Influence of Left Ventricular Ejection Fraction on the Effects of Supplemental Use of Angiotensin Receptor Blocker Olmesartan in Hypertensive Patients With Heart Failure.

Background: There is no robust evidence of pharmacological interventions to improve mortality in heart failure (HF) patients with preserved left ventricular ejection fraction (LVEF) (HFpEF). In this subanalysis study of the SUPPORT Trial, we addressed the influence of LVEF on the effects of olmesartan in HF.

Methods and results: Among 1,147 patients enrolled in the SUPPORT Trial, we examined 429 patients with reduced LVEF (HFrEF, LVEF <50%) and 709 with HFpEF (LVEF ≥50%).

Clinical impacts of additive use of olmesartan in hypertensive patients with chronic heart failure: the supplemental benefit of an angiotensin receptor blocker in hypertensive patients with stable heart failure using olmesartan (SUPPORT) trial.

We examined whether an additive treatment with an angiotensin receptor blocker, olmesartan, reduces the mortality and morbidity in hypertensive patients with chronic heart failure (CHF) treated with angiotensin-converting enzyme (ACE) inhibitors, β-blockers, or both. In this prospective, randomized, open-label, blinded endpoint study, a total of 1147 hypertensive patients with symptomatic CHF (mean age 66 years, 75% male) were randomized to the addition of olmesartan (n = 578) to baseline therapy vs. control (n = 569).

Declining trend in the in-hospital case-fatality rate from acute myocardial infarction in Miyagi Prefecture from 1980 to 1999.

The case-fatality rate from acute myocardial infarction (AMI) appears to have been declining in recent decades, so the present study reviewed the trend in in-hospital case-fatalities from AMI in Miyagi Prefecture, Japan, 1980-1999. The causes of death and the effects of gender and age on the trend were also analyzed. From the AMI registration database of the Miyagi Study Group for AMI, 12,961 cases of AMI were analyzed.

[18F] labeled diacylglycerol analogue as a potential agent to trace myocardial phosphoinositide metabolism.

Phosphoinositide metabolism plays an important role in cardiac pathophysiology. To investigate whether [18F]diacylglycerol could be used to trace myocardial phosphoinositide metabolism, lipids were extracted from rat myocardium after the injection. 1-[8-[18F]fluorooctanoyl]-2-palmitoylglycerol and 1-[8-[18F]fluoropalmitoyl]-2-palmitoylglycerol were predominantly metabolized to phosphatidylethanolamine and triacylglycerol, respectively.

Interaction between sarcomere and mitochondrial length in normoxic and hypoxic rat ventricular papillary muscles.

We hypothesized that the mitochondrial length may be altered according to changes in the sarcomere length, and that this relationship may be affected by exposure to hypoxia. Rat ventricular papillary muscles were isolated and immersed in normoxic or hypoxic solutions for 10 min. Sarcomeres of various lengths were obtained by fixing the papillary muscles in a slack or stretched state, or after exposure to a contracture solution containing saponin and CaCl(2).

Long-term right ventricular volume overload increases myocardial fluorodeoxyglucose uptake in the interventricular septum in patients with atrial septal defect.

Background: Several studies have shown that long-term right ventricular (RV) overload in animal models alters myocardial energy substrate metabolism. However, whether long-term RV volume overload alters this metabolism in the human is unclear.

Methods And Results: We performed positron emission tomography with [(18)F]fluorodeoxyglucose (FDG) and single-photon emission tomography (SPECT) with [(201)Tl]TlCl (Tl) and [(123)I]15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) in 11 patients with atrial septal defect (ASD) and 11 control subjects.

Diacylglycerol delays pH(i) overshoot after reperfusion and attenuates contracture in isolated, paced myocytes.

Although protein kinase C (PKC) plays a pivotal role in ischemic preconditioning, it is not clear what the end effector is that protects the myocardium. In isolated, paced (1.25 Hz, 36-37 degrees C) adult rat cardiomyocytes, the effects of PKC preactivation by diacylglycerol on cell motion, intracellular Ca(2+) concentration ([Ca(2+)](i); indo 1), and intracellular pH (pH(i); seminaphthorhodafluor-1) during simulated ischemia-reperfusion (I/R) were investigated.

Heterogeneous fatty acid uptake early after reperfusion in rat hearts.

We determined whether spatial distributions of substrate uptake are heterogeneous within the area at risk during reperfusion. Quantitative autoradiography with imaging plates and two long-lived radioisotopes was applied to 15 open-chest, anesthetized rats subjected to 30 min of coronary artery ligation and 30 min of reperfusion. Regions showing increased beta-methyl-[1-14C]heptadecanoic acid ([14C]BMHDA) uptake (166 +/- 17% of that in the nonischemic area) appeared at the lateral borders and subepicardial layer within the area at risk, and 2-deoxy-D-[1-3H]glucose ([3H]DG) uptake was 103 +/- 24% in these regions.

The rise time of the monophasic action potential--a new index of local use-dependent conductivity by sodium channel blockers in human myocardium.

The kinetics of global use-dependent conduction slowing produced by sodium channel blockers in the human heart, estimated as a change in the QRS width, are known to be similar to those of use-dependent block of the maximum rate of depolarization in in vitro studies. However, the kinetics of the regional use-dependent decrease in conductivity have not been investigated. We examined whether the rise time of the monophasic action potential would be clinically useful as a marker of the local use-dependent decrease in conductivity by sodium channel blockers.

Effect of dantrolene sodium on calcium-overloaded heart.

Spontaneous asynchronous contractile activity caused by spontaneous release of calcium ions (Ca2+) from the sarcoplasmic reticulum (SR) is thought to be the cause of deterioration of ventricular function under conditions of calcium overload. We examined whether dantrolene sodium, which can inhibit Ca2+ release from the skeletal SR, improves the systolic and diastolic function of calcium-overloaded hearts. In isolated hamster left ventricles, the concentration of Ca2+ in the perfusate ([Ca2+]o) was increased from 1 mmol/L to 7 mmol/L in 1-mmol/L steps in the absence (control, n = 6) and presence of dantrolene sodium (11.

Stimulated glucose uptake in the ischemic border zone: its dependence on glucose uptake in the normally perfused area.

Unlabelled: During acute regional myocardial ischemia, a "border zone" exists where the spatial distributions of blood flow and substrate uptake show gradual changes. We investigated the relationship between blood flow and glucose uptake in the border zone during acute regional ischemia.

Methods: Newly developed quantitative autoradiography using imaging plates and two long-lived radioisotopes was applied to rat hearts subjected to 30 min of left coronary artery occlusion.

Myocardial glucose metabolism is different between hypertrophic cardiomyopathy and hypertensive heart disease associated with asymmetrical septal hypertrophy.

Myocardial glucose metabolism has been shown to be heterogeneous in patients with hypertrophic cardiomyopathy (HCM). We tested the hypothesis that myocardial glucose metabolism differs between patients with HCM and those with hypertensive heart disease (HHD) associated with asymmetrical septal hypertrophy. We studied 12 patients with HCM, 7 HHD patients associated with asymmetrical septal hypertrophy using 18F 2-deoxyglucose (FDG) and positron emission tomography.

Heterogeneity of myocardial fluoro-18 2-deoxyglucose uptake in patients with apical hypertrophic cardiomyopathy.

We have shown that myocardial glucose metabolism is heterogeneous in patients with hypertrophic cardiomyopathy. It is not known, however, whether glucose metabolism is impaired in patients with apical hypertrophic cardiomyopathy, which is fairly common in Japan. We studied 7 patients with apical hypertrophic cardiomyopathy and 5 normal subjects using fluoro-18 2-deoxyglucose (FDG) and positron emission tomography (PET).

Effects of spontaneous myocardial oscillation on cardiac function: direct observation of the epicardial fluorescence image in calcium overloaded isolated hamster hearts.

Objectives: Calcium overload induces spontaneous cyclic calcium release from the sarcoplasmic reticulum, leading to spontaneous myocardial oscillation. This study was designed to elucidate (1) the effect of the myocardial oscillation on changes in ventricular performance and (2) how these changes relate to the strength of the diastolic spontaneous myocardial oscillation and the spatial extent--that is, in how extensive an area of the epicardium it occurred.

Methods: the isovolumic pressure of the left ventricle and epicardial fura 2 fluorescence in isolated hamster hearts were simultaneously observed at various calcium concentrations ([Ca2+]o).

Intracellular calcium modulators for cardiac muscle in pathological conditions.

This is a brief review of agents that stabilize calcium release from the sarcoplasmic reticulum in cardiac muscle. An excess intracellular calcium concentration (calcium overload) is a common feature in a variety of cardiac cell injuries. Calcium overload elicits diastolic and systolic failure, and is involved in the genesis of arrhythmias.

Effects of chronic right ventricular pressure overload on myocardial glucose and free fatty acid metabolism in the conscious rat.

Objective: The aim was to investigate the effects of chronic right ventricular pressure overload on myocardial glucose and free fatty acid metabolism in the right ventricular free wall, ventricular septum, and left ventricular free wall.

Methods: Using a glucose analogue, 14C-2-deoxyglucose (14C-DG), and a fatty acid analogue, 14C-beta methylheptadecanoic acid (14C-BMHDA), quantitative autoradiography was performed in conscious rats with 4 week pulmonary artery constriction.

Results: In rats with chronic pulmonary artery constriction, right ventricular peak systolic pressure and right ventricular weight to body weight ratio increased by 88% and 127%, respectively, compared with sham operated rats (P < 0.

Quantitative double-tracer autoradiography with tritium and carbon-14 using imaging plates: application to myocardial metabolic studies in rats.

Unlabelled: A system for 3H- and 14C-labeled macroautoradiography was developed that is able to quantify the tissue radioactivity of two tracers using imaging plates.

Methods: Discrimination between electrons emitted from 3H and 14C is possible on the basis of their different energy distributions. The general use imaging plate with a protective layer detects 14C radioactivity, but it does not detect 3H radioactivity which has a lower energy distribution than 14C.

Diversity of early afterdepolarizations in guinea pig myocytes: spatial characteristics of intracellular Ca2+ concentration.

We classified early afterdepolarizations (EADs) into subgroups according to the spatial features of the intracellular Ca2+ concentration ([Ca2+]i). Myocytes were enzymatically isolated from guinea pig ventricles. When fura-2 salt was applied through a whole cell patch pipette after the formation of a gigaohm seal, the membrane potential was measured using the current, clamp technique.

Spatial features of calcium transients during early and delayed afterdepolarizations.

Although changes in intracellular Ca2+ concentration ([Ca2+]i) are spatially heterogeneous during spontaneous contraction in mammalian cardiac muscle, it has not yet been observed how [Ca2+]i changes spatially within cardiac myocytes during delayed (DADs) and early (EADs) afterdepolarizations. The aim of this study is to characterize the spatial features of the increase in [Ca2+]i during such afterdepolarizations and to understand the ionic mechanisms responsible for them. Myocytes were enzymatically isolated from guinea pig ventricles and loaded with fura 2-acetoxymethylester, the Ca2+ fluorescence indicator dye.

The source of epifluorescence in isolated perfused heart loaded with fura 2-AM or indo 1-AM.

The purpose of this study is to clarify the kinds of cells that fluoresce in isolated perfused heart intracoronarily loaded with fura 2-AM or indo 1-AM. The hearts from hamsters perfused by the Langendorff method were loaded with fura 2-AM or indo 1-AM intracoronarily. The epicardium was excited by ultraviolet light at a wavelength of 340 or 380 nm (fura 2) or 360 nm (indo 1).

Initiation and development of calcium waves in rat myocytes.

To understand the characteristics of asynchrony in spontaneously occurring increases in cytoplasmic calcium concentrations ([Ca2+]i) in the cardiac myocyte, we observed newly developed changes in regional [Ca2+]i after a physical injury to the sarcolemma. Myocytes were isolated from rat left ventricle and loaded with acetoxymethyl ester of fura-2. We analyzed dynamic changes in fluorescence images by video densitometry.

Differences in myocardial fluoro-18 2-deoxyglucose uptake in young versus older patients with hypertrophic cardiomyopathy.

The purpose of this study was to determine whether regional myocardial glucose use in patients diagnosed as having hypertrophic cardiomyopathy (HC) at a younger age differs from that in those diagnosed at middle to old age. Sixteen patients with HC (group 1 aged less than 40 years (n = 8); group 2 aged greater than 40 (n = 8) were studied using positron emission tomography and fluoro-18 2-deoxyglucose (FDG). All patients were diagnosed as having HC within 6 years of the study.