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

Glycolysis is slow in the heart, especially in the cardiomyopathic heart. Glycolysis is partially rate-limited by phosphofructokinase (PFK), an enzyme which is inhibited by calcium (Ca2+)i and hydrogen ions (H+)i and activated by cAMP. (H+)i and (Ca2+)i are augmented in cardiomyopathy. With glucose as the only substrate (NADH)/(NAD) the phosphorylation potential and developed pressure were significantly lower, and concentrations of phosphomonoester sugars and hydrogen ions (H+)i were significantly higher in isolated cardiomyopathic hearts as compared to healthy hamster hearts. Pyruvate lowered diastolic (Ca2+)i in cardiomyopathic hamster hearts. With pyruvate as the substrate (NADH)/(NAD), the phosphorylation potential and developed pressure increased significantly and concentrations of phosphomonoester sugars (PME), (H+)i and diastolic (Ca2+)i decreased significantly in myopathic hamster hearts. The results suggest that late heart failure in the myopathic hamster is associated with calcium and/or hydrogen ion-induced inhibition of glycolysis.
 ...
PMID:Glycolysis in heart failure: a 31P-NMR and surface fluorometry study. 224 66

Twelve outpatients with type II diabetes mellitus and mild clinical signs and history of cardiac failure were studied to assess the effects of ibopamine on glucose and lipid metabolism. For the assessment of cardiac failure a clinical score was computed, based on the evidence of dyspnea and ankle oedema. The patients were randomly allocated to ibopamine 100 mg t.i.d. or placebo in a double-blind cross-over 3 weeks design. Daily plasma glucose profile, glycaemia and plasma insulin during glucose tolerance test, serum C-peptide, lactacidemia, free fatty acids, triglycerides, urinary glucose, diuresis and clinical evaluation were the studied parameters. During the study, a clinically favourable trend for ibopamine was observed, as far as cardiac failure was concerned. No significant differences were found between ibopamine and placebo in any of the metabolic parameters. No change in diet or in the previous dosage of the antidiabetic drugs occurred during the study in any patient. We conclude that ibopamine 100 mg t.i.d. does not affect metabolic control and lipid pattern in type II diabetic patients, therefore representing a safe tool for the treatment of chronic heart failure in these patients.
 ...
PMID:Safety of ibopamine in type II diabetic patients with mild chronic heart failure. A double-blind cross-over study. 227 53

The article reports the efficacy and tolerability of a new slow-release formulation of furosemide (Lasix Retard) given to an elderly (mean: 72 years, range 48-92) population (n = 115, 77 females) suffering from hypertension or heart failure. In 34 of 52 patients with heart failure the clinical condition improved. Lasix Retard reduced blood pressure significantly from 187/99 to 166/93 after one year on 30 mg/day (n = 19). It was found that Lasix Retard replaces thiazide diuretics without causing any significant change in blood pressure. There were no significant changes in metabolic indicators (S-potassium, S-urate, S-glucose). Side effects were in the same range as reported for thiazide diuretics. There were 33 (29%) drop-outs.
 ...
PMID:[Furosemide capsules in the treatment of hypertension or heart failure in the elderly in general practice]. 233 10

The discovery of insulin in 1922 aroused immediate clinical interest in its use in heart disease. In severe heart failure, insulin release is suppressed by the combined effect of poor pancreatic perfusion and by increased sympathetic activity. In these circumstances, myocardial metabolism of glucose may break down through the deficiency of insulin. Because of this, glucose, insulin and potassium solution (GIK solution) has been used in cardiopulmonary resuscitation. However, its mechanism is not yet fully known. This study was designed to determine the effect of insulin on cardiac muscle at various temperatures. The mechanical response of papillary muscle isolated from guinea pig ventricle was observed under various thermal conditions (23-37 degrees C). Twitch tension was increased by the administration of 0.2 I.U./ml insulin under each thermal condition. In all circumstances, the increase in contractile force was noted about 2 min after the administration of insulin. The effect of insulin on 20 preparations demonstrated the mean maximum contractile force was 226% ( +/- 34 S.D., n = 5) in 37 degrees C, 194% ( +/- 36 S.D., n = 5) in 30 degrees C, 190% ( +/- 30 S.D., n = 5) in 27 degrees C and 200% ( +/- 36 S.D., n = 5) in in 23 degrees C. The differences between different temperatures was not significant. The effect of insulin during depression Na-K pump by high concentration of ouabain (g-strophanthin, 10(-5) M) was also observed. Insulin (0.2 I.U./ml) was administered when the papillary muscle showed no response to electrical stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Response of isolated guinea pig myocardium to insulin therapy during normothermia and graded hypothermia. 242 78

Acute ischemic heart failure was induced in eight dogs by coronary embolization. Severe depression of the left ventricular (LV) performance was evidenced. At 15 min after the embolization procedure, dopamine was infused at a dosage sufficient to increase the maximum rate of LV pressure rise (LVdP/dtmax) by approximately 50%. The significant improvement in cardiac performance was obtained at unaltered myocardial oxygen consumption (MVo2). Dopamine infusion was concluded, and after a stabilization period 300 IU of insulin was injected. This was followed by the infusion of glucose and potassium to maintain levels. Insulin significantly improved the performance of the failing left ventricle at unaltered MVo2, but to a lesser extent than did dopamine. Additional dopamine infusion further significantly improved cardiac performance. The net effect of insulin and dopamine in combination as compared with dopamine alone was a significantly greater increase in stroke volume and cardiac output due to a more pronounced decrease in total peripheral resistance. Dopamine increased arterial concentrations and myocardial uptake of free fatty acids (FFA). The net metabolic effect of insulin and dopamine in combination as compared with dopamine alone was a shift in myocardial substrate uptake from FFA to carbohydrates.
 ...
PMID:Hemodynamic and metabolic effects of dopamine and insulin during acute left ventricular failure in dogs. 242 68

beta-Blockers reduce hypertension effectively and safely. However, their overall efficacy is a balance between their influence on blood pressure and their influence on other important risk factors. Thus, whereas a drug may ameliorate the primary blood pressure marker of the syndrome, this effect may be negated by enhancement of aggressive cofactors. The evolution of the beta-blockers exemplifies how this potentially dangerous conflict may be counteracted. The latest "third-generation" agents, such as celiprolol, not only achieve their primary objective of lowering blood pressure, but also have the potential to simultaneously reverse some of the deleterious cofactors. For example, celiprolol reduces the threat of atheroma by lowering serum cholesterol, and enhances the efficacy of myocardial oxygen utilization in heart failure by reducing plasma triglyceride metabolism. Its ability to reduce fibrinogen and its lack of effect on glucose metabolism are additional positive factors. Celiprolol also provides the combined pharmacodynamic advantages of vasodilatation and inotropic support of the heart, and it attenuates the myocardial oxygen-wasting effects of sympathoadrenal stimulation. These attributes all make a positive contribution to cardiovascular risk reversal in the hypertensive patient.
 ...
PMID:Celiprolol and risk factor reversal in hypertension. 248 88

A randomized, single-blind controlled study intended to assess the potential benefits of intravenous amiodarone in anterior myocardial infarction is presented. Three hundred nineteen patients entered the study, 159 received amiodarone infusion, and 160 received glucose-insulin-potassium (GIK) infusion. Basal characteristics were similar in the two experimental groups, who were randomized on a consecutive basis. Exclusion criteria were shock or pulmonary edema, hypotension, inferoposterior infarction, bradycardia, antrioventricular block, severe diabetes, and other major diseases. Patients aged 27 to 70 years, with a Q-wave anterior infarction, initiated 12-40 hours earlier at the time of admission, entered the trial. Other entry criteria were heart rate higher than 80 beats/min and systolic blood pressure higher than 100 mmHg. Amiodarone was administered in saline infusion 10-20 mg/kg, within 4 to 10 hours, through a central vein. GIK infusion consisted of 150-300 g of glucose, 25-50 IU of insulin, and 80-120 mEq of KCl in 1000 cc of water at a rate of 1.5-2.0 ml/g/hour. Both groups received digitalis, nitrates, sedatives, and diuretics as needed. Although individually the major endpoints of death, reinfarction, and sustained supraventricular and ventricular arrhythmias did not differ significantly, each was less in the amiodarone group than in the control, and the sum of all adverse events was significantly lower for the amiodarone patients (p less than 001). Heart failure and conduction disturbances were not different in the two groups. This study shows that amiodarone, with its vasodilating and antiarrhythmic properties, may be beneficial in acute anterior infarction, but further studies on larger populations will be necessary in order to show a reduction of mortality rate.
 ...
PMID:Intravenous amiodarone in acute anterior myocardial infarction: a controlled study. 248 93

Nine normal subjects and 6 coronary patients (aged 26 to 53 years) who had survived myocardial infarction more than 3 years before and showed no clinical signs of heart failure, obesity, hypertension and diabetes mellitus, while having normal glucose tolerance test values, were exposed to the insulin test in combination with physical stress in the presence of clinically manifest hypoglycemia. Plasma and erythrocyte glucose and immunoreactive insulin, and urinary excretion of catecholamines were measured. Coronary patients showed considerably increased erythrocyte immunoreactive insulin levels, recorded immediately upon discontinuation of exercise, while their sympathoadrenal hormonal activation was less significant, as compared to normal subjects. The combination of the insulin test and exercise in coronary patients with normal glucose tolerance values helps to detect disturbances of regulatory mechanisms at the erythrocyte level and can be used as an adjuvant method for the assessment of latent carbohydrate metabolic disorders.
 ...
PMID:[Characteristics of hormonal regulation in patients with ischemic heart disease after the insulin test combined with physical load]. 266 6

Refractory pump failure after cardiopulmonary bypass carries a high mortality. To assess the effectiveness of metabolic support for the heart in patients with refractory heart failure after hypothermic ischemic arrest for aortocoronary bypass surgery, we randomly assigned 22 patients to receive either intravenous glucose (50%), insulin (80 units/I), and potassium (100 meq/l) (GIK) infused at a rate of 1 ml/kg/hr for up to 48 hours or glucose (5%) and NaCl (0.225%) infused at the same rate (control). All patients required inotropic drug support, received intra-aortic balloon pump assistance, and had an initial mean cardiac index (CI) of 2.5 l/min/m2. At 12 and 24 hours, CI had risen significantly in the GIK but not in the control group (3.6 and 3.4 l/min/m2 vs. 2.5 and 2.7 l/min/m2, p less than 0.005). Time on the intra-aortic balloon pump (39 vs. 61 hours) and requirements for inotropic drug support were also significantly less in the GIK compared with the control group. Although the number of patients was relatively small, the GIK group also showed a trend for improved long-term survival: at 60 days after surgery, there were 10 of 11 survivors in the GIK-treated group compared with seven of 11 survivors in the control group. Although the exact mechanism for the beneficial effects of GIK on myocardial contractility remains to be elucidated, we conclude that GIK is safe and effective in the treatment of refractory left ventricular failure after aortocoronary bypass surgery.
 ...
PMID:Efficacy of metabolic support with glucose-insulin-potassium for left ventricular pump failure after aortocoronary bypass surgery. 267 Mar 31

A report is given on a 52-year-old female patient who showed catecholamine-refractory cardiac failure after double valve replacement. Maximum dosages of dopamine, dobutamine and epinephrine could not effect a sufficient left ventricular function. As "ultima ratio", the application of 1 g/kg b.w./min glucose and 1.5 IU/kg b.w./min insulin reversed the apparently hopeless situation. The decisive advantage of cardiac nutrition using glucose and insulin lies in an anabolic action with resynthesis of high energetic phosphates for improving the inotropic capacity of the heart.
 ...
PMID:[Cardiac resuscitation using glucose-insulin--a case report]. 267 87


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