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)

We performed exercise thallium-201 myocardial scintigraphy in 32 patients with angina pectoris to study the incidence of perfusion defects, who had no significant organic stenosis on coronary angiography. None of them had myocardial infarction or cardiomyopathy. Thallium-201 myocardial scintigraphy and 12-lead ECG recording were performed during supine bicycle ergometer exercise. Perfusion defects in thallium-201 scintigrams in SPECT images were assessed during visual analysis by two observers. In the coronary angiograms obtained during intravenous infusion of nitroglycerin, the luminal diameter of 75% stenosis or less in the AHA classification was regarded as an insignificant organic stenosis. Myocardial perfusion defects in the thallium-201 scintigrams were detected in eight (25%) of the 32 patients. Six of these eight patients had variant angina documented during spontaneous attacks with ST elevations in standard 12-lead ECGs. Perfusion defects were demonstrated at the inferior or inferoposterior regions in six patients, one of whom had concomitant anteroseptal defect. The defects were not always accompanied by chest pain. All but one patient demonstrating inferior or inferoposterior defects showed ST depression in leads II, III and aVF on their ECGs, corresponding to inferior wall ischemia. The exception was a case with right bundle branch block. Thus, 25% of the patients with angina pectoris, who had no evidence of significant organic stenosis on their coronary angiograms, exhibited exercise-induced perfusion defects in their thallium-201 scintigrams. Coronary spasms might have caused myocardial ischemia in these patients.
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PMID:[Exercise-induced thallium-201 myocardial perfusion defects in angina pectoris without significant coronary artery stenosis]. 209 48

Subchronic and chronic efficacy of a 10 mg of nitroglycerin (NTG) patch was studied in 30 patients with stable angina pectoris. The trial consisted of 2 periods of study: 1 period of 2 months with a double-blind, crossover, placebo-controlled design and a second period of open treatment with verum patch. Two 7-day washout periods were performed at entry and at the end of the study. Efficacy was evaluated by clinical assessment of anginal attacks and NTG consumption and by means of multistage treadmill exercise testing. Exercise tests were performed at time 0 (24 hours from application of last patch), at 4 and 12 hours after dosing at the end of first 7-day washout, at the end of the first month of treatment, at the end of the second month of treatment after crossover, at the end of 3 months of treatment with active patch and at the end of the second 7-day washout period. Statistics were obtained by multivariate analysis of difference. In 27 patients whose records were available for final analysis the daily attacks of angina and NTG consumption decreased significantly during both the subchronic and chronic phases of the trial compared with placebo (p less than 0.001). Subchronic study showed significant improvement of maximal exercise duration, time to onset of angina, time to ST-segment depression of 1.0 mm, time to regression of angina and time to regression of ST depression, compared with placebo.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term efficacy of nitroglycerin patch in stable angina pectoris. 211 38

A multicenter open study was carried out in order to evaluate the tolerability and antianginal efficacy of the nitroglycerin "multilayer transdermal system". Forty eight cardiologic centers enrolled 506 outpatients (123 females and 383 males), mean age: 61 +/- 8 (SD) years, with effort angina (43%), angina at rest (17%) and mixed angina (40%), not well controlled by their previous antianginal therapy (greater than or equal to 2 anginal attacks a weeks). The duration of the treatment with 5 or 10 mg/die was 10 weeks with a control every 2 weeks. At the end of the study, the weekly frequency of anginal attacks was reduced by 88%, and 60% of the patients were free from anginal attacks. In 117 patients, studied by ergometer test, the exercise time increased by 31% (p less than 0.001) and the ST depression decreased by 63% (p less than 0.001). The treatment was interrupted in 9.1% of the patients: in 4.55% for unwanted effects (headache and/or local intolerance) and in 4.55% for other reasons. The same unwanted effects, but of mild or moderate severity, were observed in 18.4% of the patients, most of them during the first 2 weeks of the treatment. In conclusion, the "multilayer system" for delivering transdermal nitroglycerin showed a good clinical and ergometer efficacy and was well tolerated and accepted by the anginal patients in study.
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PMID:[Tolerance and effectiveness of transdermal nitroglycerin in angina pectoris. A multicenter study. Adesitrin Italian Study Group]. 211 18

The clinical response to felodipine, in addition to a beta-blocker, was evaluated and compared with placebo in this double-blind cross-over study. Twenty patients with exertional angina pectoris completed the study. Felodipine reduced the number of angina attacks and the Glyceryl Trinitrate (GTN) consumption. The median exercise capacity was increased 33% after 4 weeks' felodipine treatment compared with placebo. At maximal exercise, systolic blood pressure and rate pressure product were reduced by felodipine while no change was seen in heart rate or ST-depression. Felodipine reduced both supine and erect blood pressure. The mean supine blood pressure at rest was 138/82 mm Hg after four weeks' placebo treatment compared with 114/71 mmHg after felodipine 5-10 mg b.i.d. Felodipine has overall a modest but significant anti-anginal benefit when combined with a beta-blocker.
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PMID:The effects of felodipine in angina pectoris. 211 11

Activity of endothelium-dependent relaxation factor (EDRF) was measured in 139 open ring preparations of fresh human saphenous vein from 85 patients undergoing coronary bypass grafting. The veins were constricted with phenylephrine and relaxed with the EDRF-dependent agents calcium ionophore A23187 or acetylcholine. EDRF activity produced a 36% +/- 4% relaxation of baseline contraction in response to calcium A23187. Vein graft preparation with room-temperature heparinized normal saline and pressurization to 400 mm Hg caused EDRF relaxation to fall to 10.6% +/- 2.0% versus 32.4% +/- 3.4% for control segments (p less than 0.05). Storage alone in room-temperature saline reduced EDRF response to 17.4% +/- 3.9% versus a control of 29.6% +/- 4.7% (p less than 0.05). Storage in heparinized room-temperature blood produced relaxation of 31.4% +/- 4.3% versus 34.1% +/- 5.7% (p less than 0.05). Storage in Plasma-Lyte solution (Travenol Laboratories, Inc., Deerfield, Ill), produced relaxation of 28.4% +/- 6.3% versus 30.1% +/- 5.3% (control) (p greater than 0.05). Veins stored at 2 degrees to 4 degrees C had severe depression of EDRF: 18.2% +/- 4.0% versus 34.0% +/- 5.4% for 37 degrees C storage (p less than 0.05). Pressurization to 400 mm Hg lessened EDRF relaxation: 20% +/- 3% versus 34% +/- 4% (control) (p less than 0.05), and use of nitroglycerin, papaverine, or verapamil produced no improvement. Twenty-eight vein grafts prepared with Plasma-Lyte solution were obtained from 12 patients who died 11.6 days (range up to 66 days) after operation. When compared with control veins prepared with saline and obtained at similar intervals, they had significantly more intact endothelium, less subintimal cellular infiltration, less fibrin deposition, fewer medial inflammatory changes, and less necrosis. Thus EDRF activity is significantly affected by vein graft preparation. Changes in technique to preserve EDRF produced better graft morphology early after operation.
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PMID:Endothelium-dependent relaxation in human saphenous vein grafts. Effects of preparation and clinicopathologic correlations. 212 May 19

In patients with ischemic heart disease and arrhythmias, selection of antiarrhythmic treatment is often difficult as it is hard to separate "primary" from ischemic arrhythmias. We studied 20 patients with ischemic heart disease, who developed ventricular arrhythmias consistently during exercise test. Exercise test was performed twice during infusion of placebo and then during intravenous administration of nitroglycerin, titrated to reduce systolic blood pressure by 10 mmHg. Exercise duration was 7.8 +/- 1.7 and 7.9 +/- 1.5 min, in the 2 placebo tests (NS). Angina developed in 5 patients and ischemic ST changes in 10. With nitroglycerin exercise duration increased to 8.4 +/- 20 min (p less than 0.05), diagnostic ST segment depression was observed in 2 patients and only 1 had angina. In all 20 patients, ventricular arrhythmias were consistently present during both tests on placebo, that were markedly reduced by nitroglycerin. In fact, ventricular ectopic beats were 455 (mean 35.8 +/- 16.8) and 418 (mean 34.4 +/- 11.1) in the 2 exercise tests with placebo, and 11 during nitroglycerin infusion (mean 0.6 +/- 0.1; p less than 0.001). Couplets were 28 and 29 during placebo (NS) and 0 during nitroglycerin (p less than 0.001). Ventricular tachycardia was present in 6 and 8 patients during placebo but in none during nitroglycerin (p less than 0.001). Reduction of exercise-induced arrhythmias was maintained during chronic treatment with oral vasodilators. Prevention of exercise-related arrhythmias by nitroglycerin infusion appears a good indicator of their ischemic origin and may provide valuable information for long-term profilaxis with oral vasodilators, then avoiding the use of antiarrhythmic agents and their potential side effects.
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PMID:[Intravenous nitroglycerin infusion suppresses exercise-induced arrhythmia in patients with ischemic cardiopathy: indications for chronic treatment ]. 212 40

A study was made of the antianginal and anti-ischemic effects of sustac (ST) and trinitrolong (TNL) during their cross continuous use in patients with stable angina pectoris, functional class II-III (according to the classification of the Canadian Association of Cardiologists). In accordance with the daily ECG monitoring data, the three-month treatment with the effective doses of ST and TNL produced a significant lowering of the frequency and the total intensity of the episodes of ST segment depressions of the ischemic type as compared to the continuous administration of placebo. The use of criteria for evaluating the efficacy of the antianginal drugs (the decrease of the total number of ST segment depression episodes during one day by 3 and over and/or reduction of the total intensity of ST segment depression by 50% and over) made it possible to reveal varying effects of the nitrates on painful episodes (PE) and painless episodes of ST segment depression. Both the dosage forms of nitroglycerin administered in the effective amounts (in short- and long-term continuous treatment) significantly lowered the rate and total intensity of myocardial ischemia episodes at the expense of a significant decrease of the frequency and total intensity of PE. They produced no material effect on the number of painless episodes. Provided ST and TNK turned out ineffective, there was a significant rise of the frequency and total intensity of painless episodes in short-term continuous treatment while ST produced the above effect in long-term treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An assessment of the efficacy of a course of using different forms of prolonged-action nitrates in patients with stable stenocardia with the help of repeated daily ECG monitoring]. 212 96

The 24-hour application of transdermal nitrate patches has been associated with rapid development of therapeutic tolerance. Recent reports suggest maintenance of clinical benefit by introducing a daily patch-free period. This study investigates, by means of serial treadmill testing, the efficacy of a new transdermal delivery system when used with an eight hour patch-free period in 16 subjects with chronic stable angina. Concomitant antianginal therapy was permitted. After demonstration of exercise test reproducibility and nitrate responsiveness, subjects entered a double-blind randomised placebo-controlled crossover trial comprising one week of active nitroglycerin patches (10mg/24hrs) and one week of an identical placebo patch. Exercise tests were conducted four hours after patch application on the last day of each of the treatment arms. Daily angina frequency and nitroglycerin consumption were also monitored. There was significant improvement in total exercise duration (16.5%), time to onset of angina (26%), time to 1mm ST depression (22%), and peak heart rate blood pressure product with active patch application. Angina frequency was reduced during the week of active therapy. These results demonstrate the additional efficacy of intermittent transdermal nitroglycerin in a group of subjects with continuing angina despite therapy with beta-blockers and calcium antagonists.
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PMID:Clinical benefit of transdermal glyceryl trinitrate when used with an eight hour patch-free period. 212 27

The complex-forming abilities of 2,6-di-O-ethyl-beta-cyclodextrin (DE-beta-CD), and its effect on the release of nitroglycerin (TNG) from formulations of the compound, were studied and compared with corresponding properties of beta-cyclodextrin (beta-CD) and 2,6-di-O-methyl-beta-cyclodextrin (DM-beta-CD). Complex formation was confirmed by differential scanning calorimetry and infrared absorption spectroscopy. In an accelerator test involving temperature and reduced pressure, marked depression of the volatility of TNG was observed as a result of CD complex formation. Dissolution rates of TNG from powdery TNG/DE-beta-CD complex and its tablets were retarded in comparison with the rates from other CD complexes. The release rate of TNG from ointments was accelerated by complexation with DE-beta-CD, and retarded by complexation with beta-CD. To evaluate their in vivo percutaneous absorption, samples were applied to the inside tip of the cheek pouch of male golden hamsters. The amount of TNG remaining in the cheek pouch was lowest in the case of the TNG/DE-beta-CD complex ointment, and relatively high in the case of the TNG/beta-CD complex ointment, in agreement with the in vitro results. We suggest that the combination of DE-beta-CD complex and beta-CD complex might be applicable to sustained-release preparations for percutaneous administration.
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PMID:Effect of diethyl-beta-cyclodextrin on the release of nitroglycerin from formulations. 212 21

The therapeutic efficiency of the long-term nitrates in coronary heart disease with exercise-induced heart insufficiency is recently more frequently called in question by observations of a nitrate tolerance. In own long-term studies on 34 patients with coronary heart disease with clinical and haemodynamic evidence (pathologic increase of the end-diastolic pressure of the pulmonary arteries under ergometric load) of an exercise-induced heart insufficiency the efficacy of pentaerythril tetranitrate (PETN) and isosorbide dinitrate (ISDN) in chronic dosage titration use was tested. The oral nitrate therapy evoked a clear decrease of the end-diastolic pressure of the pulmonary arteries. The reduction of the values of the pressure of the pulmonary arteries was correlated with adequate clinical findings (significant decrease of the frequency of pectanginous attacks and of the sublingual need of GTN, regression of the ST segment depression). The own results with particular valuation of the microcatherisation of the right heart on exertion plead against a clinically remarkable nitrate tolerance and confirm the efficiency of the at present usual basic medicamentous therapy in patients with coronary heart disease and exercise-induced heart insufficiency.
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PMID:[Long-term nitrate therapy in coronary heart disease--loss of effect by developing tolerance]. 212 17


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