Folic acid supplementation and chronic kidney disease progression
In contrast to prior studies demonstrating no benefit or even increased harm from B vitamin supplementation in patients with chronic kidney disease, a large randomized trial from China recently demonstrated small but statistically significant reductions in the risk of first stroke and chronic kidney disease progression with the addition of folic acid to enalapril in adults with hypertension. Differences in the study population and study intervention may explain these discordant results. (Source: Kidney International)
Source: Kidney International - November 21, 2016 Category: Urology & Nephrology Authors: Christina M. Wyatt, J. David Spence Tags: Nephrology Digest Source Type: research

Maternal Na(+) intake induces renal function injury in rats prevented by a short-term angiotensin converting enzyme inhibitor.
This article is protected by copyright. All rights reserved. PMID: 27864828 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Pharmacology and Physiology)
Source: Clinical and Experimental Pharmacology and Physiology - November 19, 2016 Category: Drugs & Pharmacology Authors: Ribeiro NE, Cabral EV, Aires RS, Vieira-Filho LD, Ribeiro VS, Gonçalves DR, Borges LP, Melo IM, Ferreira CG, Wanderley-Teixeira V, Teixeira ÁA, Soares AF, Paixão AD Tags: Clin Exp Pharmacol Physiol Source Type: research

Support for involvement of the renin-angiotensin system in dysplastic Barrett's esophagus.
CONCLUSION: Interference with angiotensin II formation was associated with altered expression of inflammation- and carcinogenesis-related proteins. The present results speak in favor of involvement of angiotensin II in BE dysplasia, but the role of AT1R should be investigated further. PMID: 27846743 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Gastroenterology)
Source: Scandinavian Journal of Gastroenterology - November 17, 2016 Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research

Preparation and physico-chemical characterization of matrix pellets containing APIs with different solubility via extrusion process.
In this study a multiparticulate matrix system was produced, containing two different APIs: enalapril-maleate and hydrochlorothiazide. The critical control points of the process were investigated by means of factorial design. Besides the generally used microcrystalline cellulose, ethylcellulose was used as matrix former to achieve modified drug release ensured by diffusion. The matrix pellets were made by extrusion-spheronization using a twin-screw extruder. Some pellet properties (aspect ratio, 10% interval fraction, hardness, deformation process) were determined. The aim of our study was to investigate how the two differ...
Source: Drug Development and Industrial Pharmacy - November 16, 2016 Category: Drugs & Pharmacology Tags: Drug Dev Ind Pharm Source Type: research

Sacubitril/valsartan in chronic heart failure with reduced ejection fraction: a guide to its use
AbstractOrally administered sacubitril/valsartan (Entresto®) comprises the neprilysin inhibitor prodrug sacubitril and the angiotensin receptor blocker valsartan, and was recently approved in the USA and the EU for the treatment of chronic heart failure (HF) with reduced ejection fraction (EF). In the PARADIGM-HF trial, the risk of death from cardiovascular causes or first hospitalization for worsening HF (primary composite endpoint) was significantly reduced with sacubitril/valsartan relative to the ACE inhibitor enalapril in patients with chronic HF with reduced EF. Sacubitril/valsartan was generally well tolerated, ...
Source: Drugs and Therapy Perspectives - November 16, 2016 Category: Drugs & Pharmacology Source Type: research

Bartonella-associated inflammatory cardiomyopathy in a dog
Publication date: Available online 12 November 2016 Source:Journal of Veterinary Cardiology Author(s): R.A. Santilli, S. Battaia, M. Perego, M. Tursi, E. Grego, C. Marzufero, P. Gianella A 6-year-old, male, mongrel dog was presented for acute onset of dyspnea and cough. At admission, the dog was cachectic and severely depressed. The electrocardiogram showed a sinus rhythm conducted with left bundle truncular branch block and interrupted by frequent multiform ventricular ectopic beats organized in allorhythmias. Thoracic radiographs revealed a marked cardiomegaly with perihilar edema, whereas transthoracic echocardiog...
Source: Journal of Veterinary Cardiology - November 13, 2016 Category: Veterinary Research Source Type: research

Efficacy of Folic Acid Therapy on the Progression of Chronic Kidney Disease The Renal Substudy of the China Stroke Primary Prevention Trial
In this substudy of eligible China Stroke Primary Prevention Trial (CSPPT), 15 104 participants with an estimated glomerular filtration rate (eGFR) 30 mL/min/1.73 m2 or greater, were randomized to receive a single tablet daily containing 10 mg enalapril and 0.8 mg folic acid (n = 7545) or 10 mg enalapril alone (n = 7559). Overall, 15 104 Chinese adults with a mean (range) age of 60 (45-75) years were recruited; median follow-up was 4.4 years. There were 164 and 132 primary events in the enalapril group and the enalapril-folic&n...
Source: Nephrology Now - November 11, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology Source Type: research

Elevated Homocysteine Concentrations Decrease the Antihypertensive Effect of Angiotensin-Converting Enzyme Inhibitors in Hypertensive Patients.
Abstract OBJECTIVE: We aimed to examine whether baseline homocysteine (Hcy) concentrations affect antihypertensive responses to enalapril treatment among previously untreated hypertensive patients (n=10 783) in the CSPPT (China Stroke Primary Prevention Trial). APPROACH AND RESULTS: After a 3-week run-in treatment with a daily dose of 10 mg enalapril, eligible hypertensive patients were randomly assigned to a double-blind daily treatment of a tablet of either enalapril (10 mg) and folic acid (0.8 mg) or enalapril (10 mg) alone for a median of 4.5 years. After the 3-week treatment period with enalapril ...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - November 10, 2016 Category: Cardiology Authors: Qin X, Li Y, Sun N, Wang H, Zhang Y, Wang J, Li J, Xu X, Liang M, Nie J, Wang B, Cheng X, Li N, Sun Y, Zhao L, Wang X, Hou FF, Huo Y Tags: Arterioscler Thromb Vasc Biol Source Type: research

Safety of Enalapril in Infants Admitted to the Neonatal Intensive Care Unit
AbstractEnalapril is used to treat hypertension and congestive heart failure in infants. However, enalapril is not labeled for neonates, and safety data in infants are sparse. To evaluate the safety of enalapril in young infants, we conducted a retrospective cohort study of infants who were exposed to enalapril in the first 120  days of life and were cared for in 348 neonatal intensive care units from 1997 to 2012. We determined the proportion of exposed infants who developed adverse events, including death, hypotension requiring pressors, hyperkalemia, and elevated serum creatinine. Using multivariable logistic regre...
Source: Mammalian Genome - November 8, 2016 Category: Genetics & Stem Cells Source Type: research

Treatment of hereditary angioedema with normal C1 ‐INH and specific mutations in the F12 gene (HAE‐FXII)
We report our experience treating HAE‐FXII with discontinuation of potential trigger factors and drug therapies. MethodsThe study included 72 patients with HAE‐FXII. Potential triggers included estrogen‐containing oral contraceptives (eOC), hormonal replacement therapy, or angiotensin‐converting enzyme inhibitors. Drug treatment comprised plasma‐derived C1 inhibitor (pdC1‐INH) for acute swelling attacks and progestins, tranexamic acid and danazol for prevention of attacks. ResultsDiscontinuation of eOC was effective in 25/28 (89.3%) of women and led to a reduction of number of attacks (about 90%). After ending ...
Source: Allergy - November 6, 2016 Category: Allergy & Immunology Authors: K. Bork, K. Wulff, G. Witzke, J. Hardt Tags: Brief Communication Source Type: research

Amlodipine and enalapril promote distinct effects on cardiovascular autonomic control in spontaneously hypertensive rats: the role of aerobic physical training
Conclusion: Amlodipine was more effective in promoting beneficial autonomic cardiovascular adaptations in sedentary animals. In contrast, enalapril achieved better autonomic results only when combined with aerobic physical training. (Source: Journal of Hypertension)
Source: Journal of Hypertension - November 4, 2016 Category: Cardiology Tags: ORIGINAL PAPERS: Exercise Source Type: research

An additive effect of anti-PAI-1 antibody to ACE inhibitor on slowing the progression of diabetic kidney disease
While angiotensin II blockade slows the progression of diabetic nephropathy, current data suggest that it alone cannot stop the disease process. New therapies or drug combinations will be required to further slow or halt disease progression. Inhibition of plasminogen activator inhibitor type 1 (PAI-1) aimed at enhancing ECM degradation has shown therapeutic potential in diabetic nephropathy. Here, using a mouse model of type diabetes, the maximally therapeutic dose of the PAI-1-neutralizing mouse monoclonal antibody (MEDI-579) was determined and compared with the maximally effective dose of enalapril. We then examined whet...
Source: AJP: Renal Physiology - November 1, 2016 Category: Urology & Nephrology Authors: Gu, C., Zhang, J., Noble, N. A., Peng, X.-R., Huang, Y. Tags: CALL FOR PAPERS Source Type: research

An additive effect of anti-PAI-1 antibody to ACE inhibitor on slowing the progression of diabetic kidney disease.
Abstract While angiotensin II blockade slows the progression of diabetic nephropathy, current data suggest that it alone cannot stop the disease process. New therapies or drug combinations will be required to further slow or halt disease progression. Inhibition of plasminogen activator inhibitor type 1 (PAI-1) aimed at enhancing ECM degradation has shown therapeutic potential in diabetic nephropathy. Here, using a mouse model of type diabetes, the maximally therapeutic dose of the PAI-1-neutralizing mouse monoclonal antibody (MEDI-579) was determined and compared with the maximally effective dose of enalapril. We ...
Source: American Journal of Physiology. Renal Physiology - November 1, 2016 Category: Physiology Authors: Gu C, Zhang J, Noble NA, Peng XR, Huang Y Tags: Am J Physiol Renal Physiol Source Type: research

Enalapril
(Source: Reactions Weekly)
Source: Reactions Weekly - November 1, 2016 Category: Drugs & Pharmacology Source Type: research

Dementia ‐related adverse events in PARADIGM‐HF and other trials in heart failure with reduced ejection fraction
ConclusionWe found no evidence that sacubitril/valsartan, compared with enalapril, increased dementia‐related AEs, although longer follow‐up may be necessary to detect such a signal and more sensitive tools are needed to detect lesser degrees of cognitive impairment. Further studies to address this question are warranted. (Source: European Journal of Heart Failure)
Source: European Journal of Heart Failure - November 1, 2016 Category: Cardiology Authors: Jane A. Cannon, Li Shen, Pardeep S. Jhund, S øren L. Kristensen, Lars Køber, Fabian Chen, Jianjian Gong, Martin P. Lefkowitz, Jean L. Rouleau, Victor C. Shi, Karl Swedberg, Michael R. Zile, Scott D. Solomon, Milton Packer, John J.V. McMurray, Tags: Original Article Source Type: research

Folic Acid Therapy Reduces the First Stroke Risk Associated With Hypercholesterolemia Among Hypertensive Patients [Clinical Sciences]
Background and Purpose—We sought to determine whether folic acid supplementation can independently reduce the risk of first stroke associated with elevated total cholesterol levels in a subanalysis using data from the CSPPT (China Stroke Primary Prevention Trial), a double-blind, randomized controlled trial.Methods—A total of 20 702 hypertensive adults without a history of major cardiovascular disease were randomly assigned to a double-blind daily treatment of an enalapril 10-mg and a folic acid 0.8-mg tablet or an enalapril 10-mg tablet alone. The primary outcome was first stroke.Results—The media...
Source: Stroke - October 24, 2016 Category: Neurology Authors: Qin, X., Li, J., Spence, J. D., Zhang, Y., Li, Y., Wang, X., Wang, B., Sun, N., Chen, F., Guo, J., Yin, D., Sun, L., Tang, G., He, M., Fu, J., Cai, Y., Shi, X., Ye, P., Chen, H., Zhao, S., Chen, M., Gao, C., Kong, X., Hou, F. F., Huang, Y., Huo, Y. Tags: Clinical Studies, Diet and Nutrition, Primary Prevention, Hypertension, Ischemic Stroke Original Contributions Source Type: research

Gene ‐Gene Interactions among PRKCA, NOS3 and BDKRB2 Polymorphisms Affect the Antihypertensive Effects of Enalapril
This article is protected by copyright. All rights reserved. (Source: Basic and Clinical Pharmacology and Toxicology)
Source: Basic and Clinical Pharmacology and Toxicology - October 1, 2016 Category: Drugs & Pharmacology Authors: Gustavo H. Oliveira ‐Paula, Marcelo R. Luizon, Riccardo Lacchini, Vanessa Fontana, Pamela S. Silva, Celso Biagi, E. Tanus‐Santos Tags: Original Article Source Type: research

Blood capillary rarefaction and lymphatic capillary neoangiogenesis are key contributors to renal allograft fibrosis in an ACE inhibition rat model
In conclusion, ACEi considerably decreased and/or delayed both glomerulosclerosis and tubulointerstitial injury. Prevention of glomerular podoplanin loss and proteinuria could be attributed to the known intraglomerular pressure-lowering effects of ACEi. Reduction of lymphangiogenesis could contribute to amelioration of tubulointerstitial fibrosis and inflammatory infiltration after ACEi. (Source: AJP: Heart and Circulatory Physiology)
Source: AJP: Heart and Circulatory Physiology - October 1, 2016 Category: Cardiology Authors: Hamar, P., Kerjaschki, D. Tags: Call for Papers: Small Vessels Big Problems Source Type: research

Adverse drug reactions in Colombian patients, 2007-2013: Analysis of population databases.
CONCLUSION: An increasing number of ADR reports were found coinciding with a worldwide tendency. Differences between inpatient and outpatient ADR reports were found when compared to scientific publications. The information on ADR reports, mainly gathered by the Instituto Nacional de Vigilancia de Medicamentos y Alimentos - Invima, should be made public for academic and institutional use. PMID: 27622439 [PubMed - in process] (Source: Biomedica : Revista del Instituto Nacional de Salud)
Source: Biomedica : Revista del Instituto Nacional de Salud - September 15, 2016 Category: Global & Universal Tags: Biomedica Source Type: research

Progenitor cell secretory products exert additive renoprotective effects when combined with ace inhibitors in experimental CKD
Conclusions: Early outgrowth cell-derived factors exert additive renoprotective effects on top of angiotensin-converting enzyme inhibitor therapy in experimental chronic kidney disease, providing the rationale for clinical trials of early outgrowth cell-based therapies for chronic kidney disease. (Source: Journal of the Renin-Angiotensin-Aldosterone System : JRAAS)
Source: Journal of the Renin-Angiotensin-Aldosterone System : JRAAS - September 15, 2016 Category: Biomedical Science Authors: Kepecs, D. M., Yuen, D. A., Zhang, Y., Thai, K., Connelly, K. A., Gilbert, R. E. Tags: Original Article Source Type: research

Enalapril protects against myocardial ischemia/reperfusion injury in a swine model of cardiac arrest and resuscitation.
This study was designed to explore whether ACEIs exert cardioprotective effects in a swine model of cardiac arrest (CA) and resuscitation. Male pigs were randomly assigned to three groups: sham‑operated group, saline treatment group and enalapril treatment group. Thirty minutes after drug infusion, the animals in the saline and enalapril groups were subjected to ventricular fibrillation (8 min) followed by cardiopulmonary resuscitation (up to 30 min). Cardiac function was monitored, and myocardial tissue and blood were collected for analysis. Enalapril pre‑treatment did not improve cardiac function or th...
Source: International Journal of Molecular Medicine - September 15, 2016 Category: Molecular Biology Authors: Wang G, Zhang Q, Yuan W, Wu J, Li C Tags: Int J Mol Med Source Type: research

The Case| A handful of hypertension
A 37-year-old woman was referred to our clinic with difficult-to-control hypertension that she has had since age 12 years. At 18 years, enalapril was administered. One year before referral to our department, she was admitted with a left-sided hemiparesis and blood pressure values>200/120 mm  Hg. Thereafter, blood pressure–lowering treatment was intensified and a statin was begun. The patient is a short-statured ballet dancer (her height is 143 cm). Physical examination was otherwise devoid of target organ damage. (Source: Kidney International)
Source: Kidney International - September 13, 2016 Category: Urology & Nephrology Authors: Bert-Jan H. van den Born, Louise C. Oskam, Majida Zidane, Carolin Sch ächterle, Enno Klussmann, Sylvia Bähring, Friedrich C. Luft Tags: Make Your Diagnosis Source Type: research

Effects of Sacubitril/Valsartan in the PARADIGM-HF Trial (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) According to Background Therapy [Original Articles]
We examined whether this benefit was consistent irrespective of background therapy. Methods and Results— We examined the effect of study treatment in the following subgroups: diuretics (yes/no), digitalis glycoside (yes/no), mineralocorticoid receptor antagonist (yes/no), and defibrillating device (implanted defibrillating device, yes/no). We also examined the effect of study drug according to β-blocker dose (≥50% and
Source: Circulation: Heart Failure - September 12, 2016 Category: Cardiology Authors: Okumura, N., Jhund, P. S., Gong, J., Lefkowitz, M. P., Rizkala, A. R., Rouleau, J. L., Shi, V. C., Swedberg, K., Zile, M. R., Solomon, S. D., Packer, M., McMurray, J. J. V., on behalf of the PARADIGM-HF Investigators and Committees* Tags: Clinical Studies, Heart Failure, Treatment, Mortality/Survival Original Articles Source Type: research

Inhibition of PARP activation by enalapril is crucial for its renoprotective effect in cisplatin-induced nephrotoxicity in rats.
Authors: Rani N, Bharti S, Tomar A, Dinda AK, Arya DS, Bhatia J Abstract Oxidative-stress induced PARP activation has been recognized to be a main factor in the pathogenesis of cisplatin-induced nephrotoxicity. Accumulating literature has revealed that ACE inhibitors may exert beneficial effect in several disease models via preventing PARP activation. Based on this hypothesis, we have evaluated the renoprotective effect of enalapril, an ACE inhibitor, and its underlying mechanism(s) in cisplatin-induced renal injury in rats. Male Albino Wistar rats were orally administered normal saline or enalapril (10, 20 and 40m...
Source: Free Radical Research - September 1, 2016 Category: Research Tags: Free Radic Res Source Type: research

Angiotensin-converting enzyme inhibitors reduce oxidative stress intensity in hyperglicemic conditions in rats independently from bradykinin receptor inhibitors.
CONCLUSION: These results suggest the existence of the bradykinin -independent antioxidative effect of ACEIs in hyperglycemic conditions, which is not related to the bradykinin mediation and the structure of the drug molecule. PMID: 27586552 [PubMed - in process] (Source: Croatian Medical Journal)
Source: Croatian Medical Journal - August 31, 2016 Category: Journals (General) Authors: Mikrut K, Kupsz J, Kozlik J, Krauss H, Pruszynska-Oszmałek E, Gibas-Dorna M Tags: Croat Med J Source Type: research

Cost-Effectiveness of Sacubitril-Valsartan in Patients With Heart Failure With Reduced Ejection Fraction.
Conclusion: Treatment with sacubitril-valsartan provides reasonable value in reducing cardiovascular mortality and morbidity in patients with NYHA class II to IV heart failure. Primary Funding Source: U.S. Department of Veterans Affairs and Institute for Clinical and Economic Review. PMID: 27571284 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - August 30, 2016 Category: Internal Medicine Authors: Sandhu AT, Ollendorf DA, Chapman RH, Pearson SD, Heidenreich PA Tags: Ann Intern Med Source Type: research

Angiotensin converting-enzyme inhibition restores glomerular glycosaminoglycans in rat puromycin nephrosis.
CONCLUSION: Treatment with ACEI improves permselectivity properties of the glomerular capillary wall by maintaining its GAG content. This finding provides an additional new mechanism, whereby ACEI exert anti-proteinuric effects. PMID: 27591087 [PubMed - as supplied by publisher] (Source: Experimental and Toxicologic Pathology)
Source: Experimental and Toxicologic Pathology - August 30, 2016 Category: Pathology Authors: Herman-Edelstein M, Chagnac A, Nevo Z, Skutelsky E, Evron Y, Hirsch Y, Ben-Dor L, Schwartz I, Schwartz D, Weinstein T Tags: Exp Toxicol Pathol Source Type: research

Effects of pimobendan on myocardial perfusion and pulmonary transit time in dogs with myxomatous mitral valve disease: a pilot study
ConclusionsContrast echocardiography was a valid, complementary tool for echocardiographic analysis of dogs with MMVD. Pimobendan decreased nPTT in dogs affected by MMVD. Myocardial perfusion was not different in dogs with severe MMVD. (Source: Australian Veterinary Journal)
Source: Australian Veterinary Journal - August 28, 2016 Category: Veterinary Research Authors: SM Apple, G Menciotti, L Braz ‐Ruivo, S Crosara, J Häggström, M Borgarelli Tags: SMALL ANIMALS Source Type: research

Practical considerations on the introduction of sacubitril/valsartan in clinical practice: current evidence and early experience
The combination of neprilysin inhibitor sacubitril with the angiotensin II receptor 1 blocker valsartan is the first agent from the angiotensin receptor neprilysin inhibitors (ARNI) class authorized for clinical use in heart failure (HF) patients with reduced ejection fraction (HFrEF). Sacubitril/valsartan resulted in 20% reduction in the incidence rate of death or HF hospitalization compared to enalapril in symptomatic HFrEF patients in the seminal PARADIGM-HF trial. As a result, the recently updated European and American HF guidelines granted this agent a class IB indication for the treatment of ambulatory/chronic sympto...
Source: International Journal of Cardiology - August 23, 2016 Category: Cardiology Authors: Dimitrios Farmakis, Vassiliki Bistola, Apostolos Karavidas, John Parissis Source Type: research

Medical interventions for treating anthracycline-induced symptomatic and asymptomatic cardiotoxicity during and after treatment for childhood cancer.
CONCLUSIONS: Only one trial evaluated the effect of enalapril in childhood cancer survivors with asymptomatic cardiac dysfunction. Although there is some evidence that enalapril temporarily improves one parameter of cardiac function (LVESWS), it is unclear whether it improves clinical outcomes. Enalapril was associated with a higher risk of dizziness or hypotension and fatigue. Clinicians should weigh the possible benefits with the known side effects of enalapril in childhood cancer survivors with asymptomatic anthracycline-induced cardiotoxicity.Only one trial evaluated the effect of phosphocreatine in childhood cancer pa...
Source: Cochrane Database of Systematic Reviews - August 23, 2016 Category: Journals (General) Authors: Cheuk DK, Sieswerda E, van Dalen EC, Postma A, Kremer LC Tags: Cochrane Database Syst Rev Source Type: research

Time to Think About Nutrient Needs in Chronic Disease
There is renewed interest in health benefits of folic acid supplementation since the China Stroke Prevention Primary Prevention Trial (CSPPT) showed the potential benefits of folic acid in preventing stroke in Chinese adults with hypertension. It has long been known that folic acid prevents neural tube defects, which are among the most severe and debilitating congenital birth defects worldwide. The CSPPT was terminated early when 800 µg of folic acid in combination with 10 mg of enalapril significantly reduced primary stroke incidence compared with the enalapril alone treatment arm. This finding was unexpected as oth...
Source: JAMA Internal Medicine - August 22, 2016 Category: Internal Medicine Source Type: research

Effects of Folate on Chronic Kidney Disease Progression
This secondary analysis of China Stroke Primary Prevention Trial data compares the effects of folic acid and enalapril vs enalapril alone on progression of CKD. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - August 22, 2016 Category: Internal Medicine Source Type: research

A Case of Refractory Heart Failure in Becker Muscular Dystrophy Improved With Corticosteroid Therapy.
Authors: Nakamura M, Sunagawa O, Hokama R, Tsuchiya H, Miyara T, Taba Y, Touma T Abstract The patient was a 26 year-old man who was referred to our hospital in June 2011 because of severe heart failure. At age 24 years, he was found to have Becker muscular dystrophy. He received enalapril for cardiac dysfunction; however, he had worsening heart failure and was thus referred to our hospital. Echocardiography showed enlargement of the left ventricle, with a diastolic dimension of 77 mm and ejection fraction of 19%. His condition improved temporarily after an infusion of dobutamine and milrinone. He was then administe...
Source: International Heart Journal - August 19, 2016 Category: Cardiology Tags: Int Heart J Source Type: research

Aliskiren, Enalapril, or Both in Heart Failure
New England Journal of Medicine,Volume 375, Issue 7, Page 701-702, August 2016. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - August 17, 2016 Category: Internal Medicine Source Type: research

The neprilysin pathway in heart failure: a review and guide on the use of sacubitril/valsartan
Inhibition of neurohumoural pathways such as the renin angiotensin aldosterone and sympathetic nervous systems is central to the understanding and treatment of heart failure (HF). Conversely, until recently, potentially beneficial augmentation of neurohumoural systems such as the natriuretic peptides has had limited therapeutic success. Administration of synthetic natriuretic peptides has not improved outcomes in acute HF but modulation of the natriuretic system through inhibition of the enzyme that degrades natriuretic (and other vasoactive) peptides, neprilysin, has proven to be successful. After initial failures with ne...
Source: Heart - August 11, 2016 Category: Cardiology Authors: Jhund, P. S., McMurray, J. J. V. Tags: Open access, Review articles Reviews Source Type: research

Nephroprotective effects of enalapril after [177Lu]-DOTATATE therapy using serial renal scintigraphies in a murine model of radiation-induced nephropathy
AbstractBackgroundRadiation-induced nephropathy is still dose limiting in radionuclide therapy of neuroendocrine tumors. We investigated the nephroprotective potential of the angiotensine converting enzyme inhibiting drug enalpril after [177Lu]-DOTATATE therapy in a murine model of radiation-induced nephropathy by renal scintigraphy.At first, the appropriate therapy activity to induce nephropathy was identified. Baseline scintigraphy (n = 12) entailed 12-min dynamic acquisitions after injection of 25 MBq [99mTc]-MAG3, which was followed by radionuclide therapy at four escalating activities of [177Lu]-DOT...
Source: EJNMMI Research - August 11, 2016 Category: Radiology Source Type: research

An additive effect of anti-PAI-1 antibody to ACE inhibitor on slowing the progression of diabetic kidney disease.
Abstract While angiotensin II blockade slows the progression of diabetic nephropathy, current data suggest that it alone cannot stop disease process. New therapies or drug combinations will be required to further slow or halt disease progression. Inhibition of PAI-1 aimed at enhancing ECM degradation has been shown therapeutic potential in diabetic nephropathy. Here using a mouse model of type II diabetes, the maximally therapeutic dose of the PAI-1 neutralizing mouse monoclonal antibody (MEDI-579) was determined and compared with the maximally effective dose of enalapril. We then examined whether addition of the ...
Source: Am J Physiol Renal P... - August 10, 2016 Category: Urology & Nephrology Authors: Gu C, Zhang J, Noble NA, Peng XR, Huang Y Tags: Am J Physiol Renal Physiol Source Type: research

Blood capillary rarefaction and lymphatic capillary neoangiogenesis are key contributors to renal allograft fibrosis in an ACE inhibition rat model.
In conclusion, ACE inhibition considerably decreased and/or delayed both glomerulosclerosis and tubulointerstitial injury. Prevention of glomerular podoplanin loss and proteinuria could be attributed to the known intra-glomerular pressure lowering effects of ACE inhibition. Reduction of lymphangiogenesis could contribute to amelioration of tubulointerstitial fibrosis and inflammatory infiltration after ACE inhibition. PMID: 27496878 [PubMed - as supplied by publisher] (Source: American Journal of Physiology. Heart and Circulatory Physiology)
Source: American Journal of Physiology. Heart and Circulatory Physiology - August 5, 2016 Category: Physiology Authors: Hamar P, Kerjaschki D Tags: Am J Physiol Heart Circ Physiol Source Type: research

Pattern of antihypertensive therapy among diabetic hyperten- sive patients in zewditu memorial hospital, addis ababa.
PATTERN OF ANTIHYPERTENSIVE THERAPY AMONG DIABETIC HYPERTEN- SIVE PATIENTS IN ZEWDITU MEMORIAL HOSPITAL, ADDIS ABABA. Ethiop Med J. 2016 Apr;54(2):77-82 Authors: Abera H, Woldemichael M Abstract INTRODUCTION: Diabetes mellitus is becoming a common chronic disease in both developed and developing nations and is associated with significant cardiovascular disease morbidity and mortality. The presence of hypertension in patients with diabetes mellitus doubles the risk of cardiovascular disease including coronary heart disease, congestive heart failure, ischemic and hemorrhagic stroke, renalfailure and peri...
Source: Ethiopian Medical Journal - August 3, 2016 Category: African Health Tags: Ethiop Med J Source Type: research

Fluidized Bed Hot Melt Granulation with Hydrophilic Materials Improves Enalapril Maleate Stability.
Freitas LA Abstract This work aimed at developing enalapril maleate granules in order to improve its stability in solid dosage form. Granules were prepared by hot melt granulation using a fluidized bed apparatus. Gelucire 50/13®, polyethylene glycol 6000 e Poloxamer 407® were studied and compared as binders in 2 × 2 factorial designs where the proportions of enalapril maleate, binders and spray dried lactose were varied. The granulation process resulted in high yields and granule sizes that indicated the prevalence of particles coating. Furthermore, the granules obtained showed adequat...
Source: AAPS PharmSciTech - August 3, 2016 Category: Drugs & Pharmacology Authors: Guimarães TF, Comelli AC, Tacón LA, Cunha TA, Marreto RN, Freitas LA Tags: AAPS PharmSciTech Source Type: research

Effect of Combination of Angiotensin-Converting Enzyme Inhibitors and Vitamin D Receptor Activators on Cardiac Oxidative Stress in Diabetic Rats.
Abstract BACKGROUND: The principle mediator of diabetic myocardial injury is oxidative stress. The aim was to compare the effect of monotherapy with enalapril, angiotensin-converting enzyme inhibitor and paricalcitol (vitamin D receptor activator), to the combined therapy with both drugs on the cardiac oxidant-antioxidant balance in the type 2 diabetic rats. MATERIALS AND METHODS: A total of 50 male Sprague-Dawley rats were divided into 5 groups, namely the normal control and diabetic, vehicle, enalapril, paricalcitol and paricalcitol and enalapril-treated groups. Enalapril was given at a dose of (25mg/L) in ...
Source: The American Journal of the Medical Sciences - August 1, 2016 Category: Journals (General) Authors: Ali TM, Mehanna OM, Elsaid AG, Askary AE Tags: Am J Med Sci Source Type: research

Effect of aqueous extract of the Vigna angularis in rats subjected to an experimental model of moderate chronic kidney disease.
Abstract PURPOSE:: To evaluate the effect of the aqueous extract of the Vigna angularis, popularly known as "Azuki beans", in rats subjected to an experimental model of moderate chronic kidney disease. METHODS:: Thirty rats underwent two surgeries - Ormrod and Miller (1980) - to obtain Moderate Chronic Kidney Disease (CKD-M). The animals were randomized into 3 groups. Group 1 (Control): distilled water. Group 2 (Azuki): Vigna angularis 5% aqueous extract. Group 3 (Treatment): 10mg/kg of enalapril maleate. The rats received their respective treatments for 14 days. RESULTS:: The treatment with az...
Source: Acta Cirurgica Brasileira - August 1, 2016 Category: Surgery Authors: Baracho NC, Monteiro NF, Borges MG, Arguelho RR Tags: Acta Cir Bras Source Type: research

Postoperative Case Study: A Collaborative Approach to Symptomatic Bradycardia
A 64 year old female patient arrived to PACU after right total hip replacement surgery. Preoperative vital signs were 110-120/70 ’s, heart rate 59-60 beat per minute (bpm), respirations 16 per minute, and pule ox 100% on room air. Home meds included aspirin, carvedilol, furosemide, hydralazine, atorvastatin, metformin, amlodipine, and enalapril. The case was done under general anesthesia with no significant intraoperative e vents. Postoperatively, vitals were 80-90’s/60’s, 40’s/sinus bradycardia, 15, and 99% on room air. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - July 28, 2016 Category: Nursing Authors: Delsene Hanner, Patricia Mefford, Mark Neuman, Julie Thomas, Donna Bernard, Jennifer Fraccaroli Source Type: research

Acute myocarditis in bodybuilder from coxsackievirus and thyrotoxicosis
Publication date: Available online 20 July 2016 Source:Journal of Cardiology Cases Author(s): Tommy Kwak, Moamen Al Zoubi, Aruni Bhavith, Carlos Rueda Rios, Surender Kumar A 25-year-old male with no past medical history presented with 1 day of chest pain. The patient had exercised with high intensity for a bodybuilding competition. He had fever, malaise, sore throat, and cough 1 week before presentation. He was tachycardic and tachypneic. Cardiac examination was unremarkable. Electrocardiogram showed diffuse ST segment elevation. Laboratory results showed leukocytosis, creatinine kinase 3078unit/L, and troponin I 78...
Source: Journal of Cardiology Cases - July 27, 2016 Category: Cardiology Source Type: research

Nodular glomerulosclerosis in a patient with cystic fibrosis, but not diabetes mellitus: A paediatric case
Conclusion Nodular glomerulosclerosis in the absence of diabetes and poor glycaemic control have not previously been reported in a paediatric patient. In adult patients without diabetes, smoking, hypertension, hypercholestrolaemia and extrarenal vascular disease have been implicated. The proteinuria decreased after commencement of treatment with enalapril. A recurrence of proteinuria responded to a dose increase. (Source: Respiratory Medicine Case Reports)
Source: Respiratory Medicine Case Reports - July 24, 2016 Category: Respiratory Medicine Source Type: research

Differential Cardiac Effects of an AT1R Biased Ligand, AT1R Antagonist and ACE Inhibitor in Mouse Models of Post-Myocardial Infarction Heart Failure
Introduction: Stimulation of the renin-angiotensin-system plays a fundamental role in heart failure (HF) pathophysiology. Angiotensin II (Ang II) stimulates multiple signaling pathways via AT1 receptors that mediate both deleterious and beneficial responses. AT1R antagonists (ARB) and inhibition of Ang II production by ACE inhibitors (ACEi) are the current standard of care for patients with HF post myocardial infarction (MI). Methods and Results: In these studies, we compared the activity of an AT1R biased agonist peptide (TRV-120027), an ARB (valsartan) and an ACEi (enalapril) on cardiac function in mouse models of MI ind...
Source: Journal of Cardiac Failure - July 23, 2016 Category: Cardiology Authors: Xiuying Ma, Shahid Tannu, John Allocco, Dike Qiu, Marisa Flaim, Earl Crain, Jeffrey Bostwick, Patricia Smith, Xue-Qing Chen, William Schumacher, Brian J. Arey, Pancras Wong Source Type: research

Pharmacokinetics/Pharmacodynamics, Efficacy and Safety of Sacubitril/Valsartan Versus Enalapril in Pediatric Patients with Heart Failure Due to Systemic Left Ventricle Systolic Dysfunction: Study Design and Rationale
Background: Pediatric HF is characterized by significant morbidity and mortality and the rationale for medical therapy primarily comes from adult studies. Sacubitril/valsartan (LCZ696) reduced mortality and delayed HF progression vs. enalapril and was generally well tolerated in PARADIGM-HF trial in adults with HFrEF; however, benefit in pediatric patients is unknown. Study Design: This multicenter study will use an adaptive, seamless, 2-stage design (Figure). Part 1, open-label study will determine the PK/PD of single-dose LCZ696 in 36 pediatric HF patients (1 month to
Source: Journal of Cardiac Failure - July 23, 2016 Category: Cardiology Authors: Robert Shaddy, Fabian Chen, Charles Canter, Nancy Halnon, Lazaros Kochilas, John Jefferies, Joseph Rossano, Damien Bonnet, Paul Kantor, Michael Burch Source Type: research

Preliminary Observations of the Initiation and Tolerability of Sacubitril/Valsartan in Hospitalized Patients with Chronic Heart Failure
Introduction: The angiotensin receptor/neprilysin inhibitor (ARNI) sacubitril/valsartan was recently found to be superior to enalapril in the reduction of cardiovascular death and hospitalization in heart failure patients with a reduced ejection fraction (HFrEF). A run phase was required to assure tolerability of enalapril 20  mg daily and sacubitril/valsartan 200 mg BID. Hypotension eliminated some candidates during the run in phase. Historical trials have also demonstrated a substantial decrease in systolic blood pressures (SBP) with dual angiotensin receptor/neprilysin blockade compared with either class u...
Source: Journal of Cardiac Failure - July 23, 2016 Category: Cardiology Authors: Kathleen M.D. Faulkenberg, J. Bradley Williams, Michael Militello, Antonio L. Perez, Randall C. Starling, W.H. Wilson Tang Source Type: research

Incidence, Predictors, and Outcomes Associated with Hypotensive Episodes among Patients Receiving Sacubitril/Valsartan or Enalapril: The PARADIGM-HF Trial
Background: In PARADIGM-HF, sacubitril/valsartan reduced the composite of CV or HF hospitalization compared with enalapril, but resulted in more hypotensive episodes. Methods: We characterized patients in PARADIGM-HF by whether or not they experienced hypotension (reported as an AE) during study run-in (sequential phases of enalapril 10  mg BID, sacubitril/valsartan 49/51 mg BID, and sacubitril/valsartan 97/103 mg BID) and following randomization. We assessed whether hypotension during run-in modified the efficacy of sacubitril/valsartan for the primary outcome. (Source: Journal of Cardiac Failure)
Source: Journal of Cardiac Failure - July 23, 2016 Category: Cardiology Authors: Orly Vardeny, Brian Claggett, Jessica Kachadourian, Scott M. Pearson, Milton Packer, Michael Zile, Jean Rouleau, Karl Swedberg, John J.V. McMurray, Scott D. Solomon Source Type: research