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)

Persistence of impaired ventricular function after repair of cyanotic congenital heart defects may be due to previous exposure to chronic hypoxemia or to perioperative ischemic injury. Clarification of this phenomenon was sought in a canine model of cyanotic cardiovascular disease (Group I), in which the left atrium was anastomosed proximal to the banded pulmonary artery. Animals that had pulmonary artery banding alone (Group II) or no prior surgical intervention (Group III) served as controls. All Group I animals became cyanotic during the study period (arterial oxygen tension, 38 +/- 4 mm Hg; hematocrit, 55 +/- 5%). Radionuclide-determined ejection fractions performed three months after operation showed significant depression of global biventricular function by 16 to 29% (p less than 0.05) compared with groups II and III. On cardiopulmonary bypass, all hearts were subjected to 4 degrees C potassium cardioplegic arrest and reperfusion with serial assays for myocardial adenosine triphosphate (ATP) and creatine phosphate (CP) levels. The ATP and CP stores in each ventricle were similar at all sampling intervals, and preischemic levels were comparable in cyanotic and control groups. However, ATP levels were significantly depressed 37 to 43% from preischemic levels (p less than 0.02) after arrest and reperfusion in cyanotic dogs, but they were preserved in Groups II and III. During ischemia, CP stores were depleted to 27% of preischemic values in Group I but only to 46 to 63% of preischemic levels in the control groups (p less than 0.05). These data indicate that chronic hypoxemia impairs global ventricular function and predisposes to the accelerated depletion of high-energy phosphates during cardioplegic arrest.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic hypoxemia depresses global ventricular function and predisposes to the depletion of high-energy phosphates during cardioplegic arrest: implications for surgical repair of cyanotic congenital heart defects. 671 31

Two hundred and twelve patients treated for prostatic cancer grade I or II were investigated for cardiovascular complications. The patients were part of a multicentre study in the Stockholm area and had been randomized to treatment with either estramustine phosphate (Estracyt) or polyestradiol phosphate and ethinyl estradiol. Cardiovascular complications categorized as impaired arterial circulation including ischemic heart disease, venous thromboembolism, cardiac incompensation and cerebral depression were found to be equally frequent following the two different forms of treatment. Among the patients getting cardiovascular complications, these occurred within two months after the start of treatment in 50% and within one year in 85% of them. There was a statistically significant correlation between the incidence of cardiovascular complications and a history of previous cardiovascular disease. This criterion was however in retrospect found to predict cardiovascular complications in only 67 of the 126 patients getting one or several of these complications.
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PMID:Cardiovascular complications to treatment of prostate cancer with estramustine phosphate (Estracyt) or conventional estrogen. A follow-up of 212 randomized patients. 693 12

Myocardial scintigraphy with thallium-201 and electrocardiogram-gated left ventriculography with technetium-99m labelled red blood cells were applied in four groups of subjects: 25 with no signs or symptoms of cardiovascular disease (group 1), 28 with a "false" positive exercise electrocardiogram (group 2), 14 with angina pectoris and normal coronary angiograms (group 3), and 43 with angina pectoris and fixed coronary artery stenoses (group 4). In groups 1 and 4 the radionuclide findings were in accordance with clinical and invasive measurements. In groups 2 and 3 the most important finding was the lack of increase in left ventricular ejection fraction during exercise in about half of these subjects (even a decrease in 25%), indicating subnormal myocardial reserve. The additional finding of pathological myocardial biopsies in four of these patients suggests that asymptomatic ST depression in patients with normal coronary angiograms may in some cases represent an early, preclinical sign of cardiomyopathy.
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PMID:Routine radionuclide techniques in evaluation of patients with suspected coronary heart disease. 710 18

157 consecutive patients (pts) with suspected coronary artery disease and an ischemic ecg response during exercise test (ET) were studied. During ET 61 of them (group I) had neither chest pain nor anginal equivalent, while 96 (group II) experienced angina. There were no significant differences between the two groups in regard to age, sex, prior myocardial infarction, history of angina or hypertension. During ET pts of group I tolerated a higher work load (group I 3467 Kpm, group II 2594 Kpm, P less than 0,05) and had a higher maximal heart rate (group I 128,3 b/min, group II 120,4 b/min, P less than 0,05) with a more marked ST segment depression (group I 2,4 mm, group II 1,8 mm, P less than 0,01) and with a more elevated incidence of arrhythmias (group I 18%, group II 7%, P less than 0,05). The coronary angiography showed significant obstruction (greater than or equal to 75%) in 91,7% of group I and in 91,6% of group II (prevalence of single vessel disease in group I and multiple vessel disease in group II). No significant difference was found between group I and II in regard to left ventricular ejection fraction (group I 51%, group II 53%), left ventricular end-diastolic pressure (group I 12,9 mmHg group II 13,6 mmHg) and left ventricular end-diastolic volume (group I 102,3 ml/m2, group II 104,2 ml/m2). We conclude that ST segment depression during ET in asymptomatic pts at risk for cardiovascular disease is predictive of coronary artery disease as in symptomatics. These subjects have, compared with symptomatics, a higher work load tolerance but with more marked ecg ischemic changes and more frequent arrhythmias during ET, thus representing a group of coronary population at potentially higher risk.
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PMID:[Positive exercise test in the absence of pain. Characteristic of a high-risk population?]. 723 79

This study was undertaken to determine the extent to which coronary heart disease risk factors are manifest in a young (17-35 years old) male military population. Approximately 360 individuals underwent medical and physical determination of body composition, blood cholesterol analysis, blood pressure measurement, history of smoking, and a maximal exercise stress test to assess maximal oxygen uptake (VO2 max) and the incidence of electrocardiographic abnormalities. Obesity (greater than 20% body fat), elevated blood cholesterol (greater than 200 mg/dl), and cigarette smoking (greater than 10 cigarettes/d) were the most predominant risk factors with incidences of 29, 32, and 36%, respectively. Only 2.4% of the sample had a positive stress test as indicated by an ST-segment depression of 1mm or greater. An inverse relationship between VO2 max and percent body fat was the only significant finding between level of aerobic power and risk factor prevalence. These data provide information on the prevalence of cardiovascular disease risk factors in an age group for which there has been only limited information.
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PMID:Prevalence of coronary heart disease risk factors in a young military population. 738 76

There has been a long-standing interest in the relationship between cardiovascular disease (CVD) and psychiatric morbidity, specifically depressive symptoms. The aims of this study were to determine the following: 1. The relationship between the presence of angina and depressive symptoms; 2. The influences of sociodemographic covariates on this relationship; and 3. The effects of functional impairment or inactivity level in mediating the relationship between angina and depressive symptoms. The data utilized for this study was from the Hispanic Health and Nutrition Examination Survey (HHANES) on 1,558 Mexican American women. The survey was cross sectional, conducted in 1982-84. The dependent variable was depression as measured by the Center for Epidemiologic Depression Scale (CES-D). The independent variable was the presence of angina as measured by the Rose Questionnaire. Covariates included functional impairment, physical activity, age, education, acculturation, poverty level, marital status, and work status. The findings suggest that functional impairment has a stronger association with depressive symptoms than angina or physical inactivity. Significant sociodemographic variables include single marital status and poverty. Comorbidity has been a neglected area of research for Mexican American women, but this study suggests that functional impairment is a more important factor associated with depressive symptomatology than angina.
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PMID:Angina, functional impairment and physical inactivity among Mexican-American women with depressive symptoms. 747 58

Fluvoxamine facilitates serotoninergic neurotransmission via potent and selective inhibition of serotonin (5-hydroxytryptamine; 5-HT) reuptake into presynaptic neurones. The overall antidepressant efficacy of fluvoxamine 100 to 300 mg/day for 4 to 6 weeks in once daily or divided dosage regimens appears to be at least comparable to that of imipramine and similar to that of clomipramine, dothiepin, desipramine, amitriptyline, lofepramine, maprotiline, mianserin and moclobemide. The efficacy of fluvoxamine has been maintained for up to 1 year, but long term data are limited, and there are no comparative studies of fluvoxamine with other selective serotonin reuptake inhibitors. In some studies, fluvoxamine appeared to have an earlier beneficial effect on suicidal ideation and/or anxiety or somatic complaints compared with imipramine, dothiepin and maprotiline. Gastrointestinal adverse effects, especially nausea, are commonly reported with fluvoxamine but are generally mild to moderate in severity. The tolerability profile of fluvoxamine appears to be more favourable than that of tricyclic antidepressants in terms of cardiotoxic and anticholinergic adverse effects, sedation, weight gain and death from overdosage. Thus, fluvoxamine is an effective and well tolerated antidepressant agent that is becoming established as an alternative to older agents in patients with mild, moderate or severe depression. Fluvoxamine may be particularly beneficial in potentially suicidal patients with severe depression, in those with an underlying compulsive personality or cardiovascular disorder, in patients with coexistent anxiety or agitation, and in the elderly.
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PMID:Fluvoxamine. An updated review of its pharmacology, and therapeutic use in depressive illness. 750 38

Earlier reports of associations between panic disorder, depression, and ischemic heart disease have not evaluated the role of the drugs used to treat these conditions. As part of a larger study on reducing cardiovascular disease in an entire community, we estimated the association between psychotropic drugs and ischemic heart disease in a large community-based population using a cohort study design. We defined exposure as current use of psychotropic medications at the time of the health interview. We determined ischemic heart disease by International Classification of Diseases, 9th revision, Clinical Modification, codes and by an epidemiologic algorithm using clinical diagnostic criteria. An elevated risk for clinically significant ischemic cardiac events was moderately associated with benzodiazepine use [relative risk (RR) = 2.0; 90% confidence interval (CI) = 1.1-3.9] and strongly associated with antidepressant use (RR = 5.7; 90% CI = 2.6-12.8), although the latter estimate was based on only six antidepressant users who had an ischemic event.
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PMID:Is the use of psychotropic drugs associated with increased risk of ischemic heart disease? 754 44

The relationship between ECG abnormalities and mortality was studied in 4797 males and 4320 females aged 25 to 74 years who took part in the Belgian Inter-university Research on Nutrition and Health (The BIRNH study). At entry all were free of angina, had no history of acute myocardial infarction and showed no evidence of an old infarction on their baseline ECG. They were followed for an average of 5.6 years, and follow-up for vital status was completed satisfactorily in 99.5%. ECG abnormalities were grouped using several classifications: any abnormality, major and minor abnormalities, ischaemic changes, left ventricular hypertrophy and the separate Minnesota codes IV (ST depression), V (abnormal T-wave) and VIII (arrhythmias). Using logistic regression analysis, adjustment of odds ratios for cardiovascular disease (CVD) mortality was done for age, systolic blood pressure, serum total cholesterol and uric acid, diabetes, smoking and antihypertensive drug treatment. Men outnumbered women more than twice in total and CVD mortality. Multivariate analysis showed that the presence of major abnormalities on the ECG was significantly related to CVD mortality in both men and women (adjusted odds ratios 2.73 and 4.40 respectively). In contrast, minor abnormalities were not independently associated with CVD mortality. In men, ST depression (OR = 5.58), signs of an ischaemic ECG (OR = 3.02) and an abnormal T-wave (OR = 2.58) were independently related to CVD mortality. In women primarily a ST depression (OR = 5.87) and arrhythmias (OR = 4.22) had a significant independent effect on CVD mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The predictive value of electrocardiographic abnormalities for total and cardiovascular disease mortality in men and women. 769 28

The incidence of mortality from cardiovascular diseases in higher in diabetic patients. The cause of this accelerated cardiovascular disease is multifactorial and, although atherosclerotic cardiovascular disease in association with well-defined risk factors has an influence on morbidity and mortality in diabetics, myocardial cell dysfunction independent of vascular defects have also been defined. We postulate that these adverse cardiac effects could presumably result as a consequence of the following sequence of events. Major abnormalities in myocardial carbohydrate and lipid metabolism occur as a result of insulin deficiency. These changes are closely linked to the accumulation of various acylcarnitine and coenzyme derivatives. Abnormally high amounts of metabolic intermediates could cause disturbances in calcium homeostasis either directly or indirectly through structural and functional subcellular membrane alterations. Over time, chronic abnormalities such as reduced myosin ATPase activity, decreased ability of the sarcoplasmic reticulum to take up calcium as well as depression of other membrane enzymes such as Na(+)-K+ ATPase and Ca(2+)-ATPase leads to changes in calcium homeostasis and eventually to cardiac dysfunction. More importantly from the point of view of pharmacological intervention, during the initial stages, acute disturbances in both the glucose and FFA oxidative pathways may provide the initial biochemical lesion from which further events ensue. Thus therapies which target these metabolic aberrations in the heart during the early stages of diabetes, in effect, can potentially delay or impede the progression of more permanent sequelae which could ensue from otherwise uncontrolled derangements in cardiac metabolism. There is little dispute that an attempt should be made to lower raised plasma triglyceride and FFA levels. This would decrease the heart's reliance on fatty acids and, hence, overcome the fatty acid inhibition of myocardial glucose utilization. In this regard, the likely application of fatty acid oxidation inhibitors (CPT inhibitors, beta-oxidation inhibitors, sequestration of mitochondrial CoA) is also apparent.
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PMID:Myocardial substrate metabolism: implications for diabetic cardiomyopathy. 776 Mar 40


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