the systemic and renal hemodynamic responses to exogenous ET. " 05/01/1994 - "A patient with acute right ventricular infarction who showed hyposecretion of atrial natriuretic peptide (ANP) in spite of abnormally high right atrial pressure and who died of a severe low cardiac output syndrome is reported. " 10/01/1992 - "1) The inhibition of ANF degradation causes sustained drop in left and right atrial pressures that appears to be mediated by an inhibition of neurohumoral activity; 2) concomitant inhibition of bradykinin breakdown (which in turn stimulates renal prostacyclin synthesis) contributes to natriuresis; 3) the close correlation between renal response and baseline cardiac index indicates that an inadequate renal perfusion secondary to low cardiac output diminishes the efficacy of this treatment modality. " 10/01/1994 - "Most clinical symptoms of congestive heart failure (CHF) were apparent after the 14 days, characterized by low cardiac output, high venous pressure, increased total peripheral resistance, increased plasma levels of ANF, noradrenaline, arginine vasopressin and renin, and marked fluid retention. "

Therapies and Procedures

1.	Cardiopulmonary Bypass (Heart-Lung Bypass) 03/01/1999 - "With improved cardiopulmonary bypass, myocardial protection, and surgical techniques the mortality rate from aortic valve replacement decreased substantially, whereas the mortality rate from mitral valve replacement remained high, largely because of low cardiac output syndrome. " 10/01/1995 - "This study examined the use of the Hemopump to treat low cardiac output syndrome after cardiopulmonary bypass. " 07/01/1991 - "These data provide further support for investigational trials of intravenous administration of T3 in the prevention or treatment of low cardiac output syndrome after cardiopulmonary bypass." 01/01/2015 - "The onset of low cardiac output follows a predictable course in the hours following cardiopulmonary bypass, as myocardial performance declines in the face of an elevated demand for cardiac output. " 01/01/2013 - "Factors related to late mortality were age greater than 60 years, male sex, ventilation time greater than 24 hours, cardiopulmonary bypass time greater than 136 minutes, and postoperative low cardiac output syndrome (p < 0.05). "
2.	Coronary Artery Bypass (Coronary Artery Bypass Surgery) 04/01/2008 - "The use of IABP is helpful for haemodynamic stability of patients with low cardiac output and compromised left ventricular function in patients who undergo coronary artery bypass grafting. " 11/15/2006 - "This study determined whether prolonged QRS duration (QRSd; > or =120 ms) is an independent predictor of low cardiac output syndrome (LCOS) in patients with low left ventricular (LV) ejection fraction (EF) who underwent isolated coronary artery bypass grafting (CABG). " 10/01/1997 - "The purpose of this study, was to ascertain whether delayed sternal closure (DSC) could eliminate the need for an intra-aortic balloon pump (IABP) or ventricular assist device (VAD) in patients with low cardiac output syndrome (LCOS) following coronary artery bypass grafting surgery (CABG). " 07/01/1996 - "The purpose of this study was to identify patients at risk for the development of low cardiac output syndrome after coronary artery bypass. " 01/01/2015 - "Low cardiac output syndrome (LCOS) is one of the most important complications following coronary artery bypass grafting (CABG) and results in higher morbidity and mortality. "
3.	Counterpulsation (External Counterpulsation) 01/01/2016 - "Preoperative aortic counterpulsation was associated with a significant reduction in low cardiac output syndrome (LCOS) in the total population (fixed-effects model: OR 0.330, 95% CI 0.214-0.508, P < 0.001) as well as in the subgroup of CAGB patients (fixed-effects model: OR 0.113, 95% CI 0.056-0.226, P < 0.001), whereas there was no benefit in the off-pump population (fixed-effects model: OR 0.555, 95% CI 0.209-1.474, P = 0.238). " 06/01/2013 - "Although intraoperative echocardiography revealed excellent results, inotropic support, and intra-aortic counterpulsation were necessary for weaning off cardio-pulmonary bypass and low cardiac output treatment. " 01/01/2012 - "The persistent oxidative stress during reperfusion may lead to depressed myocardial function resulting in low cardiac output syndrome (LCOS) necessitating inotropic or intra-aortic balloon counterpulsation support. " 05/01/2007 - "Skeletal muscular counterpulsation (MCP) has been used as a new noninvasive technique for treatment of low cardiac output. " 05/01/2007 - "ECG-triggered muscular counterpulsation for treatment of low cardiac output."
4.	Right Heart Bypass (Cavopulmonary Anastomosis) 04/01/2013 - "The long-term outcome and the indication of bi-directional cavopulmonary shunt has not been confirmed, although it is believed to be effective for saving the life of patients with low cardiac output and acute right ventricular failure. " 03/01/2004 - "The long-term outcome and the indication of bi-directional cavopulmonary shunt has not been confirmed, although it was effective for saving the life of patients with low cardiac output and acute right ventricular failure."
5.	Resuscitation 03/01/2015 - "Nevertheless, low cardiac output syndrome (12.3% vs 5.9%, p <0.01) and resuscitation (10.4% vs 5.6%, p <0.05) were more frequently seen in group A, contributing to a higher mortality at 30 days (14.3% vs 7.2%) and 1 year (33.7% vs 18.1%, p <0.001). " 01/01/2013 - "In all patients post- resuscitation course was significantly prolonged with severe low cardiac output syndrome in six patients (30%). " 01/01/2004 - "Resuscitation using HSD in a low cardiac output state restored splanchnic perfusion and microcirculation without any signs of cardiodepression." 07/01/2003 - "No resuscitation was associated with low cardiac output, whereas HSD restored and LR overshot baseline cardiac output. " 01/01/1991 - "The severe low cardiac output after coronary revascularization can be reversible with resuscitation in operating room, short assistance, and coronary reperfusion."