Nature Clinical Practice. Cardiovascular Medicine最新文献_第3页

Beyond the classic angiotensin-receptor-blocker profile. 超越了经典的血管紧张素受体阻滞剂。

Nature Clinical Practice. Cardiovascular Medicine Pub Date : 2008-07-01 DOI: 10.1038/ncpcardio0805

Theodore W Kurtz

{"title":"Beyond the classic angiotensin-receptor-blocker profile.","authors":"Theodore W Kurtz","doi":"10.1038/ncpcardio0805","DOIUrl":"https://doi.org/10.1038/ncpcardio0805","url":null,"abstract":"Antihypertensive drugs that inhibit the renin-angiotensin system (RAS) have been proposed to have additional benefits beyond their classic effects on the cardiovascular system, including reducing the risk of new-onset diabetes. Whether RAS inhibitors vary in ability to protect against new-onset diabetes is, however, unknown. The angiotensin II type 1 receptor (AT(1)) blocker telmisartan has been discovered to also activate the peroxisome proliferator-activated receptor-gamma (PPARgamma), an established antidiabetic drug target. In patients with hypertension and biochemical features of the metabolic syndrome, telmisartan has had beneficial effects on lipid and glucose metabolism. As a selective modulator of PPARgamma, telmisartan does not cause the side effects of fluid retention and weight gain associated with conventional thiazolidinedione ligands of PPARgamma. These observations raise the possibility that combined AT(1) receptor blockade and selective PPARgamma modulation with molecules such as telmisartan could provide greater protection from new-onset diabetes and cardiovascular disease than drugs that target either the RAS or PPARgamma alone. The cardioprotective and antidiabetic effects of telmisartan are being assessed in two large clinical trials, the ONgoing Telmisartan Alone in combination with Ramipril Global Endpoint Trial (ONTARGET) and the Telmisartan Randomised AssessmeNt Study in ACE-I iNtolerant subjects with cardiovascular Disease (TRANSCEND).","PeriodicalId":51263,"journal":{"name":"Nature Clinical Practice. Cardiovascular Medicine","volume":"5 Suppl 1 ","pages":"S19-26"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1038/ncpcardio0805","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40424678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 34

Renal disease: a common and a silent killer. 肾脏疾病:一种常见的无声杀手。

Nature Clinical Practice. Cardiovascular Medicine Pub Date : 2008-07-01 DOI: 10.1038/ncpcardio0853

Dick de Zeeuw

{"title":"Renal disease: a common and a silent killer.","authors":"Dick de Zeeuw","doi":"10.1038/ncpcardio0853","DOIUrl":"https://doi.org/10.1038/ncpcardio0853","url":null,"abstract":"Cardiovascular risk profiling and therapy have traditionally been based on established risk factors, such as age, smoking, sex, hypertension, dyslipidemia, body weight, and diabetes mellitus. Despite optimum therapy, cardiovascular mortality and morbidity remain high. Attention is being devoted, therefore, to identifying new risk factors that can also be used as therapeutic targets. Renal dysfunction manifesting as low glomerular filtration rate, albuminuria, or anemia is a strong risk factor for cardiovascular disease and is prevalent in the general population and among patients with cardiovascular disease. Epidemiological data suggest that 10-11% of the general population have low glomerular filtration rates, 5-7% have increased urinary albumin excretion, and 5-10% have anemia. Each of these features represents an independent but additive cardiovascular risk. Treatments for all these indications can reduce cardiovascular mortality and morbidity as well as renal risk. Such findings suggest that treatment should be directed towards improving renal function in order to achieve optimum cardiovascular benefit. Such a strategy would offer the possibility of multiorgan therapy in diseases characterized by multiorgan impairment, such as type 2 diabetes. I present the evidence that renal dysfunction is a common and powerful cardiovascular risk factor and that treatment strategies intervening in the renin-angiotensin-aldosterone system can be used to target albuminuria and reduce cardiovascular and renal risk.","PeriodicalId":51263,"journal":{"name":"Nature Clinical Practice. Cardiovascular Medicine","volume":"5 Suppl 1 ","pages":"S27-35"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1038/ncpcardio0853","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40425258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12

A new dawn in cardiovascular protection: total cardiovascular risk: rigorous treatment of risk factors. Introduction. 心血管保护的新曙光:心血管总风险:严格治疗危险因素。介绍。

Nature Clinical Practice. Cardiovascular Medicine Pub Date : 2008-07-01 DOI: 10.1038/ncpcardio0807

Eberhard Ritz, Björn Dahlöf

引用次数: 0

Does the metabolic syndrome add to the diagnosis and treatment of cardiovascular disease? 代谢综合征对心血管疾病的诊断和治疗有帮助吗?

Nature Clinical Practice. Cardiovascular Medicine Pub Date : 2008-07-01 DOI: 10.1038/ncpcardio1271

Dick de Zeeuw, Stephan Jl Bakker

{"title":"Does the metabolic syndrome add to the diagnosis and treatment of cardiovascular disease?","authors":"Dick de Zeeuw, Stephan Jl Bakker","doi":"10.1038/ncpcardio1271","DOIUrl":"https://doi.org/10.1038/ncpcardio1271","url":null,"abstract":"Much controversy has surrounded both the pathological basis and the clinical utility of the metabolic syndrome. Key questions still revolve around the definition of this syndrome, its utility as a predictor of cardiovascular risk, and the treatment implications of diagnosis. The metabolic syndrome is associated with increased cardiovascular risk. However, the metabolic syndrome clearly underperforms compared with other, established prediction equations, such as the Framingham Risk Score and SCORE (Systemic COronary Risk Evaluation). Differences arise because the components are highly correlated (whereas other tools specifically include independent predictors) and because diagnosis is based on dichotomized variables. These facts, together with uncertain pathophysiology, mean that the metabolic syndrome in its current manifestation has limited utility for the diagnosis and treatment of cardiovascular disease. The syndrome has, however, served and continues to serve a useful purpose in raising awareness of the metabolic consequences of obesity, and as a spur for research into metabolic risk factor interactions.","PeriodicalId":51263,"journal":{"name":"Nature Clinical Practice. Cardiovascular Medicine","volume":"5 Suppl 1 ","pages":"S10-4"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1038/ncpcardio1271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40424676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

The metabolic syndrome in Japan. 日本的代谢综合征。

Nature Clinical Practice. Cardiovascular Medicine Pub Date : 2008-07-01 DOI: 10.1038/ncpcardio0808

Toshiro Fujita

引用次数: 26

The value of current interventions for obesity. 当前肥胖干预措施的价值。

Nature Clinical Practice. Cardiovascular Medicine Pub Date : 2008-07-01 DOI: 10.1038/ncpcardio0854

Arya M Sharma

{"title":"The value of current interventions for obesity.","authors":"Arya M Sharma","doi":"10.1038/ncpcardio0854","DOIUrl":"https://doi.org/10.1038/ncpcardio0854","url":null,"abstract":"Obesity greatly increases risk of cardiovascular disease, metabolic syndrome, and diabetes mellitus. Most obese patients are unable to sustain appreciable weight loss; the body has a natural tendency to return to its previous weight. Although bariatric surgery is effective, it is not without risk. Until better treatments for obesity are available, management remains focused on lifestyle changes, drug therapy, and treating the metabolic complications of obesity. The main cause of metabolic dysfunction in obesity is visceral fat. Fat deposition in and around organs, skeletal muscle, and other tissues is thought to occur when subcutaneous adipose tissue stores are full. Creation of additional adipose-tissue stores is prevented by the mature adipocytes, which inhibit the differentiation of preadipocytes in a negative feedback loop. This inhibition is mediated, in part, by the renin-angiotensin system. Indeed, angiotensin II blockade has been shown to promote adipogenesis in vitro. Clinical studies are currently underway to investigate whether the angiotensin-II-receptor blocker telmisartan can stimulate adipogenesis, with the aim of diverting intramuscular fat back into adipose tissue and thereby restoring insulin sensitivity. If this effect can be demonstrated in humans, this type of agent might become the treatment of choice for obese or overweight people at risk of type 2 diabetes.","PeriodicalId":51263,"journal":{"name":"Nature Clinical Practice. Cardiovascular Medicine","volume":"5 Suppl 1 ","pages":"S3-9"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1038/ncpcardio0854","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40425259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

Cell-based gene therapy for the prevention and treatment of cardiac dysfunction. 以细胞为基础的基因疗法预防和治疗心功能障碍。

Nature Clinical Practice. Cardiovascular Medicine Pub Date : 2007-02-01 DOI: 10.1038/ncpcardio0733

Marc S Penn

{"title":"Cell-based gene therapy for the prevention and treatment of cardiac dysfunction.","authors":"Marc S Penn","doi":"10.1038/ncpcardio0733","DOIUrl":"https://doi.org/10.1038/ncpcardio0733","url":null,"abstract":"A substantial need exists for new treatments to prevent and treat cardiac dysfunction. In the 1990s, there was great hope for gene therapy in this regard. Since that time, the focus has switched to cell therapy-in particular, therapy-with the aim of inducing myocardial regeneration. Individually, gene and cell therapies still have substantial promise. Ultimately, however, the convergence of both techniques might be necessary to achieve improvements in cardiac function and more successful clinical outcomes in patients with cardiac dysfunction. This approach has already been adopted for treatment of malignancies. Several gene products are currently being studied, including growth factors and chemokines that can modulate the survival and function of cardiac myocytes following an ischemic event and influence remodeling of the left ventricle. However, several issues remain, including the optimization and characterization of cell types, selection of vectors for gene transfer, and identification of appropriate strategies for delivery. Here, we review the potential and need for cell-based gene therapy for the prevention and treatment of cardiac dysfunction and attempt to discuss the unresolved issues.","PeriodicalId":51263,"journal":{"name":"Nature Clinical Practice. Cardiovascular Medicine","volume":"4 Suppl 1 ","pages":"S83-8"},"PeriodicalIF":0.0,"publicationDate":"2007-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1038/ncpcardio0733","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26495649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21

Chimerism and microchimerism of the human heart: evidence for cardiac regeneration. 人类心脏的嵌合和微嵌合:心脏再生的证据。

Nature Clinical Practice. Cardiovascular Medicine Pub Date : 2007-02-01 DOI: 10.1038/ncpcardio0748

Antoni Bayes-Genis, Santiago Roura, Cristina Prat-Vidal, Jordi Farré, Carolina Soler-Botija, Antoni Bayes de Luna, Juan Cinca

{"title":"Chimerism and microchimerism of the human heart: evidence for cardiac regeneration.","authors":"Antoni Bayes-Genis, Santiago Roura, Cristina Prat-Vidal, Jordi Farré, Carolina Soler-Botija, Antoni Bayes de Luna, Juan Cinca","doi":"10.1038/ncpcardio0748","DOIUrl":"https://doi.org/10.1038/ncpcardio0748","url":null,"abstract":"For decades, it has been widely accepted that the heart is a terminally differentiated organ that is unable to regenerate. Studies of recipients of hearts donated by other humans have shed light on the regenerative potential of the human heart. Investigators have been able to trace the Y chromosome by fluorescence in situ hybridization or polymerase chain reaction, or both, in sex-mismatched heart recipients. Cardiac chimerism has been reported, with concentrations of chimeric cells ranging from 0.04% to 10.0%. Cardiac chimerism after bone marrow or progenitor cell transplantation has also been reported to a low extent (approximately 0.20%), suggesting that a fraction of the extracardiac cells that colonize the myocardium are of bone marrow origin. Cardiac chimerism after pregnancy with male offspring (fetal cell microchimerism) has also been demonstrated. Cells of fetal origin have been shown to be capable of differentiating into myocardial cells. Collectively, we show that chimerism studies provide a proof of concept of a process that it is likely to be part of normal cardiac homeostasis in humans but apparently insufficient for cardiac repair in diseased hearts.","PeriodicalId":51263,"journal":{"name":"Nature Clinical Practice. Cardiovascular Medicine","volume":"4 Suppl 1 ","pages":"S40-5"},"PeriodicalIF":0.0,"publicationDate":"2007-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1038/ncpcardio0748","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26494727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 31

Growth-factor-mediated cardiac stem cell activation in myocardial regeneration. 生长因子介导的心肌干细胞活化在心肌再生中的作用。

Nature Clinical Practice. Cardiovascular Medicine Pub Date : 2007-02-01 DOI: 10.1038/ncpcardio0772

Daniele Torella, Georgina M Ellison, Ioannis Karakikes, Bernardo Nadal-Ginard

{"title":"Growth-factor-mediated cardiac stem cell activation in myocardial regeneration.","authors":"Daniele Torella, Georgina M Ellison, Ioannis Karakikes, Bernardo Nadal-Ginard","doi":"10.1038/ncpcardio0772","DOIUrl":"https://doi.org/10.1038/ncpcardio0772","url":null,"abstract":"The concept of an intrinsic regenerative capacity of the adult mammalian myocardium owing to the presence of cardiac stem cells (CSCs) in the atria and ventricles is starting to be accepted by the cardiovascular research community. The identification of this cell population has improved the prospects for developing successful clinical protocols for human myocardial regeneration. In the normal adult myocardium, only a small fraction of CSCs undergo amplification and differentiation to replace the parenchymal cells lost by normal wear and tear. Physiological or pathological stimuli cause substantial activation of CSCs, which is mediated by a paracrine feedback loop between myocytes and CSCs. In response to stress, the myocytes produce growth factors and cytokines, for which CSCs have receptors, and autocrine, self-sustaining activation of growth-factor production is simultaneously triggered in the CSCs. These findings from human and animal studies led us to test whether in situ activation of CSCs by growth factors would be as effective as transplantation of CSCs into the regenerating myocardium after ischemia in an animal model that has relevance to humans. In a porcine model, we produced extensive and functionally relevant myocardial regeneration. Here, we discuss the properties of endogenous myocardial stem cells that might be exploited to produce clinical myocardial regeneration without the need for cell transplantation.","PeriodicalId":51263,"journal":{"name":"Nature Clinical Practice. Cardiovascular Medicine","volume":"4 Suppl 1 ","pages":"S46-51"},"PeriodicalIF":0.0,"publicationDate":"2007-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1038/ncpcardio0772","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26494728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 56

Cardiac stem cells: isolation, expansion and experimental use for myocardial regeneration. 心脏干细胞:分离、扩增及心肌再生的实验应用。

Nature Clinical Practice. Cardiovascular Medicine Pub Date : 2007-02-01 DOI: 10.1038/ncpcardio0738

Lucio Barile, Isotta Chimenti, Roberto Gaetani, Elvira Forte, Fabio Miraldi, Giacomo Frati, Elisa Messina, Alessandro Giacomello

引用次数: 122