• CELLMED
• /
• v.2 no.3
• /
• pp.21.1-21.8
• /
• 2012

Heart disease that ultimately leads to heart failure (HF) has been the number one cause of death in the United States as well as in many other countries for over a century. Inotropic therapy utilizing cardiotonics to increase cardiac contractility remains a significant component of the management of HF. However, adverse effects of currently available cardiotonics have been compromising their therapeutic value and often lead to further myocardial dysfunction. Thus, discovery of safe cardiotonics remains a main challenge to improvement of inotropic therapy for HF. This review briefly summarized cellular mechanisms underlying the inotropic action of currently available cardiotonics, newly-developed carditonics and the bark of Terminalia arjuna (TA), a tropical tree used in ayurvedic medicine. The potential of TA bark as a new cardiotonic in inotropic treatment for HF was also discussed.

• Korean Journal of Pharmacognosy
• /
• v.6 no.3
• /
• pp.169-177
• /
• 1975

• YAKHAK HOEJI
• /
• v.37 no.1
• /
• pp.36-40
• /
• 1993

The 4-(2'-(N-(l-methyl-3'-carbamylphenyl)-n-propyl))aminoethyl)-l- hydroxy-2-pyridone which has isoelectronic and isosteric structural similarity with dobutamine without having the Catechol-O- Methyltransferase(COMT) vulnerable m-hydroxy group was synthesized via 12 synthetic steps.

• Journal of Pharmaceutical Investigation
• /
• v.22 no.3
• /
• pp.49-63
• /
• 1992

Two different types of chemical manipulations of dobutamine were investigated in order to develop novel, improved cardiotonic drugs. Three new analogues of carbostyril, in which the m-hydroxy group of dobutamine was isosterically modified with an amide type carbostyril system, were synthesized from, ${\rho}-methoxyphenethylamine$ via multi-steps. Two analogues of (2'-aminoethyl)-1-hydroxy-2-pyridone system which has isosteric structural similarity with dopamine without having the COMT vulnerable m-hydroxy group were synthesized via 12 synthetic steps. Their biological stabilities in various media and inotropic activities were evaluated.

• Korean Journal of Pharmacognosy
• /
• v.9 no.2
• /
• pp.57-72
• /
• 1978

The constituents of Ranunculaceae plants are summerized from more than one hundred of papers. Fifteen steroidal alkaloids, thirty two of terpenoids (diterpenes and triterpenes), fifty four isoquinoline alkaloids are recorded. Thirty three papaverines, eighteen berberines, and three hydrastines belong to isoquinoline group. Besides, of alkaloids a number of glycosides are also found. Adonis glycoside, famous cardiotonics, from Adonis and cyanogenin glycoside and calthoside D were identified from the leaves of Thalictrum aquilegifolium and Caltha silvestris. Anemonin, the irritating substance, found in Pulsatilla grandiz $W_{ENDER}$. Kaempf-erol and dihydrokaempferol were isolated and identified from the leaves of Clematis brachyura ^M_{AXIMOWICZ}$ by author in 1968.

• YAKHAK HOEJI
• /
• v.39 no.5
• /
• pp.506-510
• /
• 1995

The 5-(2'-(N-(1-methyl-3'-carbamylphenyl)-n-propyl))aminoethyl)-8- hydroxy-4-methyl-carbostyril derivatives which have isoelectronic and isosteric structural similarity with dobutamine without having the Catechol-O-Methyltransferase (COMT) vulnerable m-hydroxy group were synthesized via 7 synthetic steps, and their stabilities in phosphate buffer solution(pH=7.4), human blood. 80% human plasma and 20% rat liver homogenate were determined in vitro condition.

• Journal of Chest Surgery
• /
• v.17 no.1
• /
• pp.59-66
• /
• 1984

After open heart surgery, the patient must be carefully observed and adequately managed for his survival. This report reviewed 10 cases of ventricular septal defect and 12 mitral valvular diseases as hemodynamics early after open heart surgery. For postoperative 24 hours, clinical status was evaluated for left atrial pressure, central venous pressure,DP[LAP-CVP], peak systolic pressure, heart rate, urine amount, and other clinical findings. Especially, on postoperative fourth hour, cardiac output was most decreased, when the changes of monitoring were compared with two groups with or without using cardiotonics. Finally, we concluded as followings; 1.Postoperatively, variation of CVP was noted in VSD, but mitral valvular disease was more variable change of LAP. 2.DP was 1.3\ulcorner.4 cmH2O in VSD, and 6.4\ulcorner.2 cmH2O in mitral valvular disease. 3.Parameter using cardiotonic was CVP in VSD, and LAP in mitral valvular disease.

• The Korean Journal of Pharmacology
• /
• v.12 no.1
• /
• pp.45-55
• /
• 1976

The effect of positive inotropic agents on the contractile properties of myocardial muscle were studied in the cat papillary muscle preparation. For the purpose, the effects of ouabain $(1{\times}10^{-6}g/ml)$, norepinephrine (0.05r/m1) and Aconiti tuber butanol fraction (AF(5), $1{\times}10^{-4}$, $5{\times}10^{-4}$, $1{\times}10^{-3}$, $2{\times}10^{-3}g/ml$) on the contractile dynamics of the papillary muscle preparation isolated from right ventricle of cat were observed in terms of the characteristics of isometric twitch and the lengh-tension relation, the force-velocity relation and the load-extension relation of the series elastic component of contractile model of A.V. Hill. All the studied inotropic drugs similary increased the rate and the intensity of the developed isometric tension, while shortened the time from onset of contraction to peak tension and the total duration of contraction. In the afterloaded simultaneous isotonic and isometric contraction, they also similary increased the maximal velocity of shortening accompanied with the increasing the maximum developed force. In the load-extension relation all the drugs, however, had no appreciable influence on the properties of the series elastic component. Increasing the concentration, Aconiti tuber butanol fraction produced more pronounced effect on all the studied parameters of isometric and isotonic contraction of cat papillary muscle preparation. From the aspect of contractile dynamics, it seemed that the positive inotropic effect of ouabain, norepinephrine and Aconiti tuber butanol fraction are similary achieved through an influence on the behavior of the contractile component only.

• Journal of Chest Surgery
• /
• v.36 no.5
• /
• pp.303-308
• /
• 2003

Background: It has been known that internal thoracic artery grafting has a better patency rate compare to other graft conduits in coronary revascularization. Better patency rates can be expected in more coronary arteries with the use of bilateral internal thoracic artery. However, there were some debates on the complications after the use of bilateral internal thoracic artery. The purpose of our study was to reveal the results of bilateral internal thoracic artery. Material and Method: The 26 coronary artery bypass operations with bilateral internal thoracic artery were performed from July 2001 to May 2002. We compared the results of 8 diabetic patients to those of 18 non-diabetic patients. We compared the results of BITA (bilateral internal thoracic artery) group to those of SITA (single internal thoracic artery) group that were 20 patients and performed during same period. Result: There was no mortality. There was one wound complication in the diabetic group and one in the non-diabetic group. There were no significant differences in operation time, duration of mechanical ventilation, amount of bleeding, infusing duration of cardiotonics, and complication between two groups. There were no significant differences in results between the BITA group and the SITA group. Conclusion: There were no significant differences in early results between the BITA group and the SITA group, and there were no significant differences in results between the diabetic group and the non-diabetic group. We think coronary artery bypass grafting with the use of bilateral internal thoracic artery is considered in diabetic patients.

• The Korean Journal of Pharmacology
• /
• v.13 no.2
• /
• pp.1-9
• /
• 1977

The effects of extracellular calcium concentrations and several concentration of Aconiti tuber butanol fraction, norepinephrine, ouabain on the force of isometric contraction of isolated atrial preparations obtained from rabbits were determined at $11{\sim}14$ different frequencies of contraction. Qualitatively similar results were obtained in all preparations. In most preparations, rested-state contraction was induced at the range of $120{\sim}400$ seconds stimulation interval. Over the range of intervals from 120 to 10 seconds negative inotropic effect of activation (NIEA) was predominant, so the steady-state contractile force progressively declined. At the intervals of 3 seconds, changes in the cumulated negative and positive isotropic effect of activation (PIEA) practically cancelled each other under steady-state conditions. At the interval from 3 seconds to 0.25 seconds, the additional cumulation of PIEA was greater than that of the NIEA. When the intervals between contractions were shorter than 0.25 seconds, the cumulation of the NIEA was again predominant. The positive inotropic effect of cardiac glycoside resulted at least in large part from increase in the rested-state contraction. No significant effect on the PIEA was found. The decay of the NIEA was apparently greatly accelerated in the presence of high concentration of ouabain, but this may also be a reflection of their action on the state determining the strength of the rested-state contraction. In the case of extracellular calcium concentration increment, the similar results with the ouabain treatment were obtained. Norepinephrine produced more powerful inotropic effect at shorter stimulation interval than long. The rested-state contraction and the decay of the NIEA were not significantly altered in the presence of norepinephrine, but cumulated PIEA and the amount of PIEA produced by each contraction were significantly increased. Aconiti tuber butanol fraction showed similar results with that of norepinephrine. The increment of contractile force at various contraction frequency were dose-responsive in the presence of Aconiti tuber butanol fraction. It is suggested that the positive inotropic effect of Aconiti tuber butanol fraction at various contraction frequency may be due to increase of the cumulation of PIEA and the amount of PIEA produced by each beat.