Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007222 (cardiovascular disease)
 65,817 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Decreased renal function following arteriography is much more common than is currently realized. Steps to detect this failure are necessary, especially in high risk patients, so that stressful situations such as surgery can be avoided. A recently performed prospective random study of 100 patients undergoing angiography demonstrated a 10% incidence of renal failure. Those patients most at risk had preexisting renal disease as indicated by an elevated serum creatinine and/or cardiovascular disease severe enough to require digoxin, diuretics, or nitroglycerin. No cases of renal failure occurred in the absence of one or both of these processes. The likelihood of postangiographic renal failure was unrelated to the quantity of contrast as measured either by total volume or per kilogram body weight.
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PMID:Angiographically induced renal failure and its radiographic detection. 17 27

1) In "left-sided" cardiac diseases, the effects of nitroglycerin on arterial pressure and heart rate were noted to be modest and disappeared within 15 minutes whereas the effect upon venous pressure, measured on the median cubital vein, lasted for approximately 30 minutes. 2) At 30 minutes after a dose of nitroglycerin there occured a significant depression of venous pressure elevation on exertion in patients with such "left-sided" cardiac diseases as ischemic heart disease, arteriosclerotic heart disease and hypertensive cardiovascular disorder. In patients with mitral insufficiency and aortic stenosis, on the other hand, the exertional venous pressure elevation was significantly suppressed 7 minutes after nitroglycerin although the suppression did not longer exist 30 minutes after administration. 3) The arterial pressure, heart rate, resting venous pressure and venous pressure elevation on exertion were virtually not affected by the administration of nitroglycerin in "right- or both-sided" cardiac disorders. 4) There was no significant change in cardiac output 30 minutes after a sublingual dose of nitroglycerin. The data obtained seem to stress importance of the effect of dilating capacitance vessels in the mechanism of antianginal action of nitroglycerin.
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PMID:[Effect of nitroglycerin on peripheral venous pressure at rest and during exercise in patients with heart diseases (author's transl)]. 40 92

A retrospective cohort mortality study with 5529 nitroglycerin, 4989 dinitrotoluene, and 5136 unexposed workers compared the mortality of the exposed groups with that of the United States population and that of the unexposed group with life-table analysis and Poisson regression. Mortality from ischemic heart disease was close to that expected, and mortality from cerebrovascular disease was slightly less than that expected, for the workers with both nitroglycerin and dinitrotoluene exposure and for those with dinitrotoluene exposure only. A significant interaction between age and nitroglycerin exposure was detected in the Poisson regression analyses for ischemic heart disease, particularly for workers actively exposed to nitroglycerin. The rate ratio for the workers under 45 years of age and actively exposed to nitroglycerin was 3.30 (95% confidence interval 129-8.48). This study did not show a chronic effect of nitroglycerin or dinitrotoluene exposure on cardiovascular disease risk. Potential biases related to the company's medical screening program may have limited the ability to detect chronic cardiovascular effects.
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PMID:Cardiovascular mortality among munitions workers exposed to nitroglycerin and dinitrotoluene. 155 11

Studies of the effects of atrial natriuretic peptide on the coronary circulation have yielded conflicting results in animals and have not been fully investigated in human subjects. To further characterize the direct coronary hemodynamic actions of atrial natriuretic peptide in humans and to assess the safety of its administration in patients with coronary artery disease, incremental doses of synthetic atrial natriuretic peptide and nitroglycerin were infused into the left coronary artery in 14 patients, 11 of whom had coronary artery disease. Both agents caused dose-related increases in total coronary sinus blood flow. The largest dose of atrial natriuretic peptide given to all patients (100 micrograms) increased mean coronary sinus blood flow from 127 +/- 7 to 149 +/- 9 ml/min (p less than 0.05) and decreased coronary vascular resistance from 0.93 +/- 0.07 to 0.81 +/- 0.05 mm Hg/ml per min (p less than 0.05); mean arterial blood pressure and heart rate were not affected by this dose of atrial natriuretic peptide. The greatest changes in coronary sinus blood flow (+25%) and coronary vascular resistance (-18%) after atrial natriuretic peptide administration occurred in the patients with coronary artery disease and no other associated cardiovascular disease. The maximal effects of atrial natriuretic peptide were similar to those of nitroglycerin, and no untoward effects were observed. Thus, atrial natriuretic peptide is a direct coronary vasodilator in humans. Its maximal dose effects are similar to those of nitroglycerin and were well tolerated in this small group of patients. The physiologic importance and therapeutic potential of atrial natriuretic peptide in patients with coronary artery disease merit further investigation.
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PMID:Coronary hemodynamic effects of atrial natriuretic peptide in humans. 214 9

Systemic hypertension is a risk factor for cardiovascular disease development and an aggravating factor once symptomatic coronary artery disease occurs. Some drugs that reduce high blood pressure may increase cardiovascular disease risk by altering serum electrolyte levels and/or plasma lipids. beta-Adrenergic blockers are useful agents for treating patients with both hypertension and angina pectoris, but their use may be limited by adverse reactions and/or contraindications to this type of therapy. Calcium entry blockers are a useful alternative to beta-blockers. In a placebo run-in, randomized, double-blind, crossover trial, propranolol and verapamil were found to be equally effective in reducing angina attacks and nitroglycerin consumption, while improving exercise tolerance. In another study with a similar design, both nifedipine and diltiazem were shown to be effective antianginal and antihypertensive drugs, with no differences in efficacy between them. Both calcium entry blockers and beta-blockers are effective treatments for patients with both angina and hypertension. The choice of a specific treatment will depend on the clinical and hemodynamic requirements of the individual patient.
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PMID:Calcium channel blockers in patients with both hypertension and angina pectoris. 246 12

We examined the influence of alterations in preload on pulsed Doppler indexes of left ventricular diastolic function in 50 patients including 12 without cardiovascular disease, 29 with coronary artery disease, and nine with critical aortic stenosis. Micromanometer left ventricular pressure was recorded simultaneously with pulsed Doppler echocardiography of left ventricular inflow and M-mode echocardiography of left ventricular diameter. Chamber stiffness constants, kd and kv, were obtained from the diastolic pressure-diameter and pressure-volume relations, respectively. Relaxation was measured by the isovolumic relaxation time constants, TL and TD, derived from the exponential left ventricular pressure decay and maximum negative dP/dt. In 41 patients after nitroglycerin treatment, left ventricular end-diastolic pressure decreased from 18 +/- 5 to 13 +/- 4 mm Hg (p less than 0.001). The ratio of peak early to peak atrial filling velocities and time-velocity integral ratios decreased from 1.08 +/- 0.57 to 0.90 +/- 0.42 (p less than 0.001) and from 1.77 +/- 0.95 to 1.41 +/- 0.71 (p less than 0.001), respectively. The peak early filling velocity and time-velocity integral decreased from 56.1 +/- 15.7 to 49.9 +/- 14.5 cm/sec (p less than 0.001) and from 7.9 +/- 2.7 to 6.8 +/- 2.8 cm (p less than 0.001), respectively. Relaxation (TL, TD, and maximum negative dP/dt) and chamber stiffness (kd and kv) were not impaired after nitroglycerin administration. In 48 patients after ventriculography, left ventricular end-diastolic pressure increased from 18 +/- 6 to 22 +/- 8 mm Hg (p less than 0.001). The peak early and peak atrial filling velocities increased from 57.4 +/- 15.2 to 68.3 +/- 19.7 cm/sec (p less than 0.001) and from 61.0 +/- 22.7 to 69.4 +/- 23.2 cm/sec (p less than 0.01), respectively. As a result, the ratio of peak early to peak atrial filling velocity was unchanged. However, in the aortic stenosis group, the ratio of peak early to peak atrial filling velocity increased from 0.95 +/- 0.64 to 1.10 +/- 0.72 (p less than 0.02). Relaxation and chamber stiffness were unchanged. Thus, a reduction or increase in preload may induce a diastolic filling pattern that mimics or masks diastolic dysfunction, respectively. Preload conditions need to be accounted for when the status of diastolic function is extrapolated from the pulsed Doppler mitral inflow velocity profile.
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PMID:Influence of alteration in preload on the pattern of left ventricular diastolic filling as assessed by Doppler echocardiography in humans. 249 5

The main purpose of this short review has been to present and evaluate the epidemiological evidence on CVD and environmental factors at work. It is indeed a difficult task to compare the scientific evidence in relation to the above mentioned risk factors. In some areas we find many studies, but with low overall methodological quality (noise is an example), while in others there are few, but good studies (e.g. carbon disulphide and nitroglycerine/glycol). We have to realize that in empirical sciences there is no such thing as a final proof. It would be easy if science dealt with what we know, while religion dealt with what we believe. It is more realistic however to say that science deals with what we believe we know, while religion deals with what we know we believe. Keeping this in mind the following classification of risk factors in the work environment seems to be well justified: Very probable causal relationships: Physical inactivity at work Nitroglycerine/nitroglycol Carbon disulphide Probable causal relationships: Monotonous high-paced work Shift work Noise Cobalt Arsenic Lead Possible causal relationships: Passive smoking Heat Dinitrotoluene Organophosphates Antimony Electromagnetic waves and fields No causal relationships: Cadmium Carbon monoxide One of the important questions raised by a list of this kind is whether we know enough to act, that is to use this knowledge in a preventive effort. Some might argue that we should wait until we have harder evidence. Another position would be that in many situations we have to act without such hard evidence. In my view fear of making mistakes should not prevent us from acting. If we always choose to wait until the evidence is 100% convincing, we will be very likely to make many - and often serious - mistakes.
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PMID:Work environment and cardiovascular diseases. A short review of the literature. 250 49

Vasodilator drugs are widely used in the management of cardiovascular disease. They decrease systemic vascular resistance, but they also may influence vascular arterial compliance. This study evaluated the effects of three vasodilators--nitroprusside, nitroglycerin, and hydralazine--on vascular compliance using impedance parameters determined by pulse contour and Fourier analyses. The open chest study was performed on anesthetized dogs. Mean arterial pressure decreased by a minimum of 20% after vasodilator intervention. The decrease in systemic vascular resistance was significant (p less than 0.01) only after hydralazine treatment. Proximal compliance increased after administration of all drugs, but the increase was not statistically significant. Distal compliance determined by pulse contour analysis increased by 60 to 120% after all three drug treatments (p less than 0.05 for nitroprusside, p less than 0.02 for nitroglycerin and hydralazine). Characteristic impedance from Fourier analysis responded variably, and changes were not statistically significant. The sensitivity of changes in distal compliance as a marker for the vascular effect of these drugs suggests that it might be used as a more reliable guide than blood pressure or vascular resistance in monitoring clinical response to such intervention. The more traditional measure of characteristic impedance provides a vascular measurement that is less sensitive than distal compliance to the effects of these vasodilator drugs.
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PMID:Arterial vascular compliance response to vasodilators by Fourier and pulse contour analysis. 316 48

Intravenous infusion of LY141865 (20 micrograms/kg) lowered systemic vascular resistance in anesthetized dogs resulting in a fall in mean arterial blood pressure. These effects require an intact nervous system and involve dopamine receptors as they were abolished by hexamethonium or sulpiride pretreatment. LY141865 does not appear to interact with adrenergic receptors because it did not increase diastolic blood pressure or cardiac rate of normal or hexamethonium-treated dogs, and yohimbine pretreatment did not antagonize its systemic vasodilator and hypotensive actions. Hemodynamic analysis demonstrated that infusion of LY141865 (20 and 100 micrograms/kg i.v.) resulted in persistent arterial hypotension due solely to reduced systemic vascular resistance; aortic blood flow index was maintained. LY141865 produced slight bradycardia and sustained increments in stroke volume index at the highest tested dose. Left ventricular filling pressure was unchanged by LY141865. Regional blood flows to heart, stomach, colon, small intestine, kidneys and marrow-laden bone were not changed during hemodynamic alterations produced by LY141865, although evidence of arteriovenous shunting of blood was observed in skin and skeletal muscle. Comparable systemic vasodilation and arterial hypotension induced by infusion of nitroglycerin reduced gastric and colonic blood flows, but did not produce detectable shunting. The composite data are interpreted to be a reflection of the ability of LY141865 to interact with DA2 dopamine receptors and thereby inhibit neurogenic release of norepinephrine. The present results and known oral efficacy of LY141865 lend further support for the development and use of dopamine receptor agonists for the treatment of cardiovascular disease.
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PMID:Systemic hemodynamic and regional blood flow effects of LY141865, a selective dopamine receptor agonist. 647 Sep 73

A case of timolol-associated heart failure in a 73-year old white man is reported. The patient, with a history of cardiovascular disease and glaucoma, was admitted to the hospital because of complaints of shortness of breath, orthopnea, and reduced exercise tolerance. Chest roentgenogram showed interstitial congestive failure, and an EKG demonstrated sinus bradycardia. The patient's medications before admission included quinidine, isosorbide dinitrate, dipyridamole, aspirin, pilocarpine eyedrops 4%, timolol eyedrops 0.5%, and nitroglycerin ointment and sublingual tablets. On the second day of hospitalization, it was noted that the patient's dyspnea and sinus bradycardia could be related to a recent increase in his timolol dosage. The timolol was discontinued, and the patient's heart rate increased. As the patient's pulse rate increased, the symptoms of congestive heart failure disappeared. This case demonstrated the importance of obtaining complete drug histories from patients. The potential for adverse system reactions resulting from topical medications should be considered.
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PMID:Bradycardia and congestive heart failure associated with ocular timolol maleate. 728 2


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