Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0432222 (SEM)
 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The hemodynamic and clinical effects of OPC-8212, a newly synthesized, orally effective inotropic agent, were assessed for the first time in ten patients with severe congestive heart failure by means of right heart catheterization with a Swan-Ganz catheter. Cardiac output was determined by the thermodilution technique. Patients received a single oral dose of 6 mg/kg. To determine the magnitude and time-course of the effects of OPC-8212, measurements were made during an observation period before and 2, 4, 8, and 12 h after administration. Blood was also taken at these times for measurement of the concentration of plasma OPC-8212. No large meals were allowed during the first 4 h. After the single oral dose of OPC-8212, plasma concentrations increased rapidly, reaching an effective level after 8 h and peaking at 12 h. Hemodynamic performance improved as the mean OPC-8212 plasma level increased, with the maximum effect being observed between 8 and 12 h after acute administration of the drug. At 8 h, the cardiac index was increased from the baseline value of 2.4 +/- 0.2 (SEM) to 2.8 +/- 0.3 1/min/m2 (P less than 0.01). The stroke work index rose from 26.2 +/- 5.1 to 31.7 +/- 60 g . m/m2. The excessive pulmonary artery diastolic pressure fell from 22 +/- 2 to 17 +/- 3 mmHg at 8 h (P less than 0.001) and to 16 +/- 2 mmHg (P less than 0.001) at 12 h. The incidence of ventricular premature beats was not increased and no other side effects were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Acute hemodynamic effects of a new inotropic agent, OPC-8212, on severe congestive heart failure. 372 83

This retrospective study attempted to determine if the mixed venous oxygen saturation (SVO2) is an appropriate therapeutic monitoring parameter in assessing the effectiveness of dobutamine administration in patients with advanced congestive heart failure (CHF). Twelve patients (mean age 56.7 +/- 3.2 years, SEM) with New York Heart Association functional class III or IV (11 patients) received increasing doses of dobutamine with hemodynamic and SVO2 determinations. Dose-dependent hemodynamic improvements occurred with dobutamine administration. The correlation between cardiac output (CO) and SVO2 was poor (r2 = 0.37). One subset of patients (seven patients) had a good correlation (r2 greater than or equal to 0.7), whereas a second subset (five patients) had a weak correlation (r2 less than 0.7) between CO and SVO2. The baseline hemodynamic profile of the latter group demonstrates a trend toward a more seriously ill subset of patients compared to the former group. A parallel relationship between CO and SVO2 may not occur in seriously ill CHF patients. One possible explanation may be a changing oxygen consumption rate in the seriously ill patient, resulting in changes in CO without concomitant changes in SVO2.
 ...
PMID:The value of mixed venous oxygen saturation as a therapeutic indicator in the treatment of advanced congestive heart failure. 382 64

The short-term hemodynamic effects of molsidomine (4 mg sublingually) were evaluated in 13 patients with congestive heart failure following acute myocardial infarction. Right heart catheterization was performed by means of a Swan-Ganz thermodilution catheter. Hemodynamic measurements were made 30, 60, 120, and 180 minutes after the administration of the drug. Molsidomine significantly reduced systolic blood pressure from 121.5 +/- 3.3 (mean +/- SEM) to 111.1 +/- 2.9 mm Hg (p less than 0.001) after 60 minutes, mean right atrial pressure from 6.1 +/- 1 to 2.6 +/- 0.6 mm Hg (p less than 0.0001), mean pulmonary arterial pressure from 29.8 +/- 1.9 to 20.1 +/- 1.3 mm Hg (p less than 0.0001), and left ventricular filling pressure from 20.3 +/- 0.6 to 12.2 +/- 0.7 mm Hg (p less than 0.0001). No significant change occurred in heart rate, diastolic and mean blood pressure, cardiac index, stroke volume index, left ventricular stroke work index, systemic vascular resistance, and pulmonary vascular resistance. No side effects were seen after the administration of molsidomine.
 ...
PMID:Hemodynamic effects of molsidomine in patients with heart failure following acute myocardial infarction. 383 10

To elucidate the effect of bed rest used as an adjunct to increased diuretic treatment, twelve patients with chronic congestive heart failure (CHF) had a 50% increase in loop diuretic dosage and were allocated to either continuous bed rest or bed rest during nights only. The 24-hour bed rest group reduced their weight significantly (mean +/- SEM: 2.00 +/- 0.79 kg, P less than 0.001), whereas the night bed rest group had no significant weight reduction (1.10 +/- 0.37 kg, 0.1 less than P less than 0.2) during three days of observation. Furthermore, the 24-hour bed rest group had a significantly increased diuresis (P less than 0.05) during the first day of the study and a tendency towards increased natriuresis. The cumulated diuresis for the two groups (24-hour bed rest versus night bed rest) during the three days of study were 7773 +/- 700 ml and 5861 +/- 909 ml (0.05 less than P less than 0.1), respectively. Plasma concentrations of adrenaline, noradrenaline, renin and aldosterone were increased, as measured in the supine position. No significant differences were found between the two groups. Plasma concentrations of antidiuretic hormone were within normal limits. In conclusion, continuous bed rest is a reasonable adjunct to diuretic treatment in patients with CHF.
 ...
PMID:Bed rest and increased diuretic treatment in chronic congestive heart failure. 391 4

Magnesium deficiency may play a role in the pathogenesis of atherosclerosis, cardiac arrhythmias, and coronary spasm. Because less than 1% of magnesium (Mg) is extracellular, the serum magnesium (sMg) does not always accurately reflect intracellular Mg stores. To determine the frequency of Mg deficiency in patients with cardiovascular disease, we measured blood mononuclear cell Mg content (mMg) and sMg concentrations in 104 unselected patients admitted to our intensive cardiac care unit (CCU). Twenty-seven normal healthy controls and 33 hypomagnesemic patients with chronic alcoholism and/or malabsorption syndrome served as reference groups. The sMg concentration in the CCU patients was 2.05 +/- 0.03 mg/dl (mean +/- SEM), and did not differ from normal controls (mean 2.01 +/- 0.03 mg/dl). Only 8 of 104 CCU patients were hypomagnesemic (7.7%). mMg in the CCU patients, however, was significantly lower than in the normal controls (1.15 +/- 0.02 micrograms/mg protein and 1.34 +/- 0.02 micrograms/mg protein respectively, p less than 0.001). Fifty-three percent (55 of 104) of CCU patients had mMg contents less than 1.119 micrograms/mg protein, i.e., below that of the lowest normal control. mMg was significantly lower in those patients with congestive heart failure (mMg = 1.08 +/- 0.03 micrograms/mg protein) when compared to those patients without congestive heart failure (1.23 +/- 0.02 micrograms/mg protein, p less than 0.001). We conclude that the incidence of intracellular Mg deficiency in patients with cardiovascular disease is much higher than the sMg would lead one to suspect, and may contribute to clinical cardiovascular morbidity.
 ...
PMID:Low blood mononuclear cell magnesium in intensive cardiac care unit patients. 395 55

The absorption of L-thyroxine (T(4)) and L-triiodothyronine (T(3)) and the fractional rate of conversion of T(4) to T(3) were determined from the turnover rates of T(4) and T(3) in seven patients without endogenous thyroid function during separate treatment periods with these iodothyronines. Serum T(3) concentration was measured by a radioimmunoassay procedure in which the iodothyronines are separated from the plasma proteins before incubation with anti-T(3) antibody. Metabolic clearance rates were calculated by an integral (noncompartmental) approach since the use of single compartment kinetics led to a 40% overestimation of the metabolic clearance rate of T(3). Based on the amount of hormone ingested and the observed hormonal turnover rates, the absorption of T(4) and T(3) (iodothyronine turnover/iodothyronine ingested) in man could be estimated. Absorption of T(3) was complete in three subjects but decreased to 43% in a fourth who was suffering from mild congestive heart failure. Mean T(4) absorption was 48.0+/-2.6% (SEM) for seven subjects. The mean fractional rate of T(4) to T(3) conversion determined during T(4) replacement therapy (T(3) turnover/T(4) turnover) was 42.6% (range 30.7-50.8%). Thus, approximately one-half of the T(4) which was deiodinated was converted to T(3) suggesting that monodeiodination is an obligatory step in the peripheral metabolism of T(4). Calculations based on these results together with other available data suggest that under normal physiologic circumstances the major portion of the T(3) pool is derived from monodeiodination of T(4).
 ...
PMID:Determination of iodothyronine absorption and conversion of L-thyroxine (T 4 ) to L-triiodothyronine (T 3 ) using turnover rate techniques. 469 47

Activation of the sympathetic nervous system, manifested by an increase in heart rate and circulating plasma norepinephrine, can occur in normal subjects when they are given vasodilators. The extent to which this activation occurs in patients with congestive heart failure (CHF) and whether this activation could account for the hemodynamic rebound sometimes observed following abrupt withdrawal of nitroprusside in such patients are unclear. We prospectively and retrospectively studied the effects of nitroprusside on plasma norepinephrine in 38 patients with CHF to determine if acute vasodilator therapy activates this vasoconstrictor system during or following such treatment. Thirty-six of these patients also had plasma renin activity (PRA) measured and plasma arginine vasopressin was measured in 12 patients. Baseline supine plasma norepinephrine (714 +/- 72 pg/ml, +/- SEM), PRA (15 +/- 2 ng/ml/hr), and arginine vasopressin (10 +/- 1 pg/ml) were increased at least twofold in the CHF patients. Nitroprusside (96 +/- 11 micrograms/min) was infused for 63 +/- 5 minutes after achieving an optimal hemodynamic response: cardiac index increased (2.01 +/- 0.08 to 2.67 +/- 0.1 L/min/m2, p less than 0.001), pulmonary artery wedge pressure decreased (25 +/- 1 to 16 +/- 1 mm Hg, p less than 0.001), mean arterial pressure decreased (83 +/- 1 to 72 +/- 1 mm Hg, p less than 0.001), and heart rate was unchanged. Plasma norepinephrine (632 +/- 43 pg/ml), PRA (18 +/- 3 ng/ml/hr), and arginine vasopressin (11 +/- 1 pg/ml) did not change significantly for the group during peak effect of the vasodilator.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:The acute response of plasma norepinephrine, renin activity, and arginine vasopressin to short-term nitroprusside and nitroprusside withdrawal in patients with congestive heart failure. 635 44

Vasodilators, such as nitroglycerin, have been widely used in the treatment of acute and chronic heart failure for therapeutic manipulation of the venous and arterial circulations to improve left ventricular function. We have tested the efficacy of a new formulation for sustained release buccal delivery of nitroglycerin (biological life 5-6 hr) in 21 patients with severe congestive heart failure due to ischaemic cardiomyopathy using maximal treadmill exercise testing and radionuclide angiography. A single-blind placebo-controlled acute and an open chronic phase (4 weeks) of treatment were employed. The mean dose was 23.4 mg daily, and clinical assessment suggested significant improvement in 15 patients. The mean ejection fraction (placebo) of 14.1% +/- 1.6 SEM increased to 19.1% +/- 1.7 (acute) and to 21.6% +/- 1.7 (chronic treatment) (P less than 0.001; n = 16). The mean exercise time increased from 3.02 +/- 0.4 min (basal) to 5.95 +/- 0.6 min (chronic) (P less than 0.001). Segmental wall motion abnormality was shown to improve after treatment for 4 weeks. There were no major side effects. Nine patients were reassessed after 24 weeks on the same regimen; exercise time and left ventricular ejection fraction were similar to the 4-week period, thus demonstrating a sustained improvement in cardiac function and functional capacity. A worthwhile functional and objective haemodynamic improvement was demonstrated in these patients with severe chronic congestive heart failure. This mode of treatment may have useful therapeutic value in the management of patients with a wide range of ischaemic heart failure.
 ...
PMID:Acute and chronic effects of sustained action buccal nitroglycerin in severe congestive heart failure. 642 Mar 52

Five children are described who had persistent, chronic tachycardia and left ventricular dysfunction manifested by decreased left ventricular percent fractional shortening on echocardiogram (five patients) cardiomegaly on chest roentgenogram (three), ventricular or atrial hypertrophy on ECG (three), and symptoms of congestive heart failure (three). After antidysrhythmia therapy and control of the tachycardia, signs and symptoms of congestive heart failure resolved in two infants. Moreover, in each patient signs of cardiomegaly resolved on chest roentgenogram, hypertrophy resolved on ECG, and the fractional shortening improved to normal (mean 20.2% +/- 2.4% SEM before vs 36.2% +/- 2.4%, P = 0.02, after treatment). Evaluation in the child who has dilated cardiomyopathy should include assessment of heart rate and rhythm. Moreover, when persistent tachycardia is found in an asymptomatic child, evaluation of left ventricular function is indicated.
 ...
PMID:Improvement of left ventricular dysfunction after control of persistent tachycardia. 648 31

We prospectively studied 104 patients with severe congestive heart failure (NYHA class III-IV) on admission and after clinical improvement. Clinical and echocardiographic data regarding the presence of secondary tricuspid incompetence were collected. Contrast echocardiographic and morphometric analyses of the inferior vena cava with determination of the diameter, the pulsation, and respiratory changes were carried out and the results were compared to those in a control group. Initially, tricuspid incompetence was present in 57% of the patients as shown by contrast echocardiography, and persisted in 34% after 31 +/- 5 days of appropriate medical treatment. In 43% of the patients, regurgitation of the tricuspid valve could not be clinically detected even though the incompetence was of moderate degree in 6 of these cases. Morphometric changes in the inferior vena cava were a sensitive indicator of the clinical response of the initiated therapy with diuretics and cardiac glycosides. The diameter of the inferior vena cava decreased from 14 +/- 0.8 mm/m2 (mean +/- SEM) to 12 +/- 0.9 mm/m2 (p less than 0.01, the systolic pulsation increased from 3.6% +/- 0.5% to 6% +/- 1% (p less than 0.05), and the respiratory change in diameter correspondingly increased from 16% +/- 3% to 26% +/- 4% (p less than 0.02). There was a linear correlation between the decrease in diameter of the inferior vena cava and in mean right atrial pressure (r = 0.734). The inspiratory increase in the right atrial V-wave was 87% +/- 8% in patients with tricuspid incompetence, whereas patients without tricuspid incompetence showed an inspiratory increase of 63% +/- 11%.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Functional tricuspid insufficiency in patients with severe heart failure; follow-up study using echocardiography]. 671 93


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>