Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Insulin accelerates the entry of glucose and amino acids into muscle cells by acting upon the 'carrier-facilitated' transport mechanism. For glucose this process is passive and leads to equilibration of intracellular and extracellular concentrations. In heart muscle, glucose transport is a rate-limiting step for glucose uptake. During hypoxia and ischemia the heart turns to anaerobic glycolysis for energy production and therefore, maximal glucose transport becomes important. Insulin is necessary to insure proper protein synthesis, probably at the level of membrane-bound polyribosomes. However, during myocardial hypoxia, insulin alone cannot restore the associated depression in protein synthesis. Although insulin hyperpolarizes the cell, a change in the ratio of intracellular to extracellular activities of potassium is not its primary mode of action. An insulin-induced configurational change in the plasma membrane could simultaneously account for the effects of insulin on sodium and potassium permeability and the action on facilitated transport. Intracellular levels of cyclic adenylate may be reduced by insulin in adipose tissue because of inhibition of adenyl cyclase or stimulation of phosphodiesterase. However, at this time there is little evidence that insulin alters cyclic AMP levels in the heart. Insulin secretion is depressed in patients with heart disease in proportion to the reduction of cardiac index sustained. Since the ischemic heart is dependent upon glucose as the major fuel, insulin lack may deprive the heart of adequate substrate.
 ...
PMID:Insulin: fundamental mechanism of action and the heart. 18 67

Plasma lipoprotein cholesterol and triglyceride levels were measured in 24 obese not-insulin dependent Pima Indian diabetics and 9 obese nondiabetic controls before and after 1-8 months on a 500 calorie diet. The diabetics were divided into 3 groups--severe, recent onset (n = 10), severe long-term (n = 6), and borderline (n = 8). The diet regimen resulted in weight loss and improved glucose tolerance in all of the diabetics, and insulin secretion increased in the 2 groups of severe diabetics. After the period of weight loss, total plasma cholesterol had declined greater than 20%, and LDL cholesterol decreased 25% in all diabetic groups and in the controls. In all diabetic groups, HDL cholesterol did not decline; therefore the ratio of HDL/LDL cholesterol after diet therapy was significantly increased. In the controls HDL cholesterol declined with weight loss, and the distribution of HDL/LDL cholesterol remained constant. Plasma and VLDL triglyceride levels decreased in all groups in those with initial triglyceride levels greater than 150 mg/dl. The results indicate that weight loss in not-insulin dependent diabetics not only improves glucose tolerance, but also lowerss plasma lipids and reverses the dyslipoproteinemia often associated with this disorder. This may influence the risk of arteriosclerotic heart disease in these individuals.
 ...
PMID:Changes in plasma lipoproteins accompanying diet therapy in obese diabetics. 22 83

Arteriosclerotic heart disease is a major cause of death in insulin-requiring juvenile diabetic patients treated for end-stage renal disease. Eleven consecutive diabetic patients without clinical evidence of coronary artery disease underwent complete cardiac evaluations, including coronary arteriography, as part of transplant recipient work-ups. Seven were women and four were men; their mean age was 32 (21 to 50 years). Angiographically, every patient had multifocal atherosclerotic coronary disease. Four of seven patients tested had positive-stress electrocardiograms. In this group of patients followed for a mean of 19.8 months, eight died. Of these deaths, six were due to coronary heart disease and another due to a stroke. In two patients who became clinically symptomatic, serial angiograms revealed progressive disease of the coronary circulation; in one case, despite normal renal allograft function and serum lipid levels. The mode of end-stage renal disease treatment, serum lipids or blood pressure control could not be linked to mortality. It is concluded that arteriosclerotic heart disease is common in diabetic patients with end-stage renal disease even when angina is absent. The natural history in this high risk population is an important consideration in the selection of patients for end-stage renal disease treatment.
 ...
PMID:Natural history of asymptomatic coronary arteriographic lesions in diabetic patients with end-stage renal disease. 36 Aug 37

This study evaluated the effect of hormonal exposure before or during pregnancy on the risk of congenital heart disease to the child and assessed the cardiovascular teratogenicity of other drugs taken during early pregnancy. A total of 390 cases was ascertained from all infants with congenital heart disease born to Massachusetts women during the period of 1973-1975. 1254 randomly selected births were controls. A history of oral contraceptive (OC) use, hormonal pregnancy tests, prescribed hormones, and other drugs was obtained from both cases and controls. The proportion of mothers reporting any drug use during pregnancy was 54% for cases and 41% for controls. Among those reporting drugs, the mean number of drugs reported was 1.9 for cases and 1.8 for controls. Estimates of effects of specific drugs are provided tabularly. There was a small positive association with cardiac malformation for each of 3 categories of hormonal exposure (hormones prescribed during pregnancy, hormonal pregnancy tests, and OC use after conception). Combining the 3 types, the overall estimate for the rate ratio was 1.5; the overall exposure was compatible with no effect, the 90% confidence limit for the prevalence ratio ranging from 1-2.1. No association was evident between hormones and trunco-conal or any other class of defect among the cases, an observation which casts doubt on a causal relationship between hormones and cardiovascular malformations. Among the other drugs examined, insulin had the highest prevalence rate. Several other drugs were reported more frequently by mothers of cases, including: ampicillin, aspirin, a combined antinausea agent, chlordiazopoxide, codeine, diazepam, diphenylhydantoin, phenobarbital, phenothiazine, phenylephrine, and tetracycline.
 ...
PMID:Exogenous hormones and other drug exposures of children with congenital heart disease. 44 41

In 4 out of 9711 (= 1:2400) patients, lactice acidosis due to biguanides was diagnosed. Serum lactate concentration averaged 18.2 mmol/l and the pH value 6.87. All patients showed signs of renal insufficiency and three had congestive heart disease. In addition to treatment with biguanides, other factors might have contributed to the lactice acidosis in these patients: prolonged fasting, severe dehydration due to persistent vomiting, acute bronchopneumonia, and acute pyelonephritis. On addmission, two patients were in shock and all patients were semi-conscious or comatose. All patients were treated with bicarbonate and glucose/insulin. One patient was hemodialysed. Two of our four patients died. Oour four patients are compared with 179 patients in the literature with respect to mortality and prognosis of lactic acidosis due to biguanides.
 ...
PMID:[Lactacidosis in biguanide therapy: diagnosis and therapy. 4 cases compared to 179 cases in the world literature]. 71 23

A detailed study was made of 150 women delivered of their infants within 72 hours of an amniocentesis where the lecithin/sphingomyelin (L/S) ratio was 2.0 or greater. There were nine neonates with respiratory distress (6.0 per cent). There were two neonatal deaths, both due to severe congenital heart disease. A mature amniotic fluid L/S ratio predicts a newborn infant who will not have respiratory distress syndrome (RDS) in most pregnancies. There is a significantly increased risk of RDS in neonates with a mature L/S ratio if the mother has insulin-dependent diabetes or if there is a resulting low Apgar score. The method of delivery (cesarean section or vaginal) does not affect the frequency of RDS where the L/S ratio is 2.0 or more.
 ...
PMID:Respiratory distress syndrome with mature lecithin/sphingomyelin ratios: diabetes mellitus and low Apgar scores. 98 67

In 1912 Goulston advocated glucose therapy for several different kinds of heart disease, and in 1933 Shirley-Smith recommended glucose and insulin for coronary artery disease. Thirty years later, Laborit noted that treatment of rabbits with glucose and insulin prevented ventricular fibrillation induced by potassium chloride solutions. Sodi-Pallares et al, pioneers in glucose-insulin-potassium (GIK) therapy for heart disease, showed not only that potassium may be a major excitant in the genesis of ventricular tachycardia in the ischemic heart but that GIK solution was capable of enhancing oxidative phosphorylation in the ischemic heart. Interest in GIK therapy for ischemic heart disease has been renewed as the effects of GIK solutions on myocardial infarct size, metabolism and electrical properties are better understood. In this paper, selected new information regarding the actions of GIK and the clinical applications will be reviewed.
 ...
PMID:Glucose-insulin-potassium (GIK) therapy for ischemic heart disease. 110 62

The effect of congestive cardiac failure, hypoxia and hypoglycaemia on glucose tolerance and insulin secretion were studied in selected groups of infants with congenital heart disease. Fasting blood glucose level was significantly decreased in patients with congestive heart failure and in cyanotic infants without congestive heart failure. In the former it seemed to be correlated with the degree of malnutrition, while in cyanotic infants it was independent of the nutritional state. Plasma insulin levels were reduced in infants, with congestive cardiac failure, although their glucose tolerance test and free fatty acid concentrations were normal. It is suggested that the decreased plasma insulin concentration was a consequence of adaptation to reduced requirements. Glucose tolerance and insulin secretion were not affected by hypoxia or hypoglycaemia.
 ...
PMID:Plasma glucose, insulin and free fatty acids in infants with congenital heart disease. 124 3

We have studied the effects of moderate dietary fat restriction on plasma triglyceride, cholesterol, glucose, and insulin response in 27 subjects. Compared with a control diet (45% fat, 40% carbohydrate [CHO], 15% protein) the low fat (higher CHO) diet (30% fat, 55% CHO, 15% protein) produced a 41% increase in fasting triglyceride level (155 +/- 17 to 219 +/- 23 mg%) with no change in fasting plasma cholesterol level. Furthermore, this increase in triglyceride levels; induced by the higher CHO content of the low fat diet, was seen in 26 out of 27 subjects. Postprandial triglyceride, glucose, and insulin levels were also higher on the low fat (higher CHO) diet. Since hypertriglyceridemia is a significant risk factor for the development of coronary heart disease, and since our data indicate that the moderate increase in dietary CHO associated with a low fat diet will elevate plasma triglyceride levels, we believe that more caution is necessary before recommending the wide-spread use of low fat diets for heart disease prevention.
 ...
PMID:Induction of hypertriglyceridemia by a low-fat diet. 126 45

Between 1980 and 1988, 32 infants under three years of age with left to right shunt congenital heart disease underwent cardiac catheterizations, and their glucose tolerance and insulin secretion were investigated. These patients were divided into three groups by weight and compared. Group I consisted of 11 patients whose weights were 80% or more of the ideal body weight (IBW) for their age. Group II consisted of 10 patients whose weights were between 70% and 80% of the IBW. Group III consisted of 11 patients whose weights were less than 70% of the IBW. The CTR and biochemical blood studies showed no difference. By cardiac catheterization, Group III showed higher pulmonary/systemic vascular pressure ratio (Pp/Ps) than Group I. The mixed venous O2 saturation (SvO2) were 69.5 +/- 6.41% in Group I, 64.8 +/- 5.78% in Group II, 57.2 +/- 3.59% in Group III. Group III showed the lowest SvO2 of the three. Group III also showed the lowest arterial O2 saturation (SaO2). This indicates that the patients of Group III had the most serious congestive heart failure. In the 0.5 g/kg intravenous glucose tolerance tests, the K values (glucose disappearance rates) were as follows: Group I: 3.30 +/- 0.597, Group II: 2.91 +/- 0.624, Group III: 2.48 +/- 0.417. Group III showed the lowest values of the three. This indicates the deterioration of glucose tolerance in Group III. In the examination of serum insulin secretion, Group III showed the lowest serum insulin levels: 26.6 +/- 18.3 mmu/ml at 3-minute intervals, 22.8 +/- 14.3 mmu/ml at 5-minute intervals. After cardiac catheterization, corrective operations were performed on 17 patients out of 32. Fifteen patients survived, though 2 patients of Group III died early postoperatively. The results of glucose tolerance test and serum insulin levels before and after operation in 12 survivors were compared. Although the K values had been 2.8 +/- 0.41 before operation, it rose up to 3.81 +/- 0.81 three to four weeks after operation. The serum insulin levels at 3, 5, 10 and 15-minute intervals also rose after operation. This indicates the improvement of glucose tolerance and insulin secretion due to the improved circulation. It is suggested that the adequate nutritional management before and after operation on infants with serious congestive heart failure, because they tend to have malnutrition before operation. Aggressive and careful nutritional management is advisable.
 ...
PMID:[Glucose tolerance and insulin secretion in infants with the left to right shunt congenital heart disease]. 140 84


1 2 3 4 5 6 7 8 9 10 Next >>