Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The influence of patient age on mortality risk and on the incidence of serious hemorrhagic complications after treatment of acute myocardial infarction (AMI) with intravenous streptokinase (SK) and heparin was examined in 120 consecutive patients. No upper age limit was set for patient inclusion. The mortality rate increased abruptly in patients aged 75 years or older such that the 24 patients in that age group had a 10-fold higher in-hospital mortality rate (33% vs 3%) and 1-year mortality rate (42% vs 4%) than the 96 patients younger than 75 years. This increased mortality rate in the elderly patients was related to a 2-fold higher incidence of major hemorrhagic complications (24% vs 11%) and an increased incidence of anterior AMI, healed prior AMI, multiple-vessel coronary artery disease and extensive myocardial necrosis estimated by peak creatine kinase-MB. Hemorrhagic complications were more frequent in women than in men and in patients with diabetes mellitus or systemic hypertension; all of these conditions were more prevalent in patients aged 75 years and older than in those younger than 75 years. In contrast, the incidence of hemorrhagic complications in nondiabetic elderly men (1 of 12) was similar to the incidence of bleeding in the patients younger than 75 years. Based on our data and those from other studies reporting no reduction in mortality in elderly patients with AMI who are treated with intravenous SK, it is recommended that patients aged 75 years or older should not be routinely treated with intravenous SK.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mortality and morbidity rates of patients older and younger than 75 years with acute myocardial infarction treated with intravenous streptokinase. 381 17

The incidence, risk factors and long-term prognosis of complex ventricular arrhythmias after coronary artery bypass graft surgery are not known. Complex ventricular arrhythmias are defined as Lown grades 4a (couplets), 4b (ventricular tachycardia) and 5 (R on T phenomenon). Ninety-two patients with normal left ventricular function who underwent elective coronary artery bypass graft surgery were prospectively evaluated. Ventricular arrhythmias were documented by predischarge 24 hour ambulatory electrocardiographic monitoring; 43% of patients had no or simple ventricular arrhythmias (Lown grades 1 to 3) and 57% had complex ventricular arrhythmias. Risk factors analyzed included age, sex, diabetes, hypertension, smoking, preoperative digoxin or propranolol therapy, cardiopulmonary bypass time, aortic cross-clamp time, number of vessels bypassed, peak creatine kinase (CK) elevation and pericarditis. No risk factor identified patients at higher risk for complex ventricular arrhythmias. Patients were followed up for 6 to 24 months (mean 16). Patients with complex ventricular arrhythmias did not have a higher incidence of sudden death, cardiac death, syncope, angina, myocardial infarction or cerebrovascular accident. It was concluded that: Complex ventricular arrhythmias are common after coronary artery bypass graft surgery. None of the risk factors considered identify high risk patients. Complex ventricular arrhythmias after coronary artery bypass graft surgery do not indicate a poor prognosis in patients with normal left ventricular function.
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PMID:Ventricular arrhythmias after coronary artery bypass graft surgery: incidence, risk factors and long-term prognosis. 387 91

We report two pediatric cases of rhabdomyolysis. This disease involves the destruction of skeletal muscle, which can present with myalgia and a brown-pigmented urine. The first patient presented with acute renal failure, hypertension, and hyponatremia. The second patient was pyrexic, hypernatremic, and hypokalemic, and later developed hypertension. Evidence of rhabdomyolysis in both patients included dark, o-tolidine-positive urine, granular casts in the urinary sediment, and grossly increased activities of creatine kinase (greater than 60 000 U/L) in serum. An uncommonly recognized entity in the pediatric age group, rhabdomyolysis often presents as an acute disease with severe onset but can be diagnosed with relatively simple laboratory tests.
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PMID:Rhabdomyolysis: two pediatric case reports. 396 73

A study was made of the effect of euphylline administration (25 mg/kg) for 20 days on some indicators of carbohydrate, energy, lipid and electrolyte metabolism in blood serum and tissues of the heart, aorta and liver during pituitrin hypertension in rabbits experiencing arterial pressure normalization. It was found that euphylline appreciably decreased hypercholesterolemia and hyperlipoproteinemia seen in hypertension. At the same tine the aortal wall showed a decrease in cholesterol content, in lactate dehydrogenase activity, and the normalization of transketolase activity and calcium concentration. In liver tissue, the activity of glycolytic enzymes was inhibited and cholesterol level declined. The heart muscle manifested a decrease in the activity of glycolytic and pentosephosphate pathway enzymes and in that of creatine kinase. The changes in electrolyte balance included sodium elevation in blood serum, heart and liver tissues.
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PMID:[Effect of euphyllin on metabolic processes in blood and tissues during experimental pituitrin hypertension]. 619 12

Myocardial hypertrophy was produced in the dog by volume overload, secondary to hypertension, and pressure overload to left or right ventricles and in the rat by pressure overload to the left or right ventricles, by elevating thyroxine-levels and secondary to spontaneous hypertension in order to test whether there are changes in the creatine kinase system in hypertrophied heart. Although there was little or no change in total creatine kinase activity, there were changes in the distribution of the creatine kinase isozymes. In the dog, a 4-10-fold increase in the tissue content of MB-creatine kinase was observed for heart chambers with a 40-90% increase in the ratio of ventricular weight to body weight. In the rat, MB-creatine kinase also accumulated in hypertrophied ventricles. For the spontaneously hypertensive rat, the correlation between increased fetal creatine kinase isozymes and increased ratio of ventricular weight to body weight was excellent (r approximately 0.92). During the transition from compensated hypertrophy to failure in the spontaneously hypertensive rat, there is a 50% decrease in mitochondrial creatine kinase activity. P-31 NMR magnetization transfer experiments suggest that flux through the creatine kinase reaction is 3-fold lower than normal in these failing hearts. These results show that there are changes in the distribution of the creatine kinase isozymes in hypertrophied heart and suggest that one of these changes characterizes compensated hypertrophy (increased fetal-type creatine kinase isozymes) while another characterizes the transition to failure (decreased mitochondrial creatine kinase).
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PMID:The hypertrophied myocardium accumulates the MB-creatine kinase isozyme. 624 87

A prospective study of 208 consecutive survivors of acute myocardial infarction was undertaken to determine the differences between Q- and non-Q-wave infarction, concerning data from the history, clinical course, and 6-month follow-up. There were 177 patients with Q-wave infarction and 31 patients with non-Q-wave infarction. There were no significant differences for the following variables: age, sex, diabetes mellitus, smoking, positive family history, hypertension, obesity, previous infarction, history of unstable angina, heart failure or chronic obstructive pulmonary disease (COPD), Killip class in the Coronary Care Unit (CCU), arrhythmias and conduction defects in the CCU as well as drugs used. Patients with non-Q wave infarction had a higher incidence of stable angina before the myocardial infarction and a lower value of creatine kinase (CK) and serum glutamic oxalacetic transferase (SGOT). During the 6-month follow-up, 9 cardiac deaths and 17 reinfarctions occurred, while 74 patients presented angina. There were no differences between the two groups concerning the incidence of cardiac death or angina, but patients with non-Q-wave infarction had a higher incidence of reinfarction at 6 months (p less than 0.001). We conclude that although patients with non-Q-wave myocardial infarction have a lesser degree of myocardial damage, they have a high incidence of early reinfarction which puts them in a high-risk group.
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PMID:Q- versus non-Q-wave myocardial infarction: clinical characteristics and 6-month prognosis. 671 48

The diagnosis of venous insufficiency and hypertension was established in 53 patients using standard diagnostic methods including ascending and descending venography, venous pressure measurements, and photoplethysmography. Autogenous vein valve transplant, which is gaining acceptance as a treatment for this condition, was employed in this group of patients to relieve venous valvular insufficiency. Biopsy specimens of the gastrocnemius muscle were obtained before surgery in all 53 patients and studied pathologically. Three types of morphologic injury were encountered, suggesting that disuse, denervation, and ischemia may each be partially responsible for damage in skeletal muscle subjected to venous insufficiency and hypertension. Skeletal muscle injury probably explains the preoperative elevations of serum creatine kinase levels in many of our patients and may account for the failure of venous pressures to return to normal levels following surgery.
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PMID:Muscle changes in venous insufficiency. 674 10

Myocardial injury was studied in 104 patients undergoing coronary artery grafting without cold chemical cardioplegia using the quantity of the isoenzyme MB of the creatine kinase liberated as an indicator. This method of evaluation, which is said to permit comparison of different techniques of myocardial protection, allowed us to consider the relative importance of several factors believed to have an influence on intraoperative myocardial injury. Indices of significance were duration of symptoms before operation, presence of chronic arterial hypertension, and the type of antiangina treatment employed. Other operative factors included severity of the arterial lesions, number of anastomoses performed, and duration of extracorporeal circulation and of aortic cross-clamping.
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PMID:MB creatine kinase and the evaluation of myocardial injury following aortocoronary bypass operation. 696 45

The prospectively assessed time course of changes in ventricular repolarization during acute myocardial infarction (AMI) is reported in 32 patients admitted 2.0 +/- 1.8 (SD) hours after AMI onset. The initial corrected QT interval (QTc) upon hospitalization was longer (0.52 +/- 0.07 seconds) in the 14 patients developing ventricular tachycardia (VT) within the first 48 hours as compared to QTc (0.47 +/- 0.03 seconds) in the eight patients with frequent ventricular premature beats (VPBs) and to QTc (0.46 +/- 0.03 seconds) in the 10 patients with infrequent VPBs (p less than 0.001; analysis of variance). By the fifth day after AMI onset, the QTc shortened significantly only in the VT group, suggesting a greater initial abnormality of repolarization in these patients. All 32 patients had coronary angiography, radionuclide ventriculography, and myocardial perfusion scintigraphy before hospital discharge. Significant discriminating factors related to early phase VT in AMI included initially longer QT and QTc intervals, faster heart rate, higher peak serum levels of creatine kinase, acute anterior infarction, angiographically documented proximal stenosis of the left anterior descending coronary artery, and scintigraphic evidence of hypoperfusion of the interventricular septum. Prior infarction, angina pectoris, hypertension, multivessel coronary artery disease, and depressed left ventricular ejection fraction did not provide discrimination among the three different ventricular arrhythmia AMI groups. We conclude that (1) the QT interval is frequently prolonged early in AMI, (2) the initial transiently prolonged ventricular repolarization facilitates and predicts complex ventricular tachyarrhythmias within the first 48 hours of AMI, (3) jeopardized blood supply to the interventricular septum frequently coexists, and (4) therapeutic enhancement of rapid recovery of the ventricular repolarization process merits investigation for prevention of VT in AMI.
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PMID:Prolonged QT interval at onset of acute myocardial infarction in predicting early phase ventricular tachycardia. 724 9

We investigated the effect of chronic angiotensin-covering enzyme (ACE) inhibitor treatment on functional and biochemical cardiac parameters in stroke-prone spontaneously hypertensive rats (SHRsp). Animals were treated prenatally and, subsequently, up to the age of 20 weeks with the ACE inhibitor perindopril (0.01 and 1 mg/kg per day). The contribution of endogenous bradykinin potentiation to the actions of the ACE inhibitor was assessed by co-treatment with the bradykinin B2-receptor antagonist, icatibant (500 micrograms/kg/day s.c.), from 6 to 20 weeks of age and by measurement of myocardial prostacyclin and cyclic guanosine monophosphate (GMP) concentrations. Chronic high-dose treatment with perindopril attenuated the development of hypertension and left ventricular hypertrophy while low-dose perindopril treatment had no effect on these parameters. However, low-dose perindopril improved cardiac function of isolated perfused hearts as demonstrated by an increasing left ventricular pressure and dp/dtmax without change in heart rate. Low-dose perindopril further reduced lactate concentrations and the enzymatic activities of lactate dehydrogenase and creatine kinase in the coronary venous effluent and increased tissue concentrations of glycogen, adenosine triphosphate, and creatine kinase in the myocardium. Concomitant chronic bradykinin receptor blockade abolished all ACE inhibitor-induced effects on cardiac function and metabolism. Cardiac prostacylin concentrations were 3-fold elevated in perindopril-treated animals when compared to vehicle-treated controls, while cardiac cyclic GMP concentrations remained unchanged. Our data demonstrate that chronic ACE inhibitor treatment can improve cardiac function and metabolism independently of the antihypertensive and antihypertrophic drug actions by potentiation of endogenous bradykinin.
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PMID:Chronic low-dose treatment with perindopril improves cardiac function in stroke-prone spontaneously hypertensive rats by potentiation of endogenous bradykinin. 748 88


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