Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.6.1.3 (ATPase)
 65,361 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The epidemiology and etiology, pathophysiology, diagnosis, and treatment of congestive heart failure (CHF) are reviewed. CHF affects as many as 4 million Americans and is one of the most prevalent causes of death in hospitalized patients. Major risk factors for developing CHF include advanced age, male sex, hypertension, coronary artery disease, smoking, hypercholesterolemia, diabetes mellitus, and rheumatic heart disease. Heart failure results from decreased intrinsic myocardial contractility caused by one or more of three changes: (1) altered adrenergic nervous system function, (2) impaired delivery of calcium to contractile elements in the heart, and (3) reduced myosin-ATPase activity in the myocardium. The disease is progressive, and no intervention has yet been found to stop it effectively. CHF is diagnosed based on subjective signs and symptoms and objective assessment using auscultation, ECG, chest roentgenogram, laboratory tests, and noninvasive and invasive tests. Treatment of CHF begins with restriction of physical activity and sodium intake. Pharmacologic interventions start with either digitalis glycosides or thiazide diuretics; both may be used concomitantly as the disease progresses. Current studies are focusing on the use of angiotensin-converting enzyme inhibitors as first-line agents for CHF. When CHF worsens, loop diuretics are substituted for or added to the thiazide diuretics, and vasodilators are added to reduce the workload on the heart. Other inotropic agents, including the new bipyridine derivatives, may also be used. In patients not responding to these and other aggressive therapeutic interventions, cardiac transplantation is the only option. Despite advances in management of CHF, little improvement in overall survival has been demonstrated, and no intervention has stopped or reversed the progression of CHF.
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PMID:Current concepts in clinical therapeutics: congestive heart failure. 287 92

Myocardial fibres were studied in the right atrial biopsies from 32 patients with chronic rheumatic heart disease (RHD). Paraffin and, particularly, araldite sections showed many muscle fibres well preserved, and others with large hyperchromatic nuclei, or with depleted myofibrils and increased mitochondria. With the SDH and ATPase reactions, there was no type difference in the myocardial fibres, and the former showed the reaction predominantly in the centre while the latter showed it mainly at the periphery of the fibres. At electronmicroscopy, fibres with intact myofibrils were found close to "degenerating" fibres with variable degrees of myofibrillar and myofilament disorganisation and loss, mitochondrial proliferation, occasionally with degeneration of cristae, and accumulation of lipofuscin in varying amounts, and irregularly tortuous or loosened intercellular junctions. This study has revealed more severe muscle changes than expected, even in the clinically less affected right atrial chamber in chronic RHD. It is speculated that this might be due to subclinical involvement of the tricuspid valve, known to be frequent in Indian patients, and the resulting "back pressure" on the right atrium might lead to changes in its myofibres.
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PMID:Changes in atrial biopsies in chronic rheumatic heart disease. II: Muscle fibre reaction. 402 37

A number of protein signaling mechanisms are known to be involved in the progression of heart failure, yet the mechanism(s) by which the heart fails remains poorly understood. Therefore, we undertook a global approach to this question and used an antibody microarray to identify proteins differentially expressed in dysfunctional right ventricles in a bovine model of heart failure and the results were validated using cardiac tissue from both bovine and human heart failure. We found that protein disulfide isomerase 3, PDIA3, a protein that resides in the lumen of the endoplasmic reticulum, is significantly upregulated in both animal and human models of right and left heart failure. Altered expression of this protein has not previously been described in models of heart failure. In our initial microarray analysis, we found that CSK (c-Src kinase) was among the proteins upregulated in failing bovine ventricle. To further elucidate the role of CSK in heart failure, we studied the expression of its downstream target, Src, and found that Src expression and phosphorylation were markedly upregulated in failing ventricles. However, we also noted a smaller immunologically reactive protein that was only seen in experimental animals. In order to positively identify the smaller, Src-reactive protein, we used 2-dimensional gel electrophoresis and mass spectrophotometry. Surprisingly, we identified this protein as PDIA3, a protein that did not belong to the Src family of proteins. Upon sequence examination we found that PDIA3 contains a short C-terminal sequence with strong homology to Src and that it was this short sequence to which the antibody was generated. PDIA3 participates in MHC class I presentation and is implicated in the progression of valvular dysfunction in rheumatic heart disease, as well as calcium modulation in the sarcoplasmic reticulum. The molecule resides in the lumen of the endoplasmic reticulum and participates in disulfide bond formation during protein folding by interacting with calnexin and calreticulin. This interaction may indirectly effect SERCA (sarco/endoplasmic reticulum Ca(2+)-transport ATPase) activity and by extension contribute to the calcium dysregulation that characterizes progressive heart failure. Further studies are needed to elucidate the role that PDIA3 may play in the progression of heart failure.
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PMID:Serendipitous discovery of a novel protein signaling mechanism in heart failure. 2250 78

Mitochondrial diseases are a heterogeneous group of disorders in which a primary mitochondrial dysfunction is proven by morphological, biochemical, and genetic examinations. The mitral valve has important function in the regulation of blood flow from one chamber to another. Often, the mitral valve becomes abnormal with age, in Rheumatic fever or it is abnormal from birth (Congenital) or it can be destroyed by infection i.e. bacterial endocarditis and needs replacement. Myocardial function depends on energy produced by mitochondria and in any of these disease conditions, mitochondrial functions and enzyme activities may be impaired. With this in view, we analyzed the relationship between preoperative clinical conditions (as per New York heart Association) and extent of mitochondrial enzyme activities in damaged Human mitral valve in two types of heart disease such as Rheumatic Heart Disease (RHD) and Bacterial Endocarditis (BE). Thirty nine Patients undergoing cardiopulmonary bypass (CPB) for routine valvular heart surgery were included in the study. Controls included 11 normal porcine mitral valve samples without any evidence of heart disease. Mitochondrial enzymes like cytochrome oxidase (COX), succinate dehydrogenase (SDH), malate dehydrogenase (MDH), citrate synthase (CS) and ATPase were determined. Mitochondrial COX, SDH, CS and Total ATPase activities were significantly decreased in disease condition like BE and RHD when compared with control (P<0.001). On the other hand as per New York Heart Association (NYHA) preoperative clinical classification, all the mitochondrial enzymes were significantly (p<0.05) impaired in class IV as compared with NYHA class I, II and III. Present study shows that impairment in the mitochondrial enzymes activities are more pronounced in bacterial endocarditis (BE). It also indicates that damage to mitochondrial enzymes are most pronounced in NYHA class IV.
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PMID:Defect in mitochondrial functions in damaged human mitral valve. 2310 35