Efficacy of Steroid Therapy for Pacing Failure in a Patient with Chronic Myocarditis

Mitsuya, Nobuyuki; Kishi, Ryoji; Suzuki, Noriyuki; Tamura, Masachika; Imai, Yukiko; Tanaka, Osamu; Takagi, Akihiko; Nakazawa, Kiyoshi; Miyake, Fumihiko; Nobuoka, Sachihiko; Koike, Jyunki

doi:10.2169/internalmedicine.43.213

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…In the heart, there is evidence from experimental and human studies indicating that glucocorticoid treatment is harmful, leading to cardiomyopathy (Zecca et al. , 2001; Mitsuya et al. , 2004) characterized by an accumulation of lipid droplets, cardiomyocyte hypertrophy and dissolution of myofibrils (Clark et al.…”

Section: Influence Of Glucocorticoids On the Cardiovascular Systemmentioning

confidence: 99%

“…In the heart, there is evidence from experimental and human studies indicating that glucocorticoid treatment is harmful, leading to cardiomyopathy (Zecca et al, 2001;Mitsuya et al, 2004) characterized by an accumulation of lipid droplets, cardiomyocyte hypertrophy and dissolution of myofibrils (Clark et al, 1982;de Vries et al, 2002). In the adult, dexamethasone treatment can induce hypertrophy and precocious degeneration of cardiomyocytes (de Vries et al, 2002) while glucocorticoid exposure in neonates can induce myocardial hypertrophy and changes in contractile proteins (Werner et al, 1992;La Mear et al, 1997).…”

Section: Cardiovascular Remodellingmentioning

confidence: 99%

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Therapeutic manipulation of glucocorticoid metabolism in cardiovascular disease

Hadoke

Iqbal

Walker

2009

British J Pharmacology

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The therapeutic potential for manipulation of glucocorticoid metabolism in cardiovascular disease was revolutionized by the recognition that access of glucocorticoids to their receptors is regulated in a tissue-specific manner by the isozymes of 11b-hydroxysteroid dehydrogenase. Selective inhibitors of 11b-hydroxysteroid dehydrogenase type 1 have been shown recently to ameliorate cardiovascular risk factors and inhibit the development of atherosclerosis. This article addresses the possibility that inhibition of 11b-hydroxsteroid dehydrogenase type 1 activity in cells of the cardiovascular system contributes to this beneficial action. The link between glucocorticoids and cardiovascular disease is complex as glucocorticoid excess is linked with increased cardiovascular events but glucocorticoid administration can reduce atherogenesis and restenosis in animal models. There is considerable evidence that glucocorticoids can interact directly with cells of the cardiovascular system to alter their function and structure and the inflammatory response to injury. These actions may be regulated by glucocorticoid and/or mineralocorticoid receptors but are also dependent on the 11b-hydroxysteroid dehydrogenases which may be expressed in cardiac, vascular (endothelial, smooth muscle) and inflammatory (macrophages, neutrophils) cells. The activity of 11b-hydroxysteroid dehydrogenases in these cells is dependent upon differentiation state, the action of pro-inflammaotory cytokines and the influence of endogenous inhibitors (oxysterols, bile acids). Further investigations are required to clarify the link between glucocorticoid excess and cardiovascular events and to determine the mechanism through which glucocorticoid treatment inhibits atherosclerosis/restenosis. This will provide greater insights into the potential benefit of selective 11b-hydroxysteroid dehydrogenase inhibitors in treatment of cardiovascular disease.

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Section: Influence Of Glucocorticoids On the Cardiovascular Systemmentioning

confidence: 99%

Section: Cardiovascular Remodellingmentioning

confidence: 99%

Therapeutic manipulation of glucocorticoid metabolism in cardiovascular disease

Hadoke

Iqbal

Walker

2009

British J Pharmacology

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“…Epidemiological studies suggest that atherosclerosis and myocardial infarction occur in patients with long-term glucocorticoid treatment or Cushing's syndrome (33,109,187). Recent clinical reports also indicated that glucocorticoid treatment in newborn fetuses and aged patients potentially induced cardiomyopathy (113,203). Although this pathological process is not yet completely elucidated, some early morphological evaluations indicated that glucocorticoid-induced cardiomyopathy is characterized by increased accumulation of lipid droplets, cardiomyocyte hypertrophy, and dissolution of myofibrils (31,36).…”

Section: Glucocorticoids and Heart Diseasementioning

confidence: 99%

Glucocorticoids produce whole body insulin resistance with changes in cardiac metabolism

Rodrigues

2007

American Journal of Physiology-Endocrinology and Metabolism

133

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Insulin resistance is viewed as an insufficiency in insulin action, with glucocorticoids being recognized to play a key role in its pathogenesis. With insulin resistance, metabolism in multiple organ systems such as skeletal muscle, liver, and adipose tissue is altered. These metabolic alterations are widely believed to be important factors in the morbidity and mortality of cardiovascular disease. More importantly, clinical and experimental studies have established that metabolic abnormalities in the heart per se also play a crucial role in the development of heart failure. Following glucocorticoids, glucose utilization is compromised in the heart. This attenuated glucose metabolism is associated with altered fatty acid supply, composition, and utilization. In the heart, elevated fatty acid use has been implicated in a number of metabolic, morphological, and mechanical changes and, more recently, in "lipotoxicity". In the present article, we review the action of glucocorticoids, their role in insulin resistance, and their influence in modulating peripheral and cardiac metabolism and heart disease.

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“…These actions can be correlated to the complex effects of these drugs in the healing process [16][17][18] , such as progressive decrease of the fibroblast number, thus, the collagen synthesis with consequent delay in healing. And it is also possible that, in addition to the leukocytes and fibroblasts inhibition, the corticosteroids exercise these actions through the cytokines reduction and cellular growth factors 17 .…”

Section: Major Findingsmentioning

confidence: 99%