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)

In order to understand the effect of LVEDP changes caused by contrast injection during angiography on coronary hemodynamics we studied 15 patients (5 congestive CMP, 5 mixed angina and 5 controls). Our results do not cope with an important negative role played from LVEDP changes on coronary hemodynamics and cardiac metabolism. Actually LVEDP increase after ventriculography was balanced by coronary flow increase and impedance reduction even when the latter has been matched with LVEDP. We also observed lactate metabolism changes which are not likely to be provoked by myocardial ischemia, since there was not a definite negativization of % lactate extraction and delta A-VO2 always turned to reduction; this is apparently not in agreement with other Authors who had reported metabolic alterations suggestive for myocardial ischemia, even if they did not calculate delta A-VO2 and coronary flow. This difference could be related to the different populations studied, specially when considering the different functional meaning of coronary stenoses of the same degree at angiography. Is thus the Authors' thought that, when coronary reserve is still adequate, is it possible not to take into account LVEDP, which becomes important in patients with a more advanced coronary disease as in those cases this extravascular impedance factor to coronary flow could take his own worsening role.
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PMID:[Effect of changes of the left ventricular diastolic pressure on the coronary circulation hemodynamics]. 209 49

Duration of symptom-limited exercise on a bicycle ergometer (constant workload of 25 W) was determined in 12 patients with severe chronic congestive heart failure (CHF) due to dilated cardiomyopathy (CMP, 4 patients) or ischemic heart disease (IHD, 8 patients) undergoing hemodynamic monitoring. Mean exercise duration was 214 +/- 124 s and produced severe dyspnea lasting > 5 min in all patients. The next morning, each patient exercised again to the same level; pimobendan (10 mg orally) was then administered, and exercise to the same workload was repeated 4 and 10 h later. Mean +/- SD exercise-induced changes in heart rate (HR, min-1), pulmonary capillary wedge pressure (PCW, mm Hg), cardiac output (CO, L/min-1), and stroke volume index (SVI, ml.min-1) were as follows. At baseline, HR was 85 +/- 17-110 +/- 21 beats/min (p < 0.001), PCW 21 +/- 10-31 +/- 10 mm Hg (p < 0.05), CO 3.7 +/- 1.0-3.9 +/- 1.0 L.min-1 (NS), and SVI, 25 +/- 7-20 +/- 7 ml.m-2 (NS). Four hours after pimobendan administration, HR was 90 +/- 14-113 +/- 21 beats/min (p < 0.001), PCW 11 +/- 7-20 +/- 10 mm Hg (p < 0.05), CO 5.3 +/- 0.7-5.8 +/- 1.0 L.min-1 (NS), and SVI 33 +/- 3-29 +/- 7 ml.m-2 (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hemodynamic performance during exercise in patients with severe chronic congestive heart failure before and after a single dose of pimobendan. 752 56

In the treatment of hyperlipoproteinaemias (HLP) our main effort should be treatment of the patient and not achievement of defined biochemical values. The basic goals of HLP treatment can be defined on the basis of results of intervention studies as follows: reduction of general mortality, reduction of morbidity from IHD, reduction of the incidence of CMP, improved course of ischaemia of the lower extremities, better quality of life of patients with cardiovascular disease and reduced necessity of revascularization surgery. Even if we shall assume that the positive effect of treatment with HLP are in the first place optimization of the lipid spectrum, in particular a drop of total and LDL cholesterol, we cannot overlook so-called "non-lipid" effects of hypolipidaemic agents, in particular statins. In the treatment of patients with HLP it is important in the first place to evaluate the comprehensive risk of the patient, nevertheless it is possible to define "target values" e.g. according to recommendations of "European societies". Even these target values may be the subject of further discussions. It may be however stated that the objective is that total cholesterol should be less than 5 mmol/l, LDL cholesterol less than 3 mmol/l and triglycerides less than 2 mmol/l, HDL cholesterol higher than 1 mmol/l. Attention should be however drawn to the fact that evidence is increasing that in particular patients with already manifest IHD will benefit from even more aggressive treatment and attempts to achieve minimal lipid and lipoprotein values. LDL cholesterol should be reduced to 2.5 mmol/l and triglycerides should be below 2 mmol/l. It is a problem how to achieve these values. The strongest evidence is in favour of statin administration. On the other hand it is important to mention that optimation of the lipid and lipoprotein spectrum may be more important than prescription of a drug from a certain group.
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PMID:[Therapeutic goals in hyperlipoproteinemia]. 1134 52