tetracycline and Heart-Failure

Topics: Ampicillin; Bronchodilator Agents; Carbon Dioxide; Central Nervous System Stimulants; Digitalis Glycosides; Diuretics; Heart Failure; Humans; Intubation, Intratracheal; Monitoring, Physiologic; Oxygen; Oxygen Inhalation Therapy; Positive-Pressure Respiration; Pulmonary Heart Disease; Respiratory Insufficiency; Steroids; Tetracycline; Ventilators, Mechanical

Fibroblast growth factor 9 (FGF9) is secreted from bone marrow cells, which have been shown to improve systolic function after myocardial infarction (MI) in a clinical trial. FGF9 promotes cardiac vascularization during embryonic development but is only weakly expressed in the adult heart.. We used a tetracycline-responsive binary transgene system based on the α-myosin heavy chain promoter to test whether conditional expression of FGF9 in the adult myocardium supports adaptation after MI. In sham-operated mice, transgenic FGF9 stimulated left ventricular hypertrophy with microvessel expansion and preserved systolic and diastolic function. After coronary artery ligation, transgenic FGF9 enhanced hypertrophy of the noninfarcted left ventricular myocardium with increased microvessel density, reduced interstitial fibrosis, attenuated fetal gene expression, and improved systolic function. Heart failure mortality after MI was markedly reduced by transgenic FGF9, whereas rupture rates were not affected. Adenoviral FGF9 gene transfer after MI similarly promoted left ventricular hypertrophy with improved systolic function and reduced heart failure mortality. Mechanistically, FGF9 stimulated proliferation and network formation of endothelial cells but induced no direct hypertrophic effects in neonatal or adult rat cardiomyocytes in vitro. FGF9-stimulated endothelial cell supernatants, however, induced cardiomyocyte hypertrophy via paracrine release of bone morphogenetic protein 6. In accord with this observation, expression of bone morphogenetic protein 6 and phosphorylation of its downstream targets SMAD1/5 were increased in the myocardium of FGF9 transgenic mice.. Conditional expression of FGF9 promotes myocardial vascularization and hypertrophy with enhanced systolic function and reduced heart failure mortality after MI. These observations suggest a previously unrecognized therapeutic potential for FGF9 after MI.

Topics: Animals; Bone Morphogenetic Protein 6; Fibroblast Growth Factor 9; Gene Expression; Heart; Heart Failure; Hypertrophy, Left Ventricular; Mice; Mice, Transgenic; Myocardial Infarction; Neovascularization, Pathologic; Phosphorylation; Rats; Tetracycline

A patient presenting with congestive cardiac failure and anaemia underwent investigation which led to the diagnosis of Whipple's disease, associated with dilated cardiomyopathy. Conventional antibiotic therapy for Whipple's disease resulted in resolution of the traditional features of Whipple's disease and a marked improvement in the patient's heart failure.

Topics: Aged; Anemia; Echocardiography; Heart Failure; Humans; Intestine, Small; Male; Tetracycline; Whipple Disease

Rapidly progressive heart failure, in part related to severe pulmonary hypertension, developed in a patient with biopsy-proved Whipple's disease. The patient's pulmonary hypertension progressed despite antibiotic therapy and histologic remission of his intestinal disease. The combination of oral nifedipine and low-flow continuous oxygen led to both short- and long-term increases of at least 2 liters per minute in cardiac output and reductions of more than 10 mm Hg in mean pulmonary artery pressure. Accompanying these hemodynamic changes was an improvement of more than 10 percent in right ventricular ejection fraction. The relationship between this patient's pulmonary hypertension and his Whipple's disease is not known.

Topics: Drug Combinations; Furosemide; Heart Failure; Heart Murmurs; Humans; Hypertension, Pulmonary; Male; Middle Aged; Nifedipine; Oxygen; Penicillins; Pulmonary Wedge Pressure; Recurrence; Stroke Volume; Sulfamethoxazole; Tetracycline; Trimethoprim; Whipple Disease

Topics: Acute Disease; Aged; Furosemide; Heart Failure; Humans; Lanatosides; Male; Morphine; Oxygen Inhalation Therapy; Pulmonary Edema; Reserpine; Tetracycline

Topics: Acidosis; Clostridium Infections; Clostridium perfringens; Endocarditis, Bacterial; Enterococcus faecalis; Heart Failure; Humans; Male; Middle Aged; Penicillin Resistance; Penicillins; Streptococcal Infections; Streptomycin; Tetracycline

Topics: Blood Gas Analysis; Blood Pressure; Cardiac Catheterization; Chronic Disease; Diagnosis, Differential; Digoxin; Electrocardiography; Female; Heart Failure; Heparin; Humans; Hypertension, Pulmonary; Middle Aged; Pulmonary Circulation; Pulmonary Embolism; Radiography; Radionuclide Imaging; Recurrence; Tetracycline; Thrombosis

Topics: Adrenocorticotropic Hormone; Cardiomegaly; Convalescence; Digitalis Glycosides; Diuretics; Endocarditis, Bacterial; Erythromycin; Glucocorticoids; Heart Failure; Humans; Injections, Intramuscular; Penicillins; Pericarditis; Rheumatic Heart Disease; Socioeconomic Factors; Streptococcal Infections; Tetracycline

Topics: Adult; Aged; Biological Assay; Blood Urea Nitrogen; Bronchopneumonia; Cachexia; Cerebrovascular Disorders; Creatine; Female; Heart Failure; Humans; Laryngeal Neoplasms; Male; Mastectomy; Methacycline; Middle Aged; Neoplasms; Prostatic Neoplasms; Tetracycline; Urinary Tract Infections

Topics: Acidosis, Respiratory; Acute Disease; Alkalosis; Blood Gas Analysis; Bronchodilator Agents; Catheterization; Chlorides; Dehydration; Heart Failure; Humans; Hypokalemia; Penicillin G; Potassium Chloride; Respiration, Artificial; Respiratory Insufficiency; Respiratory Tract Infections; Tetracycline

Topics: Adrenal Cortex Hormones; Aminobutyrates; Anti-Bacterial Agents; Bronchodilator Agents; Chloramphenicol; Heart Failure; Humans; Muscle Relaxants, Central; Nikethamide; Oxygen Inhalation Therapy; Respiratory Insufficiency; Tetracycline