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Case 3: A patient with systemic hypertension and left ventricular hypertrophy

AMERICAN JOURNAL OF CARDIOLOGY 2000年第4期85卷 522-522页

作者： Kloner, RA Friedewald, VE Hosp Good Samaritan Inst Heart Los Angeles CA 90017 USA Univ So Calif Los Angeles CA USA Baylor Coll Med Houston TX 77030 USA

Interactive Grand Rounds is designed to provide health care providers with the opportunity to earn CME credit by accessing the Internet at www. ***. The program features a clinical case accompanied by a discussion of ... 详细信息

关键词：血管紧张素转换酶抑制药/治疗应用抗高血压药/治疗应用血压膳食限钠药物疗法联合超声心动描记术心电描记术高血压/并发症高血压/病理生理学高血压/治疗肥大左心室/并发症肥大左心室/治疗肥大左心室/超声检查生活方式血管舒张药/治疗应用老年人人类男(雄)性

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Pretreatment with a potassium-channel opener before prolonged cardiac storage: An evaluation in an experimental brain death model

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ANNALS OF THORACIC SURGERY 1999年第6期67卷 1623-1629页

作者： Kirsch, M Bertrand, S Garnier, JP Fernandez, C Baufreton, C Astier, A Loisance, D Ctr Rech Chirurg Henri Mondor Fac Med F-94010 Creteil France Hop St Louis Dept Biochem Paris France

Background. Pretreatment with a potassium-channel opener has been shown to improve functional recovery after long-term cardioplegic arrest. We evaluated whether pretreatment with the potassium-channel opener cromakalim is beneficial in a more clinically relevant experimental model of brain death in the rabbit. Methods. Four groups of rabbits were studied in a 2 x 2 factorial experiment (n = 8 per group). Rabbits were subjected to a sham operation or 90 minutes of brain death induced by inflating a subdurally placed balloon. Thirty minutes before heart explantation, rabbits received either no pretreatment or an intravenous injection of cromakalim, 30 mu g/kg. Hearts then received 5 hours' hypothermic storage in St. Thomas' Hospital solution and were assessed on a buffer-perfused isolated heart preparation. Hemodynamic recovery, coronary now, and creatine kinase release were determined after 60 minutes of reperfusion. Results. Systolic function and diastolic function were significantly altered in hearts explanted from brain-dead rabbits compared with hearts from rabbits having a sham operation. Cromakalim pretreatment had no significant effect on poststorage systolic or diastolic function of hearts explanted from brain-dead or sham-operation rabbits. Further, cromakalim pretreatment did not affect coronary flow or overall creatine kinase release during reperfusion. Conclusions. In vivo pretreatment of brain-dead rabbits or anesthetized rabbits with an intravenous injection of cromakalim had no significant effect on functional recovery of or enzymatic release from explanted hearts after 5 hours' hypothermic storage and 60 minutes' reperfusion. These findings underscore the importance of clinically relevant experimental models. (C) 1999 by The Society of Thoracic Surgeons.

关键词：脑死亡/代谢冠状动脉循环肌酸激酶/代谢色满卡林/治疗应用疾病模型动物肾上腺素/血液评价研究缺血预处理心肌/方法去甲肾上腺素/血液器官保存器官保存液血管舒张药/治疗应用动物兔

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Beneficial effects of angiotensin-converting enzyme inhibitor and nitrate association on left ventricular remodeling in patients with large acute myocardial infarction: The Delapril Remodeling after Acute Myocardial Infarction (DRAMI), trial

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AMERICAN HEART JOURNAL 2003年第1期146卷 133页

作者： Latini, R Staszewsky, L Maggioni, AP Marino, P Hernandez-Bernal, F Tognoni, G Labarta, V Gramenzi, S Bianchi, F Sarcina, G Cremonesi, G Nicolosi, GL Geraci, E ANMCO Florence Italy Univ Verona I-37100 Verona Italy Hosp Desio Desio Italy Hosp Lavagna Lavagna Italy Hosp Barletta Barletta Italy Chiese Grp Parma Italy Hosp Pordenone Pordenone Italy V Cervella Hosp Palermo Italy

Background In the large-scale trial, Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-3 (GISSI-3), patients receiving the combination of lisinopril and glyceryl trinitrate benefited most from experimental therapy. Therefore, a multicenter, randomized, double-blind study, Delapril Remodeling After Acute Myocardial Infarction (DRAMI), was designed to assess (1) the possible additive beneficial effect on left ventricular remodeling of nitrates when combined with an angiotensin-converting enzyme inhibitor (ACEI), and (2) the tolerability of a new ACEI, delapril, in respect to lisinopril in patients with large myocardial infarction (MI). Methods A total of 177 patients were randomized to receive delapril plus isosorbide-5-mononitrate (IS5MN) placebo, delapril plus IS5MN, lisinopril plus IS5MN placebo, or lisinopril plus IS5MN starting within the first 36 hours after the onset of symptoms and continuing for 3 months. Results More than 80% of the patients showed extensive ST-segment changes and 36.7% had signs or symptoms of heart failure during the first 36 hours. Over 3 months, IS5MN reduced, by 76%, the increase in LVEDV (17.4 +/- 5.0 mL placebo vs 4.2 +/- 4.4 ml. IS5MN, P =.0439), reversed the increase in LVESV (7.5 +/- 3.9 mL placebo vs -5.5 +/- 2.9 mL IS5MN, P =.0052), and increased the recovery of LVEF (1.9% +/- 1.3% placebo vs 6.7% +/- 1.2% IS5MN, P =.0119). Overall, 3-month mortality was 10.2%;the most frequent clinical events were new episodes of severe heart failure (18.1%), persistent hypotension (10.7%), and post-MI angina (18.1%), with no differences between treatment groups. Conclusions Administration for 3 months of IS5MN combined with an ACE[, both started within 36 hours from the onset of symptoms, was safe and effective in reducing LV dilation and dysfunction after MI. The 2 ACEls, delapril and lisinopril, appeared to be equally well tolerated.

关键词：赖诺普利/治疗应用心肌梗死/药物疗法心肌梗死/病理生理学安慰治疗效应统计数据血管舒张药/治疗应用心室重构/药物作用心室重构/生理学男(雄)性中年人

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Successful resuscitation using nitroglycerin for refractory pulseless electrical activity in intensive care unit

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INTENSIVE CARE MEDICINE 2000年第2期26卷 255-255页

作者： Osada, M Tanaka, Y Komai, T Maeda, Y Kitano, M Oishi, M Masui, K Nakazawa, S Tamura, K Yamanashi Med Univ Div Crit Care Med Tamaho Yamanashi 4093898 Japan Yamanashi Med Univ Dept Internal Med 2 Tamaho Yamanashi 4093898 Japan

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Alert to physicians: Possible interaction of Aggrenox and adenosine

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 2000年第4期36卷 1432-1432页

作者： Bergmann, SR Columbia Univ Coll Phys & Surg Dept Cardiol New York NY 10032 USA

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Raynaud's phenomenon affecting the tongue of a patient with scleroderma

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ANNALS OF THE RHEUMATIC DISEASES 2002年第5期61卷 472-472页

作者： Bridges, MJ Kelly, CA Queen Elizabeth Hosp Dept Rheumatol Gateshead NE9 6SX Tyne & Wear England

Treatment is similar to that of Raynaud's disease of the digits, and successful outcomes have been reported with nifedipine. 3 Success has also been reported with prednisolone in cases of Raynaud's phenomenon of the tongue associated with systemic lupus erythematosus. 2 This case of Raynaud's disease of the tongue highlights the need to assess thoroughly any patient with connective tissue disease who presents with atypical oral symptoms, and to inspect the tongue carefully during the presence of symptoms.

关键词：洛沙坦/治疗应用雷诺病/并发症雷诺病/药物疗法硬皮病系统性/并发症硬皮病系统性/药物疗法舌疾病/并发症舌疾病/药物疗法血管舒张药/治疗应用女(雌)性人类中年人

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Current medical treatment for the exacerbation of chronic heart failure resulting in hospitalization

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AMERICAN HEART JOURNAL 2003年第2期145卷 S3-S17页

作者： Jain, P Massie, BM Gattis, WA Klein, L Gheorghiade, M Northwestern Univ Feinberg Sch MEd Div Cardiol Chicago IL 60611 USA Univ Calif San Francisco San Francisco CA 94143 USA San Francisco VA Med Ctr San Francisco CA USA Duke Clin Res Inst Durham NC USA Advocate Illinois Masonic Med Ctr Chicago IL USA

Am Heart J 2003;145:S3-17.

关键词：利尿药/治疗应用多巴酚丁胺/治疗应用依那普利拉/治疗应用住院腙类/治疗应用注射静脉内米力农/治疗应用促尿钠排泄剂/治疗应用利钠肽脑硝普钠/治疗应用肺楔压/药物作用肺楔压/生理学哒嗪类/治疗应用肾脏用药/治疗应用血管舒张药/治疗应用老年人女(雌)性人类男(雄)性

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Oral prednisolone improved acetylcholine-induced sweating in Sjogren's syndrome-related anhidrosis

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CLINICAL RHEUMATOLOGY 2000年第5期19卷 396-397页

作者： Maeda, A Yamanouchi, H Lee, JB Katayama, I Nagasaki Univ Sch Med Dept Dermatol & Nat Med Nagasaki 852 Japan

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Dyspnea as an end point in clinical trials of therapies for acute decompensated heart failure

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AMERICAN HEART JOURNAL 2003年第2期145卷 S26-S33页

作者： Teerlink, JR San Francisco Vet Affairs Med Ctr Heart Failure Clin San Francisco CA 94121 USA Univ Calif San Francisco Sch Med San Francisco CA USA

Am Heart J 2003;145:S26-33.

关键词：急性病药物批准呼吸困难/药物疗法呼吸困难/病理生理学预测住院腙类/治疗应用促尿钠排泄剂/治疗应用利钠肽脑哒嗪类/治疗应用吡啶类/治疗应用疾病严重程度指数四唑类/治疗应用治疗结果血管舒张药/治疗应用人类

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Vasodilator therapy for chronic aortic and mitral regurgitation

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AMERICAN JOURNAL OF THE MEDICAL SCIENCES 2000年第3期320卷 202-208页

作者： Grayburn, PA Univ Texas SW Med Ctr Div Cardiol Dept Internal Med Dallas TX 75235 USA VA Med Ctr Dallas TX USA

The use of vasodilator therapy in chronic AR and MR may be beneficial in selected patients and harmful in others. The hemodynamics of the two conditions are different and must be taken into account. In AR, vasodilators reduce afterload mismatch and can preserve LV function and delay the need for surgery. However, if the patient has severely reduced diastolic blood pressure, vasodilators could potentially impair coronary perfusion. In MR, vasodilators may reduce regurgitant volume and LV preload depending on the mechanism of MR. In patients with MR caused by dilated cardiomyopathy, vasodilators reduce symptoms, and improve functional class. However, in mitral valve prolapse or hypertrophic cardiomyopathy, vasodilators may worsen the MR and should be avoided. In other primary causes of MR, vasodilators could potentially mask the development of LV dysfunction and lead to unnecessary and harmful delays in surgery.

关键词：主动脉瓣关闭不全/诊断主动脉瓣关闭不全/药物疗法主动脉瓣关闭不全/病理生理学主动脉瓣关闭不全/外科学慢性病地高辛/治疗应用心室/病理生理学二尖瓣闭锁不全/诊断二尖瓣闭锁不全/药物疗法二尖瓣闭锁不全/病理生理学二尖瓣闭锁不全/外科学硝苯地平/治疗应用存活率血管舒张药/治疗应用人类

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