RESUMEN
We studied efficiency of a retard form of isosorbide-5-mononitrate (Mono Mac 50D) in patients with stable angina pectoris (NYHA class II and III). This efficiency was assessed by clinical examinations and 24-h Holter ECG monitoring before and after the treatment. 16 patients with angina of functional class II and 12 patients with functional class III received combined treatment: prolonged mononitrate (Mono Mac 50D), disaggregants, beta-blockers, ACE inhibitors and calcium antagonists (on demand). In angina functional class II Mono Mac 50D was given in a single dose 50 mg/day (1 tablet) in the morning for 4 weeks, in functional class III angina the drug was taken for 2 weeks in a dose 50 mg/day, the next two weeks in a dose 100 mg/day once in the morning. The other drugs were taken in moderate recommended doses. After two weeks of treatment with 50 mg/day Mono Mac 50D angina symptoms attenuated (in functional class II) and the patients' condition improved (in functional class III). In elevation of the dose to 100 mg/day the latter patients improved still greater. We think it valid to use a single 50 mg/day dose in angina functional class II and 100 mg once a day in functional class III.
Asunto(s)
Angina de Pecho/tratamiento farmacológico , Dinitrato de Isosorbide/uso terapéutico , Vasodilatadores/uso terapéutico , Adulto , Anciano , Preparaciones de Acción Retardada/uso terapéutico , Esquema de Medicación , Femenino , Humanos , Dinitrato de Isosorbide/análogos & derivados , Masculino , Persona de Mediana EdadRESUMEN
A comprehensive study was made of 140 males aged 26-55 years who were divided into 3 groups: (1) 47 healthy individuals; (2) 67 subjects with early signs of coronary heart disease; and (3) 29 patients with coronary heart disease (Functional Class II). The pattern of chest pain was thoroughly analyzed by a specially developed questionnaire. The results were compared with the data obtained from an interview by Rose's questionnaire. The analysis demonstrated that neither Rose's questionnaire nor the detailed one specially developed by the authors identified subjects with preclinical coronary heart disease.
Asunto(s)
Angina de Pecho/diagnóstico , Dolor en el Pecho/diagnóstico , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad Coronaria/diagnóstico , Adulto , Dolor en el Pecho/etiología , Diagnóstico Diferencial , Prueba de Esfuerzo , Reacciones Falso Negativas , Humanos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
The study demonstrated a decreased level of glucocorticoid receptors (GR) in peripheral blood lymphocytes from hypercholesterolemic subjects, and an elevated level in patients with acute myocardial infarction. In the lymphocytes with a high GR number, dexamethasone inhibited [3H]-thymidine and [3H]-acetate incorporation into DNA and cholesterol, respectively, in the same manner as in the control cells. On the other hand, a decreased GR number resulted in a less efficient dexamethasone inhibition of the incorporation of labeled compounds. These data showed that the sensitivity of lymphocytes to glucocorticoids changed only with a decrease of GR level.
Asunto(s)
Dexametasona/farmacología , Hipercolesterolemia/sangre , Linfocitos/metabolismo , Infarto del Miocardio/sangre , Receptores de Glucocorticoides/metabolismo , Adulto , Colesterol/biosíntesis , ADN/biosíntesis , Dexametasona/metabolismo , Humanos , Linfocitos/efectos de los fármacos , Masculino , Persona de Mediana Edad , Receptores de Glucocorticoides/efectos de los fármacosRESUMEN
Fractional myocardial extraction/release of glutamate, glutamine, alanine, ammonia, asparagine, glucose and lactate was studied in 12 subjects with normal coronary anatomy (controls) and 28 patients with coronary artery disease (CAD) during rest and atrial pacing. At rest patients with CAD showed an increased myocardial extraction of glutamate, glucose and lactate and an augmented glutamine and alanine release compared with controls. In all CAD patients myocardial ammonia and asparagine release was found at rest, while all controls showed myocardial extraction of these compounds. Myocardial glutamate extraction correlated positively with glucose and lactate extraction, glutamine and alanine release and inversely with ammonia release in CAD patients at rest. In patients with two- and three-vessel disease pacing-induced ischaemia resulted in a pronounced decrease in myocardial glutamate extraction and glutamine release, augmented myocardial production of ammonia and asparagine and a conversion of lactate extraction into lactate release. During pacing myocardial glutamate extraction was related to alanine and glutamine release and correlated inversely with ammonia and lactate release in these patients. The results indicate that glutamate extraction is closely connected with glucose and lactate extraction and ammonia binding via glutamine formation in the hearts of CAD patients and, thus, with the energy supply of ischaemic myocardium. An assessment of myocardial exchange of the nitrogenous compounds we have studied, complimentary to lactate, is a promising biochemical test for the identification of ischaemic heart disease in man.
Asunto(s)
Aminoácidos/metabolismo , Amoníaco/metabolismo , Enfermedad Coronaria/metabolismo , Glucosa/metabolismo , Lactatos/metabolismo , Miocardio/metabolismo , Adulto , Alanina/metabolismo , Asparagina/metabolismo , Estimulación Cardíaca Artificial , Enfermedad Coronaria/fisiopatología , Estudios de Evaluación como Asunto , Glutamatos/metabolismo , Glutamina/metabolismo , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Angina de Pecho/fisiopatología , Corazón/fisiopatología , Angina de Pecho/diagnóstico por imagen , Angiografía , Angiografía Coronaria , Electrocardiografía , Prueba de Esfuerzo , Femenino , Pruebas de Función Cardíaca , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Contracción MiocárdicaRESUMEN
Catheterization of the coronary sinus, the atrial stimulation test with repeated ventriculographies and investigation of myocardial metabolism of lactate, and coronary ventriculography were performed in 25 CHD patients. The absence of interrelationships between the gravity of affection of the coronary arteries and changes in left ventricular contractility in the atrial stimulation test, a limited role of quantitative determination of myocardial extraction of lactate and the absence of direct interrelationships between metabolic and mechanical symptoms of myocardial ischemia were established.
Asunto(s)
Estimulación Cardíaca Artificial , Enfermedad Coronaria/diagnóstico , Contracción Miocárdica , Adulto , Cateterismo Cardíaco , Angiografía Coronaria , Enfermedad Coronaria/fisiopatología , Electrocardiografía , Femenino , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/fisiopatología , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/fisiopatología , Hemodinámica , Humanos , Lactatos/sangre , Masculino , Miocardio/metabolismoRESUMEN
Venous blood plasma content of prostaglandins (PG) E, A, and F was studied in myocardial infarction patients using radioimmunoassay. Two types of quantitative changes in the blood plasma PG content were found. These changes were associated with the peculiarities of the clinical course of the disease. The data obtained can evidence the pathogenetic role of endogenous PG in the development of myocardial infarction and its complications.
Asunto(s)
Infarto del Miocardio/sangre , Prostaglandinas A/sangre , Prostaglandinas E/sangre , Prostaglandinas F/sangre , Adulto , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , VenasRESUMEN
The quantitative composition of depressor prostaglandins PGE1 and PGA1 in the plasma of arterial and venous blood and blood from the great cardiac vein was studied in comparison with the values of hemodynamics in dogs with experimental myocardial infarction and cardiogenic shock. The content of prostaglandins in blood plasma was determined by the radioimmune method. The development of acute coronary insufficiency was attended with changes in the quantitative composition of the depressor PGE1 and PGA1 in the plasma of arterial and venous blood and blood from the great cardiac vein. In myocardial infarction and particularly in cardiogenic shock, intensification of PGE1 and PGA1 synthesis and an increase in the consumption of these PG by the myocardium occurred beginning with the first hours following occlusion of the coronary arteries, which suggests that PGE1 and PGA1 may probably take part in the normalization of the activity of the affected heart.