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)

Acute course and long-term regimens of depin-E administration were evaluated clinically and pharmacologically in 50 patients with chronic obstructive bronchitis (COB) and chronic cor pulmonale (CCP). The drug has three mechanisms of action: arteriolovenodilating, bronchodilating, direct pulmonary vascular. Therapeutic effect was achieved in 80% and 60% of COB and CCP patients, respectively. No response was demonstrated for patients with severe cardiac failure. Depin-E can be recommended for prophylaxis and treatment of CCP, to arrest hypertension crises in lesser circulation, to improve pulmonary circulation, central hemodynamics, exercise tolerance.
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PMID:[Effectiveness of depin-E in patients with chronic bronchitis]. 221 46

Altogether 52 patients with severe forms of congestive cardiac failure (CCF) developing as a result of rheumatic valvular heart diseases, were examined. The patients were divided into 2 groups: 35 living permanently in the lowlands (LL) and 17 living in the highlands (HL). All the patients received corinfar (nifedipine) as part of multimodality therapy at a single dose of 20 mg/m2 with 8-h intervals for 10 days. The results of the administration of the drug in a single dose or in a course were controlled on clinical observation and by instrumental examination including electro- and echocardiography, tetrapolar chest rheography and indirect measurement of pressure in the pulmonary artery (PPA). PPA direct measurement was performed in 8 patients. At both altitudes corinfar resulted in the improvement of the patients' general status, postexercise recovery reduction, a decrease in PPA and mitral regurgitation volume, and an increase in the efficacy of cardiac pump function. Corinfar did not make any noticeable effect on preload and myocardial contractility. Therefore the drug can be recommended for multimodality therapy of CCF both in the high- and lowlands.
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PMID:[The use of corinfar in combined treatment of congestive heart failure at high altitude]. 358 83

The acute effect of nifedipine (Adalat, Bayer) was evaluated in 54 men with a history of transmural myocardial infarction. Haemodynamic changes (in 20 patients) and/or changes in left ventricular radionuclide ejection fraction (LVREF) (41 patients) were studied. 20 to 30 min after sublingual administration of 1 Adalat capsule (10 mg nifedipine) a decrease in arterial pressure and systemic resistance, and an increase in heart rate and cardiac output were observed already at rest. During exercise (50 W) there moreover occurred a decrease in pulmonary artery pressure and in arterial oxygen tension. LVREF was pathologically reduced already at rest, and in most patients exercise led to its further decrease. LVEF increased after Adalat administration only during exercise. In men with a history of myocardial infarction without clinical manifestations of heart failure, Adalat acted predominantly as a peripheral vasodilator; a negative inotropic effect was not demonstrable. The decrease in arterial oxygen tension, observed during exercise, was not clinically important.
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PMID:Evaluation of the effect of nifedipine in men after myocardial infarction. 648 99

The release of Adalat Oros 60 on the Belgian market was justified since it has been clearly demonstrated that the dosage of 60 mg significantly increases the proportion of responders to nifedipine monotherapy. This gives us the opportunity to briefly review the history of nifedipine and to describe the original and ingenious galenic controlled-release formulation known as Oros (Gastrointestinal Therapeutic System, or GITS in the anglo-saxon world). Cleary, nifedipine is a potent calcium antagonist the action of which is now smooth and devoid of the usual ups and downs observed with the regular capsules, even in their Retard form. These abrupt changes in plasma concentrations, with the subsequent variations in heart rate and blood pressure, were dangerous and bothersome. Oros allows plasma concentrations of nifedipine to plateau for at least 24 hours after oral administration. This reduces the incidence of side-effects which remain those classically attributable to calcium antagonists (i.e.: flushes, headaches); interestingly, they tend to appear early after treatment initiation which allows to easily ascribe them to the drug and to quickly assess tolerance. The INSIGHT trial compared the effects on nifedipine Oros to those of a classical diuretic combination (hydrochlorothiazide-amiloride) in 6321 hypertensives who had at least one additional risk factor for cardiovascular disease. The rate of the primary outcome (a composite of cardiovascular death, myocardial infarction, heart failure, stroke) was similar in the two treatment groups, but nifedipine was superior among the subgroup of diabetics. Substudies suggested that nifedipine slows the progression of atherosclerotic lesions (carotid and coronary arteries), preserves renal function, and prevents the development of new diabetes.
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PMID:[Medication of the month. Adalat Oros 60 mg]. 1513 4

The year 2004 was not marked by major pharmacological advances, but by confirmation of previous "evidence". Several innovative drugs for stable angina (ranolazine, ivabradine), some interesting results in acute coronary syndrome (PROVE IT study), some classic concepts (cannabinoid receptors and their antagonists such as rimonabant) applied to novel indications (treatment of obesity), hopes for the "sartans" revived in the light of new evidence (VALUE study), advances in the management of diabetes and hypertension (ASCOT and CARDS studies), nebivolol which is not just a betablocker but also produces the NO radical (is this why it decreased the mortality of heart failure in the elderly in the SENIOR study?). In contrast, although Chronadalate did not live up to expectations for coronary insufficiency, the year was marked above all by the much heralded withdrawal of Vioxx for increasing cardiovascular risk. The old adage: primum non nocere springs to mind.
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PMID:[The best of clinical pharmacology in 2004]. 1571 64

Nifedipine (Adalat) is marketed as an anti-hypertensive agent. Nifedipine inhibits voltage-dependent L-type calcium channels, which leads to vascular (and other) smooth muscle relaxation and negative inotropic and chronotropic effects on the heart. Vasodilation, followed by a baroreceptor-mediated increase in sympathetic tone then results in indirect cardiostimulation. Nifedipine was introduced as a tocolytic agent at a time when beta-agonists and magnesium sulphate dominated the arena for the prevention of preterm birth. The oral administration route, the availability of immediate and slow-release preparations, the low incidence of (mild) side effects, and its limited costs explain the attraction to this medication from the obstetric field and its rapid and widespread distribution. Currently, over 40 studies have been published on nifedipine's tocolytic effectiveness, including seven meta-analyses. The quality of the studies suffers particularly from performance bias because the majority of them failed to ensure adequate blinding to treatment both for providers and patients. Concerns about other methodological flaws include measurements, outcome assessment and attrition bias. In particular, the safety aspects of nifedipine for tocolysis have been under-assessed. Conclusions from the meta-analyses, favouring the use of nifedipine as a tocolytic agent, are not supported by close examination of the data. The tocolytic effectiveness and "safety" of nifedipine has been studied primarily in normal pregnancies. Based on its pharmacological properties, one should be cautious to administer nifedipine when the maternal cardiovascular condition is compromised, such as with intrauterine infection, twin pregnancy, maternal hypertension, cardiac disease, etc. Life-threatening pulmonary oedema and/or cardiac failure are definite risks and have been reported. Under such circumstances, the baroreceptor-mediated increase in sympathetic tone may not balance the cardiac-depressant activity of nifedipine.
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PMID:Nifedipine trials: effectiveness and safety aspects. 1571 1

A 50-year-old woman presented with combined systolic and diastolic heart failure and Raynaud's phenomenon with painful necrotic lesions around several nail beds. Several clinical criteria and the specific biochemical findings lead to the diagnosis of mixed connective tissue disease (MCTD) which is an autoimmune connective tissue disease characterized by cutaneous and visceral fibrosis and widespread vascular pathology.After treatment with diuretics, angiotensin-converting enzyme inhibitors (ACE-inhibitor) and beta blockers the heart failure symptoms disappeared and the ejection fraction improved. The severe pain in the hands due to Raynaud's phenomenon diminished only after treatment with calcium channel blocker nifedipine (Adalat, 10 mg, PO, Bayer HealthCare, Germany) without affecting the cardiovascular status. Cardiac involvement in connective tissue disease is not uncommon, but to our knowledge we present here the first case of MCTD with a combined systolic and diastolic heart failure as primary manifestation.
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PMID:Combined systolic and diastolic heart failure as the first presentation of mixed connective tissue disease. 1782 6