Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.3.1.21 (CPT)
 4,580 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It is shown in a prospective study that the initial beneficial hemodynamic effect of nitroglycerine (NTG) significantly decreased after continuous 3-day infusion of this drug (10-50 micrograms/min) in acute myocardial infarction (AMI) patients associated with acute left heart failure. The effect of ameliorating anginapectoris and improving heart function with isosorbide dinitrate (ISDN) gradually decreased almost to pretreatment levels after oral administration of this drug (10-20mg, 4 times daily) for 3 weeks in anginapectoris patients associated with congestive heart failure (CHF) with accompanying increased level of plasma angiotensin II (AII) and body weight. However, when captopril (CPT, 12.5-25mg, 3 times daily) was combined with nitrates, the clinical effects were enhanced and maintained throughout the study, along with a decrease in the level of AII and body weight. In the hearts of rats perfused with CPT and NTG, the coronary flow (CF) significantly increased as compared with the flow when either drug was used alone. Enelapril (ENL, a non-sulfhydryl drug), however, did not show such effect. The above results indicate that repletion of sulfhydryl to vascular smooth muscle and antineurohumoral activation may be the potential mechanisms by which CPT reverses nitrate tolerance and enhances its clinical effects.
 ...
PMID:[A study of captopril enhancement of nitrate effect coronary arterial disease patients associated with heart failure]. 786 40

This study was designed to investigate the effect of angiotensin-converting enzyme (ACE) inhibitors with and without a sulfhydryl group on intracellular production of cGMP, forearm blood flow, and neurohormonal factors during continuous transdermal application of nitroglycerin in patients with chronic heart failure. Platelet cGMP level and forearm blood flow were measured before and 5 min after sublingual administration of nitroglycerin (NTG) in 20 patients with chronic heart failure during the following 4 phases: (1) baseline phase; (2) NTG phase (1 week after NTG tape 10 mg/day); (3) CPT phase (1 week after both captopril 37.5 mg/day and NTG tape 10 mg/day); and (4) ENL phase (1 week after both enalapril 5 mg/day and NTG tape 10 mg/day). The platelet GMP level before sublingual NTG and forearm blood flow were significantly higher during the 3 phases with NTG tape than during the control phase. The percent increases in platelet cGMP level and forearm blood flow after sublingual NTG were significantly lower during the NTG phase than during the baseline phase. In contrast, concomitant application of ACE inhibitors maintained the percent increase in platelet cGMP level and forearm blood flow. These results indicate that concomitant therapy with ACE inhibitors may be helpful in preventing the attenuation of intracellular cGMP production in patients with chronic heart failure during continuous transdermal application of NTG.
 ...
PMID:Preventive effects of angiotensin-converting enzyme inhibitors on nitrate tolerance during continuous transdermal application of nitroglycerin in patients with chronic heart failure. 962 3