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)

Twenty patients (ten with mitral and/or aortic valve disease and ten with ischemic heart disease, all in the New York Heart Association class IV, aged between 18 and 74 yr, with cardiogenic pulmonary edema unresponsive to drug treatment) were treated with polysulphone membrane ultrafiltration (UF) in a veno-venous circuit. All patients had dyspnea, pulmonary rales, hypoxemia, tachycardia, hypotension, overhydration, radiologic evidence of engorged pulmonary vasculature, and Kerley-B lines. Systemic and pulmonary arterial pressures, cardiac output (by thermodilution), and intrapulmonary shunt fraction (Qsp/Qt) were determined and chest x-ray was obtained at the beginning and the end of UF. Average duration of the treatment was 150 +/- 28 min; UF volume averaged 3000 +/- 170 ml. UF reduced the Qsp/Qt by 58% from control condition, and did not significantly affect hemodynamic variables. Chest x-rays documented clearing of alveolar edema and venous congestion. These changes were associated with unequivocal clinical improvement and no mechanical ventilation was necessary to improve gas exchange. Short-term fluid subtraction did not result in undesired circulatory alternations. Because the ultrafiltrate composition is similar to plasmatic fluid, no modification in the plasma osmolarity was detected. In conclusion, UF may be considered an effective tool for the treatment of acute pulmonary edema refractory to drug therapy, as an alternative to mechanical ventilation, and as a remedy for excessive extravascular lung water.
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PMID:Isolated ultrafiltration in cardiogenic pulmonary edema. 229 64

Isolated adult rat myocytes were used to develop an in vitro model of myocardial ischemia. Freshly isolated myocytes were spun into a cell pellet to limit extracellular volume. Excess supernatant was removed and the pellet was covered with mineral oil and incubated in a temperature controlled water bath. After various periods of incubation, cells were analyzed for adenine nucleotide levels, lactate accumulation, rate of cell death, and cell morphology. Adenine nucleotide profiles after 60 min incubation at 37 degrees C showed marked depletion of adenosine triphosphate (ATP) and large increases in adenosine monophosphate (AMP), adenosine, inosine, and lactate and no significant difference in levels of inosine monophosphate. These results are consistent with ischemic conditions. Reduction of the incubation temperature to 34 and 30 degrees C slowed the rate of cell squaring and the onset of cell death. Resuspension of ischemic cells after 30, 45, 60 and 90 min incubation in hypotonic buffer (170 mosmol) to induce acute cell swelling caused an increase in the number of non-viable cells at each time point. Control cells and ischemic cells incubated less than 30 min did not show increases in non-viable cells when subjected to hypotonic swelling. Morphological analysis revealed that isolated myocytes respond to ischemia in a heterogeneous fashion and exhibit changes at both light and electron microscopic levels similar to those seen in other ischemic models. These results indicate that pelleted isolated adult rat myocytes may be a useful in vitro model to study myocardial ischemic cells injury.
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PMID:An in vitro model of myocardial ischemia utilizing isolated adult rat myocytes. 232 36

Because of an epidemiologic association of decreased risk of death from ischemic heart disease with moderate use of alcoholic beverages, and because numerous abnormalities found in people with ischemic heart disease are also found in animals deficient in copper, rats were fed a diet deficient in copper and were given either beer or water to drink. Rats drinking beer lived nearly six times as long and had lower plasma cholesterol, less cardiac enlargement, and higher liver copper. Apparent absorption and biological half-life of oral radiocopper were increased by beer. The effects were not attributable to alcohol, chromium, or copper in beer. Beer intakes were similar to those of some people in the United States. Results may explain seasonal cycles in plasma cholesterol and may be germane to the epidemiology of ischemic heart disease because diets in the United States seem to be low in copper.
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PMID:Beer mitigates some effects of copper deficiency in rats. 233 45

Health problems at a heavy metal mining Superfund site were surveyed using prevalence information from 1980-85. Current environmental exposures include lead and cadmium in drinking water, mine wastes, and surface soils. Age- and sex-specific illness rates in whites in an exposed town (Galena) were compared with similar rates in two control towns. Multivariate analyses of morbidity data examined statistically significant risk factors for relevant illness in the three towns. Mortality rates for 1980-85 for white residents of Galena and for the U.S. were compared using univariate analysis. Among residents of the three towns who had lived there at least 5 years prior to 1980, there was either a statistically significant or borderline excess reported prevalence in Galena of chronic kidney disease (females aged greater than or equal to 65), heart disease (females aged greater than or equal to 45), skin cancer (males aged 45-64), and anemia (females aged 45-64). Multivariate analyses revealed statistically significant associations of stroke, chronic kidney disease, hypertension, heart disease, skin cancer, and anemia with variables related to Galena exposure. Personal physicians were contacted to confirm the information provided by the subjects; validity was good for all reported illnesses except chronic kidney disease. A statistically significant excess of deaths from hypertensive disease (females aged greater than or equal to 65), ischemic heart disease (males and females aged greater than or equal to 65), and stroke (females aged greater than or equal to 65) was found in residents of Galena City. This study confirms that environmental agents in Galena are associated with, and may have contributed to, the causation of several chronic diseases in residents of this community. Further studies are recommended.
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PMID:Health problems in Galena, Kansas: a heavy metal mining Superfund site. 236 37

It has been shown that low-density plasma lipoproteins in patients with ischemic heart disease and hypertriglyceridemia are heavier in density, smaller in size, more negatively charged and more inclined to peroxide modification and aggregation than in healthy persons. The protein in the composition of such lipoproteins deviates towards the water phase, which may result in the masking of the domen, recognized by the BE-receptor and may lead to hyperlipidemia of a retaining character.
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PMID:[Properties of plasma low density lipoproteins in patients with hypertriglyceridemia and ischemic heart disease]. 239 21

Dietary fat-type and copper (Cu) deficiency have been independently identified as potentially important factors in the etiology of ischemic heart disease (IHD); a disease that has been linked to inflammation and oxygen free radical (OFR) mediated damage. Group (n = 6) of male, weanling, Wistar rats were provided ad libitum with deionized water and control or low Cu diets containing (200 g/kg) either saturated or polyunsaturated fatty acids (SFA or PUFA, respectively) for 56 d. Measurement of several indices of Cu status indicated that both groups fed the low Cu diets were Cu-deficient. SFA consumption resulted in significantly increased hepatic Cu (p less than 0.001) and iron (Fe) (p less than 0.001) concentrations and xanthine oxidase activity (p less than 0.05) and significantly decreased hepatic glucose-6-phosphate dehydrogenase activity (p less than 0.001). Although Cu deficiency resulted in significantly decreased hepatic copper-zinc superoxide dismutase (CuZnSOD) activity (p less than 0.01), no significant effect on the activities of the other hepatic antioxidant enzymes, manganese superoxide dismutase, catalase, and glutathione peroxidase, or glutathione reductase, were observed. Cu deficiency also resulted in significantly decreased hepatic Cu levels (p less than 0.001) and cytochrome c oxidase activity (p less than 0.01). No significant difference in hepatic thiobarbituric acid reactive substances (TBARS), a measure of lipid peroxidation, was found between groups consuming SFA or PUFA, but both Cu-deficient groups exhibited significantly increased hepatic TBARS (p less than 0.001), compared to controls. This was probably owing to the significantly decreased hepatic CuZnSOD activity observed in the Cu-deficient, compared to control animals.
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PMID:Dietary saturated or polyunsaturated fat and copper deficiency in the rat. 248 34

The 2-nitroimidazole fluoromisonidazole is metabolically trapped in viable hypoxic cells in inverse proportion to PO2. This attribute suggests that [18F]fluoromisonidazole may be useful for imaging hypoxic tissue using positron emission tomography. To examine this potential, we studied the pharmacokinetics and biodistribution of [3H]fluoromisonidazole in six open chest dogs. In two normal dogs, plasma and urine samples were collected over a 4-hr period following i.v. injection of the drug. In four animals, regional myocardial ischemia was produced 2 hr prior to drug injection by occlusion of the circumflex coronary artery and maintained during the 4-hr sampling period. In all animals, postmortem samples of myocardium and other organs were obtained and tissue, plasma, and urine tritium activity were determined by liquid scintillation counting. In areas of reduced flow, [3H]fluoromisonidazole accumulated in myocardium in inverse proportion to myocardial blood flow measured by microspheres, indicating enhanced binding in hypoxic tissues. Maximum tissue concentrations in ischemic myocardium were two- to three-fold greater than in normal myocardium and plasma. Plasma clearance data indicate the drug is rapidly distributed into the total-body water, clears from the body with a half-life of 275 +/- 50 min, and undergoes minimal metabolism by 4 hr. We conclude [18F]fluoromisonidazole may be a suitable agent for radionuclide imaging of hypoxic myocardium.
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PMID:Enhanced binding of the hypoxic cell marker [3H]fluoromisonidazole in ischemic myocardium. 273 48

Previous attempts to define the etiology of coronary arterial spasm have been focused on mechanisms such as autonomic nervous dysfunction and/or enhanced platelet activation. In the present study, humoral regulation was investigated in patients with vasospastic angina and scintigraphically documented transient myocardial perfusion abnormalities after a peripheral cold pressor test. Serial changes in angiotensin II, epi- and norepinephrine as well as thromboxane B2 (the stable derivate of thromboxane A2), and malondialdehyde were determined at baseline (I), immediately after 5 minutes cold water hand immersion (II), and following 10 minutes recovery (III). Angiotensin II and epinephrine remained unchanged during observation (I vs II, II vs III: P = NS). Norepinephrine was elevated after cold (I vs II: P less than 0.001) and normalized after 10 minutes (I vs III: P = ns). Thromboxane B2 and malondialdehyde increased continuously (I vs III: P less than 0.05 and I vs III: P less than 0.002, respectively). Further radiothin-layer chromatography results indicate an activation of platelet function during myocardial ischemia. Our results do not establish a cause-effect relationship but, together with other evidence, they may suggest that thromboxane A2 is unlikely to be the cause of spasm. It might, however, play an important role in the maintenance of vasoconstriction.
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PMID:Humoral regulation during cold-induced coronary arterial spasm. 280 8

The effects of two antianginal drugs, nicorandil and isosorbide dinitrate (ISDN), on metabolism and function of the ischemic myocardium were studied in a preparation of multiple coronary occlusions in barbital-anesthetized dogs. The preparation consisted of three 5 min occlusions of the left anterior descending coronary artery interspersed by 30 min of reperfusion. An equihypotensive dose of nicorandil (7.5 micrograms/kg/min) or ISDN (12.5 micrograms/kg/min) was infused 15 min before and during the second occlusion period. Hemodynamics, myocardial segment shortening (%SS), tissue blood flow, and myocardial oxygen consumption were determined throughout. Uptake of free fatty acids (FFA), glucose, and lactate were determined during control and ischemic periods. At the end of the final 30 min reperfusion period, biopsy samples of transmural tissue were taken for analysis of phosphocreatine, adenine nucleotides, and total tissue water content. No major hemodynamic changes were produced by either drug except for a 5 to 10 mm Hg decrease in mean aortic pressure. Compared with untreated and ISDN-treated hearts, hearts of dogs treated with nicorandil exhibited reversal of a significant increase in FFA uptake during recurrent ischemia. This was accompanied by an attenuation of the increase in oxygen extraction and CO2 production in the ischemic zone by nicorandil, but not by ISDN. Nicorandil, but not ISDN, improved %SS during reperfusion. Endocardial ATP and total adenine nucleotides were preserved in both nicorandil- and ISDN-treated hearts. Tissue edema was also attenuated by both compounds. Thus, nicorandil improved both function and metabolism during recurrent myocardial ischemia independent of a hemodynamic effect, whereas ISDN only attenuated the loss of adenine nucleotides and increase in tissue water.
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PMID:Salutary action of nicorandil, a new antianginal drug, on myocardial metabolism during ischemia and on postischemic function in a canine preparation of brief, repetitive coronary artery occlusions: comparison with isosorbide dinitrate. 295 76

Recent evidence indicates that mechanical obstruction of capillaries by leukocytes plays an important role in the "no-reflow" phenomenon in the heart. This entrapment of leukocytes in the microcirculation precedes their recognized role in an inflammatory reaction following ischemia. It is a fundamental rheological mechanism that may be associated with ischemic injury and reflow injury and it has not been elucidated. To explore the accumulation of granulocytes during myocardial ischemia we studied the accumulation of 111Inlabeled autologous granulocytes in acutely ischemic myocardium during 3 h of flow reduction with and without a subsequent period of reflow in open-chest dogs. Granulocytes accumulated in the ischemic endocardium of all animals and, for the majority of dogs, also in the epicardium. Accumulation in the endocardium was enhanced by reperfusion. The entrapped leukocytes may have an influence on the increase in resistance, since regional accumulation of leukocytes in the endocardium inversely correlated with ischemic blood flow during 3 h of ischemia. The tissue water content measured from the wet and dry weights of biopsies showed a significant positive correlation with the number of entrapped granulocytes. These results suggest that collateral flow is an important mechanism of leukocyte arrival early in ischemic myocardium and that reperfusion enhances granulocyte accumulation.
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PMID:Accumulation of polymorphonuclear leukocytes during 3-h experimental myocardial ischemia. 308 32


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