Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The anti-anginal effects of KB-944 (Fostedil), a new calcium ion antagonist with a half life of approximately 23-28 hr, were evaluated in 20 patients with exertional angina pectoris in a placebo-controlled single-blind dose titration trial. Ambulatory monitoring and multistage treadmill exercise with computer-assisted electrocardiographic analysis was performed after 2 weeks of placebo therapy and after two 2-weekly periods of KB-944 therapy. The mean (+/- SEM) exercise time to the development of angina on treadmill walking increased from 6.9 +/- 0.4 min on placebo to 9.4 +/- 0.5 min on KB-944 100 mg/day (P less than 0.001) and 9.7 +/- 0.8 min on KB-944 200 mg/day (P less than 0.001 vs placebo and not significant vs KB-944 100 mg/day). The time to the development of 1 mm ST-segment depression of 5.3 +/- 0.4 min on placebo increased to 6.5 +/- 0.5 and 6.6 +/- 0.5 min on KB-944 100 and 200 mg/day, respectively (P less than 0.01 vs placebo). The heart rate at rest of 77 +/- 3 beats/min on placebo was reduced to 68 +/- 3 beats/min on KB-944 100 mg/day (P less than 0.001) and 71 +/- 2 beats/min on KB-944 200 mg/day (P less than 0.01). The maximal heart rate and the rate-pressure product were not altered by KB-944 therapy. One patient developed unstable angina during the treatment phase of KB-944 200 mg/day and was withdrawn. Five patients complained of dyspepsia and one of headache and lethargy during KB-944 200 mg/day. One patient developed ventricular tachycardia during treadmill testing while on KB-944 200 mg/day. The 24-hr ambulatory monitoring data confirmed the findings of exercise testing. KB-944 (Fostedil) in a dose of 100 mg once daily was well tolerated as compared to KB-944 200 mg once daily and both the doses were equally effective. The drug merits further evaluation for the treatment of exertional angina pectoris.
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PMID:Ambulatory monitoring and exercise testing in the evaluation of a new long-acting calcium ion antagonist KB-944 (Fostedil) for the treatment of exertional angina pectoris. 390 75

Coronary heart disease (CHD), previously neither diagnosed nor suspected, was strongly suspected in 115 of 2014 men aged 40-59 years during a cardiovascular survey examination. Sixty-nine of 105 men who underwent diagnostic coronary angiography had pathologic angiograms. Twenty-six of these 69 had angina pectoris (AP) with and without pathologic exercise ECGs and 43 had pathologic exercise ECG as the only indicator of CHD. The extent of coronary artery changes was similar in the two groups. The men without AP were in almost all respects similar to 1832 men labelled as normals. The men with AP differed in several respects from their non-AP angiographic counterparts and from their non-AP angiographic counterparts and from the normals: they had more dyspepsia, a higher stress score, higher serum cholesterol and triglycerides, lower antithrombin III levels in the blood and lower blood platelet retention values. These results indicate that coronary artery disease with and without AP may represent somewhat different pathogenetic entities.
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PMID:Coronary artery disease with and without angina--two different entities? 710 61

The effects of fluvastatin and bezafibrate on lipids, lipoproteins, and apoproteins (apo) were investigated in a multicenter randomized, double-blind, parallel-group study. After 8 weeks of strictly controlled (computer-based assessment) dietary stabilization, patients with primary hypercholesterolemia (low-density lipoprotein cholesterol [LDL-C] > or = 160 mg/dL; triglycerides < or = 300 mg/dL) were enrolled into a 6-week placebo phase. Altogether, 131 patients were randomized to receive either fluvastatin at 40 mg once daily (n = 64; mean age 53 years) or bezafibrate at 400 mg once daily (n = 67; mean age 52 years) for 12 weeks. Compliance with the diet was monitored (3-day food records) after 6 and 12 weeks. Fluvastatin led to significant reductions in LDL-C (-23%), total cholesterol (-17%), LDL-C/high-density lipoprotein cholesterol (HDL-C) (-24%) and apo B (-19%). Fluvastatin significantly increased LpA-I (+8%) and apo E (+20%). Bezafibrate produced significant reductions in LDL-C (-17%), total cholesterol (-13%), LDL-C/HDL-C (-24%), triglycerides (-28%), apo B (-15%), and LpA-I (-10%) and significantly increased HDL-C (+12%), apo A-I (+9%), apo A-II (+30%), apo E (+14%), and Lp(a) (+3%). No clinically notable increases in levels of liver enzymes or creatine phosphokinase were observed with either treatment. Both treatments were well tolerated. There was a low incidence of adverse events that tended to be mild and included headache, muscular pain, angina, and dyspepsia. The frequency of adverse events was similar in both treatment groups, and no significant differences in dietary behavior were observed. In conclusion, fluvastatin is a well tolerated 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor for the treatment of primary hypercholesterolemia. Effects of fluvastatin on LpA-I occur irrespective of changes in HDL-C.
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PMID:Treatment of primary hypercholesterolemia: fluvastatin versus bezafibrate. 801 68

Impotence, a common problem especially among older men, can now be treated with Viagra, This oral pill, unlike previous approved treatments mostly involving local injections, does not directly cause penile erection, but increases response to sexual stimulation. It acts by enhancing the relaxant effects of nitric acid on smooth muscle, and thus increases blood flow to certain areas of the penis, leading to erection. It has been evaluated in many randomized trials and in all was more successful in inducing erection than placebos. The most common side-effects include headache, flushing and indigestion, but there have also been reports of fatalities. We describe a 75-year-old man who had an acute myocardial infraction in the past and who had maturity-onset diabetes and hypertension. In the week prior to admission he had a cardiac scan following a few weeks of exacerbation of anginal pain for which he had been taking nitrites. He took a Viagra pill without prescription or medical advice and 2 hours later, during intercourse with his wife, developed audible respiratory distress and lost consciousness. His wife started cardiac massage but not mouth-to-mouth breathing. The emergency team found ventricular fibrillation and gave 5 electrical shocks and amines and atropine. He remained unconscious, but his pulse returned and he was hospitalized. He then had several generalized convulsions treated with i.v. valium. 20 minutes after admission there was asystole and all attempts at resuscitation failed. Cardiovascular status must be considered prior to prescribing Viagra, and the associated risk evaluated.
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PMID:[Viagra--the first oral treatment for impotence that is not lacking in fatal effects]. 1090 27

The aim of this study was to evaluate the efficacy and safety of oral sildenafil to treat erectile dysfunction (ED) in chronic renal failure in patients on hemodialysis (HD). A double-blind, randomized, placebo-controlled study of oral sildenafil (50 mg) administered as required in HD patients with ED was designed. Patients on HD for at least 6 mo and who had a stable relationship with a female sexual partner were included. Patients older than 70 yr with penile anatomic abnormalities, cirrhosis, diabetes, angina, severe anemia, and those who were on nitrate treatment or with a recent history of stroke or myocardial infarction were not included. The International Index of Erectile Dysfunction (IIEF) was employed to evaluate ED and treatment response. Forty-one patients were evaluated (21 received placebo, and 20 sildenafil). Baseline clinical and demographic parameters were similar in both groups. Sildenafil was associated with improvement in the score of all questions and domains of the IIEF, except those related to sexual desire. Using the erectile function domain to evaluate primary efficacy, improvement was observed in 85% of the sildenafil patients compared with 9.5% of placebo patients. Sildenafil use resulted in normal EF scores in 35% of sildenafil patients. Sildenafil was well tolerated. Headaches and flushing occurred in both groups. Dyspepsia was reported by two patients in the sildenafil group. In conclusion, oral sildenafil seems to be an effective and safe treatment for ED in selected patients with chronic renal failure on hemodialysis.
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PMID:Efficacy of oral sildenafil in hemodialysis patients with erectile dysfunction. 1239 48

This study aims to assess the efficacy and tolerance of the metabolic antianginal agent trimetazidine, a 3-KAT inhibitor, in 141 stable angina patients aged 65-86 years. Efficacy was assessed with exercise tests and clinical evaluation after 12 weeks of treatment. The main outcome was an increase in exercise duration by 52 +/- 92 sec (p < 0.001). Other exercise test parameters also improved, with no change in rate-pressure product. Angina attacks and short-acting nitrate consumption significantly decreased, indicating an improvement in quality of life. Two adverse events were reported (gastric pain and dyspepsia) but they were mild and transient. In conclusion, in elderly stable angina patients, trimetazidine improves exercise stress tests and angina symptoms. Because of its metabolic effect, free from any haemodynamic action, trimetazidine proved to be beneficial in elderly patients and with an excellent tolerance profile.
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PMID:Trimetazidine in geriatric patients with stable angina pectoris: the tiger study. 1471 87

Symptomatic hepato-diaphragmatic interposition of a bowel loop or Chilaiditi's syndrome is a peculiar anatomical condition most often found by chance. Its described symptoms range from intermittent, mild abdominal pain and dyspepsia to acute intestinal obstruction. We report a case of hepato-diaphragmatic migration of the hepatic flexure of the colon associated to an unusual, heretofore unreported, angina-like pain exclusively evoked by the left lateral decubitus. To maximize the chance of observing anatomical changes in different postures, computed tomography of the chest and abdomen was performed after air insufflation into the colon. While frank herniation into the chest was excluded, the scan showed that the hepatic flexure-with the interposition of the diaphragm-came in contact with the right side of the heart in the left lateral, but not in the supine, decubitus. This finding was reproduced by echocardiography which also showed virtually unaltered hemodynamics after the change of posture. ECG, left and right ventricular global and regional function as well as cardiac injury markers also remained unchanged during the maneuver, indicating that the pain evoked by the latter was unlikely due to myocardial ischemia. This case suggests that Chilaiditi's syndrome should be included among the possible, although rare, causes of unexplained angina-like symptoms.
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PMID:Heart-touching Chilaiditi's syndrome. 1605 99

Symptomatic hepato-diaphragmatic interposition of a bowel loop or Chilaiditi's syndrome [Pronounced "Ky-La-Ditty"] is a very rare (0.1-0.25%) anatomical condition most often found by chance. Its described symptoms range from intermittent, mild abdominal pain and dyspepsia to acute intestinal obstruction. We report a case of acquired hepato-diaphragmatic migration of the hepatic flexure of the colon associated to an unusual, angina-like pain more in the left lateral position. ECG, stress test, 2D echo and regional cardiac injury markers were within normal limits indicating that the pain was unlikely due to myocardial ischemia. It is possible that the pain felt by the patient, concomitant to the migration of the hepatic flexure, was simply due to the transient stimulation of cardiac nervous fibers or to the internal compression of the chest or to overstretching of the major vessels-including the aorta and vena cava, or to a combination of these last two factors. This case suggests that Chilaiditi's syndrome should be included among the possible, although rare, causes of unexplained angina-like symptoms.
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PMID:Chilaiditi's syndrome with associated angina. 2064 99

The aim of the study was to determine the frequency of functional and organic dyspepsia and possible predictors for organic dyspepsia in coronary artery disease (CAD) patients. The 150 patients (109 men; mean age 62.61 +/- 10.23 yr) undergoing coronary artery by-pass grafting because of stable pectoral angina due to significant CAD were enrolled in the study. Dyspepsia was determined by the existence of epigastralgy, heartburn, nausea and vomiting. Dyspepsia with endoscopic lesions was defined as organic, and dyspepsia with normal endoscopy was defined as functional. Multivariate analysis (logistic regression) was used to estimate predictive values of some independent clinical and demographic variables in relation to organic dyspepsia (dependent variable). One hundred thirty-five (90%) patients had at least one symptom of dyspepsia. Eighty five patients (63%) had organic dyspepsia, and 50 (37%) patients had functional dyspepsia (P < 0.001). Patients with organic dyspepsia had more dyspeptic symptoms than patients with functional dyspepsia (1.92 +/- 0.88 vs. 1.38 +/- 0.87, P < 0.001). More dyspeptic symptoms correlated with heavy GD lesions (r = 0.267; P < 0.0001). Multivariate analysis revealed independent correlation of consuming low-dose aspirin (standardized coefficient beta = 11.701, P = 0.004), diabetes (beta = 2.921, P = 0.027), cigarette smoking (beta = 2.910, P = 0.037) and nausea (beta = 3.620, P = 0.015) with organic dyspepsia. The study showed high frequency of dyspepsia, especially organic dyspepsia, in CAD patients. Three or more dyspeptic symptoms, low-dose aspirin, cigarette smoking, diabetes and nausea, increased the probability of organic dyspepsia. Therefore, for patients with combination of dyspeptic symptoms and present risk factors the endoscopic examination should be considered.
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PMID:[Frequency and characteristics of dyspepsia in coronary artery disease patients]. 2085 6