cardiovascular-agents and Hematologic-Diseases

Reviewing advances in cardiology and haematology together may appear at first sight to require some artificiality to make a satisfying fit. For two reasons, at least, this is not the case. Firstly, convergence in biology has become very clear over the past decade and this could not be better illustrated by the demonstration that the haemangioblast is the common progenitor of both haemapoietic stem cells and vascular endothelium. This opens the way to common (and differential) approaches to the manipulation of these cells, a field at present in its infancy. A second convergence is the common goal of understanding the processes resulting in haemostasis, thrombosis and vascular occlusion and the means for developing effective antithrombotics. This is exemplified by a number of agents either in use or in clinical trial as a result of haematological and cardiological collaboration. This collaboration is recognisable with the development, many years ago, of streptokinase and the use of aspirin in vascular disease and continues to this day with specific antiplatelet inhibitors and oral thrombin inhibitors as they become accepted into clinical use over the next few years. Here we review current advances in pharmacological treatments in cardiology and haematology, grouped primarily by disease process, focusing on novel and emerging therapies likely to be of importance in the future.

Topics: Angioplasty, Balloon, Coronary; Animals; Cardiovascular Agents; Coronary Disease; Heart Diseases; Hematologic Diseases; Hematologic Neoplasms; Humans; Myocardial Infarction; Stem Cell Transplantation; Thrombosis

There is a fascinating and exceedingly important area of medicine that most of us have not been exposed to at any level of our medical training. This relatively new area is termed chronobiology; that is, how time-related events shape our daily biologic responses and apply to any aspect of medicine with regard to altering pathophysiology and treatment response. For example, normally occurring circadian (daily cycles, approximately 24 hours) events, such as nadirs in epinephrine and cortisol levels that occur in the body around 10 PM to 4 AM and elevated histamine and other mediator levels that occur between midnight and 4 AM, play a major role in the worsening of asthma during the night. In fact, this nocturnal exacerbation occurs in the majority of asthmatic patients. Because all biologic functions, including those of cells, organs, and the entire body, have circadian, ultradian (less than 22 hours), or infradian (greater than 26 hours) rhythms, understanding the pathophysiology and treatment of disease needs to be viewed with these changes in mind. Biologic rhythms are ingrained, and although they can be changed over time by changing the wake-sleep cycle, these alterations occur over days. However, sleep itself can adversely affect the pathophysiology of disease. The non-light/dark influence of biologic rhythms was first described in 1729 by the French astronomer Jean-Jacques de Mairan. Previously, it was presumed that the small red flowers of the plant Kalanchoe bloss feldiuna opened in the day because of the sunlight and closed at night because of the darkness. When de Mairan placed the plant in total darkness, the opening and closing of the flowers still occurred on its intrinsic circadian basis. It is intriguing to think about how the time of day governs the pathophysiology of disease. On awakening in the morning, heart rate and blood pressure briskly increase, as do platelet aggregability and other clotting factors. This can be linked to the acrophase (peak event) of heart attacks. During the afternoon we hit our best mental and physical performance, which explains why most of us state that "I am not a morning person." Even the tolerance for alcohol varies over the 24-hour cycle, with best tolerance around 5 pm (i.e. "Doctor, I only have a couple of highballs before dinner"). Thus, all biologic functions, from those of the cell, the tissue, the organs, and the entire body, run on a cycle of altering activity and function.(ABSTRACT TRUNCATED AT 400 W

Topics: Arthritis; Autonomic Nervous System Diseases; Cardiovascular Agents; Cardiovascular Diseases; Chronobiology Phenomena; Circadian Rhythm; Endocrine System Diseases; Female; Gastrointestinal Diseases; Hematologic Diseases; Humans; Hypersensitivity; Kidney Diseases; Male; Nervous System Diseases; Neuromuscular Diseases; Phototherapy; Respiratory Physiological Phenomena; Respiratory Tract Diseases; Sleep; Sleep Apnea Syndromes

To observe the validity and safety of Kangxin capsule curing the patients with vascular dementia (VaD).. Fifty-six patients with vascular dementia of kidney deficiency and blood stagnation type were selected on the basis of defined diagnostic criteria and were randomly divided into Kangxin group (29) and control group (27), observing the relevant accumulation scores in dementia scale before and after treatment and changes of endothelin (ET), sex hormone, immunity and routine examinations.. Kangxin capsule can effectively improve the symptom of patients with VaD of senile kidney deficiency and blood stagnation type, and the average value of curative effect index of 29 patients in the treatment group is 23.01>/=20%, i.e. effective; compared with that before treatment, both CD(4) and CD(4).CD(8)(-1) rises (P<0.05) after the treatment with Kangxin capsule; for the male VaD patients of the Kangxin group, T level increases (P<0.05) and estrodial (E(2)).testerone (T)(-1) value decreases (P<0.05) after the treatment; for the female VaD patients of the Kangxin group, E(2), E(2).T(-1) value increases a great deal (P<0.05) compared with that before treatment; ET level of both groups decreased on average (P<0.01), and did not demonstrate any obvious toxic side effect.. Kangxin capsule is a valid and safe preparation of Chinese traditional medicine for curing VaD of senile kidney deficiency and blood stagnation type.

Topics: Aged; Aging; Capsules; Cardiovascular Agents; CD4 Lymphocyte Count; CD8-Positive T-Lymphocytes; Dementia, Vascular; Double-Blind Method; Drugs, Chinese Herbal; Endothelins; Female; Gonadal Steroid Hormones; Hematologic Diseases; Humans; Killer Cells, Natural; Male; Middle Aged; Psychiatric Status Rating Scales; Renal Insufficiency

Topics: Blood Substitutes; Cardiovascular Agents; Cardiovascular Diseases; Drug Discovery; Hematologic Agents; Hematologic Diseases; Humans; Protective Agents

Topics: Cardiovascular Agents; Cardiovascular Diseases; Drug Discovery; Hematologic Agents; Hematologic Diseases; Humans

The landmark Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) trial first demonstrated that implantation of left ventricular assist devices (LVADs) as destination therapy (DT) can provide survival superior to any known medical treatment in patients with end-stage heart failure who are ineligible for transplantation. In the present study, we describe outcomes of DT in the post-REMATCH era in the United States.. The present study included 280 patients who underwent HeartMate XVE LVAD implantation between November 2001 and December 2005. A preoperative risk score for in-hospital mortality after LVAD implantation was established in 222 patients with complete data. All patients were followed up until death or December 2006. The 1-year survival after LVAD implantation was 56%. The in-hospital mortality after LVAD surgery was 27%. The main causes of death included sepsis, right heart failure, and multiorgan failure. The most important determinants of in-hospital mortality were poor nutrition, hematological abnormalities, markers of end-organ or right ventricular dysfunction, and lack of inotropic support. Stratification of DT candidates into low (n=65), medium (n=111), high (n=28), and very high (n=18) risk on the basis of the risk score calculated from these predictors corresponded with 1-year survival rates of 81%, 62%, 28%, and 11%, respectively.. Appropriate selection of candidates and timing of LVAD implantation are critical for improved outcomes of DT. Patients with advanced heart failure who are referred for DT before major complications of heart failure develop have the best chance of achieving an excellent 1-year survival with LVAD therapy.

Topics: Aged; Cardiovascular Agents; Cause of Death; Equipment Failure; Female; Follow-Up Studies; Heart Failure; Heart Transplantation; Heart-Assist Devices; Hematologic Diseases; Hospital Mortality; Hospitalization; Humans; Kaplan-Meier Estimate; Logistic Models; Male; Malnutrition; Middle Aged; Multiple Organ Failure; Quality of Life; Registries; Retrospective Studies; Risk; Sepsis; Survival Analysis; Survival Rate; Treatment Outcome; United States; Ventricular Dysfunction, Right

Topics: Adrenal Cortex Hormones; Cardiovascular Agents; Drug Therapy; Glucocorticoids; Hematologic Diseases; Humans

Topics: Adrenal Cortex Hormones; Cardiovascular Agents; Glucocorticoids; Hematologic Diseases

Topics: Cardiovascular Agents; Erythroblastosis, Fetal; Flavonoids; Hematologic Diseases; Pregnancy; Vitamins