Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The ELAN (Etude longitudinale dans l'angor) study was carried out both to acquire better knowledge of the occurrence of major cardiovascular events (myocardial infarction, revascularization surgery, death) in patients followed up for angina pectoris, and to determine the factors influencing such events. A cohort of angina patients was formed in January 1997, and 3,284 patients were followed up by 488 French cardiologists during a one-year period. Of these 3,284 patients, 96 (29/1000) died; causes of death included underlying coronary heart disease in 31, sudden death in 8, other cardiac aetiologies in 35, and noncardiac causes in 22. Sixty-nine (21/1000) patients developed myocardial infarction, 240 (73/1000) underwent PTCA, and 119 (36/1000) underwent coronary bypass surgery. Factors associated with an increased risk of death were age, diabetes mellitus, heart failure and angina type, mixed and rest angina being associated with poorer prognosis compared to exertional angina. Infarction risk increased with age and a history of previous infarction. Analysis of therapeutic factors after adjustment for the above risk factors showed a beneficial effect of betablockers on both cardiovascular and all-cause mortality and of aspirin on all-cause mortality.
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PMID:[One-year follow-up of a population of patients with angina. Factors influencing mortality and occurrence of cardiovascular events. Results of the ELAN study]. 1100 68

Cardiac amyloidosis usually presents with heart failure, but rarely leads to coronary insufficiency. The authors report a case of a 69-year-old Japanese woman with cardiac amyloidosis presenting as microvascular angina. She had exertional angina with positive exercise test and normal coronary angiograms. However, heart failure developed, and she died 3 years after symptom onset. On autopsy, coronary arteries were patent. In contrast to that of the epicardial coronary arteries, histologic examination of the heart revealed severe obstructive alterations of the intramural coronary arteries with amyloid. Furthermore, amyloid was present mainly in the endocardium and the intramural coronary arteries, but there was little present in the myocardium. This case was a rare AL amyloidosis. There have been only 4 reported cases of cardiac amyloidosis that presented with exertional angina, a positive exercise test, and normal coronary angiograms and histologic examination.
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PMID:Cardiac amyloidosis presenting as microvascular angina--a case report. 1133 May 10

Collateral Therapeutics and Schering AG in Germany are developing a gene therapy product, GENERX for coronary artery disease. Based on the terms of the agreement, Schering or its affliates will be responsible for conducting and financing phase II/III clinical trials which are currently underway in the US and Europe. In particular, Berlex Labs (the US subsidiary of Schering AG), is involved in developing the gene therapy in the US. GENERX is an angiogenic gene therapy which triggers the production of a protein that stimulates new blood vessel growth providing an alternative route for blood to bypass clogged and blocked arteries in the heart. GENERX involves a one-time, non-surgical delivery of an adenovirus vector containing the human fibroblast growth factor-4 (FGF-4) into coronary arteries via a standard catheter. The FGF-4 gene was licensed from New York University. Collateral Therapeutics has been granted a US patent for "gene transfer-mediated angiogenesis therapy" for the nonsurgical administration of angiogenic genes for coronary and peripheral vascular disease. The patented technology has been licensed from the University of California. Collateral and Berlex have initiated pivotal phase IIb/III trials with GENERX in the US and Europe. The US-based study will evaluate the safety and efficacy of GENERX in patients with stable exertional angina due to coronary artery disease. The European-based study will evaluate patients with advanced coronary artery disease who are not considered candidates for interventions such as angioplasty and bypass surgery and/or patients who are unlikely to have positive outcomes from such interventions. Both studies, of a multicentre, randomised, double-blind and placebo-controlled design, will evaluate 2 dose levels of GENERX which will be non-surgically administered to the heart via intracoronary infusion through a standard cardiac catheter. Collateral also plans to develop a non-surgical gene therapy product using the FGF-4 gene for the treatment of patients with heart failure. In a blinded placebo-controlled study in a pig model of pacing-induced heart failure, intracoronary delivery of human FGF-4 expressed in an adenovirus vector showed significant improvement in regional cardiac function and a reduction in the size of the heart over a 3-week study period. If these results translated favourably to humans, FGF-4 gene therapy may be a therapeutic option for patients with dilated heart failure. Collateral Therapeutics has also announced a research collaboration with Targeted Genetics on the use of viral vectors to deliver therapeutic genes in cardiovascular disease. Under the terms of the agreement, Targeted Genetics and Collateral Therapeutics each have the option to collaborate further to use Targeted Genetics' recombinant adeno-associated viral vector to treat congestive heart failure. In such an event, Targeted Genetics would be responsible for constructing and manufacturing the vector, and Collateral Therapeutics will fund the costs of future collaboration. Either party may terminate this agreement at any time upon 30 days prior written notice.
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PMID:FGF-4 gene therapy GENERX--Collateral Therapeutics. 1190 5

Our objective in this study was to compare particular features of pathogenesis of diastolic dysfunction of the right ventricle (RV) in patients with arterial hypertension (AH), stable exertional angina, and myocardial infarction of the left ventricle (LV) and to establish diagnostic significance thereof. As many as 429 AH patients presenting with different clinical forms of ischemic heart disease (IHD) were examined. Of these, 209 patients presented with stage I to III AH, 105 had functional class (FC) I-III stable exercise-induced angina, 115 patients had acute LF myocardial infarction (MI) verified by clinical findings, changes in ECG, and time-course of activity of myocardial enzymes. The control group was 30 essentially healthy subjects with no signs of cardiovascular and respiratory affections. All examinees underwent Doppler echocardiography as recommended by the American Society of Echocardiography. Measured in the above series were LV wall relative thickness, LV ejection fraction (EF) as recommended by L. Teichholz et al., LV isovolumetric relaxation time (IVRT), peak velocities of early (E) and atrial (A) filling of the heart's ventricles, E/A ratio, early diastolic filling deceleration time (DT) for both transmitral and transtricuspid flows, acceleration time of systolic flow in the pulmonary trunc as an indirect indicator of pressure in it. In AH patients, there was a close direct correlation between indices for filling of both ventricles (E/A ratio, E-wave DT and IVRT) but no significant correlation between indices for RV diastolic function and dimensions of left chambers or LV EF. In AH patients, disturbances in the diastolic function of the heart were at their greatest in eccentric hypertrophy of the myocardium when in the presence of pseudonomal and restrictive indices for LV filling "pseudonormalization" of the transtricuspid flow was being formed. In stable angina and MI, it was LV systolic dysfunction and pulmonary diastolic dysfunction that proved to play a major part in the development of RV diastolic dysfunction, its indices correlating significantly with heart failure and stable angina functional classes.
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PMID:[Diastolic filling of the right ventricle in patients with arterial hypertension and ischemic heart disease]. 1271 6

Left-ventricular (LV) systolic-diastolic function and cardiac rhythm variability, the rate of pathological LV remodeling and outcomes of the disease for 18 months were studied in 394 males at the age 35-68 years suffering from chronic cardiac failure (CCF) of NYHA functional class I-II consequent to myocardial infarction occurring 9.6-4.2 months before. It was found that long-term (12-24 weeks) taking sauna, underwater dousch-massage, general effervescent baths and exercise in combination with drug therapy in patients with asymptomatic CCF inhibit the rate of LV remodeling, decrease LV hypertrophy, improve diastolic function of the heart. This results in lowering a cumulative risk of unfavourable outcomes of the disease by 42% (p = 0.006). The best of effect of the combined therapy is not achieved in angina of effort, massive myocardial hypoperfusion zones, no viable myocardium in the zones of the lesion, marked LV hypertrophy.
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PMID:[Duration-outcome relations in nonpharmacological treatment of chronic cardiac failure developed after acute myocardial infarction]. 1285 8

In 60 patients with stable functional class II exertional angina with hyperkinetic type of circulation, baseline hemodynamics was studied following a 2-week treatment. A negatively chrono- and inotrophic effect was observed with taking anaprilin in a dose of 160 mg per day and a dose of 80 mg per day combined with 2 ml of 5 per cent solution of thiamine-chloride in injections. No effect was elicited with an 80 mg/d anaprilin without thiamine. The use of anaprilin and thiamine combined in treatment of IHD patients permits to reduce doses of beta-adrenoblockers as large doses of it may result in heart failure.
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PMID:[Combined use of anaprilin and thiamine in the treatment of ischemic heart disease]. 1461 3

The purpose of the study was to evaluate anti-ischemic and metabolic effects of the cardioselective beta-adrenoblockers nebivolol and retarded metoprolol-metaprolol CR/XL (betalok ZOK) in patients with postinfarction heart dysfunction, associated with type II diabetes mellitus (DM). 40 patients with coronary heart disease (CHD), functional class (FC) II-III exertional angina, postinfarction left ventricular (LV) dysfunction, and NYHA FC II heart failure, associated with type II DM, were randomized into 2 groups. The 20 patients of the 1st group were administered nebivolol in a dose of 1.25 to 5 mg per day, the 20 patients of the 2nd group - betalok ZOK in a dose of 12.5 to 100 mg per day. The course therapy lasted 8 weeks. The effects of the treatment were evaluated using paired veloergometry, echoCG, and lipid spectrum analysis. The study found that nebivolol in a mean dose of 4.2 +/- 0.3 mg per day and betalok ZOK in a dose of 46.5 +/- 6.2 mg per day reduced the frequency and severety of angina attacks (by 73.8% and 67.8%, respectively) and daily nitroglycerine uptake (by 78.6% and 69.1%, respectively), and increased activity tolerance (by 7.9% and 25.3%, respectively). None of the preparations displayed any adverse effects on carbohydrate exchange and blood lipid spectrum. Nebivolol, unlike betalok ZOK, significantly (p = 0.02) reduced triglyceride blood level by 29%. Thus, the new generation cardioselective beta1-adrenoblockers nebivolol and metoprolol CR/XL (betalok ZOK) provide anti-ischemic and metabolic effects in patients with CHD and postinfarction LV dysfunction, associated with type 2 diabetes mellitus. Nebivolol is preferable as far as blood lipid spectrum is concerned.
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PMID:[Antiischemic and metabolic effects of nebivolol and metaprolol CR/XL (betalok ZOK) in patients with postinfarction heart dysfunction]. 1594 Nov 46

130 young and middle age patients of both sexes with chronic form of coronary heart disease: functional class II-III stable exertional angina pectoris including functional class I-III chronic cardiac insufficiency were studied. In protocol 1 cured 70 patients (48 (68.6%) males and 22 (31.4%) females) 32-59 years of age (medium age was 48.4 +/- 3.25 years) with coronary heart disease. In protocol 2 (with prescription of calcium-D3) cured 60 patients (40 (66.7%) males and 20 (33.3%) females) 34-58 years of age (medium age was 47.8 +/- 3.12 years) with coronary heart disease. The groups were comparable on key parameters of disease. All patients had alimentary calcium deficit and (or) risk factors of osteoporosis, instrumental signs (X-ray filming and densitometry) of initial or evident osteoporosis. Correction of alimentary calcium deficit was realized by prescription of 1-3 tablets of calcium- Ds in different food intakes. Positive dynamics in decrease of functional class of angina pectoris and nitroglycerin requirement in both groups was noticed. Negative influence of calcium- D3 on studied indices of coronary heart disease severity was absent. The thirst and dry mouth in patients, who took furosemide, in group 1 were noticed against the background of body weight decrease (p < 0.05) and increase of diuresis. Decrease of the therapy antiarrhythmic action (p < 0.05) in patients, who took hydrochlorothiazide, was noticed too. It leaded to needs of furosemide and hydrochlorothiatide dose correction in protocol 1. In whole use of calcium- D3 together with anti-ischemic drugs in patients with chronic forms of coronary heart disease did not impair clinical course of angina pectoris and did not decrease efficiency of coronary heart disease therapy.
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PMID:[Interaction of calcium drug and vitamin D3 with some medicines used in coronary heart disease therapy]. 1844 6

Based on retrospective analysis of 2446 in-patient cards, autopsy protocols, outpatient medical documentation, prevalence and features of clinical manifestation of cardiorespiratory pathology (CRP): coronary heart disease (CHD) combined with chronic obstructive pulmonary disease (COPD)--1 stage of study, and also (after randomization and forming of main and control groups), efficiency of myocardial cytoprotector trimetazidin (TMZ) at its long-term use (1 year) in combined therapy (2 stage of study): 135 CHD patients (stable exertional angina functional class II-III: 92 and 43 persons respectively) with COPD of medium severe (111 persons) and severe course (24 persons), were studied. It is shown that CRP is prevailed in elder age groups (after 45 years) and noticed in 56.7% CHD patients. More sevenre course with great risk of myocardial infarction with Q wave (twice, p < 0.001), prolongation of painless ischemia (62.4+/-11.5 min/day vs. 22.8+/-11.1 min/day), inclination to complicated rhythm disturbances (38 vs. 21.9, p < 0.05) and earlier clinical manifestations of heart failure (4.3+/-0.6 years earlier, p < 0.001) is typical for CHD with COPD vs. patients without pulmonary pathology. In one year after beginning of treatment with TMZ (35 mg) number of weekly pain attacks was decreased in patients of 1st group vs. 2nd group (at the average -50.8% -29.3% vs. +12.5% +16.6% respectively); significant (p < 0.05) decrease in duration of painless myocardial ischemia was registered. Decrease in number of supraventricular and ventricular extrasystoles (42.7+/-1.48 vs. 20.5+/-1.07 cases in a day, a < 0.0001), significant (p < 0.05) increase in ejection fraction and decrease in left ventricle end-diastolic volume (12.2+/-0.4% E 12.2+/-0.3% respectively), in dimensions of left (10.9+/-0.03%) and right (8.8+/-0.9%) atrium, in risk of development of acute coronary syndrome were noticed in the patients of main group received TMZ. Thus, long-term (not less then 1 year) use of TMZ (35 mg) in combined treatment assists to normalization of cardiovascular indices, decreases cardiovascular complication occurrence, improves disease prognosis and do not has negative side-effects.
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PMID:[Clinicopathogenetic features of coronary heart disease combined with chronic obstructive pulmonary diseases and efficiency of therapy with trimetazidin]. 1872 Jul 10

Results of 145 surgeries for direct myocardial revascularization without artificial circulation are presented. FC III and IV angina of effort was diagnosed in 80.6% and 13.5% of the patients respectively, acute coronary syndrome in 6.5%, past myocardial infarction in 63.8%. Mean left ventricular ejection fraction (EF) prior to surgery was 48.7 +/- 5.1%; it was below 40% in 28.8% of the patients. Three- and two-vessel coronary disease was documented in 54.7% and 35.3% of the patients respectively; 10% of them presented with the affected anterior interventricular branch, 14% with the stenotic trunk of the left coronary artery. Mean revascularization index increased from 22 to 76. The frequency of complete autoarterial revascularization amounted to 42.7%. Sequential and composite grafts were used in 93 and 257 cases respectively. No patient experienced perioperative myocardial infarction, acute disturbance of cerebral circulation, acute renal or cardiac insufficiency. Immediate postoperative hemorrhage requiring resternotomy developed in 0.9% of the patients, 1.2% with suppurative complications needed additional surgical treatment. It is concluded that myocardial revascularization on a beating heart is an efficacious and reliable method ensuring good results in the immediate and late postoperative period. Its success first and foremost depends on the previously gained experience that permits to operate patients with severe multi-vessel coronary artery disease and various concomitant disorders and thereby correct combined pathological conditions. The available data give reason to consider each patients in need of aortocoronary bypass as a candidate for myocardial revascularization on a beating heart regardless of the character and extent of coronary lesions and anatomical feature of the coronary bed.
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PMID:[Multiple aortocoronary bypass without artificial circulation]. 2125 17


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