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1.
J Clin Hypertens (Greenwich) ; 23(2): 334-344, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33400348

RESUMO

Elevated serum uric acid is a cardiovascular risk factor in patients with hypertension, even when blood pressure (BP) is well controlled. Xanthine oxidoreductase inhibitors (XORi) reduce serum uric acid levels and have several other potential effects. This multicenter, randomized, open-label study compared the effects of two XORi, topiroxostat and febuxostat, on arterial stiffness, uric acid levels, and BP in hypertensive patients with hyperuricemia. Patients received topiroxostat 40-160 mg/day or febuxostat 10-60 mg/day, titrated to maintain serum uric acid <6 mg/dl, for 24 weeks. The primary endpoint was change in the cardio-ankle vascular index (CAVI) from baseline to 24 weeks. There were no significant changes in CAVI from baseline to 24 weeks (from 9.13 to 9.16 [feboxustat] and 8.98 to 9.01 [topiroxostat]). Compared with baseline, there were significant reductions in serum uric acid (-2.9 and -2.5 mg/dl; both p < 0.001) and morning home systolic BP (-3.6 and -5.1 mm Hg; both p < 0.01) after 24 weeks' treatment with febuxostat and topiroxostat. BP decreased to the greatest extent in the subgroup of patients with uncontrolled blood pressure at baseline. Topiroxostat, but not febuxostat, significantly decreased plasma xanthine oxidoreductase activity versus baseline. The urinary albumin-creatinine ratio (UACR) decreased significantly from baseline to 24 weeks with topiroxostat (-20.8%; p = 0.021), but not febuxostat (-8.8%; p = 0.362). In conclusion, neither topiroxostat nor febuxostat had any significant effects on arterial stiffness over 24 weeks' treatment.


Assuntos
Hipertensão , Hiperuricemia , Febuxostat/uso terapêutico , Supressores da Gota/uso terapêutico , Humanos , Hipertensão/tratamento farmacológico , Hiperuricemia/complicações , Hiperuricemia/tratamento farmacológico , Nitrilas , Piridinas , Resultado do Tratamento , Ácido Úrico
2.
Circ J ; 68(11): 1030-4, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15502384

RESUMO

BACKGROUND: The hemodynamic effects of enhanced external counterpulsation (EECP) and its mechanism(s) were investigated in relation to neurohumoral factors in patients with acute myocardial infarction (AMI). METHODS AND RESULTS: Twenty-four patients with AMI were studied before, during and after EECP treatment for 60 min. Heart rate (HR), right atrial pressure (RAP), pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) were determined. In addition, circulating concentrations of neurohumoral factors were determined at each time point. HR did not change following EECP treatment. However, RAP and PCWP increased significantly and CI was significantly elevated during EECP and thereafter. Blood atrial natriuretic peptide (ANP) concentration was significantly increased 15 and 60 min after the start of EECP treatment, but brain natriuretic peptide (BNP) did not change. Renin, aldosterone and catecholamine concentrations also did not change. CONCLUSION: Treatment with EECP resulted in an increased preload because of increased venous return, and CI was increased thereafter. In patients with AMI, EECP increased blood ANP concentration, but not BNP, which suggests that an increase in ANP without an increase in BNP is an important mechanism for the effects of EECP treatment.


Assuntos
Contrapulsação , Hemodinâmica , Infarto do Miocárdio/fisiopatologia , Infarto do Miocárdio/cirurgia , Neurotransmissores/sangue , Idoso , Função do Átrio Direito , Fator Natriurético Atrial/sangue , Débito Cardíaco , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pressão , Pressão Propulsora Pulmonar , Função Ventricular Esquerda
3.
Circ J ; 67(5): 443-8, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12736485

RESUMO

To evaluate the effects of synthetic human atrial natriuretic peptide (hANP) on myocardial reperfusion injury and left ventricular remodeling, 19 patients within 12 h of a first attack of anterior myocardial infarction (AMI) underwent intracoronary injection of 25 microg of hANP immediately after coronary angioplasty, combined with intravenous infusion of 0.025 microg x kg(-1) x min(-1) of hANP initiated on admission for 1 week (hANP group); 18 similar patients had saline administered (control group). The incidences of premature ventricular contraction, ventricular tachycardia and/or fibrillation in the hANP group were significantly less than in the control group after coronary angioplasty. Left ventricular ejection fraction was significantly greater and left ventricular end-diastolic volume index was significantly smaller 6 months after coronary angioplasty. Left ventricular regional wall motion of the infarcted segments significantly increased. Thus, hANP remarkably suppressed reperfusion phenomena and preserved left ventricular function through improvement of regional wall motion of the infarcted segments after coronary angioplasty.


Assuntos
Angioplastia Coronária com Balão , Fator Natriurético Atrial/uso terapêutico , Infarto do Miocárdio/terapia , Traumatismo por Reperfusão Miocárdica/prevenção & controle , Função Ventricular Esquerda/fisiologia , Angioplastia Coronária com Balão/efeitos adversos , Pressão Sanguínea/efeitos dos fármacos , Circulação Coronária/efeitos dos fármacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Contração Miocárdica/efeitos dos fármacos , Fibrilação Ventricular/etiologia , Fibrilação Ventricular/fisiopatologia , Função Ventricular Esquerda/efeitos dos fármacos
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