Influence of long-term treatment of imidapril on mortality, cardiac function, and gene expression in congestive heart failure due to myocardial infarction

2004 ◽  
Vol 82 (12) ◽  
pp. 1118-1127 ◽  
Author(s):  
Bin Ren ◽  
Qiming Shao ◽  
Pallab K Ganguly ◽  
Paramjit S Tappia ◽  
Nobuakira Takeda ◽  
...  
Keyword(s):  
Gene Expression ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Sarcoplasmic Reticulum ◽  
Cardiac Function ◽  
Term Treatment ◽  
Cardiac Performance ◽  
Long Term Treatment

Although it is generally accepted that the efficacy of imidapril, an angiotensin-converting enzyme inhibitor, in congestive heart failure (CHF) is due to improvement of hemodynamic parameters, the significance of its effect on gene expression for sarcolemma (SL) and sarcoplasmic reticulum (SR) proteins has not been fully understood. In this study, we examined the effects of long-term treatment of imidapril on mortality, cardiac function, and gene expression for SL Na+/K+ ATPase and Na+–Ca2+ exchanger as well as SR Ca2+ pump ATPase, Ca2+ release channel (ryanodine receptor), phospholamban, and calsequestrin in CHF due to myocardial infarction. Heart failure subsequent to myocardial infarction was induced by occluding the left coronary artery in rats, and treatment with imidapril (1 mg·kg–1·day–1) was started orally at the end of 3 weeks after surgery and continued for 37 weeks. The animals were assessed hemody nam ically and the heart and lung were examined morphologically. Some hearts were immediately frozen at –70 °C for the isolation of RNA as well as SL and SR membranes. The mortality of imidapril-treated animals due to heart failure was 31% whereas that of the untreated heart failure group was 64%. Imidapril treatment improved cardiac performance, attenuated cardiac remodeling, and reduced morphological changes in the heart and lung. The depressed SL Na+/K+ ATPase and increased SL Na+–Ca2+ exchange activities as well as reduced SR Ca2+ pump and SR Ca2+ release activities in the failing hearts were partially prevented by imidapril. Although changes in gene expression for SL Na+/K+ ATPase isoforms as well as Na+–Ca2+ exchanger and SR phospholamban were attenuated by treatments with imidapril, no alterations in mRNA levels for SR Ca2+ pump proteins and Ca2+ release channels were seen in the untreated or treated rats with heart failure. These results suggest that the beneficial effects of imidapril in CHF may be due to improvements in cardiac performance and changes in SL gene expression.Key words: sarcolemmal Na+/K+ ATPase, Na+–Ca2+ exchange, sarcoplasmic reticulum, heart failure, ACE inhibition.

scholarly journals The relevance of prescribing triple neurohormonal blockade in real clinical practice: the role of mineralocorticoid receptor antagonists

2021 ◽  
Vol 23 (6) ◽  
pp. 491-497
Author(s):  
Igor V. Zhirov ◽  
◽  
Igor V. Zhirov ◽  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Mineralocorticoid Receptor ◽  
Systolic Dysfunction ◽  
Term Treatment ◽  
Mineralocorticoid Receptor Antagonists ◽  
Long Term Treatment ◽  
Real Clinical Practice

In the article is outlined the main concepts use of the mineralocorticoids receptors antagonists in the treatment of congestive heart failure and systolic dysfunction after acute myocardial infarction. Claimed the pivotal role of eplerenone in the long-term treatment strategy due to decrease of mortality and improving the clinical outcomes.

scholarly journals Long-term treatment of congestive heart failure with captopril.

1982 ◽  
Vol 14 (S2) ◽  
pp. 223S-229S
Author(s):  
M Komajda ◽  
M Eugene ◽  
J Evans ◽  
G Drobinski ◽  
JL Laurenceau ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Term Treatment ◽  
Long Term Treatment

Counterpulsation Circulatory Assist Devices

2019 ◽  
pp. 119-126
Author(s):  
Reza Salabat ◽  
Valluvan Jeevanandam
Keyword(s):  
Heart Failure ◽  
Cardiac Function ◽  
Term Treatment ◽  
Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Bridge To Transplant ◽  
Intra Aortic Balloon Pump ◽  
Long Term Treatment

An increasing number of patients with heart failure need advanced therapy. Heart transplantation remains the definitive long-term treatment, but its use is limited by the low number of donor hearts. This limitation has led to the development of mechanical circulatory support devices that assist cardiac function by direct blood pumping (e.g. ventricular assist devices) and counterpulsation (e.g. the intra-aortic balloon pump). Ventricular assist devices provide long-term treatment for heart failure but are associated with potentially severe complications, such as driveline infection, stroke, and gastrointestinal bleeding. Counterpulsation improves cardiac function by augmenting diastole and reducing afterload, which increases coronary perfusion and decreases cardiac workload. Since the concept was introduced in 1960s, several devices have been used in humans. The intra-aortic balloon pump, a counterpulsation device, is the most commonly used device for short-term support as a bridge to transplant or recovery. A minimally invasive counterpulsation device, such as an intravascular ventricular assist system that allows ambulation, could potentially offer versatile solutions for long-term heart failure therapy or as a bridge to transplant or to recovery. The intravascular ventricular assist system has fewer complications and avoids the need for sternotomy or thoracotomy.

Sign in / Sign up

Export Citation Format

Share Document