Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The reduction of cardiovascular disease risk in kidney failure involves treatment of modifiable risk factors and provision of proven interventions to patients with established disease. Volume status management is key to blood pressure control. Statins are the agents of choice for the treatment of dyslipidemia. Target hemoglobin levels should be achieved using intravenous iron and erythropoietic agents. Combinations of calcium and noncalcium-containing phosphorus binders and vitamin D and its analogues should be used to attain target parathyroid hormone, phosphorus, and calcium phosphorus product levels. beta Blockers and aspirin are recommended in patients with ischemic heart disease and angiotensin-converting enzyme inhibitors (or angiotensin II receptor blockers), and beta blockers are recommended in patients with heart failure with reduced ejection fraction. In patients who require revascularization, studies suggest a survival benefit of coronary artery bypass graft surgery over percutaneous transluminal coronary angioplasty and coronary artery stenting.
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PMID:Treating the Patient with Kidney Failure to Reduce Cardiovascular Disease Risk. 1521 21

The prevalence of hyperphosphatemia and increased calcium-phosphorus product has never been evaluated in a large multicenter study in a developing country. Our aim is to study the prevalence of hyperphosphatemia in 38 HD centers in Egypt (as an example of a developing country) and to correlate it with different co-morbid conditions and the patient's demographic data. This is a cross-sectional study conducted on 1005 chronic kidney disease stage 5 patients (CKD-stage 5) on HD for a period of more than 1 year in 38 dialysis centers in Egypt. All patients were receiving calcium-based salts as a phosphate binder. Hyperphosphatemia and increased calcium-phosphorus product were evaluated and correlated with different parameters including age, sex, knowledge by diet parameters, HD session duration, the frequency of HD per week, the type of dialysis membrane, the surface area of the dialyzer, dialyzer phosphorus clearance (phosphorus KoA), and the type of dialysate. Other co-morbid medical conditions and evidence of IHD were also investigated. Hyperphosphatemia was present in 69.1% of cases and a high calcium-phosphorus product was present in 30.2%. A higher calcium-phosphorus product was found among males. 83.2% of those with a poor knowledge by diet parameters had hyperphosphatemia compared with 67.6% in patients with a satisfactory knowledge by diet parameters. 72.3% of patients using a membrane with low-to-medium clearance had hyperphosphatemia, compared with 67.2% using a membrane with a high clearance. Seventy-two percent of patients with IHD were hyperphosphatemic compared with 67.6% of the non-ischemic patients. Hyperphosphatemia is a major problem in dialysis patients in developing countries, reflecting differences from developed countries regarding dietary habits, ethnic factors, dialysis quality, types of dialysis membranes, as well as economic factors hampering the use of the more expensive phosphate binders. Extended dialysis hours may be a good alternative solution in developing countries.
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PMID:Hyperphosphatemia among end-stage renal disease patients in developing countries: a forgotten issue? 1621 62

Magnetic resonance spectroscopy (MRS) utilizes magnetic resonance signals from nuclei, such as phosphorus-31, to provide information regarding the biochemical composition and metabolic state of cardiac muscle. This technique is the only method available for noninvasive assessment of cardiac metabolism without the need for the application of external radioactive tracers. MRS provides insights into the role of cardiac energetics in ischemic heart disease, heart failure, hypertrophy, and valve disease. Furthermore, response to therapeutic intervention can be monitored using this method. At present, this technique is used as a research tool, because low spatial and temporal resolution, as well as low reproducibility, precludes its diagnostic use in clinical practice; however, higher-field magnetic resonance systems-using, for example, 7 T-will enable improvements in resolution and reproducibility that may take cardiac MRS into the clinical realm.
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PMID:Detection of myocardial disorders by magnetic resonance spectroscopy. 1864 7

Although cardiovascular disease is a principal cause of death in patients with chronic kidney disease (CKD), it is often asymptomatic in diabetic patients. The coronary artery calcification score (CACS) measured by multidetector computed tomography (MDCT) is useful for screening ischemic heart disease in the general population. We investigated which clinical parameters predict high CACS in predialysis diabetic nephropathy (DN). Participants were 85 patients with DN. Nobody had any history of coronary angioplasty or coronary bypass surgery. We measured blood counts, blood chemistry, bone alkaline phosphatase, intact-PTH, interleukin-6, osteoprotegerin (OPG), hemoglobin A1c, 25-hydroxyvitamin D (25(OH)D) and fetuin-A. CACS and bone mineral density (BMD) were measured by a single 16-slice MDCT and DEXA, respectively. The median value of CACS equaled 256 Agatston units (range 0-4494 units). Stepwise increase in CACS with CKD stage progression was observed (p<0.01 for trend). Simple regression analyses showed that Log (CACS+1) was positively correlated with age, systolic blood pressure, phosphorus and OPG. In addition, it was negatively correlated with nutritional parameters, such as body mass index, albumin, total-cholesterol and 25(OH)D. Fetuin-A and BMD had no impact on CACS. Multiple regression analyses showed that low albumin and high OPG were associated with high CACS. The sensitivity of OPG for detecting CACS>200 was 80%, when the cut-off value was 1.2 ng/mL. In conclusion, CACS increased with CKD stage progression in predialysis DN patients. Serum OPG was positively associated with high CACS and can be a useful screening tool for severe coronary calcification, whereas no association between fetuin-A and CACS was found.
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PMID:Serum osteoprotegerin as a screening tool for coronary artery calcification score in diabetic pre-dialysis patients. 1871 64

Magnetic resonance spectroscopy (MRS) is the only noninvasive, nonradiation exposure technique for the investigation of cardiac metabolism in vivo. MRS uses magnetic resonance signals from nuclei, such as (31)phosphorus, (1)hydrogen, and (23)sodium, to provide comprehensive metabolic and biochemical information about cardiac muscle. This method is highly versatile and can provide metabolic insights into the role of cardiac metabolism, in particular, cardiac energetics, in a wide number of conditions, including hypertensive, valvular, and ischemic heart disease, heart failure, and cardiac transplantation, as well as cardiomyopathies. This method can also be used to monitor patient responses to therapeutic interventions: pharmacologic, surgical, or interventional. When combined with cardiovascular magnetic resonance imaging, MRS enables detailed pathophysiologic insights into the inter-relations among cardiac structure, function, perfusion, and metabolism. However, MRS is currently used primarily as a research tool because of low temporal and spatial resolution and low reproducibility. It is hoped that future technical developments and use of higher magnetic field strengths (such as 7-T) may enable application of cardiac MRS in clinical practice.
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PMID:Magnetic resonance spectroscopy in myocardial disease. 1935 40

One hundred and seventy-eight patients aged 60-95 years who had ischemic heart disease (IHD) and osteoporosis (OP) were examined. The serum levels of total cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, apoA- and apoB-lipoproteins, calcium, phosphorus, alkaline phosphatase, etc. were measured on a Vitalab Flexor E. biochemical analyzer. Bone metabolic markers, such as parathyroid hormone (PTH), osteocalcin (OC), calcitonin (CT), as well as C-terminal telopeptides (CTTP) resulting from collagen type I (in serum and urine) were determined on a Stat Fax photometer. There was a high direct correlation between the serum levels of OC, CTTP and those of calcium and an inverse correlation between the serum concentrations of alkaline phosphatase and PTH and those of calcium in the groups of geriatric patients with IHD and OP. The plots of the function approximating the relationship of the levels of total protein, total and ionized calcium, creatinine, and alkaline phosphatase to age could predict a adaptation potential reduction in these patient groups.
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PMID:[Biochemical markers of bone resorption and formation in geriatric patients with ischemic heart disease and osteoporosis]. 1971 20

Effective myocardial oxygen supply should not be compromised during cardiac surgery as it is essential to avoid circulatory and cardiac dysfunction. Local measurement of myocardial oxygen partial pressure (pO2) was therefore introduced into the operative monitoring of myocardial ischemia. The aim of the present study was to assess whether myocardial oxygen partial pressure correlates with the content of high energy phosphates (HEPs). Seven male rabbits were examined in parallel with measurement of myocardial pO2 by an implanted Clark electrode and 31phosphorus-NMR spectroscopy. The ventilatory management established hyperoxygenation followed by systemic hypoxia with hypercapnia for 20 min. Additionally, analysis of end-expiratory gas composition in combination with blood gas analysis was performed simultaneously, and hemodynamic parameter was recorded. Under hypoxic conditions the cardiovascular system was severely compromised, whereas the myocardial pO2 was only moderately impaired (pO2M 45.0+/-16.0 mm Hg). Immediately before cardiac arrest, low values of arterial and venous pO2 were found (17.6+/-6.0 and 12.9+/-6.1 mm Hg). In contrast to near normal myocardial pO2, HEP content in the myocardium was considerably reduced and inorganic phosphorus was increased. Artificial ventilation leading to systemic hypoxia and eventually circulatory arrest resulted in almost normal myocardial pO2 but severely compromised HEP content. This somewhat unexpected finding requires further clarification, but is in accordance with findings reported previously where regulatory mechanisms have been shown to play a role in the pathophysiology of severe hypoxic conditions such as those for cellular oxygen delivery and demand, P/O coupling and finally control of HEP production facilitating the interaction between respiratory chain and myoglobin oxygen transport.
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PMID:Direct measurement of myocardial oxygen tension and high energy phosphate content under varying ventilatory conditions in rabbits. 1980 83

One hundred and eighty-four patients aged 60-95 years who had ischemic heart disease (IHD) were examined. The serum levels of total cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, apoA- and apoB-lipoproteins, calcium, phosphorus, alkaline phosphatase, etc. were measured on a Vitalab Flexor E. biochemical analyzer. The content of cytokines was determined by solid-phase immunoassay using the Protein contour test systems (State Research Institute of Particularly Pure Biologicals, Saint-Petersburg) on a Stat Fax photometer. There were pronounced changes in the cytokine spectrum in elderly and senile persons despite the fact that they had an adequate lipid spectrum. The increased levels of interleukin (IL)-1 beta and IL-6 suggest that there is an inflammatory reaction whereas those of tumor necrosis factor-alpha may be indicative of the body's autoimmune readiness. There was a high direct correlation of the content of apolipoproteins Apo-B1 and IL-6, as well as LP alpha and IL-6; ApoB1/Apo-A1 and IL-6. A high inverse correlation was found in the content of Apo-B1 and IL-6, which is a poor predictor in old age group patients. There was a mean correlation in the levels of apolipoproteins (B1 and B alpha) and the cytokines IL-1 beta, IL-4, IFN-gamma, TNF-alpha, and IFN-alpha; and there was a mean inverse correlation between the concentrations of apolipoproteins A1 and these cytokines.
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PMID:[Plasma lipids and interleukins in geriatric patients with ischemic heart disease]. 1982 89

Chronic kidney disease is a pathology progressively increasing in the world. Patients with renal disease have an about 20 times greater chance of dying for cardiovascular disease than to reach the stage of dialysis and, compared to general population, they have a three times greater risk of developing acute myocardial infarction. Based on these considerations, we analyzed the most important metabolic changes that occur in renal failure, predisposing to ischemic heart disease. Changes in lipids and calcium-phosphorus metabolism, inflammation and oxidative stress, hyperhomocysteinemia, renin-angiotensin-aldosterone axis, anemia, left ventricular hypertrophy and albuminuria have been considered.
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PMID:[From kidney disease to ischemic heart disease]. 2157 94

Cardiac magnetic resonance spectroscopy (MRS) is a noninvasive tool for the assessment of myocardial metabolism, without the use of radiation or intravenous contrast agents. Using the intrinsic magnetic resonance signals from nuclei, including (31)Phosphorus, (1)Hydrogen, (23)Sodium, and (13)Carbon and, more recently, hyperpolarization techniques, MRS provides a comprehensive metabolic assessment of cardiac muscle. This highly versatile technique has provided insights into the pathophysiology of cardiac metabolism in a wide range of conditions, including ischemic heart disease, heart failure, genetic cardiomyopathies, heart transplantation, hypertensive heart disease, valvular heart disease, and diabetes. In addition, MRS has value in the assessment of prognosis and for monitoring therapeutic strategies in heart failure. However, because of the low temporal and spatial resolution of the technique, MRS has so far been limited to research applications. With higher field strength magnets and novel hyperpolarization techniques, the promise of using MRS for clinical applications may eventually be fulfilled.
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PMID:Clinical cardiac magnetic resonance spectroscopy. 2201 98


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