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 expression of ischemic heart disease was studied in a large kindred with familial hypercholesterolemia. Tendon xanthomas, multiple generation transmission, and the appearance of bimodality in the distributions of total and low-density lipoprotein cholesterol were found. The segregation ratio was 0.9 in females and 0.43 in males, a difference first apparent during adolescence. The upper quartile of total and low-density lipoprotein cholesterol contained all but two cases of ischemic disease, whereas the lower quartile of high-density lipoprotein cholesterol contained one half of the cases. The ratio of high- to low-density lipoprotein cholesterol (range, 0.06 to 1.6) was less than or equal to 0.20 in each patient with ischemic disease. The association of a low level of high-density lipoprotein cholesterol with ischemic disease persisted after adjustment for differences in other lipids and lipoproteins. A low level of high-density lipoprotein cholesterol, as well as a high level of low-density lipoprotein cholesterol, may influence the development of ischemic heart disease in this disorder.
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PMID:Plasma high-density lipoproteins and ischemic heart disease: studies in a large kindred with familial hypercholesterolemia. 21

The serum cholesterol and triglyceride levels and the incidence of ischemic heart disease were studied in 122 (55 men and 67 women) consecutive heterozygous familial hypercholesterolemic patients in the Hokuriku district of Japan. (1) The mean +/-SD of serum cholesterol level was 354.0 +/- 71.0 mg/100 ml, which was lower than those of the Western countries by about 60--70 mg/100 ml. (2) The mean +/-SD of serum triglyceride level was 116.5 +/- 54.0 mg/100 ml. (3) The average serum cholesterol values in the 20--50-year-old group showed no differences from those of the Western countries. However, in the above 50 years of age group the serum cholesterol levels were much lower than those in the United States. (4) The occurrence of ischemic heart disease in 83 heterozygous familial hypercholesterolemic patients was 43.3%. The incidence of myocardial infarction was 20.5%. Thus, familial hypercholesterolemia is as highly atherogenic as that of the Western countries even in Japan where the low incidence of coronary heart disease in the general population has been attributed to the low level of serum cholesterol.
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PMID:Serum lipids and coronary heart disease in heterozygous familial hypercholesterolemia in the Hokuriku District of Japan. 59 49

Achilles tendon thickness (ATT) of 112 patients with familial hypercholesterolemia (FH) with and without ischemic heart disease (IHD) was measured radiographically and was compared with that of normal subjects. The mean and SD of serum cholesterol in the heterozygotes (107 cases), the homozygotes (5 cases) and the normal subjects (36 cases) were 347 +/- 63, 589 +/- 69 and 187 +/- 30 mg/dl, respectively. The mean and SEM of ATT in the heterozygotes, the homozygotes and the normal subjects were 12.5 +/- 0.4 mm, 18.6 +/- 6.6 mm, and 6.3 +/- 0.2 mm, respectively. Cutaneous xanthomas were observed in 34 out of 112 patients (30.4%). Increased ATT was observed in 95 (84.8%). IHD was diagnosed in 39 (34.8%). The ATT of FH with IHD was significantly thicker than that of FH without IHD (P less than 0.05) and that of normal subjects (p less than 0.001). Thus, the increased ATT evaluated by x-ray was the earliest clinical sign of FH and the measurement of ATT seems to be a useful adjunctive procedure for detecting familial hypercholesterolemic patients and predicting IHD in them.
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PMID:Achilles tendon thickness and ischemic heart disease in familial hypercholesterolemia. 70 7

Atherosclerosis is a fundamental cause of life-threatening disorders, such as ischemic heart disease or stroke. Therefore, prevention and treatment of atherosclerosis is a matter of importance. In atherosclerotic lesions, there are many foam cells which contain large amounts of cholesteryl ester. In particular, most of these foam cells in the early stage of atherosclerosis derive from monocytes/macrophages. Today, foam cell transformation of macrophages in subendothelial space is considered to occur by a mechanism in which macrophages take up oxidized low density lipoprotein. We have already discovered that atherosclerosis of Watanabe heritable hyperlipidemic rabbits, an animal model for hereditary hyperlipidemia and severe atherosclerosis, could be prevented by probucol. This drug was originally developed as an antioxidant, and the mechanism of prevention of atherogenesis with this drug is considered that it prevents oxidative modification of LDL. On the other hand, probucol also causes regression of xanthoma in patients with familial hypercholesterolemia. This effect implies that probucol can be effective for treatment of atheromatous lesions, because xanthoma is a lesion which consists of macrophage-derived foam cells. However, the precise mechanism of probucol in causing regression of xanthoma has not been clarified. Considering these observations, we paid special attention to the oxidative modification of high density lipoprotein (HDL). HDL makes contact with foam cells in subendothelial space and stimulates efflux of cholesterol. This is the very place where oxidative modification of LDL is considered to occur. Therefore, it is rational to attempt to determine what would happen when HDL is oxidized and whether probucol could prevent oxidative modification of HDL.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Studies on atherosclerosis with an animal model]. 161 1

LDL-apheresis is introduced in many cases all over Japan. Among them, evaluation of long-term effect on ischemic heart disease (IHD) has made on 10 cases with homozygous familial hypercholesterolemia (FH) and 49 cases with heterozygous FH. As to homozygous FH, 3 patients had angina pectoris. Mean duration of treatment was 26 months (52 treatments). The changes in total cholesterol (TC) in each treatment was from 426 mg/dl to 151 mg/dl. Improvement in IHD was observed in 5 out of 10 cases. As to heterozygous FH, 17 cases had history of myocardial infarction and 12 had angina pectoris. Mean duration of treatment was 13 months (19 treatments). Mean TC was decreased from 271 mg/dl to 126 mg/dl by each treatment. Regression in Achilles tendon thickenting or skin and palpebral xanthomas was observed. Frequency of anginal attacks decreased in 8 out of 17 cases. Ischemic change in ECG were improved in 3 out of 26 cases. Coronary angiography performed with 2 to 3 years of interval in some cases revealed regression or no progression in coronary stenosis. As a whole, IHD improved in 15 cases and exacerbated in 2 cases. Main side effect was hypotension attack. Bradycardia and anginal attack during treatment were observed in some cases. LDL-apheresis was judged as effective in 25 out of 44 patients with IHD or xanthoma.
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PMID:Long term effect of LDL apheresis in Japan. LDL Apheresis Study Group. 175 69

Non-dietary, non-pharmacological reduction of cholesterol in patients with severe hypercholesterolemia can be obtained by partial ileal by-pass, portacaval shunt operation or liver transplantation. A non-surgical method is apheresis, by which low density and very low density lipoproteins are removed from blood in an extracorporal circulation system. Apheresis methods include plasmapheresis, immunoadsorption, chemical affinity and Double Membrane Filtration. Treatment of a 30 year old man with severe familial hypercholesterolemia and ischaemic heart disease, by LDL-apheresis, resulted in an average decline in serum-cholesterol of 35%. LDL-apheresis is indicated in the treatment of this type of patient and in homozygous familial hypercholesterolemia.
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PMID:[Non-dietary, non-pharmacological treatment of severe hypercholesterolemia]. 185 84

We reported a case of a 48-year-old male with homozygous familial hypercholesterolemia who underwent coronary revascularization successfully. Coronary artery bypass grafting (CABG) utilizing internal mammary artery graft to LAD, and percutaneous transluminal angioplasty for residual stenosis after CABG was able to relieve symptomatic myocardial ischemia. LDL apheresis every two weeks in addition to combined drug treatment had maintained total cholesterol at an acceptable level (120-280 mg/dl) before and after CABG. It was confirmed by repetition of coronary angiography at one year after CABG that all grafts were widely patent, and the native coronary artery did not accelerate the atherosclerotic lesion. It was important in patients with homozygous familial hypercholesterolemia, to carry out active coronary revascularization with reduction of serum cholesterol level by using LDL apheresis.
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PMID:[Coronary revascularization with reduction of serum cholesterol level using LDL apheresis in patient with homozygous familial hypercholesterolemia]. 223 67

We analyzed serum lipoproteins and apolipoprotein E (apo E) from 199 patients in CCU, having ischemic heart disease, and from 211 healthy subjects. It was suggested that serum lipoprotein abnormalities, especially elevated low density lipoprotein (LDL) levels, are closely related to atherogenesis in relatively young patients and subjects with severe coronary lesions. The frequency of apo E-4 was higher and that of E-2 was lower in the CCU group than in the control group. Apo E mutants, E-7 (Glu244----Lys, Glu245----Lys) and E-5 (Glu3 (Glu3----Lys), were also frequent in the CCU group. Apo E isoproteins have higher pI in the order E-2, E-3, E-4, and we observed that LDL-cholesterol levels increased in the same order. The apo E mutants, E-5 and E-7, are also more basic than E-4. These findings suggest that basic apo Es were associated with the development of atherosclerosis. The prevalence of familial hypercholesterolemia (FH) in the CCU group was more than 10 times higher than the reported frequency of FH heterozygotes in normal population. The persistence of marked hypercholesterolemia from infancy probably makes FH patients susceptible to atherosclerosis. Based on the analysis of LDL-receptor protein synthesis, various types of mutations were observed even in phenotypically homozygous FH patients. FH homozygotes were divided into 2 groups, a receptor-negative group and a receptor-defective group. We found a great difference in the frequency of coronary heart disease depending on whether even a small number of receptors were present or not.
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PMID:Hyperlipoproteinemia as a risk factor for ischemic heart disease. 239 26

Heterozygote familial hypercholesterolemia (FH) is a frequent genetic trait (one in 500) that predisposes to coronary atherosclerosis. Male heterozygotes often develop clinical manifestations of coronary heart disease in their fourth or fifth decade, females, about 10 years later. Other risk factors for ischemic heart disease like smoking interact with the gene for FH. Homozygotes and compound heterozygotes (i.e., those who carry two different FH genes) are very rare (one in 1,000,000) have severe hypercholesterolemia with xanthomas, and develop coronary heart disease early in life. FH is caused by one of many different mutations (deletions, insertions, missense, or nonsense mutations) affecting the well-defined low density lipoprotein (LDL) receptor gene on chromosome 19. Some populations that started with a small founder group like the Afrikaners in South Africa and the French Canadians carry only a few FH mutations. The diagnosis of heterozygote FH is often difficult, since physical findings (xanthomas) are frequently absent, and overlap of laboratory test values between affected and nonaffected subjects occurs. The a priori probability of heterozygosity of FH varies from one in 500 in population studies to one in two in family studies and must be considered when assessing borderline quantitative test results based on cholesterol, LDL cholesterol, or LDL-receptor assays. The mutational heterogeneity of FH makes it very difficult to use DNA methodology for population detection. However, direct molecular diagnosis by appropriate DNA probes is possible if the specific LDL receptor defect is known. Indirect molecular diagnosis based on genetic linkage of a common DNA variant of the LDL receptor to the basic defect is often feasible but requires family studies.
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PMID:Genetic aspects of familial hypercholesterolemia and its diagnosis. 256 20

Familial hypercholesterolemia (FH), an autosomal dominant disease caused by mutations in the LDL receptor gene, is five times more frequent in the Afrikaner population of South Africa than it is in the population of the United States and Europe. It has been proposed that the high frequency is due to a founder effect. In this paper, we characterized 24 mutant LDL receptor alleles from 12 Afrikaner individuals homozygous for FH. We identified two mutations that together makeup greater than 95% of the mutant LDL receptor genes represented in our sample. Both mutations were basepair substitutions that result in single-amino acid changes. Each mutation can be detected readily with the polymerase chain reaction and restriction analysis. The finding of two common LDL receptor mutations in the Afrikaner FH homozygotes predicts that these mutations will predominate in the Afrikaner population and that the high frequency of FH is due to a founder effect. The increased incidence of ischemic heart disease in the Afrikaner population may in part be due to the high frequency of these two mutations in the LDL receptor gene.
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PMID:Two common low density lipoprotein receptor gene mutations cause familial hypercholesterolemia in Afrikaners. 256 82


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