ангиотензин转化酶基因型调节结合性稳定心力衰竭的治疗患者的肺功能和运动能力
M Roselle Abraham1, Lyle J Olson, Michael J Joyner
1Division of Cardiovascular, Mayo Clinic and Foundation, Rochester, Minn 55905, USA.
Circulation
|October 3, 2002
概括
血管酶转化酶 (ACE) DD基因型与患有血栓性心力衰竭 (CHF) 患者的运动耐受性降低有关. 这可能是由于肺功能受损,这表明有针对性的ACE抑制可以提高运动能力.
科学领域:
- 心脏病学 心脏病学
- 遗传学 遗传学是一种遗传学.
- 肺部医学 肺部医学
背景情况:
- 血管酶转化酶 (ACE) 基因多态性影响ACE活性和血管活性物质.
- 肺功能障碍在充血性心力衰竭 (CHF) 中很常见,但其机制尚未完全理解.
- 抑制ACE可以改善CHF患者的气体交换和运动能力.
研究的目的:
- 为了研究ACE基因型与治疗中心血管疾病患者的肺功能之间的关联.
- 确定ACE基因型是否与CHF患者的运动不耐受性相关.
主要方法:
- 研究了57名CHF患者,按ACE基因型分层 (DD,ID,II).
- 评估了肺功能,左心室喷射率 (LVEF),ACE活性和血动脉素II.
- 在分级运动期间评估的峰值氧气消耗 (VO2) 和气体交换.
主要成果:
- 在基因类型之间,LVEF,腹筋功能或肺动脉压力没有显著差异.
- ACE DD基因型与显著降低VO2峰值和强迫生命能力有关.
- 在运动期间,DD同位素体表现出较高的血清ACE活性,血血管新酶II,以及呼吸系统对二氧化碳 (VE/VCO2) 的等效.
结论:
- ACE DD基因型与CHF的运动耐受性降低有关,可能是通过肺功能改变.
- 针对更完整的ACE抑制或布拉迪基宁强化策略可能会提高DD基因型的CHF患者的运动能力.
相关概念视频
01:26Heart Failure Drugs: Inotropic Agents
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
01:22Heart Failure Drugs: β-Blockers
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
01:11Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase
Genetic polymorphisms in drug targets have emerged as critical determinants of interindividual variability in drug response and toxicity. Pharmacogenomic investigations increasingly focus on identifying these variations to personalize and optimize therapeutic interventions. A drug target may be a receptor, enzyme, or signaling protein involved in pharmacologic responses or disease-related pathways. While early pharmacogenetic studies focused primarily on drug metabolism, current research...
01:30Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...