Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This double-blind, placebo-controlled, parallel, multicenter study was designed to evaluate the anti-anginal and anti-ischemic effects of celiprolol in patients with stable, exercise-induced angina pectoris. The study began with a 4-week single-blind, placebo run-in, followed by 4 weeks of double-blind active treatment with celiprolol 200, 400, or 600 mg once daily or placebo, and 1 week of a placebo run-out. Patients studied had a history of chronic, stable angina pectoris and myocardial ischemia (greater than or equal to 1.0 mm ST segment depression) within 3-12 min of treadmill exercise (modified Bruce) after 3 and 4 weeks of placebo. After 2 weeks treatment, treadmill testing results indicated a mean time to myocardial ischemia for patients receiving placebo increased by 0.5 min (8%), whereas the increases for celiprolol 200, 400, and 600 mg were 0.8 min (11%), 2.1 min (33%), and 1.1 min (16%) respectively. Mean time to anginal symptoms for placebo patients was increased by 0.6 min (10%), and for celiprolol patients by 1.8 min (27%), 1.5 min (19%), and 1.0 min (14%) respectively at the 3 dose levels. The maximum exercise double product (heart rate X systolic BP) 24 h after medication, was increased by a mean of 373 (2%) after placebo, but decreased by 3301 (-15%), 3400 (-17%), and 3549 (-16%) for celiprolol 200, 400, and 600 mg respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Celiprolol in angina pectoris: a controlled study. 242 43

The effects of different types of exercise on ischemic threshold were studied in 33 patients with chronic stable angina, documented coronary artery disease, and reproducible positive exercise test results. On average, ST segment depression developed at a significantly higher heart rate and rate-pressure product when the standard modified Bruce protocol was preceded by a warm-up period (113 +/- 13 vs 119 +/- 15 beats/min and 18,813 +/- 3682 vs 20,357 +/- 4227 beats/min X mm Hg, respectively; p less than 0.05 and less than 0.01). No significant changes were observed when the exercise was started abruptly. Analysis of results in individual patients showed that changes in rate-pressure product at 1 mm ST segment depression greater than or equal to 2000 beats/min X mm Hg developed with different types of exercise in 11 patients (group I), whereas in 22 patients little or no change occurred (group II). All patients also underwent exercise testing before and after 0.5 mg of sublingual nitroglycerin; improvement induced by nitroglycerin was significantly greater in group I than in group II (22 +/- 8 vs 8 +/- 9 beats/min and 4896 +/- 1998 vs 1064 +/- 2145 beats/min X mm Hg; p less than 0.01). Furthermore, isometric handgrip exercise carried out during angiography resulted in significant reduction of luminal diameter at the site of the stenosis of group I (1.22 +/- 0.39 vs 0.99 +/- 0.35 mm; p less than 0.01) but not in group II (1.12 +/- 0.22 vs 1.16 +/- 0.3 mm, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ischemic threshold varies in response to different types of exercise in patients with chronic stable angina. 250 3

In a double-blind parallel group study, 46 patients with chronic stable angina were randomized, after a 2-week placebo washout period, to 1 of 3 treatment groups for an additional 2 weeks. Groups 1 and 2 received nicorandil (5 mg, n = 5; 10 mg, n = 10) twice daily, respectively, increasing to 10 and 20 mg (n = 20) twice daily after 1 week of treatment; group 3 continued to receive placebo. A symptom-limited Bruce protocol exercise test was performed before and 2 hours after the initial dose and, after 2 weeks of treatment, 2 and 12 hours after administration. The following parameters were measured: resting, peak exercise and recovery blood pressure and heart rate, exercise duration, time to onset of angina and time to 1 mm of ST-segment depression. After initial dosing, there were significant increases in exercise duration (16%--n = 5, n = 10 vs -2% [placebo]) and time to onset of angina (20%, n = 5; 26%, n = 10 vs 5% [placebo]) (p less than 0.05). Time to onset of 1 mm of ST-segment depression increased in the nicorandil-treated groups compared with that in the placebo group (27%, n = 5; 25%, n = 10 vs 8% [placebo]). Calculated total exercise work increased in both nicorandil groups compared with exercise work in the placebo group (30%, n = 5; 19%, n = 10 vs 3% [placebo]). A decrease in resting systolic blood pressure (12%) in the 10-mg group was the only significant alteration in the hemodynamic parameters.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Exercise capacity after single and twice-daily doses of nicorandil in chronic stable angina pectoris. 252 29

To examine the chronic effects of nicorandil, a new coronary vasodilator, on exercise tolerance, we gave this drug for ten days at 15 mg/day orally in three divided doses to 10 patients with stable effort angina. An increase in exercise capacity by more than 1 stage of modified Bruce's protocol was observed in 6 of 10 patients on the 5th and 10th day after the administration. The exercise duration was significantly prolonged from 294 +/- 86 sec (mean +/- SD) before the administration to 363 +/- 106 sec and 405 +/- 139 sec on the 5th and 10th day after the administration, respectively. With nicorandil administration, the time to 0.1 mV of ST-segment depression was also significantly delayed from 3.1 +/- 1.9 minutes to 4.5 +/- 2.6 minutes on the 10th day. On the other hand, systolic blood pressure, heart rate and pressure rate product did not demonstrate any significant change before and after the administration. These results indicate that oral nicorandil of 5 mg 3 times a day can chronically increase exercise tolerance without decreasing myocardial oxygen consumption in patients with stable effort angina.
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PMID:Chronic effects of nicorandil on exercise tolerance in patients with stable effort angina pectoris. 253 51

We studied 14 patients to determine whether sustained-release diltiazem is a satisfactory long-term substitute for the combination of propranolol plus hydrochlorothiazide (HCTZ), control phase, in the treatment of systemic hypertension with coexisting chronic stable angina pectoris. All patients had either one- or two-vessel coronary disease and normal left ventricular systolic function. Measurements were made during the control phase and 4 and 8 weeks after substitution of sustained-release diltiazem. Only the sitting blood pressure was available before the control phase (pretreatment). Blood pressure and heart rate were measured with patients supine, sitting, and 5 minutes after standing. Cardiac output was measured in the supine position using a computerized Doppler system, and stroke volume, mean arterial pressure, and total systemic resistance were calculated. Symptom-limited modified Bruce protocol treadmill tests were performed to determine time to onset of 1 mm ST segment depression, time to termination of exercise, reason for cessation of exercise, and maximum rate-pressure product. The patients were initially receiving 160-240 mg/day of propranolol (40-60 mg q.i.d.) plus 25-50 mg/day of HCTZ and, subsequently, 12 of 14 had substitution with 240 mg/day (120 mg b.i.d.) of sustained-release diltiazem, and two received 360 mg/day with one of these patients also receiving 50 mg/day of HCTZ. These patients are a subset of a larger group of patients in whom the response of blood pressure alone has been previously reported. Diltiazem resulted in reduction of blood pressure equivalent to that with the propranolol plus HCTZ combination.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Response of blood pressure, cardiac output, peripheral resistance, and exercise performance to substitution of calcium blocker for beta-blocker plus thiazide diuretic therapy in patients with both systemic hypertension and mild stable angina. 257 40

In patients with a strongly positive exercise electro-cardiogram, the workload achieved during the test allows the identification of subsets with good or poor survival rates. To determine whether the same criteria also predict acute ischemic heart events such as unstable angina and myocardial infarction, fatal and nonfatal acute manifestations were documented in 241 patients medically treated during an 8-year follow-up. All patients had a Bruce protocol treadmill exercise test with ST-segment depression greater than or equal to 2 mm and coronary angiographic studies. There were 52 deaths; of these 44 were due to coronary artery disease. There were 41 episodes of unstable angina and 21 myocardial infarcts documented as first morbid events. As expected, survival improved with increased workload achieved; patients terminating their exercise at stage I (5.1 METs) had an 8-year survival rate of 45 +/- 9% while those reaching stage IV or more (10 METs) had a survival rate of 93 +/- 6%. In a multivariate analysis, the duration of exercise and the number of narrowed coronary arteries and of left ventricular segment abnormalities correlated significantly with survival. In contrast, nonfatal acute events occurred in about 20 to 35% of patients whatever the stage of the exercise test. Furthermore, neither variables during the exercise test nor angiographic findings predicted nonfatal events. Thus, although the workload achieved did identify patients with different mortality rates, it failed to predict subsets of patients with different morbid event rates.
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PMID:Prognosis in patients with a strongly positive exercise electrocardiogram. 258 94

The response to verapamil alone and combined with isosorbide dinitrate in a group of 12 patients with severe ischemic heart disease and stable effort angina was assessed by means of serial treadmill testing. The study was randomized, of a square latin design and double-blind. The tested drugs and dosages were 120 mg of verapamil, 120 mg of verapamil plus 20 mg of isosorbide dinitrate and placebo. Patients were serially tested (Bruce protocol) over three consecutive days at 8-9-12 and 16 hours. A significative improvement was observed in several ischemic parameters both with verapamil alone and combined with isosorbide dinitrate, but this improvement was remarkably enhanced with the combination of drugs. The mean exercise time to produce angina improved from 268 +/- 18 sec (basal) to 379 +/- 19 sec (verapamil plus isosorbide dinitrate) and the time for 1 mm ST segment depression from 163 +/- 22 sec (basal) to 257 +/- 19 sec (verapamil plus isosorbide dinitrate) when measured at the last daily test (8 hours after drug administration). It is concluded that both verapamil alone and combined with isosorbide dinitrate at the chosen doses are clinically efficient, significantly improving the ischemic parameters. The combination of verapamil and isosorbide dinitrate resulted in a remarkably better improvement in this group of patients with stable effort angina.
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PMID:[Evaluation using serial exercise tests of verapamil alone and combined with isosorbide dinitrate in exertional angina]. 260 7

The prognostic value of the exercise testing as well as coronary risk factors was assessed in 890 patients (pts) with a history of myocardial infarction (MI, n = 114) or chest pain (typical angina; TA, n = 134, others; OTH, n = 642) in relation to cardiac events (cardiac death, non-fatal MI). Clinical questionnaires and symptomatic-maximal graded treadmill exercise were performed in all pts. Follow-up was obtained prospectively by mail or telephone interview annually. Twenty eight pts were lost to follow-up. In the remaining 862 pts (96.9%), the mean follow-up duration was 3.1 +/- 1.4 (mean +/- SD) years. During follow-up period, 39 cardiac events (21 cardiac death, 18 non-fatal MI) (4.5%) occurred. Cardiac event rates in pts with MI, TA, and OTH were 16.2%, 9.8%, and 1.3%, respectively. Univariate analyses revealed that the event rate was influenced by age, sex (male), hypertension, diabetes mellitus, and HDL-cholesterol among coronary risk factors, and by anginal pain during exercise, ST depression, poor exercise tolerance, and abnormal blood pressure response among treadmill exercise findings. By Cox proportional hazard model analysis, the history of MI, age, TA, and ST depression (within 6 minutes of Bruce protocol) was significantly independent predictors for future cardiac events in all pts; and age, sex, and TA in pts without MI. In conclusion, the exercise testing combined with conventional coronary risk factor analysis was effective means in predicting future cardiac events.
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PMID:[A prospective study of future cardiac events in subjects who underwent treadmill exercise testing]. 260 49

Thirty-one boys between the ages of 9 and 17 years were subjected to submaximal exercise stress testing on a treadmill using the Bruce's protocol. All the children completed the test with the younger group (9-13) reaching Grade III and the older group boys (14-17) reaching Grade IV on an average. The heart rate, blood pressure and FEV1 during exercise compared well with other reported studies. On ECG analysis there were no significant ST segment changes or J junction depression. This study was conducted in well nourished boys from high-socio-economic group who regularly took part in sports.
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PMID:Cardiorespiratory response to stress test in normal Indian boys and adolescents. 263 5

A "Hibernation Induction Trigger" (HIT) isolated from plasma of winter-hibernating woodchucks induced hibernation in summer-active ground squirrels (Citellus tridecemlineatus). Effects of kappa opioid U69593 on the HIT-induced hibernation were examined. U69593 alone did not elicit marked behavioral alteration or hibernation in summer-active ground squirrels. U69593, however, antagonized hibernation induced by HIT in summer active ground squirrels. In the guinea pig ileum myenteric plexus-longitudinal muscle preparation, woodchuck HIT depressed the electrically-induced contraction. The depression was, however, neither reversed nor blocked by naloxone even when naloxone was used at high doses. This study demonstrates that kappa opioid, at least in the case of U69593, was unable to induce hibernation in the summer-active ground squirrels. The results also demonstrate that woodchuck HIT, like the bear HIT, did not act directly at opioid receptors. Together with our previous observation that naloxone blocked summer hibernation induced by HIT (Bruce et al., Life Sci.., this issue), it is tempting to suggest that HIT may not mediate its effects through kappa opioid receptors but may do so through other types of opioid receptors such as mu or delta. U69593 may antagonize HIT-induced hibernation as a mu or delta receptor antagonist.
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PMID:Opioids and hibernation. II. Effects of kappa opioid U69593 on induction of hibernation in summer-active ground squirrels by "hibernation induction trigger" (HIT). 282 39


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