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)

Phenol appears in high concentrations in renal failure with uremia. The effects of this material on contractile activity of isolated cardiac muscle were studied in right ventricular moderator band (MB) of piglets and papillary muscle (PM) of cats and kittens. The muscles were bathed in modified Krebs solution containing 5.6 mM glucose at 30 C and gassed with 95% O2 and 5% CO2. They were paced at 24 contractions per minute, isometrically at Lmax. Over the range 2.5-119.0 mg%, phenol produced dose-related decreases in both developed tension (DT) and maximal rate of tension development (max dT/dt) in MB of piglets. In contrast, the dose-dependent negative inotropic effect of phenol was not detected in feline PM until concentrations in excess of 12.5 mg% were used. Increasing extracellular Ca2+ from 2.5 to 5.0 mM as well as the addition of norepinephrine (3.94 x 10(-7) M) attenuated the phenol-induced cardiac depression in porcine MB. There were no further changes in either DT or max dT/dt when the extracellular Ca2+ was increased to 10 mM. These findings demonstrate that phenol elicits a direct negative inotropic effect on mammalian cardiac muscle that is modified by calcium and norepinephrine. Phenol may participate in the biochemical alterations leading to cardiac failure and death in uremia.
 ...
PMID:Negative inotropic effects of phenol on isolated cardiac muscle. 721 19

Therapy of chronic renal failure requires individual management in diet and vigorous treatment of disorders of fluid and electrolyte metabolism and renal acidosis. Concomitant diseases such as renal hypertension, arrhythmia, cardiac insufficiency, pulmonary complications, gastrointestinal disorders, renal anaemia, affection of central nervous system, disturbance in glucose, uric acid and lipid metabolism and infections, demand careful medication Selection of drugs and doses related to impaired renal functions, is indicated.
 ...
PMID:[Therapy in chronic renal insufficiency (author's transl)]. 724 18

The overall objective with the present investigations was to study the influence of insulin-dependent diabetes mellitus (IDDM) on periodontal conditions and to identify factors that may be predictors for severe periodontal disease in individuals with IDDM. Periodontal conditions were studied in two cross-sectional studies of adult, insulin-dependent diabetics and age-and sex-matched controls. In one study 72 diabetics with short-(SD) and 82 with long-duration (LD) diabetes and 77 controls participated. In the other study 83 LD diabetics and 99 controls took part. The portion of individuals exhibiting severe periodontal disease was larger in the diabetic group than in the control group. Advanced periodontal disease appeared in earlier ages (40-49 years) in the LD diabetics compared to the SD diabetics and controls. In fact, the 40-49-year-old LD diabetics had alveolar bone loss equal to the older controls (60-69 years). LD diabetics exhibited more severe periodontitis than SD diabetics. Some salivary factors were studied in 72 SD and 82 LD diabetics and 77 controls. LD and SD diabetics had a lower stimulated salivary secretion rate and an increased glucose content compared to the controls. The reduction in flow rate, however, was moderate, and all mean values were within the normal limits. The moderately increased glucose content did not result in higher mean numbers of Candida albicans, lactobacilli, and mutans streptococci. The subgingival bacterial species currently considered to be associated with periodontitis were studied in 30 LD diabetics and 34 controls. All these bacterial species were recovered in diabetics as well as controls. More LD diabetics than controls harboured Porphyromonas gingivalis. In the control group the periopathogens were recovered more often in deep periodontal pockets. In the LD group, however, these bacterial species were recovered as often in shallow as in deep periodontal pockets. The medical status of 39 matched pairs of LD diabetics was analysed. One in each pair had severe periodontal disease while the other had no/minor symptoms of periodontal disease. Biochemical analyses and clinical variables routinely used in monitoring diabetics failed to discriminate between diabetics with severe and minor periodontal disease. Diabetics with severe periodontal disease, however, showed a higher prevalence of renal disease and cardiovascular complications such as stroke, transient ischemic attacks, angina, myocardial infarct, heart failure, and claudicatio intermittens than diabetics with only minor periodontal disease. This indicates that closer cooperation between the diabetologist and the dentist is necessary in monitoring the diabetic patient.
 ...
PMID:Periodontal disease in adult insulin-dependent diabetics. 763 66

With the development of subtype specific angiotensin II (Ang II) receptor antagonists and their introduction into the treatment of heart failure and hypertension, the regulation of the Ang II receptor with its subtypes AT1 and Ang T2 gains clinical importance. In cell cultures, the number of surface AT1 is clearly down-regulated by Ang II exposure. Down-regulation can be due to reversible internalization, to phosphorylation and to reduced synthesis and involves protein kinase C and phospholipase C mediated pathways. In this respect, the AT1 behaves as a typical G-protein coupled receptor. Aldosterone, cAMP, norepinephrine and extracellular glucose concentrations can contribute to AT1 regulation. There are very few data regarding the regulation of the subtype AT2, indicating modulation by a number of growth factors and by Ang II. In whole animal models receptor regulation deviates partially from cell cultures. In the rat, the two subtypes AT1A and AT1B are differentially regulated and the expression of subtypes is organ specific. In most experiments, including our own experiences, the AT1, in the adrenals was up-regulated by Ang II infusion and down-regulated by angiotensin converting enzyme inhibitors (ACEI) or Ang II receptor antagonists. Differing effects were observed in other organs. In humans, a number of studies seeking an association between Ang II levels, Ang II receptor regulation and physiological events have been conducted in platelets. In pregnant women, a negative correlation between plasma Ang II levels and Ang II binding and an association between receptor regulation and pregnancy-induced hypertension has been described.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Regulation of the angiotensin receptor subtypes in cell cultures, animal models and human diseases. 771 21

The use of phosphodiesterase-III-inhibitors (PDI) as inotropic substances in the treatment of cardiac failure can be associated with hyperglycaemia. This phenomenon could be caused by hepatic events induced by PDI. The purpose of our study was to investigate the effects of the PDI enoximone on hepatic carbohydrate metabolism and bile flow. In the rat liver perfusion model, hepatic glucose and lactate production, portal flow and bile flow were determined. Administration of enoximone (1, 10, 100 microM) increased hepatic glucose output and bile acid-independent bile flow in a dose-dependent manner. The PDI enhanced the glycogenolytic effects of glucagon (from 15.7 to 38.6 mumol glucose/g/20 min), of epinephrine (from 7.1 to 38.7 mumol glucose/g/20 min), of norepinephrine (from 9.8 to 32 mumol/g/20 min) and of phenylephrine (from 25.5 to 40.8 mumol glucose/g/20 min). Furthermore, lactate production was significantly reduced by enoximone. The effect of epinephrine and phenylephrine on portal flow was blocked or diminished by enoximone administration. In summary, it was shown that the PDI enoximone is able to enhance hepatic glucose production. Bile acid-independent bile flow was increased by the inhibition of phosphodiesterase-III. The effects of enoximone and glycogenolytic hormones on glucose release were synergistic. The vasoconstrictive action of catecholamines was reduced or completely prevented by enoximone. In conclusion, enoximone has glycogenolytic, vasodilatory and choleretic properties in the liver.
 ...
PMID:Enhancement of hepatic glucose release and bile flow by the phosphodiesterase-III-inhibitor enoximone in the perfused rat liver. 772 1

Non-insulin-dependent (type 2) diabetes mellitus (NIDDM) affects middle-aged or elderly people who frequently have several other concomitant diseases, especially obesity, hypertension, dyslipidaemias, coronary insufficiency, heart failure and arthropathies. Thus, polymedication is the rule in this population, and the risk of drug interactions is important, particularly in elderly patients. The present review is restricted to the interactions of other drugs with antihyperglycaemic compounds, and will not consider the mirror image, i.e. the interactions of antihyperglycaemic agents with other drugs. Oral antihyperglycaemic agents include sulphonylureas, biguanides--essentially metformin since the withdrawn of phenformin and buformin--and alpha-glucosidase inhibitors, acarbose being the only representative on the market. These drugs can be used alone or in combination to obtain better metabolic control, sometimes with insulin. Drug interactions with antihyperglycaemic agents can be divided into pharmacokinetic and pharmacodynamic interactions. Most pharmacokinetic studies concern sulphonylureas, whose action may be enhanced by numerous other drugs, thus increasing the risk of hypoglycaemia. Such an effect may result essentially from protein binding displacement, inhibition of hepatic metabolism and reduction of renal clearance. Reduction of the hypoglycaemic activity of sulphonylureas due to pharmacokinetic interactions with other drugs appears to be much less frequent. Drug interactions leading to an increase in plasma metformin concentrations, mainly by reducing the renal excretion or the hepatic metabolism of the biguanide, should be avoided to limit the risk of hyperlactaemia. Owing to its mode of action, pharmacokinetic interferences with acarbose are limited to the gastrointestinal tract, but have not been extensively studied yet. Pharmacodynamic interactions are quite numerous and may result in a potentiation of the hypoglycaemic action or, conversely, in a deterioration of blood glucose control. Such interactions may be observed whatever the type of antidiabetic treatment. They result from the intrinsic properties of the coprescribed drug on insulin secretion and action, or on a key step of carbohydrate metabolism. Finally, a combination of 2 to 3 antihyperglycaemic agents is common for treating patients with NIDDM to benefit from the synergistic effect of compounds acting on different sites of carbohydrate metabolism. Possible pharmacokinetic interactions between alpha-glucosidase inhibitors and classical antidiabetic oral agents should be better studied in the diabetic population.
 ...
PMID:Antihyperglycaemic agents. Drug interactions of clinical importance. 774 82

Hypertensive therapy based on diuretics is time-honored. Thiazides represent the most commonly used class of diuretics for uncomplicated hypertension because of economic motivations, their tolerance and efficacy both as monotherapy and in combined treatment with other agents. Clinical studies using diuretics and beta-blockers reported that thiazide treatment prevents the development of malignant hypertension, renal and heart failure, hypertensive retinopathy, and reduces in five years overall mortality of 33%, cardiovascular mortality of 41%, fatal and non-fatal cerebrovascular events of 51% and the risk of coronary events of 15%. The less than expected risk reduction of cardiovascular disease raised many concerns about the possibility of adverse biochemical changes of thiazides through their effects on lipids, electrolytes and glucose metabolism. However, the real clinical significance of these metabolic effects remains actually uncertain and needs further investigation. The treatment of the hypertensive patient cannot be adequately managed using a merely adjunctive step-care criterium. Hypertensive subjects have different haemodynamic, metabolic and endocrine disorders and a tailored treatment should consider the different activities of the various agents as monotherapy or in association in the single patient.
 ...
PMID:[The role of diuretics in antihypertensive therapy]. 779 57

In 18 patients with acute myocardial infarction admitted to the Cardiological Care Department within 6 hours after the onset of chest pain, before administration of drugs and then in the 2nd, 3rd, 5th and 7th day, the levels of glucose, pyruvate, lactate in venous blood, the lactate/pyruvate ratio (L/P) and pH, actual hydrocarbons, PCO2 and PO2 in capillary arterialized were determined. Depending on the clinical status at admission the patients were classified into 2 groups: I--without complications (I class according to Killip-Kimbal; n = 10), and II--with complications (II-IV class of cardiac failure according to Killip-Kimbal and/or complex ventricular arrhythmias e.i. III-V class according to Lown and heart block of Mobitz--type II and III degree; n = 8). None of the patients had diabetes, chronic respiratory tract diseases, renal failure and liver cirrhosis. The control group consisted of 11 healthy persons. On the first day of myocardial infarction, the significant increase of blood glucose, lactate, pyruvate, as well as significant decrease of blood pH, HCO3- and PO2, and non significant increase of L/P ratio were observed in both groups as compared to the control group. Also there were non significant difference of the glucose, lactate, pyruvate L/P ratio and pH, PCO2 and HCO3- values between the I and II group on the first day of the acute myocardial infarction, with exception of the PO2, which was significantly lower in the group II. In the following days an increase of PO2 was observed. Since this effect coincided with a decrease of lactate concentration (significant only in the group II) it could be concluded, that the observed decrease of the lactate concentration resulted from the higher supply of oxygen. The obtained results have shown, that increase of glycaemia values and decrease of PO2 values may be considered as biochemical markers for hemodynamic complications of acute myocardial infarction.
 ...
PMID:[Lactate metabolism in acute myocardial infarction]. 780 May 82

The objective of this study was to investigate the existence of abnormalities of insulin sensitivity in patients with chronic heart failure. Glucose metabolism and insulin resistance were assessed in 10 male patients with severe, chronic heart failure and in 10 matched control subjects. Glucose, insulin and C-peptide concentration profiles were measured following a 0.5 g.kg-1 intravenous glucose tolerance test. Insulin sensitivity (inversely related to insulin resistance) was estimated by minimal modelling analysis of the glucose and insulin profiles. Heart failure patients had similar mean fasting plasma glucose concentration to controls but a significantly greater mean fasting plasma insulin concentration (P = 0.002) and C-peptide concentration (P = 0.02). Plasma glucose response profile was similar in the two groups but the incremental plasma insulin response profile of the heart failure group was significantly greater (P = 0.004). Mean insulin sensitivity was 73% lower in the heart failure patients (P = 0.003). These findings show that patients with severe chronic heart failure are hyperinsulinaemic and insulin resistant compared with a matched health group. This insulin resistance and hyperinsulinaemia may contribute to the progressive deterioration in myocardial function and associated clinical features of fatigue and reduced exercise tolerance seen in heart failure. Interventions designed to overcome or reduce insulin resistance warrant further investigation.
 ...
PMID:Insulin resistance in chronic heart failure. 783 69

Postischemic derangement of myocardial metabolism that is further aggravated by the systemic neuroendocrine response to surgical trauma may explain reversible myocardial dysfunction after cardiac surgical procedures. Since 1991, all patients with signs of cardiac failure after operation for ischemic heart disease (45/515 patients) were treated according to our metabolic strategy. Sixteen patients in whom we previously would have considered use of an intraaortic balloon pump were treated by prolonged unloading of the heart with cardiopulmonary bypass, by glutamate infusion, and by high-dose glucose-insulin-potassium. Rapid improvement in hemodynamic performance was seen in the first hour and almost full recovery within 6 hours in the surviving patients (12/16). None of the 3 patients requiring mechanical assist survived. Our early clinical experience suggests that metabolic support with glutamate and high-dose glucose-insulin-potassium is a safe treatment with a high success rate in reversible cardiac failure.
 ...
PMID:Glutamate and high-dose glucose-insulin-potassium (GIK) in the treatment of severe cardiac failure after cardiac operations. 784 Jun 95


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