Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-three patients with essential hypertension and diabetes mellitus type II were treated with the calcium antagonist diltiazem (120 to 180 mg twice daily). The mean dose was 307 mg/day. The study was a double-blind, placebo-controlled, crossover design. All measurements were performed 12 to 14 hours after drug intake. Blood pressure, heart rate and forearm blood flow were measured noninvasively. Platelet function was studied by measuring adenosine diphosphate-induced platelet aggregation and the platelet specific proteins, beta thromboglobulin and platelet factor 4. Thromboxane B2 formation in serum and the plasma concentration of diltiazem and its metabolites N-demethyldiltiazem, deacetyldiltiazem and N-demethyldeacetyldiltiazem were measured both during placebo and diltiazem treatment. Diabetic control was evaluated by following HbA1C, fasting blood glucose and urinary glucose. Diltiazem reduced both systolic and diastolic (supine and standing) blood pressure significantly. Forearm blood flow was significantly increased by 32%, p less than 0.05. Supine heart rate decreased significantly, while no such change was seen in the standing position. No significant changes were observed in platelet function during diltiazem treatment. There was no relation between the observed blood pressure reduction and the plasma concentration of diltiazem or its metabolites. A positive correlation between the change in heart rate and the metabolite N-demethyldeacetyldiltiazem was observed (r = 0.647, p = 0.005). Three patients were excluded during diltiazem treatment (skin exanthema, headache and atrial fibrillation) and 1 during placebo treatment (angina pectoris). No negative effect on diabetes control was observed. Thus, diltiazem could be used for treatment of hypertension in diabetic patients.
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PMID:Diltiazem in hypertensive patients with type II diabetes mellitus. 317 28

The effect of IV fructose-1,6-diphosphate (FDP) on transient, reproducible myocardial ischemia was evaluated in ten patients, aged 50 to 66 years, with chronic, stable exertional angina. FDP or placebo (glucose) were administered between basal and posttreatment ergometric stress testing; an identical procedure was repeated in each patient with the second treatment on the following day according to a single-blind, cross-over design. FDP improved exercise tolerance and total work capacity, significantly delaying the onset of ST-segment depression and angina. Nevertheless, the critical level of the rate x pressure (R X P) product, causing appearance of myocardial ischemia, was not remarkably changed. However, the R X P product at same workload was significantly lower after FDP. These results suggest that improved exercise tolerance might have resulted from peripheral (increased oxygen delivery to skeletal muscle) rather than from central (cardiac) effects of FDP.
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PMID:Improved exercise tolerance by i.v. fructose-1,6-diphosphate in chronic, stable angina pectoris. 323 Jan 48

The majority of epidemiological studies on the benefits and risks of oral contraceptive (OC) use have been conducted during the late 1960s and early 1970s when OCs had 50 mcg of estrogen. Based on these studies, the risk of death due to OC use for nonsmokers 35-39 years old was lower than using no contraceptive at all (14.1 deaths/100,000 women/year vs. 25.7 deaths/100,000 women/year). In addition to smoking, other contraindications include women with a history of angina, myocardial infarction, blood clots or stroke, estrogen dependent cancer, hypertension, a known lipid disorder, and women with hepatitis or cirrhosis of the liver. Suitable 35 year old candidates for OC use would be nonsmokers with blood group O, at low risk for cardiovascular disease, and who might receive additional benefits, including those with severe dysmenorrhea or hypermenorrhea and possibly those who have a strong family history of osteoporosis, early menopause, or ovarian cancer. Practitioners should take a thorough history of these women and give a physical examination with a blood pressure check. They should also administer screening tests, such as a PAP test, mammograms, a lipoprotein profile, and a glucose test. After the practitioners have deemed these women to be healthy based on the examination and the results of the screening test, they then should prescribe only a low dose OC containing 50 mcg of estrogen. Today most estrogen based OCs contain 35 mcg and research on their effects have not yet begun. Scientists expect to find that the dose response effects for risks for thromboembolism, myocardial infarction, stroke, and gallbladder disease to be lower in users of the low dose preparations.
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PMID:Risks and benefits of oral contraceptive use in women over 35. 323 16

This article presents a review of studies carried out with positron tomography on myocardial blood flow and glucose metabolism in patients with coronary artery disease and either stable (SA) or unstable angina (UA) pectoris. Regional blood flow was assessed with rubidium 82, an analogue of potassium, and glucose metabolism both with fluorine 18-labeled fluorodeoxyglucose (FDG) and carbon 11-labeled glucose (CG). There were no clear differences in regional myocardial blood flow between SA and UA patients and a group of normal volunteers. FDG uptake was low and homogeneous in both SA patients and normals. In contrast, all UA patients showed abnormally high FDG uptake in at least one left ventricular region at rest in the absence of symptoms or signs of acute ischemia. In the recovery from a period of exercise-induced angina, FDG uptake in SA patients was observed to be higher in previously ischemic regions than in nonischemic regions (as defined by 82Rb). It is postulated that higher FDG uptake in the postischemic myocardium of SA patients is due to repletion of glycogen stores. It remains unclear whether the high uptake in UA patients is due to a recent ischemic episode or is a reflection of a chronic adaptation to repeated stress.
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PMID:Regional myocardial glucose metabolism in angina pectoris obtained from positron emission tomography. 328 74

Nifedipine influence on a clinical course of angina pectoris, some indices of hemodynamics, glucose and insulin was studied in 39 male patients suffering from coronary heart disease (CHD) with different glucose tolerance. In CHD patients with normal glucose tolerance (NGT) nifedipine therapy did not cause any considerable changes in the blood levels of glucose and insulin whereas in patients with lowered glucose tolerance (LGT) a hypoglycemic effect of the drug and an increase in the level of insulin were noted during therapy. An increase in physical exercise tolerance, a decrease in the frequency of anginal attacks, and a decrease in the number of nitroglycerin tablets administered by CHD patients with LGT per week were significant. The study showed that nifedipine was indicated for CHD patients with LGT.
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PMID:[Effect of corinfar on the course of angina pectoris and indices of carbohydrate metabolism in relation to the type of glucose tolerance]. 332 83

After 10 mg nicardipine IV a patient with stable angina developed chest pain and ST-segment depression accompanied by excessive tachycardia, low arterial blood pressure, and initially decreased coronary sinus blood flow. Measurements of arterial concentrations and cardiac exchanges of lactate, glucose, free fatty acids, glutamate, and alanine showed alterations indicative of severe ischemia.
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PMID:Hemodynamic and cardiac metabolic changes during nicardipine-induced myocardial ischemia. 334 16

Plasma fructosamine was determined in 41 patients with acute coronary heart disease (acute myocardial infarction and instable angina) to assess its usefulness as a screening method for diabetes mellitus. The results (11/15 true positive and 23/26 true negative) were comparable to those for glycated hemoglobin (14/15, 22/26). Discriminant analysis was performed to extract additional information from further laboratory data (glucose and albumin).
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PMID:[Fructosamine determination as a screening test for diabetes mellitus in patients with acute coronary heart disease]. 335 4

The impact of diabetes was prospectively studied during a 5-year period in 428 unselected and consecutive patients with acute cerebrovascular disease of whom 18% were diabetic. Cerebral infarction was more frequent in diabetics (81 vs 70%, p less than 0.02) whereas transient cerebral ischaemia was less frequent (4 vs 14%, p less than 0.01). Case fatality rate during hospitalization was higher in the diabetic than in the non-diabetic patients (28 vs 15%, p less than 0.02). Patients who died during hospitalization, diabetic as well as non-diabetic, had significantly higher blood glucose concentrations on admission compared with patients who survived. Hematocrit values were higher in the diabetic than in the non-diabetic patients (p less than 0.02). Diabetics had higher systolic blood pressure levels than the non-diabetics in the acute phase (p less than 0.005). The diabetic stroke patients more often had a history of hypertension, atrial fibrillation, heart failure and angina pectoris than non-diabetics stroke patients and diabetic control patients without stroke. Stroke patients, not known to be diabetic, had larger mean oral glucose tolerance test curve areas when compared with healthy controls but not when compared with hospitalized controls. We propose that diabetes increases the risk for stroke through other concurrent risk factors, cardiac disorders in particular.
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PMID:Clinical characteristics in diabetic stroke patients. 339 27

Myocardial extraction of free fatty acids (FFA), together with glucose, lactate, pyruvate, glycerol and oxygen was determined by simultaneous sampling of blood from an artery (a) and the coronary sinus (cs) at rest and during chest pains induced by atrial pacing in seven fasting male patients with ischaemic heart disease. Results were compared to those, at rest and during pacing at heart rate 140 beats min-1, in ten healthy men of similar age. A continuous i.v. infusion of 14C oleate and 3H palmitate enabled the calculation of simultaneous myocardial uptake and release of FFA as well as of the fraction of extracted FFA which underwent direct oxidation. During chest pain lactate net extraction decreased to become, in some patients, negative. FFA extraction, as estimated from the fractional extraction of labelled fatty acid was likewise decreased, while the a-cs O2 difference was not significantly altered. The fractional oxidation of extracted FFA was increased, whereas the calculated fatty acid release from the heart was unaltered. The increase in fractional oxidation was quantitatively correlated with the decrease in lactate extraction suggesting that it was related to the degree or extent of ischaemia. It was also proportional to the decrease in FFA extraction. Thus, in patients with angina pectoris the ischaemic myocardium may be subjected to a limitation not only with regard to oxygen but also substrate flux into the myocardial cells.
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PMID:Myocardial turnover of plasma free fatty acids during angina pectoris induced by atrial pacing. 340 86

In 21 control subjects with atypical chest pains and normal coronary arteries and in 64 patients with stable angina and coronary artery disease (CAD), myocardial exchanges of free fatty acids, glucose, lactate, citrate, glutamate, alanine and oxygen were determined before, during and after pacing. At rest, myocardial uptake of fatty acids was 50% lower in CAD patients than in the control subjects (p less than 0.001), whereas uptakes of glucose and lactate were twice as high (p less than 0.01). CAD patients showed increased myocardial glutamate uptake (p less than 0.001) and alanine release (p less than 0.001). In control subjects, myocardial fatty acid uptake was directly related (r = 0.54, p less than 0.01), whereas uptakes of glucose (r = -0.42, p less than 0.05) and lactate (r = -0.46, p less than 0.05) were inversely related to arterial fatty acid levels. Citrate release was inversely related to glucose uptake (R = 0.44, p less than 0.05). These relations were absent in CAD patients. Glutamate consumption correlated only with glucose uptake in CAD patients (p less than 0.001) but did so with lactate uptake and alanine release in all individuals (p less than 0.001). Pacing caused angina in the CAD patients but not in the control subjects. Pacing induced no metabolic changes among control subjects but provoked myocardial lactate release in 40 CAD patients, including an additional decrease of fatty acid uptake (p less than 0.05) and increase of glucose uptake (p less than 0.05) compared with resting levels.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Altered global myocardial substrate preference at rest and during pacing in coronary artery disease with stable angina pectoris. 342 Nov 65


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