Pharmacological Aspects of Heart Disease

The importance of heart and artery disease as a cause of death and disability is difficult to exaggerate: it causes over half of all deaths in the western world and now accounts for one-quarter of deaths in the entire world. This appalling incidence persists in spite of commendable progress in treatment and prevention, particularly in the last two or three decades. Deaths from coronary disease have decreased by a third in the past twenty years and stroke has decreased by a half in the same period. This remarkable improvement, saving thousands of lives per year, has come about due to changes in life style (low fat diet, control of high blood pressure, less smoking and more exercise) and progress in treatment (more effective drugs, coronary care units, pacemakers, and cardiac surgery). Progress in understanding the pathophysiologic and pharn,acologic mechanisms operative in heart disease have been paramount in the development of more rational and more effective therapy. Dramatic and spectacular surgical treatments have fired the public imagination. Bypass surgery is commonplace and results in complete or considerable relief of symptoms in the majority of patients operated upon.

Zusammenfassung
Proceedings of an International Symposium on Heart Metabolism in Health and Disease and the 3rd Annual Cardiology Symposium of the University of Manitoba July 8-11, 1986, Winnipeg, Canada

Inhalt
Preface.- Acknowledgements.- A. Antiarrhythmic Agents.- 1. Approaches to the Selection of an Antiarrhythmic Drug.- 2. Antiarrhythmic Action of Calcium Antagonists.- 3. Ouinidine Reduces Outward Current in Single Canine Cardiac Purkinje Cells.- 4. Antiarrhythmic Drug Therapy for Patients with Ventricular Tachyarrhythmias in the Setting of Left Ventricular Dysfunction: 1. The Role of Propafenone, 2. The Role of Adjunct Beta-Blockade.- 5. Protective Effect of Nifedipine upon Ouabain-Induced Arrhythmias.- 6. Effect of Isoprenaline or Stress on Adrenaline-Induced Arrhythmias in Albino Rats.- B. Therapy Of Hypertension And Heart Failure.- 7. Clinical Trials in Hypertension and Congestive Heart Failure.- 8. Interaction of Calcium Entry Blockers and Adrenergic System in Hypertension and Heart Failure.- 9 Prazosin Therapy in Chronic Congestive Heart Failure.- 10. Influences of a Long-Term Treatment with Antihypertensive Drugs on Left Ventricular Myosin Isoenzyme Pattern in Spontaneously Hypertensive Rats.- 11. Enhanced Action of Nifedipine upon Vascular Smooth Muscle from Hypertensive Rats.- 12. Ajmaloon a Unique Herbal Polypharmaceutical Possessing Both Hypotensive and Cadmium Lowering Property.- 13. Pathophysiology and Treatment of Decreased Cardiac Output Complicating Pulmonary Hypertension.- C. Calcium Antagonists And Beta Adrenergic Receptor Blockers.- 14. Ca Antagonists in Cardiopulmonary Changes Induced by High Altitude Hypoxia.- 15. Effect of Crystalloid Cardioplegia and Diltiazem on the Cardiac Function and Some Biochemical Parameters During Hypothermic Cardiac Arrest Using Cardiopulmonary Bypass.- 16. Effects of Verapamil on Metabolism and Function of Hearts From Normal and Hyperthyroid Rats.- 17. Regulation of Beta-Adrenergic Pathways in the Heart.- 18. Involvement of?2-adrenergic Receptors in the Potentiation of the Chronotropic Action of Isoprenaline Evoked in Rocker-Cultured Neonatal Rat Heart Cells by Pyruvate and L(+)-Lactate.- 19. Cardiac Effects of ?-Adrenergic Blockers in Combination with Metabolic Interventions.- 20. Local Adrenergic Effects on Metabolism in Heart and Skeletal Muscle in Man.- D. Cardiac Glycosides And Sodium Pump.- 21. Multiple Forms of the Cardiac Glycoside Receptor with Different Affinities for Cardiac Glycosides.- 22. Modulation of Glycoside Sensitivity of the Cardiac Sodium Pump.- 23. Up and Down Regulation of the Sodium Pumping Sites in Myocardium.- 24. Sensitivity of the Hypertrophied Heart to Ouabain. An In Vivo and In Vitro Study..- 25. Mitochondrial Calcium Overload in Digitalis-Induced Mechanical Toxicity.- E. Newer Inotropic Agents And Calcium.- 26. Classification and Mechanism of Action of the Cardiac Inotropic Agents: An Overview.- 27. New Approaches for the Treatment of the Failing Myocardium: Myofibrillar Proteins as Potential Targets for Pharmacotherapy.- 28. The Role of the Lipid Bilayer in Amphiphile-Membrane/Receptor Interactions: A Unifying Hypothesis.- 29. Forskolin, A New Inotropic Agent.- 30. Dependence of Vasoconstrictor Responses on Extracellular Calcium.- 31. Cytosolic Free Calcium Transients Induced by Ergonovine in Cultured Vascular Smooth Muscle Cells.