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Impact of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on the mortality in sepsis: A meta-analysis
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作者 Deng-Can Yang Jian Xu +1 位作者 Li Jian Yi Yu 《World Journal of Clinical Cases》 SCIE 2023年第36期8498-8506,共9页
BACKGROUND The effect of angiotensin-converting enzyme inhibitors(ACEIs)or angiotensin receptor blockers(ARBs)on the mortality of patients with sepsis is not well characterized.AIM To elucidate the association between... BACKGROUND The effect of angiotensin-converting enzyme inhibitors(ACEIs)or angiotensin receptor blockers(ARBs)on the mortality of patients with sepsis is not well characterized.AIM To elucidate the association between prior ACEI or ARB exposure and mortality in sepsis.METHODS The PubMed,EMBASE,Web of Science,and Cochrane Library databases were searched for all studies of premorbid ACEI or ARB use and sepsis mortality until November 302019.Two reviewers independently assessed,selected,and ab-stracted data from studies reporting ACEIs or ARBs,sepsis,and mortality.The primary extracted data consisted of premorbid ACEI or ARB exposure,mortality,and general patient data.Two reviewers independently assessed the risk of bias and quality of evidence.RESULTS A total of six studies comprising 281238 patients with sepsis,including 49799 cases with premorbid ACEI or ARB exposure were eligible for analysis.Pre-morbid ACEIs or ARBs exposure decreased the 30-d mortality in patients with sepsis.Moreover,the use of ACEIs or ARBs was associated with approximately a 6%decreased risk of 30-d mortality.CONCLUSION The results of this systematic review suggest that ACEI or ARB exposure prior to sepsis may be associated with reduced mortality.Further high-quality cohort studies and molecular mechanism experiments are required to confirm our results. 展开更多
关键词 SEPSIS MORTALITY Angiotensin-converting enzyme inhibitors Angiotensin receptor blockers
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Hyperkalemia of Angiotensin-converting Enzyme Inhibitors or Angiotensin Receptor Blockers in Hemodialysis: A Meta-analysis 被引量:1
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作者 张茜 栾弘 +4 位作者 王艻 张妙 陈艳 吕永曼 马祖福 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2012年第5期785-792,共8页
The safety of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) used in hemodialysis (HD) patients was evaluated.Medline,Embase,the Cochrane Library,some databases of clinical tr... The safety of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) used in hemodialysis (HD) patients was evaluated.Medline,Embase,the Cochrane Library,some databases of clinical trial registries,grey literatures,other reference lists of eligible articles and review articles for the randomized clinical trials (RCTs) on comparison of ACEIs/ARBs or placebo in HD patients were retrieved.RCTs reporting the risk of hyperkalemia by using ACEIs/ARBs in HD patients were selected.Eight articles met the eligibility criteria and were subjected to meta-analysis by using the Cochrane Collaboration’s RevMan 4.2 software package.The results showed that there was no significant difference in hyperkalemia in HD patients between ACEIs or ARBs group and control group (ACEIs vs.control:RD=0.03,95% CI=-0.13?0.18,Z=0.34,P=0.73;ARBs vs.control:RD=-0.02,95% CI=-0.07?0.03,Z=0.75,P=0.45).However,there was no significant difference in the serum potassium between ACEIs or ARBs group and control group in HD patients (ACEIs vs.control:WMD=0.10,95% CI=0.06?0.15,Z=4.64,P<0.00001;ARBs vs.control:WMD=-0.24,95% CI=-0.37--0.11,Z=3.58,P=0.0003).The use of ACEIs or ARBs could not cause an increased risk of hyperkalemia in HD patients,however the serum potassium could be increased with use of ACEIs in HD patients.Therefore the serum potassium concentration should still be closely monitored when ACEIs are taken during the maintenance HD. 展开更多
关键词 angiotensin-converting enzyme inhibitors angiotensin receptor blockers HYPERKALEMIA META-ANALYSIS
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Role of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in cryoballoon ablation outcomes for paroxysmal atrial fibrillation 被引量:3
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作者 Ibragim Al-Seykal Abhishek Bose +4 位作者 Parag A Chevli Zeba Hashmath Nitish Sharma Ajay K Mishra Douglas Laidlaw 《World Journal of Cardiology》 2022年第10期537-545,共9页
BACKGROUND Cryoballoon ablation(CBA)is recommended for patients with paroxysmal atrial fibrillation(AF)refractory to antiarrhythmic drugs.However,only 80%of patients benefit from initial CBA.There is growing evidence ... BACKGROUND Cryoballoon ablation(CBA)is recommended for patients with paroxysmal atrial fibrillation(AF)refractory to antiarrhythmic drugs.However,only 80%of patients benefit from initial CBA.There is growing evidence that pretreatment with angiotensin-converting enzyme inhibitors(ACEIs)and angiotensin receptor blockers(ARBs)decreases the recurrence of AF postablation,particularly in nonparoxysmal AF undergoing radiofrequency ablation.The role of ACEIs and ARBs in patients with paroxysmal AF in CBA remains unknown.We decided to investigate the role of ACEIs and ARBs in preventing the recurrence of atrial arrhythmia(AA)following CBA for paroxysmal AF.AIM To investigate the role of ACEIs and ARBs in preventing recurrence of AA following CBA for paroxysmal AF.METHODS We followed 103 patients(age 60.6±9.1 years,29%women)with paroxysmal AF undergoing CBA 1-year post procedure.Recurrence was assessed by documented AA on electrocardiogram or any form of long-term cardiac rhythm monitoring.A multivariable Cox proportional hazard model was used to assess if ACEI or ARB treatment predicted the risk of AA recurrence.RESULTS After a 1-year follow-up,19(18.4%)participants developed recurrence of AA.Use of ACEI or ARB therapy was noted in the study population.Patients on ACEI/ARB had a greater prevalence of hypertension and coronary artery disease.On a multivariate model adjusted for baseline demographics and risk factors for AF,ACEI or ARB therapy did not prevent recurrence of AA following CBA(P=0.72).Similarly,on Kaplan–Meier analysis pretreatment with ACEI/ARB did not predict the time to first recurrence of AA(P=0.2173).CONCLUSION In our study population,preablation treatment with an ACEI or ARB had no influence on the recurrence of AA following CBA for paroxysmal AF. 展开更多
关键词 Angiotensin-converting enzyme inhibitors Angiotensin receptor blockers Paroxysmal atrial fibrillation Cryoballoon ablation OUTCOME
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Potential protective role of ACE-inhibitors and AT1 receptor blockers against levodopa-induced dyskinesias:a retrospective case-control study 被引量:2
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作者 Elena Contaldi Luca Magistrelli +3 位作者 Anna VMilner Marco Cosentino Franca Marino Cristoforo Comi 《Neural Regeneration Research》 SCIE CAS CSCD 2021年第12期2475-2478,共4页
Growing evidence has highlighted that angiotensin-converting enzyme(ACE)-inhibitors(ACEi)/AT1 receptor blockers(ARBs)may influence the complex interplay between dopamine and the renin-angiotensin system in the nigrost... Growing evidence has highlighted that angiotensin-converting enzyme(ACE)-inhibitors(ACEi)/AT1 receptor blockers(ARBs)may influence the complex interplay between dopamine and the renin-angiotensin system in the nigrostriatal pathway,thus affecting the development of levodopa-induced dyskinesia in Parkinson’s disease(PD).In the present study,we analyzed whether the use of this class of medication was associated with a reduced occurrence of levodopa-induced dyskinesia,using electronically-stored information of idiopathic PD patients enrolled at Novara University Hospital“Maggiore della Carità”.We conducted a retrospective case-control study identifying PD patients with dyskinesias(PwD;n=47)as cases.For each PwD we selected a non-dyskinetic control(NoD),nearly perfectly matched according to sex,Unified Parkinson’s Disease Rating Scale(UPDRS)part III score,and duration of antiparkinsonian treatment.Binary logistic regression was used to evaluate whether dyskinesias were associated with ACEi/ARBs use.Ninety-four PD patients were included,aged 72.18±9 years,with an average disease duration of 10.20±4.8 years and 9.04±4.9 years of antiparkinsonian treatment.The mean UPDRS part III score was 18.87±7.6 and the median HY stage was 2.In the NoD group,25(53.2%)were users and 22(46.8%)non-users of ACEi/ARBs.Conversely,in the PwD group,11(23.4%)were users and 36 non-users(76.6%)of this drug class(Pearson chi-square=8.824,P=0.003).Concerning general medication,there were no other statistically significant differences between groups.After controlling for tremor dominant phenotype,levodopa equivalent daily dose,HY 3-4,and disease duration,ACEi/ARBs use was a significant predictor of a lower occurrence of dyskinesia(OR=0.226,95%CI:0.080-0.636,P=0.005).Therefore,our study suggests that ACEi/ARBs may reduce levodopa-induced dyskinesia occurrence and,thanks to good tolerability and easy management,represent a feasible choice when dealing with the treatment of hypertension in PD patients.The study was approved by the Ethics Committee of Novara University Hospital“Maggiore della Carità”(CE 65/16)on July 27,2016. 展开更多
关键词 angiotensin-converting enzyme inhibitors AT1 receptor blockers DYSKINESIAS hypertension LEVODOPA motor complications NEUROINFLAMMATION Parkinson’s disease renin-angiotensin system
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Angiotensin converting enzymes inhibitors or angiotensin receptor blockers should be continued in COVID-19 patients with hypertension 被引量:1
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作者 Ci Tian Nan Li +5 位作者 Yi Bai Han Xiao Shu Li Qing-Gang Ge Ning Shen Qing-Bian Ma 《World Journal of Clinical Cases》 SCIE 2021年第1期47-60,共14页
BACKGROUND Recent studies have revealed that sustained ingestion of angiotensin converting enzymes inhibitors or angiotensin receptor blockers(ACEIs/ARBs)had no harmful effects on coronavirus disease 2019(COVID-19)pat... BACKGROUND Recent studies have revealed that sustained ingestion of angiotensin converting enzymes inhibitors or angiotensin receptor blockers(ACEIs/ARBs)had no harmful effects on coronavirus disease 2019(COVID-19)patients complicated with hypertension.AIM To investigate the impact on COVID-19 patients complicated with hypertension who discontinued using ACEIs/ARBs.METHODS All COVID-19 patients complicated with hypertension admitted to our isolated unit were consecutively recruited in this study.Some patients switched from ACEIs/ARBs to calcium channel blocker(CCBs)after admission,while others continued using non-ACEIs/ARBs.We compared characteristics and clinical outcomes between these two groups of patients.RESULTS A total of 53 patients were enrolled,27 patients switched from ACEIs/ARBs to CCBs while 26 patients continued with non-ACEIs/ARBs.After controlling potential confounding factors using the Cox proportional hazards model,hospital stay was longer in patients who discontinued ACEIs/ARBs,with a hazard ratio of 0.424(95%confidence interval:0.187-0.962;P=0.040),upon discharge than patients using other anti-hypertensive drugs.A sub-group analysis showed that the effect of discontinuing use of ACEIs/ARBs was stronger in moderate cases[hazard ratio=0.224(95%confidence interval:0.005-0.998;P=0.0497)].CONCLUSION Patients in the discontinued ACEIs/ARBs group had longer hospital stays.Our findings suggest that COVID-19 patients complicated with hypertension should continue to use ACEIs/ARBs. 展开更多
关键词 COVID-19 HYPERTENSION Angiotensin converting enzymes inhibitors Angiotensin receptor blockers Angiotensin-converting enzyme-2 PROGNOSIS
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Effects of angiotensin receptor blockers and angiotensin-converting enzyme inhibitors on COVID-19 被引量:1
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作者 Xiao-Long Li Tao Li +2 位作者 Qi-Cong Du Li Yang Kun-Lun He 《World Journal of Clinical Cases》 SCIE 2021年第20期5462-5469,共8页
BACKGROUND The World Health Organization reported that 28637952 people worldwide had been infected with severe acute respiratory syndrome coronavirus 2,the causative agent of coronavirus disease 2019(COVID-19),by Sept... BACKGROUND The World Health Organization reported that 28637952 people worldwide had been infected with severe acute respiratory syndrome coronavirus 2,the causative agent of coronavirus disease 2019(COVID-19),by September 13.AIM The aim was to investigate whether long-term use of renin-angiotensin-aldosterone system(RAAS)inhibitors for the treatment of hypertension aggravates the performance of COVID-19 patients with hypertension.METHODS This was a retrospective analysis of lung computed tomography(CT)data and laboratory values of COVID-19 patients with hypertension who were admitted to Huoshenshan Hospital,Wuhan,Hubei Province,between February 18 and March 31,2020.Patients were divided into two groups.Group A included 19 people who were long-term users of RAAS inhibitors for hypertension;and group B included 28 people who were randomly selected from the database and matched with group A by age,sex,basic diseases,and long-term use of other antihypertensive drugs.All patients underwent a series of CT and laboratory tests.We compared the most severe CT images of the two groups and the laboratory examination results within 2 d of the corresponding CT images.RESULTS The time until the most severe CT images from the onset of COVID-19 was 30.37±14.25 d group A and 26.50±11.97 d in group B.The difference between the two groups was not significant(t=1.01,P=0.32).There were no significant differences in blood laboratory values,C-reactive protein,markers of cardiac injury,liver function,or kidney function between the two groups.There was no significant difference in the appearance of the CT images between the two groups.The semiquantitative scores of each involved lobe were 11.84±5.88 in group A and 10.36±6.04 group B.The difference was not significantly different(t=0.84,P=0.41).CONCLUSION Chest CT is an important imaging tool to monitor the characteristics of COVID-19 and the degree of lung injury.Chronic use of RAAS inhibitors is not related to the severity of COVID-19,and it does not worsen the clinical process. 展开更多
关键词 COVID-19 infection Hypertensive patients Angiotensin-converting enzyme inhibitors Angiotensin receptor blockers
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Renin-angiotensin system blockers-SGLT2 inhibitorsmineralocorticoid receptor antagonists in diabetic kidney disease:A tale of the past two decades! 被引量:1
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作者 Awadhesh Kumar Singh Ritu Singh 《World Journal of Diabetes》 SCIE 2022年第7期471-481,共11页
Several pharmacological agents to prevent the progression of diabetic kidney disease(DKD)have been tested in patients with type 2 diabetes mellitus(T2DM)in the past two decades.With the exception of renin-angiotensin ... Several pharmacological agents to prevent the progression of diabetic kidney disease(DKD)have been tested in patients with type 2 diabetes mellitus(T2DM)in the past two decades.With the exception of renin-angiotensin system blockers that have shown a significant reduction in the progression of DKD in 2001,no other pharmacological agent tested in the past two decades have shown any clinically meaningful result.Recently,the sodium-glucose cotransporter-2 inhibitor(SGLT-2i),canagliflozin,has shown a significant reduction in the composite of hard renal and cardiovascular(CV)endpoints including progression of end-stage kidney disease in patients with DKD with T2DM at the top of reninangiotensin system blocker use.Another SGLT-2i,dapagliflozin,has also shown a significant reduction in the composite of renal and CV endpoints including death in patients with chronic kidney disease(CKD),regardless of T2DM status.Similar positive findings on renal outcomes were recently reported as a top-line result of the empagliflozin trial in patients with CKD regardless of T2DM.However,the full results of this trial have not yet been published.While the use of older steroidal mineralocorticoid receptor antagonists(MRAs)such as spironolactone in DKD is associated with a significant reduction in albuminuria outcomes,a novel non-steroidal MRA finerenone has additionally shown a significant reduction in the composite of hard renal and CV endpoints in patients with DKD and T2DM,with reasonably acceptable side effects. 展开更多
关键词 Renin-angiotensin system blockers SGLT-2 inhibitors Mineralocorticoid receptor antagonist Diabetic kidney disease Chronic kidney disease Renal outcomes Cardiovascular outcomes
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Changes of pulmonary beta-adrenergic receptors and their relationship with membranous phospholipid metabolism in endotoxin-induced lung injury in rats
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作者 孙耕耘 毛宝龄 吕宝璋 《Journal of Medical Colleges of PLA(China)》 CAS 1997年第2期124-127,共4页
The changes of beta-adrenergic receptors (AARs) in lung tissue in endotoxin-induced acute lung injury was investigated with radioligand bindig assay in rats. The lipid fluidity and phospholipid content of the cellular... The changes of beta-adrenergic receptors (AARs) in lung tissue in endotoxin-induced acute lung injury was investigated with radioligand bindig assay in rats. The lipid fluidity and phospholipid content of the cellular membrane of lung tissue were measured with fluorescent polarization and high performance liquid chromatography respectively. The findings were as follows:1- Four hours after endotoxin injection, there was a 47% decrease of the maximal binding capacity of fyARsas compared with the control.2. Endotoxin was able to decrease the lipid fluidity and phospholipid content of the pulmonary cellular membrane markedly and at the same time. There was an elevated activity of phospholipase A2 in the pulmonary tissueThese findings suggest that the decrease of the binding capacity of &ARs results in a decrease of the PAR mediated functions, which plays a ro1e in the pathogensis of endotoxin-induced acute lung injury and the activation of phospholipase A2 which is an important factor to reduce the phospholipid content of cell membrane and subsequently to decrease its lipid fluidity, can result in a reduction of the lateral diffusion and rotatory movement of β-ARs and to decrease the chances of β-ARs to bind with the ligands. 展开更多
关键词 acute lung injury ENDOTOXIN beta-adrenergic receptor MEMBRANOUS PHOSPHOLIPID rat
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Evaluation of Anti-inflammatory Effects of Angiotensin Receptor Blockers in an Experimental Model of Acute Inflammation in Rats
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作者 Prasad Pandit Pratiksha Chandrakant Mainkar Sanket Subhash Sawant 《Journal of Pharmacy and Pharmacology》 2014年第3期185-193,共9页
There is a renewed interest in ARBs (angiotensin receptor blockers) for their effects on inflammation, as they are commonly used in the elderly suffering from disorders like arthritis, atherosclerosis which may have... There is a renewed interest in ARBs (angiotensin receptor blockers) for their effects on inflammation, as they are commonly used in the elderly suffering from disorders like arthritis, atherosclerosis which may have a potential inflammatory etiology. But there have been conflicting reports on the effect of ARBs on inflammation. The present study was aimed to evaluate the anti-inflammatory effect of ARBs in rat model of acute inflammation. Albino Wistar rats were randomly assigned to seven groups, i.e., Control (1% CMC (carboxy methyl cellulose)), Aspirin, Losartan, Telmisartan, Valsartan, Candesartan and Irbesartan groups. Rats were orally pretreated with drugs for three consecutive days. On the 3rd day, rats were challenged by a subcutaneous injection of 0.05 mL of 1% carrageenan into the plantar side of right hind paw, 30 min after drug administration. Paw edema was measured using a mercury plethysmograph and paw diameter by micrometer screw-gauge at 0, 3, 6 and 24 h after carrageenan challenge. Percentage inhibition of edema was also calculated. All the ARBs showed a significant anti-inflammatory effect at 3, 6 and 24 h as compared to control, although not comparable to that of aspirin. This anti-inflammatory effect, although not comparable to a known anti-inflammatory agent like aspirin, would perhaps prove beneficial in elderly patients routinely treated with these drugs. 展开更多
关键词 Angiotensin receptor blockers INFLAMMATION CARRAGEENAN paw edema.
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AB033.Implication of beta-adrenergic receptor in choroidal neovascularization
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作者 Houda Tahiri Samy Omri +1 位作者 Isabelle Lahaie Sylvain Chemtob 《Annals of Eye Science》 2018年第1期439-439,共1页
Background:We investigated the role of beta-adrenergic receptor(B-AR)on choroidal neovascularization(CNV)in an animal model of age-related macular degeneration in mice.Methods:The angiogenic effect of the B-AR was eva... Background:We investigated the role of beta-adrenergic receptor(B-AR)on choroidal neovascularization(CNV)in an animal model of age-related macular degeneration in mice.Methods:The angiogenic effect of the B-AR was evaluated in retinal pigment epithelium(RPE)-choroid explants from C57Bl6 mice stimulated with propranolol or isoproterenol(10μM)(respectively antagonist and agonist of the B-AR)during 24 h.Conversely,a classic choroidal neovascularization(CNV)model induced by laser burn in C57Bl6 mice(8 weeks)was used to assess the anti-angiogenic effect of propranolol.In this experiment,mice were treated with intraperitoneal propranolol(6 mg/kg/d)or vehicle(saline solution)daily for 10 days,starting on day 4 after laser burn and until sacrifice(day 14).Immunostaining analysis on retinal flatmounts and cryosections were performed to determine the surface of CNV,the distribution of B-AR and the number and morphology of microglia/macrophages associated with CNV.To explore if the antiangiogenic effect of propranolol involved the modulation of the inflammatory microenvironment associated with CNV,we used RPE primary cells,J774 macrophages cell line and polarized M1 and M2 bone marrow-derived macrophage(BMDM).Choroidal explants treated with conditioned media(CM)from J774 or polarized M1/M2 BMDM pre-treated with propranolol to confirm the anti-angiogenic effect of propranolol.Expression of angiogenic factors was evaluated by RT PCR and Elisa.Results:The expression and distribution of the B-1,B-2 and B-3 adrenergic receptors were localized in the choroid and RPE cells.The stimulation of RPE-choroid explants with isoproterenol increased CNV compared to vehicle,while propranolol decreased CNV.In vivo,propranolol inhibited significantly the levels of VEGF and CNV growth in laser burn model compared to the vehicle.Additionally,the treatment with propranolol decremented the number of activated(amoeboid shape)microglia/macrophages but surprisingly,the number of non-activated microglia/macrophages around the CNV was higher than with the vehicle treatment.In vitro,propranolol modulated the angiogenic balance in macrophages promoting anti-angiogenic factors expression,especially with M2 BMDM.CM from macrophages pre-treated with propranolol reduced CNV on choroidal explants.Conclusions:These ex vivo and in vivo studies highlight the importance of B-adrenergic receptor in the CNV.Propranolol can inhibit CNV by decreasing the levels of VEGF and modulating microglia/macrophages activation.Further work will investigate the role of B-adrenergic receptor on suppression of the inflammatory environment in order to understand the link between neovascularization and inflammation in CNV during age-related macular degeneration. 展开更多
关键词 Choroidal neovascularization(CNV) MACROPHAGES beta-adrenergic receptor(B-AR)
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Effect of angiotensin Ⅱ type 1 receptor blocker and angiotensin converting enzyme inhibitor on the intraocular growth factors and their receptors in streptozotocin-induced diabetic rats 被引量:5
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作者 Ik Soo Byon Dong Hyun Lee +3 位作者 Eun Sook Jun Min Kyu Shin Sung Who Park Ji Eun Lee 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2017年第6期896-901,共6页
AIM: To investigate the effect of angiotensin II type 1 receptor blocker (ARB) and angiotensin converting enzyme inhibitor (ACEI) on intraocular growth factors and their receptors in streptozotocin-induced diabet... AIM: To investigate the effect of angiotensin II type 1 receptor blocker (ARB) and angiotensin converting enzyme inhibitor (ACEI) on intraocular growth factors and their receptors in streptozotocin-induced diabetic rats. METHODS: Forty Sprague-Dawley rats were divided into 4 groups: control, diabetes mellitus (DM), candesartan- treated DM, and enalapril-treated DM (each group, n---10). After the induction of DM by streptozotocin, candesartan [ARB, 5 mg/(kg · d)] and enalapril [ACEI, 10 mg/(kg · d)] were administered to rats orally for 4Wko Vascular endothelial growth factor (VEGF) and angiotensin II (Ang II) concentrations in the vitreous were measured using enzyme-linked immunosorbent assays, and VEGF receptor 2 and angiotensin II type 1 receptor (ATIR) levels were assessed at week 4 by Western blotting. RESULTS: Vitreous Ang II levels were significantly higher in the DM group and candesartan-treated DM group than in the control (P=0.04 and 0.005, respectively). Vitreous ATIR increased significantly in DM compared to the other three groups (P〈0.007). Candesartan-treated DM rats showed higher vitreal ATIR concentration than the enalapril-treated DM group and control (P〈0.001 and P=0.005, respectively). No difference in vitreous Ang II and ATIR concentration was found between the enalapril- treated DM group and control. VEGF and its receptor were below the minimum detection limit in all 4 groups. CONCLUSION: Increased Ang II and ATIR in the hyperglycemic state indicate activated the intraocular renin-angiotensin system, which is inhibited more effectively by systemic ACEI than systemic ARB. 展开更多
关键词 angiotensin converting enzyme inhibitor angiotensin II type 1 receptor blocker diabetic rat intraocularrenin-angiotensin system
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Angiotensin receptor blocker drugs and inhibition of adrenal beta-arrestin-1-dependent aldosterone production: Implications for heart failure therapy 被引量:12
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作者 Anastasios Lymperopoulos Beatrix Aukszi 《World Journal of Cardiology》 CAS 2017年第3期200-206,共7页
Aldosterone mediates many of the physiological and pathophysiological/cardio-toxic effects of angiotensin II(Ang II). Its synthesis and secretion from the zona glomerulosa cells of the adrenal cortex, elevated in chro... Aldosterone mediates many of the physiological and pathophysiological/cardio-toxic effects of angiotensin II(Ang II). Its synthesis and secretion from the zona glomerulosa cells of the adrenal cortex, elevated in chronic heart failure(HF), is induced by Ang II type 1 receptors(AT1Rs). The AT1R is a G protein-coupled receptor, mainly coupling to Gq/11 proteins. However, it can also signal through β-arrestin-1(βarr1) or-2(βarr2), both of which mediate G protein-independent signaling. Over the past decade, a second, Gq/11 proteinindependent but βarr1-dependent signaling pathway emanating from the adrenocortical AT1R and leading to aldosterone production has become appreciated. Thus, it became apparent that AT1R antagonists that block both pathways equally well are warranted for fully effective aldosterone suppression in HF. This spurred the comparison of all of the currently marketed angiotensin receptor blockers(ARBs, AT1R antagonists or sartans) at blocking activation of the two signaling modes(G protein-, and βarr1-dependent) at the Ang IIactivated AT1R and hence, at suppression of aldosterone in vitro and in vivo. Although all agents are very potent inhibitors of G protein activation at the AT1R, candesartan and valsartan were uncovered to be the most potent ARBs at blocking βarr activation by Ang II and at suppressing aldosterone in vitro and in vivo in post-myocardial infarction HF animals. In contrast, irbesartan and losartan are virtually G protein-"biased" blockers at the human AT1R, with very low efficacy for βarr inhibition and aldosterone suppression. Therefore, candesartan and valsartan(and other, structurally similar compounds) may be the most preferred ARB agents for HF pharmacotherapy, as well as for treatment of other conditions characterized by elevated aldosterone. 展开更多
关键词 Adrenal cortex Adrenocortical zona glomeru losa cell ALDOSTERONE Angiotensin receptor blocker Angiotensin II type 1 receptor β-arrestin-1 Heart failure Suppression efficacy
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Effects of angiotensin-converting enzyme inhibitor and angiotensin Ⅱ receptor blocker on one-year outcomes of patients with atrial fibrillation: insights from a multicenter registry study in China 被引量:4
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作者 Si-Qi LYU Yan-Min YANG +5 位作者 Jun ZHU Juan WANG Shuang WU Jia-Meng REN Han ZHANG Xing-Hui SHAO 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2020年第12期750-758,共9页
Objective To evaluate the effect of angiotensin-converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB)therapy on the prognosis of patients with atrial fibrillation(AF).Methods A total of 1,991 AF patie... Objective To evaluate the effect of angiotensin-converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB)therapy on the prognosis of patients with atrial fibrillation(AF).Methods A total of 1,991 AF patients from the AF registry were divided into two groups according to whether they were treated with ACEI/ARB at recruitment.Baseline characteristics were carefully collected and analyzed.Logistic regression was utilized to identify the predictors of ACEI/ARB therapy.The primary endpoint was all-cause mortality,while the secondary endpoints included cardiovascular mortality,stroke and major adverse events(MAEs)during the one-year follow-up period.Univariable and multivariable Cox regression were performed to identify the association between ACEI/ARB therapy and the one-year outcomes.Results In total,759 AF patients(38.1%)were treated with ACEI/ARB.Compared with AF patients without ACEI/ARB therapy,patients treated with ACEI/ARB tended to be older and had a higher rate of permanent AF,hypertension,diabetes mellitus,heart failure(HF),left ventricular ejection fraction(LVEF)<40%,coronary artery disease(CAD),prior myocardial infarction(MI),left ventricular hypertrophy,tobacco use and concomitant medications(all P<0.05).Hypertension,HF,LVEF<40%,CAD,prior MI and tobacco use were determined to be predictors of ACEI/ARB treatment.Multivariable analysis showed that ACEI/ARB therapy was associated with a significantly lower risk of one-year all-cause mortality[hazard ratio(HR)(95%CI):0.682(0.527-0.882),P=0.003],cardiovascular mortality[HR(95%CI):0.713(0.514-0.988),P=0.042]and MAEs[HR(95%CI):0.698(0.568-0.859),P=0.001].The association between ACEI/ARB therapy and reduced mortality was consistent in the subgroup analysis.Conclusions In patients with AF,ACEI/ARB was related to significantly reduced one-year all-cause mortality,cardiovascular mortality and MAEs despite the high burden of cardiovascular comorbidities. 展开更多
关键词 Angiotensin-converting enzyme inhibitor Angiotensin II receptor blocker Atrial fibrillation MORTALITY
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Angiotensin receptor blocker neprilysin inhibitors 被引量:3
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作者 Daisuke Usuda Toshihiro Higashikawa +16 位作者 Yuta Hotchi Kenki Usami Shintaro Shimozawa Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Toshihiko Yoshizawa Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita 《World Journal of Cardiology》 2021年第8期325-339,共15页
Heart failure(HF)is a clinical syndrome that results from a structural or functional cardiac disorder that reduces the ability of the ventricle of the heart to fill with,or eject,blood.It is a multifaceted clinical co... Heart failure(HF)is a clinical syndrome that results from a structural or functional cardiac disorder that reduces the ability of the ventricle of the heart to fill with,or eject,blood.It is a multifaceted clinical condition that affects up to 2%of the population in the developed world,and is linked to significant morbidity and mortality;it is therefore considered a major concern for public health.Regarding the mechanism of HF,three neurohumoral factors-the reninangiotensin-aldosterone system,the sympathetic nervous system,and natriuretic peptides—are related to the pathology of chronic HF(CHF),and the targets of treatment.Angiotensin receptor blocker and neprilysin inhibitor(angiotensinreceptor neprilysin inhibitor),namely sacubitril/valsartan(SAC/VAL),has been introduced as a treatment for CHF.SAC/VAL is an efficacious,safe,and costeffective therapy that improves quality of life and longevity in patients with HF with reduced ejection fraction(HFrEF),and reduces hospital admissions.An inhospital initiation strategy offers a potential new avenue to improve the clinical uptake of SAC/VAL.In the last five years,SAC/VAL has been established as a cornerstone component of comprehensive disease-modifying medical therapy in the management of chronic HFrEF.On the other hand,further work,with carefully designed and controlled preclinical studies,is necessary for understanding the molecular mechanisms,effects,and confirmation of issues such as long-term safety in both human and animal models. 展开更多
关键词 Angiotensin receptor blocker and neprilysin inhibitor Chronic heart failure Renin-angiotensin-aldosterone-system Sympathetic nervous system Natriuretic peptide Sacubitril/valsartan
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The Significance of Angiotensin Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker Use in Sudden Cardiac Death
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作者 Makoto Onodera Satoshi Kikuchi +2 位作者 Yasuhisa Fujino Yoshihiro Inoue Yuji Fujita 《International Journal of Clinical Medicine》 2017年第8期496-503,共8页
Objectives: To investigate the relationship between the use of angiotensin converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) and hyperkalemia in patients diagnosed with sudden cardiac death. M... Objectives: To investigate the relationship between the use of angiotensin converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) and hyperkalemia in patients diagnosed with sudden cardiac death. Methods: We examined oral ACE inhibitor or ARB use among cardiopulmonary arrest patients brought by ambulance to our emergency room during a 5-year period from January 2012 to December 2016. The cause of death was determined to be sudden cardiac death, despite temporary return of spontaneous circulation after starting cardiopulmonary resuscitation. Subjects were dichotomized into 2 groups, those taking and those not taking an ACE inhibitor or ARB. Variables determined retrospectively included serum potassium, estimated glomerular filtration rate as an index of kidney function and time from cardiopulmonary arrest to return of spontaneous circulation. The Mann-Whitney U-test was used to compare continuous data, and the chi-square test to compare categorical data between groups. The results are expressed as the median plus range. Statistical significance was assumed at p Results: Thirty-five patients met the inclusion criteria. The mean age was 77.1 years (range, 35 - 93 years), and there were 26 males and 9 females. Eleven subjects were ACE inhibitor or ARB users, and 24 were non-users. The serum potassium level was significantly higher in users than non-users (median, 6.2 mEq/L (range, 4.5 - 10.0) vs. 5.2 mEq/L (range, 3.6 - 8.3);p = 0.001). The estimated glomerular filtration rate was significantly lower in users than non-users (median, 25.1 mL/min/1.73 m2 (range, 4.6 - 60.3) vs. 46.9 mL/min/1.73 m2 (range, 19.8 - 97.1);p = 0.009). There was no significant difference in time from cardiopulmonary arrest to return of spontaneous circulation between the 2 groups (median, 24 minutes (range, 3 - 111) vs. 29 minutes (range, 10 - 54);p = 0.355). Conclusion: It is possible that hyperkalemia induced by ACE inhibitor or ARB use is a cause of sudden cardiac death, especially in patients with chronic kidney disease. 展开更多
关键词 ANGIOTENSIN CONVERTING Enzyme Inhibitors ANGIOTENSIN II receptor blockers Glomerular Filtration Rate HYPERKALEMIA SUDDEN Cardiac DEATH
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厄贝沙坦通过调节NLRP3表达在糖尿病肾病大鼠中的保护作用 被引量:1
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作者 赵青 文丹 +7 位作者 叶坚 黄佳晏 王瑜 刘思逸 蒋青 罗来敏 陈钦开 吕金雷 《华中科技大学学报(医学版)》 CAS CSCD 北大核心 2024年第3期308-314,共7页
目的 观察糖尿病肾病大鼠中NLRP3(NOD-like receptor protein 3)的表达,并在沉默NLRP3和以血管紧张素受体抑制剂(ARB)厄贝沙坦干预后观察NLRP3及炎症和纤维化因子的表达变化,探讨厄贝沙坦对糖尿病肾病大鼠的保护作用。方法 雄性SD大鼠... 目的 观察糖尿病肾病大鼠中NLRP3(NOD-like receptor protein 3)的表达,并在沉默NLRP3和以血管紧张素受体抑制剂(ARB)厄贝沙坦干预后观察NLRP3及炎症和纤维化因子的表达变化,探讨厄贝沙坦对糖尿病肾病大鼠的保护作用。方法 雄性SD大鼠随机分成5组:对照(Control)组、模型(Model)组、空载(Model+Blank)组、NLRP3沉默(Model+NLRP3 Sh)组、ARB(Model+ARB)组,分别在糖尿病肾病模型建立后8周、12周处死大鼠并收集肾脏组织。实时荧光定量PCR检测NLRP3、半胱氨酸天冬氨酸蛋白酶-1(Caspase-1)、核因子κB(NF-κB)P65和波形蛋白(Vimentin)的mRNA表达水平;Western blot检测NLRP3、P65、热休克蛋白47(heat shock protein 47,HSP47)和Vimentin的蛋白表达水平;免疫荧光法观察NLRP3、Caspase-1和Vimentin的表达;PAS、PASM和Masson染色观察肾脏病理改变。结果 与对照组比较,模型组及空载组NLRP3、Caspase-1、P65和Vimentin mRNA的表达升高(均P<0.05),NLRP3、Caspase-1、P65、HSP47和Vimentin的蛋白表达升高(均P<0.05)。与模型组及空载组相比,NLRP3沉默组及ARB组的上述指标表达均下调(均P<0.05),模型组与空载组以上指标之间差异无统计学意义。病理染色结果显示NLRP3沉默和厄贝沙坦干预可减轻糖尿病肾病大鼠肾脏损害,减轻肾小球肥大、肾小球硬化、系膜扩张、间质纤维化。结论 糖尿病肾病大鼠肾脏NLRP3信号通路被激活,且炎性和纤维化因子表达上调。厄贝沙坦可阻断NLRP3信号通路,减轻肾脏损害。天然免疫受体NLRP3可能成为治疗糖尿病肾病的新靶点。 展开更多
关键词 糖尿病肾病 NLRP3炎症小体 血管紧张素受体阻断剂 肾脏纤维化 天然免疫
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外用β受体阻滞剂和脉冲燃料激光治疗低、中风险血管瘤的效果对比
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作者 陈茜岚 钱秋芳 +2 位作者 林晓 黄迎 杨芸 《智慧健康》 2024年第16期40-43,共4页
目的比较外用β受体阻滞剂和激光治疗低、中风险血管瘤的效果。方法将2018年10月—2021年9月本院收治的262例低、中风险婴幼儿血管瘤患者根据治疗方式分为脉冲燃料激光组(85例)、外用0.5%噻马洛尔组(91例)和外用2%卡替洛尔组(86例)。对... 目的比较外用β受体阻滞剂和激光治疗低、中风险血管瘤的效果。方法将2018年10月—2021年9月本院收治的262例低、中风险婴幼儿血管瘤患者根据治疗方式分为脉冲燃料激光组(85例)、外用0.5%噻马洛尔组(91例)和外用2%卡替洛尔组(86例)。对比各组的疗效。脉冲燃料激光治疗采用595nm PDL联合1064nm Nd:钇铝石榴石(yttrium aluminum garnet,YAG),每月1次,持续治疗1~6月。其余两组将外用β受体阻滞剂湿敷于瘤体上,持续30min,每日湿敷2次。结果总有效率方面,激光组与噻马洛尔组的差异不明显,无统计学意义(P>0.05),但与卡替洛尔组相比,组间差异显著,有统计学意义(P<0.05)。激光组疗程为(3.47±1.46)月,明显快于外用β受体阻滞剂组,组间差异显著,有统计学意义(P<0.05)。噻马洛尔组的疗程(9.33±5.80月)较卡替洛尔组(5.57±2.57月)长,但噻马洛尔组有效率(85.4%)较卡替洛尔组(79.3%)高。三组血管瘤疗效与性别、风险等级没有相关性。浅表性血管瘤的疗效明显优于混合性。结论无论是脉冲燃料激光还是外用β受体阻滞剂均对低、中风险血管瘤有效。激光治疗较外用β受体阻滞剂控制快、疗程短。建议尽早开始治疗,最好在出生3月以内,并坚持用药保证一定的疗程,使治疗效果达到最优。 展开更多
关键词 Β受体阻滞剂 噻吗洛尔 卡替洛尔 脉冲激光 风险等级 婴幼儿血管瘤
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术前多沙唑嗪准备时长对嗜铬细胞瘤和副神经节瘤患者术中血流动力学的影响
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作者 景晓利 陶磊 张富军 《上海医学》 CAS 2024年第1期26-33,共8页
目的分析在精确麻醉管理模式下,多沙唑嗪术前准备时长对嗜铬细胞瘤(phaeochromocytoma,PCC)和副神经节瘤(paraganglioma,PGL)患者术中血流动力学的影响情况。方法采用回顾性队列研究方法,收集、分析上海交通大学医学院附属瑞金医院2015... 目的分析在精确麻醉管理模式下,多沙唑嗪术前准备时长对嗜铬细胞瘤(phaeochromocytoma,PCC)和副神经节瘤(paraganglioma,PGL)患者术中血流动力学的影响情况。方法采用回顾性队列研究方法,收集、分析上海交通大学医学院附属瑞金医院2015年1月—2021年1月择期行PCC和PGL切除手术的患者资料。根据纳入、排除标准,共有232例患者被纳入本研究。其中,PCC 199例,PGL 33例。按照患者术前多沙唑嗪准备时长[以天(T)表示]分为4组:组1 T<14 d;组2 T为14~28 d;组3 T为<28~42 d;组4 T>42 d。计算4组术前多沙唑嗪准备时长患者的术中血流动力学不稳定(hemodynamic instability,HI)的发生率。比较非HI与HI患者的一般资料、ASA分级、合并症、术前用药等。观察4组患者的术中收缩压、舒张压、平均动脉压和心率的最大值、最小值及波动范围,术中低血压的发生情况,术中血管活性药物使用情况,以及术中强心药的使用率。采用Clavien-Dindo评分标准评估4组患者的术后早期预后并记录术后住院时间。结果232例患者中,98例发生了HI,纳入HI组,剩余134例纳入非HI组。单因素分析显示,与非HI组比较,HI组ASAⅢ级患者占比、糖尿病患者占比,以及术前最高水平血浆甲氧基肾上腺素和血浆甲氧基去甲肾上腺素的数值显著增高(P值均<0.05)。将单因素分析中P<0.25的变量及术前多沙唑嗪准备时长纳入多因素logistic回归分析,结果显示:患者术前ASA分级高、合并糖尿病是其术中发生HI的危险因素(P值均<0.05),而术前多沙唑嗪准备时长不是术中发生HI的危险因素(P>0.05)。与组1相比,组2、组4患者合并术前高血压的患者占比均显著增高(P值均<0.05/6)。4组术前多沙唑嗪准备时长患者术中HI的发生率、血流动力学各指标水平、麻醉时长、手术时长、强心药物使用情况、液体正平衡水平、各手术方式占比,以及术中使用各类血管活性药物单位剂量的差异均无统计学意义(P值均>0.05/6)。与组1相比,术后组2、组4中Clavien-Dindo 2级患者的占比均显著增高(P值均<0.05/6)。术后,4组间的Clavien-Dindo 1、3、4级的患者占比,以及术后住院天数的差异均无统计学意义(P值均>0.05/6)。4组患者均未发生术后的院内死亡。结论在精确麻醉管理模式下,术前多沙唑嗪准备时间长短对PCC和PGL患者术中的血流动力学稳定性无显著影响。“理想麻醉状态”的维持、完善的血流动力学监测、目标导向的液体管理策略,以及个体化快速短效血管活性药物的使用是维持术中血流动力学稳定的关键。 展开更多
关键词 嗜铬细胞瘤 副神经节瘤 多沙唑嗪 Α-受体阻滞剂 精确麻醉管理 血流动力学
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应激性心肌病的研究进展
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作者 唐琛 史宏志 +4 位作者 韩红亚 刘晓丽 赵亦骢 王琛茜 张佳宜 《心血管病学进展》 CAS 2024年第7期593-597,共5页
应激性心肌病是以可逆性室壁运动异常为特征的一种心血管综合征,临床表现与急性冠脉综合征相似,但冠状动脉造影显示冠状动脉解剖正常。应激性心肌病的发病机制尚未完全明确,临床诊断不易,标准治疗药物存在争议,因并发症和复发风险导致... 应激性心肌病是以可逆性室壁运动异常为特征的一种心血管综合征,临床表现与急性冠脉综合征相似,但冠状动脉造影显示冠状动脉解剖正常。应激性心肌病的发病机制尚未完全明确,临床诊断不易,标准治疗药物存在争议,因并发症和复发风险导致预后不佳。现总结应激性心肌病的流行病学、发病机制、诊断和治疗方面的最新进展,以期为改善疾病的预后提供思路。 展开更多
关键词 应激性心肌病 儿茶酚胺 嗜铬细胞瘤 Β肾上腺素受体阻滞剂
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Role of renin-angiotensin system/angiotensin converting enzyme-2 mechanism and enhanced COVID-19 susceptibility in type 2 diabetes mellitus 被引量:1
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作者 Ashwin Kumar Shukla Komal Awasthi +1 位作者 Kauser Usman Monisha Banerjee 《World Journal of Diabetes》 SCIE 2024年第4期606-622,共17页
Coronavirus disease 2019(COVID-19)is a disease that caused a global pandemic and is caused by infection of severe acute respiratory syndrome coronavirus 2 virus.It has affected over 768 million people worldwide,result... Coronavirus disease 2019(COVID-19)is a disease that caused a global pandemic and is caused by infection of severe acute respiratory syndrome coronavirus 2 virus.It has affected over 768 million people worldwide,resulting in approx-imately 6900000 deaths.High-risk groups,identified by the Centers for Disease Control and Prevention,include individuals with conditions like type 2 diabetes mellitus(T2DM),obesity,chronic lung disease,serious heart conditions,and chronic kidney disease.Research indicates that those with T2DM face a hei-ghtened susceptibility to COVID-19 and increased mortality compared to non-diabetic individuals.Examining the renin-angiotensin system(RAS),a vital regulator of blood pressure and pulmonary stability,reveals the significance of the angiotensin-converting enzyme(ACE)and ACE2 enzymes.ACE converts angiotensin-I to the vasoconstrictor angiotensin-II,while ACE2 counters this by converting angiotensin-II to angiotensin 1-7,a vasodilator.Reduced ACE2 exp-ression,common in diabetes,intensifies RAS activity,contributing to conditions like inflammation and fibrosis.Although ACE inhibitors and angiotensin receptor blockers can be therapeutically beneficial by increasing ACE2 levels,concerns arise regarding the potential elevation of ACE2 receptors on cell membranes,potentially facilitating COVID-19 entry.This review explored the role of the RAS/ACE2 mechanism in amplifying severe acute respiratory syndrome cor-onavirus 2 infection and associated complications in T2DM.Potential treatment strategies,including recombinant human ACE2 therapy,broad-spectrum antiviral drugs,and epigenetic signature detection,are discussed as promising avenues in the battle against this pandemic. 展开更多
关键词 Angiotensin-converting enzyme 2 Angiotensin-converting enzyme inhibitors Angiotensin-II receptor blockers Complex diseases COVID-19 Type 2 diabetes
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