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)

Coronary heart diseases (CHD) have high indices of mortality and morbidity. A number of CHD and myocardial ischaemic syndromes such as unstable angina pectoris, sudden death ischaemic heart disease, acute myocardial infarction and ventricular arrhythmias have been associated with losses of myocardial magnesium and potassium. Mg++ ions are essential for regulation of Na+ and K+ transport across cell membranes, including those found in cardiac and vascular smooth muscle cells. Mg++ activates an Na+-K+-ATPase pump which in turn plays a major role in regulating Na+-K+ transport. Loss of cellular Mg++ results in loss of critically important phosphagens: MgATP and creatine phosphate. Thus, under conditions where cellular Mg++ is depleted (e.g. hypoxia, ischaemia, anoxia), the Na+-K+ pump and phosphagen stores will be compromised, leading to alterations in resting membrane potentials. Cellular Mg++ depletion has been found to result in concomitant depletion of K+ in a number of cells, including cardiac and vascular muscles. The consequences of these events are often production of cardiac arrhythmias. Myocardial and vascular injury lead to disturbances in electrolyte transport across cell membranes, whereby Na+ and Ca++ uptakes are enhanced and, just prior or concomitantly, Mg++ and K+ are lost. Such electrolyte disturbances often lead to necrotic foci. Considerable evidence has accumulated to indicate that the extracellular concentration of Mg++ is important in control of arterial tone and blood pressure via pressure via regulation of vascular membrane Mg++-Ca++ exchange sites. A reduction in the extracellular Mg++ concentration can produce hypertension, coronary vasospasm and potentiation of vasoconstrictor agents by allowing excess entry of Ca++; concomitantly, the potency of vasodilator agents is reduced. Alterations in vascular membrane Mg++ results in arterial and arteriolar membranes which are 'leaky', thus contributing to the cellular reduction in K+ and gain of Na+ and Ca+. Alterations in extracellular K+ or Na+ concentrations over physiological ranges, in the face of a Mg++ deficit, can exacerbate the coronary vasospasm noted with reduction in only extracellular Mg++. Since free Mg++ ions are necessary for maintaining Ca+ ions (both plasma membrane-bound and sarcoplasmic reticulum membrane-bound via Ca++ ATPases), intracellular free Mg++ would rise in conditions which result in cellular loss of Mg++, thereby exacerbating and contributing to elevation of blood pressure and coronary vasospasm.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Magnesium, electrolyte transport and coronary vascular tone. 614 22

Ultracytochemical changes in ATPase activity of ischemic myocardial cells were studied in the dog heart by electron microscopy in the early stage of myocardial infarction and compared to the fine structural alterations in the ischemic myocardium. 1) In the normal myocardial cell, ATPase activity was observed intensely in the terminal cisternae (TC) of the sarcoplasmic reticulum (SR), and moderately in the myofilaments in the longitudinal SR and around the gap junctions of the intercalated discs. 2) The most striking change in the ischemic myocardial cells was the reduction in the ATPase reaction product in the TC of the SR and along the gap junctions 60 min after coronary ligation, simultaneously with swelling of the TC and the appearance of mitochondrial dense deposits. The reaction product began to decrease at 30 min on the myofilaments, and for 3 to 12 hours no reaction product was observed except irreversible morphologic changes in 60 to 70% of the longitudinal SR in the ischemic subendocardial cells. 3) A decrease in ATPase activity was recognized in the early stage of myocardial ischemia simultaneously with the fine structural changes of myocardial cells and it is considered to be one of the signs of ischemic irreversibility.
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PMID:Electron microscopic studies on the ATPase activity in myocardial infarction -changes in the early myocardial infarction. 621 2

The molecular consequences of acute myocardial ischemia induced in rabbit hearts by ligation of the left circumflex branch of the coronary artery were assessed in terms of the biochemical properties of subcellular organelles. Mitochondrial alteration, as reflected in progressive decrease in the activity of azide-sensitive ATPase, was apparent as early as 5 min postligation, but the activity of another mitochondrial enzyme, cytochrome c oxidase, was unchanged, even following 60 min of coronary ligation. Sarcolemmal Na+K+-ATPase exhibited a time course of inactivation similar to that of the mitochondrial ATPase, but differed from the latter in that the impairment was not reversed on reperfusion. Cellular levels of ATP, which decreased in parallel with the loss of ATPase activities, also remained depressed following reperfusion. Decreases in lysosomal enzyme latency were noted, but these occurred somewhat later than the sarcolemmal and mitochondrial alterations. Attempts to demonstrate the production of a population of labile lysosomal structures during ischemia were unsuccessful. Similarly, no alterations in the gel electrophoretic profiles of proteins or in the P phosphatidylcholine/P phosphatidylethanolamine ratio of isolated mitochondrial or sarcolemmal membranes from hearts subjected to ischemia and (or) subsequent reperfusion could be found. It is suggested that sarcolemmal Na+,K+-ATPase may serve as a sensitive and readily quantifiable index of irreversible cellular necrosis and, therefore, be of value in assessing the possible beneficial effects of pharmacological interventions.
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PMID:Membrane alterations in acute myocardial ischemia. 625 43

We have investigated alterations in sarcolemmal function that occur during myocardial ischemia. Rabbit ventricles were incubated at 37 degrees C for time periods ranging from 5 min to 2 h. The ischemic tissue was homogenized, and activities of the sarcolemmal enzymes Na+-K+-ATPase, K+-p-nitrophenylphosphatase (K+-pNPPase), and adenylate cyclase were measured in the crude homogenate. Na+-K+-ATPase and K+-pNPPase were substantially inhibited after only 10 min of ischemia, and activities for all three enzymes declined progressively up to 1 h of ischemia, when activities were 37-59% of control. Highly purified sarcolemmal membranes prepared from control tissue and myocardium that had been made ischemic for 1 h showed similar purification of sarcolemmal enzymes, passive Ca2+ binding, and passive permeability to Ca2+. However, the velocity of Na+-Ca2+ exchange in ischemic sarcolemmal vesicles was reduced approximately 50% due to a reduction in Vmax. Although the parallel decline in activities of several sarcolemmal functions might suggest a change in membrane structure, phospholipid and cholesterol contents in ischemic sarcolemma were the same as control.
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PMID:Sodium-calcium exchange and sarcolemmal enzymes in ischemic rabbit hearts. 628 34

A local increase in the extracellular potassium concentration [K+]o, up to about 8 meq/liter either by topical application or intra-arterial infusion of K+ salts, causes arteriolar dilation and decreased resistance to blood flow in systemic vascular beds. Isolated vascular smooth muscle responds to a similar increase in [K+] in the bathing fluid with relaxation if the preparation has some initial active tension. Reduction in [K+] over physiological ranges produces arteriolar constriction and increased resistance to blood flow. K+ vasodilation is accompanied by hyperpolarization of the smooth muscle cell whereas the vasoconstriction is accompanied by depolarization. All these responses can be blocked by ouabain, a potent Na+, K+-ATPase inhibitor. It is therefore thought that K+ vasodilation results from stimulation of the electrogenic Na+-K+ pump whereas the vasoconstriction results from inhibition of this pump. A number of conditions that alter resistance also alter interstitial fluid [K+]. These include exercise, myocardial ischemia, epileptic convulsions, and evoked electrical activity of the somatomotor cortex. Certain findings, including those during administration of ouabain, suggest that changes in [K+] contribute significantly to some of the changes in resistance.
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PMID:Potassium effects on contraction in arterial smooth muscle mediated by Na+, K+-ATPase. 629 24

Ischemic myocardium was produced by occluding the left circumflex coronary artery in anesthetized dogs. Autolyzed myocardium was produced by incubating transmural samples of canine left ventricle at 37 degrees C. Tissue pH was recorded continuously in each model using a microcombination pH electrode impaled into the midmyocardium. The activities of the five mitochondrial inner membrane enzyme complexes of electron transport and coupled oxidative phosphorylation were assayed as a function of time of ischemia or autolysis. While the activities of complex II (succinate-CoQ reductase) and IV (cytochrome c oxidase) were completely stable, that of complex I (NADH-CoQ reductase) decreased markedly, but largely only after 20 min of ischemia or autolysis. At 20 min and beyond, the decrease in the activity of complex I paralleled closely the decrease in whole mitochondrial oxygen uptake with NAD-linked substrates in both models. The activity of complex III (CoQH2-c reductase) decreased at a more gradual rate during ischemia or autolysis, and its rate of decrease paralleled that of succinate-supported oxygen uptake. The activity of complex V (oligomycin-sensitive ATPase) decreased most rapidly (by 40% in only 5 min of autolysis) but nearly leveled off beyond 20 min in the two models. A strikingly similar pattern of differential enzyme lability was observed in isolated control mitochondria incubated at lowered pH values. The results demonstrate 1) differential enzyme lability within the mitochondrial inner membrane, 2) a connection between severity of acidosis and the degree of enzyme activity loss, and 3) the usefulness of simple tissue autolysis as an analogue of in situ myocardial ischemia.
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PMID:Mitochondrial complexes I, II, III, IV, and V in myocardial ischemia and autolysis. 630 12

Activity of Na+, K+-ATPase and the molar ratio "cholesterol/phospholipids" were estimated in erythrocyte membranes of patients with ischemic heart disease, in which an impairment of coronary arteries was documented by means of angiography. Distinct inhibition of the enzymatic activity as well as an increase in the ratio "cholesterol/phospholipids" was observed in erythrocyte membranes of all the patients; the alteration of these parameters was maximal in the patients with IIa and IIb forms of hyperlipoproteinemia. Reverse correlation (r = -0.604) was found between the enzymatic activity in erythrocyte membranes and the "atherogeneity coefficient" in blood plasma lipoproteins. The data obtained suggest that blood plasma lipoproteins are responsible for regulation of cholesterol content in cell membranes and, according to the membrane hypothesis of atherogenesis, this phenomenon is important in development of atherosclerosis.
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PMID:[Na+, K+-ATPase activity and cholesterol content in erythrocyte membranes of patients with coronary atherosclerosis in various forms of dyslipoproteinemia]. 631 64

Left anterior descending coronary artery occlusion in anesthetized pigs produced a stable transmural ischemia characterized by a rapid and then sustained loss of blood flow and mechanical function. After 2 h of occlusion, mitochondria from the ischemic area exhibited a 36 +/- 6% drop in state 3 respiratory activity (QO2) supported by the NAD-linked substrates, glutamate plus malate, but only a 5 +/- 3% decrease in QO2 with succinate plus rotenone. The activity of electron transfer complex I (NADH-CoQ reductase) decreased commensurately by 33 +/- 4% with the decrease in QO2 with NAD-linked substrates. Consistent with the nearly unchanged QO2 with succinate plus rotenone, the activities of electron transfer complexes III and IV decreased only slightly by 9 +/- 5% and 9 +/- 4%, respectively. Mitochondrial ATPase (complex V) activity decreased by 48 +/- 2% with little change in its oligomycin sensitivity. A 48% drop in ATPase activity was shown, by means of oligomycin titrations, to correspond to a 32% decrease in NAD-linked substrate supported QO2. The decreases observed in NADH-CoQ reductase and ATPase activities each account nearly quantitatively for the impaired mitochondrial phosphorylating respiration observed during sustained myocardial ischemia. These results suggest that mitochondrial inner enzyme complexes I and V are important sites of cellular injury in myocardial ischemia.
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PMID:Mitochondrial inner membrane enzyme defects in porcine myocardial ischemia. 645 Nov 85

Cardiogenic endotoxin shock (ES) refers to the intermediate and latter stages of ES characterized by a progressive myocardial dysfunction. This laboratory has been developing the hypothesis that a major etiology of this observed myocardial failure is a progressive state of global ischemia. In order to further test this hypothesis, ES (E coli, Difco Labs, 026:B6, 4 mg/kg) was induced in the canine model (n = 6) and coronary flow, myocardial contractility (dP/dtmax), and systemic hemodynamics were continuously monitored for five hours, following which the cardiac contractile proteins were isolated and characterized. In the ES group, control coronary flow (CF) = 90.5 +/- 3.6 ml/min/100 gm LV, coronary vascular resistance (CVR) = 61.82 X 10(3) +/- 2.28 X 10(3) dyne . sec. cm--5 and dP/dtmax 2,200 +/- 160 mm Hg/sec. Between four and five hours, CF decreased to 58.6 +/- 16 ml/min/100 gm LV, CVR increased to 128.6 X 10(3) +/- 18 X 10(3) dyne . sec. cm--5, and dP/dtmax decreased to 968 +/- 62 mm Hg/sec. Sham animals (n = 7) demonstrated no significant difference in CF, CVR, or dP/dtmax. Control myofibrillar ATPase activity demonstrated 50% activation (specific activity = 0.072 +/- 0.002 mumoles Pi/mg protein . min) at p Ca++ = 6.4, with no significant difference between endocardium and epicardium. ES myofibrils demonstrated 50% activation (specific activity = 0.060 +/- 0.002 mumoles Pi/mg protein . min endocardial, and 0.068 +/- 0.005 mumoles Pi/mg protein . min epicardial at pCa++ = 6.48 and 6.45, respectively, incriminating a change in affinity for Ca++ binding to the regulatory proteins. Thus, it would appear that the documented decrease in myocardial contractility is due in part to a depression of myofibrillar ATPase activity, which is related to a decrease in coronary flow, an increase in coronary vascular resistance, and a state of global myocardial ischemia.
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PMID:Cardiogenic endotoxin shock: coronary flow and contractile protein dysfunction as determinants of depressed cardiac contractility. 645

In a prospective symptom-oriented study, patients with (n = 81) or without (n = 206) digoxin toxicity were not discernible on their serum digoxin concentration (SDC) because of a large overlap between toxic and non-toxic groups. There was, however, a significant difference between the mean values of the groups (p < 0,01). Serum creatinine, the presence or absence of ischemic heart disease, and/or chronic pulmonary heart disease were significantly different (both p < 0,025) between toxic and non-toxic groups. It is concluded that a decision on digitalis toxicity should be made by a synopsis of the influencing factors in the individual case. Dosage, serum creatinine and cardiac status seem to be the most important factors to be taken into account. Lack of agreement between SDC and digoxin effects could be demonstrated in differences in "T 1/2" between SDC and the normalisation of prolonged PQ-time after digoxin withdrawal. The inability of the SDC to describe all alterations important for digitalis effects and side effects seems to be that it does neither mirror the glycoside concentration at the receptor site, nor the changes of receptor affinity, nor the changes of (Na+ + K+)-ATPase activity.
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PMID:Is the determination of serum digoxin concentration useful for the diagnosis of digitalis toxicity? 745 Sep 27


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