RESUMO
Eighty-five young Mauritian Indians, male survivors of premature myocardial infarction (MI) and thus belonging to a high risk group, were compared with 108 stringently selected controls for a possible association between premature MI and an insertion/deletion (I/D) polymorphism in the gene encoding angiotensin I-converting enzyme (ACE). The frequency of the D allele was 0.42 in the MI group and 0.43 in the control group, and thus no association between I/D polymorphism of ACE with susceptibility to early-onset MI was found in this population group. Other gene components of the renin-angiotensin system and lipid metabolism need to be explored to understand the genetic factors involved in causing MI at an early age.
Assuntos
Etnicidade/genética , Infarto do Miocárdio/etnologia , Peptidil Dipeptidase A/genética , Polimorfismo Genético , Adulto , Idade de Início , Genótipo , Humanos , Índia/etnologia , Masculino , Maurício/epidemiologia , Pessoa de Meia-Idade , Infarto do Miocárdio/enzimologia , Infarto do Miocárdio/genéticaAssuntos
Anemia Falciforme/etnologia , Etnicidade/genética , Globinas/genética , Hemoglobina Falciforme/genética , África/etnologia , Anemia Falciforme/genética , Análise Mutacional de DNA , Etnicidade/história , Haplótipos/genética , História do Século XIX , História do Século XX , Humanos , Índia/etnologia , Maurício/epidemiologia , LinhagemRESUMO
A new (quality of life) visual analogue scale of dyspnoea has been designed to evaluate the severity of dyspnoea in patients with congestive heart failure (CHF). The index has 10 numerical values, rated on a scale from 0-10, each value corresponding to an intensity of breathlessness. Since dyspnoea is a primary symptom that restricts the quality of life in patients with congestive heart failure, the new scale provided a simple, easily comprehensible and inexpensive instrument to assess the severity of breathlessness. We also report the sensitivity of the visual scale of dyspnoea before and after the administration of intravenous injection of a diuretic (frusemide) in CHF patients.
Assuntos
Dispneia/diagnóstico , Insuficiência Cardíaca/complicações , Medição da Dor , Dispneia/etiologia , Furosemida/administração & dosagem , Furosemida/farmacologia , Humanos , Injeções Intravenosas , Masculino , Qualidade de Vida , Sensibilidade e Especificidade , Índice de Gravidade de DoençaRESUMO
A novel 8-bp bi-allelic insertion/deletion polymorphism is described within a polyadenylate stretch in the second intron of the human atrial natriuretic peptide gene locus. This new marker is located in the candidate gene for familial susceptibility to hypertension.
Assuntos
Fator Natriurético Atrial/genética , Poli A/genética , Polimorfismo Genético , Sequência de Bases , Mapeamento Cromossômico , Cromossomos Humanos Par 1 , DNA , Frequência do Gene , Marcadores Genéticos , Humanos , Hipertensão/genética , Dados de Sequência Molecular , Mutação , Deleção de SequênciaRESUMO
A unique two allele polymorphism for both HpaII and SmaI is described in the second intron of the human atrial natriuretic peptide gene. It should be a useful marker of this candidate gene in familial susceptibility to hypertension.
Assuntos
Fator Natriurético Atrial/genética , Polimorfismo Genético , Polimorfismo de Fragmento de Restrição , Alelos , Sequência de Bases , DNA de Cadeia Simples/análise , DNA-Citosina Metilases , Desoxirribonuclease HpaII , Desoxirribonucleases de Sítio Específico do Tipo II , Humanos , Dados de Sequência Molecular , Reação em Cadeia da PolimeraseRESUMO
The ScaI polymorphic site within the stop codon of the human atrial natriuretic peptides (hANP) gene was investigated in Mauritian Indian, black African and French Caucasian populations. A distinct distribution pattern is observed in these three populations.
Assuntos
Fator Natriurético Atrial/genética , Cromossomos Humanos Par 1 , Polimorfismo Genético , Animais , Sequência de Bases , População Negra/genética , Mapeamento Cromossômico , Cricetinae , DNA de Cadeia Simples , Desoxirribonucleases de Sítio Específico do Tipo II , Etnicidade/genética , Frequência do Gene , Humanos , Células Híbridas , Maurício , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , População Branca/genéticaRESUMO
To assess whether an inotropic agent may affect quality of life in severe heart failure, a double-blind, placebo-controlled crossover study was performed in 10 patients over three periods of 3 weeks, including an initial control period of 3 weeks and periods on placebo or enoximone, 150 mg t.d.s. Quality of life was assessed by a questionnaire following initial training of patients to evaluate their symptoms after certain stresses, by visual analogue scales of symptoms, and by objective assessments during graded exercise. Daily dyspnoea score decreased from 33.2 +/- 2 (placebo) to 27.7 +/- 4 (enoximone) (P less than 0.01) and daily fatigue score decreased from 14.8 +/- 2.5 (placebo) to 12.6 +/- 2 (enoximone) (P less than 0.05). There were also significant beneficial responses in the mean daily NYHA class and in the duration of a walking test. Self-assessed global quality of life score increased from 2.7 +/- 0.6 (placebo) to 3.6 +/- 0.8 (enoximone) (P less than 0.05). It was concluded that over periods of 3 weeks, enoximone significantly improved self-assessed quality of life.
Assuntos
Cardiotônicos/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Imidazóis/uso terapêutico , Inibidores de Fosfodiesterase/uso terapêutico , Qualidade de Vida , Cardiotônicos/farmacologia , Avaliação de Medicamentos , Dispneia/tratamento farmacológico , Enoximona , Fadiga/tratamento farmacológico , Humanos , Imidazóis/farmacologia , Inibidores de Fosfodiesterase/farmacologia , Esforço Físico/efeitos dos fármacosRESUMO
Several reports had concluded that nitrates were not efficacious when administered by the oral route, on the basis of experiments which had shown a rapid denitration by the liver enzyme glutathion-organic nitrate reductase. Recent data demonstrate the efficacy of nitrates on parameters measured at cardiac catheterisation and echocardiography on condition that adequate doses are used. Doses commonly used up to now are often inadequate. The demonstration in the blood, after oral administration of adequate doses, of concentration of non-metabolized nitrates which are of the same order as those obtained after sublingual administration of clinically efficacious doses, confirms the efficacy of nitrates administered by the oral route.
Assuntos
Hemodinâmica/efeitos dos fármacos , Nitratos/administração & dosagem , Vasodilatadores/administração & dosagem , Administração Oral , Humanos , Dinitrato de Isossorbida/administração & dosagem , Nitratos/metabolismo , Nitratos/farmacologia , Nitroglicerina/administração & dosagem , Tetranitrato de Pentaeritritol/administração & dosagem , Vasodilatadores/metabolismo , Vasodilatadores/farmacologiaAssuntos
Dinitrato de Isossorbida/metabolismo , Nitroglicerina/metabolismo , Tetranitrato de Pentaeritritol/metabolismo , Administração Oral , Hemodinâmica/efeitos dos fármacos , Humanos , Dinitrato de Isossorbida/administração & dosagem , Dinitrato de Isossorbida/uso terapêutico , Nitroglicerina/administração & dosagem , Nitroglicerina/uso terapêutico , Tetranitrato de Pentaeritritol/administração & dosagem , Tetranitrato de Pentaeritritol/uso terapêuticoAssuntos
Hemodinâmica/efeitos dos fármacos , Dinitrato de Isossorbida/farmacologia , Nitroglicerina/farmacologia , Administração Oral , Pressão Sanguínea/efeitos dos fármacos , Débito Cardíaco/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Humanos , Injeções Intravenosas , Dinitrato de Isossorbida/administração & dosagem , Nitroglicerina/administração & dosagem , Resistência Vascular/efeitos dos fármacosAssuntos
Catecolaminas/uso terapêutico , Glicosídeos Digitálicos/uso terapêutico , Diuréticos/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Vasodilatadores/uso terapêutico , Débito Cardíaco/efeitos dos fármacos , Insuficiência Cardíaca/fisiopatologia , Hemodinâmica/efeitos dos fármacos , Humanos , Contração Miocárdica/efeitos dos fármacos , Equilíbrio Hidroeletrolítico/efeitos dos fármacosAssuntos
Farmacologia , Pesquisa , Ensaios Clínicos como Assunto , Humanos , Estatística como AssuntoRESUMO
The effects of nitroglycerin on systemic vascular resistance and cardiac output are highly debated. This study demonstrates that these effects depend on the initial haemodynamic condition, and explains the conflicting results previously reported. 31 patients presenting initially with a fairly wide spectrum of various haemodynamic parameters underwent cardiac catheterisation with measures of parameters before and after nitroglycerin infusion. Multifactorial statistical analysis by correspondence analysis identifies 3 types of haemodynamic responses and demonstrates the association of each response with a particular haemodynamic profile. It is demonstrated that systemic vascular resistance is decreased only when it is initially elevated and cardiac output is increased only when initial pulmonary wedge pressure and systemic vascular resistance are elevated and cardiac output is low. The effects of nitroglycerin on cardiac output, systemic vascular resistance, heart rate and arterial pressure differ significantly according to the presence or not of cardiac insufficiency and depend mainly on the initial value of three parameters: systemic vascular resistance, pulmonary wedge pressure and cardiac output.
Assuntos
Insuficiência Cardíaca/tratamento farmacológico , Nitroglicerina/uso terapêutico , Adulto , Idoso , Débito Cardíaco/efeitos dos fármacos , Análise Fatorial , Hemodinâmica/efeitos dos fármacos , Humanos , Infusões Parenterais , Pessoa de Meia-Idade , Nitroglicerina/farmacologia , Resistência Vascular/efeitos dos fármacosAssuntos
Insuficiência Cardíaca/tratamento farmacológico , Hemodinâmica/efeitos dos fármacos , Insuficiência da Valva Mitral/tratamento farmacológico , Infarto do Miocárdio/tratamento farmacológico , Nitroglicerina/uso terapêutico , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Débito Cardíaco/efeitos dos fármacos , Avaliação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nitroglicerina/administração & dosagem , Nitroglicerina/efeitos adversos , Circulação Pulmonar/efeitos dos fármacos , Resistência Vascular/efeitos dos fármacosRESUMO
Seventy four clinically comparable cases of myocardial infarction, admitted on average at the 10th hour were divided at random in two groups: thirty nine were treated with a prolonged intravenous infusion of trinitrin lasting for 24 hours in 12 cases and during 5 at 7 days in 27 cases: 35 served as controls. The results showed the following: a) the good tolerance of the drug used in this way; b) on the basis of precordial cartography, a reduction of 56.2 +/- 14.5% to 30 +/- 7.3% in the index of secondary extension of necrosis; c) clinical signs of left ventricular failure developed in 60% of the controls as compared with 45.8% of the treated group; d) the prevalence of rhythm disturbances was also lower in those treated; e) overall mortality during the first 4 weeks was 8 amongst the 35 controls and 2 of the treated patients (p less than 0.05).
