Quantitative angiographic evaluation and pathophysiologic mechanisms in valvular heart disease.
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Angiocardiography↗
Biomedical subjects
C E Rackley
Publications and source records attributed to C E Rackley.
Cardiovascular basis for cholesterol therapy.
The success of cholesterol treatment in reducing cardiovascular events has suggested addition of a cholesterol paradigm to previous clinical models of stenosis and occlusion in coronary artery disease. Risk factors for coronary artery disease now serve as guidelines for treatment goals for low-density lipoprotein cholesterol reduction. Oxidation of low-density lipoprotein cholesterol within the vessel wall initiates a variety of deleterious mechanisms contributing to atherosclerosis. Hepatic hydroxymethylglutaryl-coenzyme A reductase inhibitors or statin drugs exert a primary action on hepatic cholesterol metabolism, as well as influences on vascular reactivity, thrombus formation, inflammation, ischemia, and plaque stabilization. Trials with statin drugs have reported reduction of cardiovascular events in men and women without clinical evidence of coronary artery disease. Several trials have demonstrated angiographic stabilization with cholesterol lowering and a greater reduction in cardiovascular events, revascularization procedures, and strokes. Recent studies suggest benefits in lowering triglycerides and raising high-density lipoprotein cholesterol with drugs. A clinical approach with available cholesterol-lowering drugs is presented based on National Cholesterol Education Program guidelines and follow-up time tables. Thus, cholesterol therapy offers the opportunity to treat atherosclerotic vascular disease before, during, and after ischemic events.
Anticholesteremic Agents↗
Elderly patients at risk for coronary heart disease or stroke: selecting an ideal product for lipid lowering.
Coronary heart disease is an affliction of the elderly: 84% of those who die from the disease are over 65 years of age. In patients over 55 years, the incidence of stroke more than doubles with each decade of life. The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, or statins, have been shown to lower cholesterol and lipids in both middle-aged and elderly patients in large clinical trials. Some statins have been shown to improve endothelial function and vasodilation and to normalize thrombin formation, which may be among the mechanisms involved in both coronary event and stroke prevention.
Aged↗
Direct effects of streptokinase on the isolated rat myocardium.
The utilization of streptokinase as a thrombolytic agent is prevalent in the management of patients following a myocardial infarction. The present investigation was designed to assess the direct effects of streptokinase infusion on the normal isolated rat heart and on the globally ischemic isolated rat heart. The effects of streptokinase on the mechanical function of the hearts were monitored, as well as the effects on the membrane integrity of the cells, as indicated by enzyme release. The normal hearts were infused with either buffer or streptokinase. Both the normal and streptokinase-treated normal hearts exhibited a decrease in function during the course of each experiment. Under these conditions, there were no significant differences in the values for mechanical function in either group. The release of lactate dehydrogenase (LDH) and creatine kinase (CK) into the coronary effluents was not significantly increased during the infusion of streptokinase. There was a significant increase in the release of nucleosides during the streptokinase infusion period compared with the buffer infusion period. The infusion of either buffer or streptokinase was compared in the preischemic and postischemic rat heart. The values obtained during preischemic infusion with buffer or streptokinase were comparable to the values obtained in the normal and streptokinase-treated normal hearts. There were no significant differences in the values for mechanical function measured during buffer infusion following ischemia compared with those measured during streptokinase infusion following ischemia. In the postischemic hearts, there was a sixfold increase in the release of nucleosides during buffer infusion, whereas only a twofold increase was observed in the postischemic hearts during streptokinase infusion.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗