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- Volume 14, Issue 2, 2003
Cardiovascular Journal of South Africa - Volume 14, Issue 2, 2003
Volume 14, Issue 2, 2003
Author A.J. BrinkSource: Cardiovascular Journal of South Africa 14, pp 57 –58 (2003)More Less
Extracted from text ... We live in an information age where the management and communication of published information is being revolu-tionised. Print is rapidly making way for a digitised form of presentation. 1 Non-print material is increasingly being produced and dis-seminated by electronic means. Direct digital communication between individuals or groups can be accomplished in a syn-chronous manner by voice or visual means. Writing and read-ing is an asynchronous mode of communication that is very much in vogue and occurs mostly through the use of e-mail and, increasingly, by e-publications. e-Journal publication in medicine and other spheres is becoming either an addition to or ..
Abnormal serum lipoprotein levels as a risk factor for the development of human lenticular opacities : cardiovascular topicsSource: Cardiovascular Journal of South Africa 14, pp 60 –64 (2003)More Less
Aim : To determine whether an association exists between the different plasma lipoprotein constituents and the prevalence of lenticular opacities in dyslipidaemic subjects. <br>Methods : Adult patients (<i>n</i> = 115) of both genders were included if their fasting total serum cholesterol concentrations exceeded the 95th percentile of normal or their serum low-density lipoprotein (LDL) : high-density lipoprotein (HDL) ratios exceeded 5. Patients were excluded if they suffered from any condition known to cause, or predispose them to, elevated lipoprotein levels or lenticular opacification. Lenticular changes were assessed by means of a slit-lamp through the fully dilated pupil. <br>Results : An extremely strong association (<i>p</i> < 0.0001) was found to exist between HDL cholesterol levels and the development of lens opacities. Below an HDL-C level of 1.5 mmol / l subjects had a seven-fold higher calculated probability of falling in the lens opacity subgroup than those with HDL-C levels above 1.5 mmol / l [odds ratio = 7.33 (95% CI = 2.06-26.10; <i>p</i> = 0.001)]. An equally strong association was found between high (> 5) LDL : HDL ratios and the development of lens opacities (<i>p</i> < 0.0003). The risk of falling into the cataract subgroup if the individual's LDL : HDL ratio exceeded 5 was 2.35 (95% CI = 1.09-5.04; <i>p</i> = 0.014). <br>Conclusions : This study strongly suggests that an association exists between low levels of HDL cholesterol and high LDL : HDL ratios on one hand and the development of adult lens opacification on the other.
Source: Cardiovascular Journal of South Africa 14, pp 66 –72 (2003)More Less
Long-term outcomes of single-lead VDD pacing were studied retrospectively and partly prospectively. Records were analysed of 81 patients out of 133 in whom a single-lead VDD pacemaker was implanted between January 1993 and December 1997 and who attended a follow-up clinic more than two years after the implant. Forty-eight of them attended a prospective follow-up 54 Â± 15 months after the implant. <br>Sinus rhythm was present in 91.5% of the patients and atrial fibrillation in the remaining 8.5%. A-V synchronous pacing was documented in 91.9 to 94.9% at different follow-up periods; however, an intermittent asynchronous ventricular (VVI) pacing of more than 10% occurred intermittently in 19.1% of the patients. Chronic sensed P-wave amplitude was significantly lower than the implant P-wave amplitude (by 70%) and did not correlate with the implant amplitude. Postural changes (supine, sitting, standing, with normal breathing and during deep inspiration) did not have a significant impact on sensed P-wave amplitude more than four years after the implant. Rate histograms were remarkably stable over the years, with dominant heart rate 70 to 79 beats per minute observed for 25 to 30% of the monitored periods. <br>Single-lead VDD pacing was found to be a reliable method of long-term physiological pacing in patients with heart block who returned for follow-up. Routine testing more than four years after the implant does not require postural manoeuvres.
Mechanisms of opioid delta (?) and kappa (κ) receptors' cardioprotection in ischaemic preconditioning in a rat model of myocardial infarction : cardiovascular topicsSource: Cardiovascular Journal of South Africa 14, pp 73 –80 (2003)More Less
It has been demonstrated that brief periods of coronary artery occlusion before a prolonged period of sustained occlusion paradoxically protect the myocardium against infarction. The mechanisms involved in this phenomenon, termed 'ischaemic preconditioning' (IPC) are still not clear, although it has been established that opioid receptors are involved. The aim of this study was to probe some of the plausible mechanisms involved in the phenomenon by using an in vivo model of myocardial infarction in intact rat, a model that allows electrocardiographic and enzymatic in addition to morphometric evaluation of the development of 24-hour myocardial infarction. Selective opioid ?-receptor agonist (DADLE) and antagonist (natrindole), and opioid κ-receptor agonist (U-50488H) and antagonist (nor-BNI) were used.
Dietary markers of hypertension associated with pulse pressure and arterial compliance in black South African children : the THUSA Bana study : cardiovascular topicsSource: Cardiovascular Journal of South Africa 14, pp 81 –89 (2003)More Less
Aims : The aim of the study was to determine which dietary factors contribute to the impairment of arterial compliance, stroke volume, total peripheral resistance and pulse pressure, and could thereby be identified as risk markers in the development of hypertension in black children. <br>Methods : Children aged 10 to 15 years were recruited from 30 schools in the North West Province over two years (2000 to 2001). These children comprised 321 black males and 373 females from rural to urbanised communities and 40 male and 79 female subjects with identified high-normal to hypertensive blood pressure. Blood pressure was measured by means of a Finapres apparatus. Through analysis with the Fast Modelflo software program, systemic arterial compliance, pulse pressure, total peripheral resistance and stroke volume were obtained. A 24-hour dietary recall questionnaire and weight and height measurements were taken. Results : In a stepwise regression analysis the following nutrients were significantly associated (<i>p</i> &#8804; 0.05) with cardiovascular parameters of hypertensive subjects : protein, carbohydrates, total fat, polyunsaturated fat, mono-unsaturated fat, saturated fat, fibre, vitamin A, nicotinic acid, biotin, vitamin B12, ascorbic acid, vitamin E, magnesium, manganese, phosphorus and iron. No significant dietary markers were indicated for the normotensive groups. Dietary intakes of most of these nutrients were below the dietary reference intakes for all groups. <br>Conclusions : The results indicate strong associations of protein, polyunsaturated fats, fibre, vitamin A, vitamin C, vitamin E, nicotinic acid, vitamin B12, biotin and phosphorus with the rate of hypertension in black South African children.
Source: Cardiovascular Journal of South Africa 14, pp 89 –94 (2003)More Less
Extracted from text ... The answer is provided on page 94. By Prof William Nelson MD, Clinical Professor of Medicine at the University of Colorado School of Medicine and Director of Cardiology Education, St Joseph Hospital, Denver. Below is the ECG of a 35-year-old man: Do you agree with the reviewer? PR 117 Sinus tachycardia, rate 112 QRSD 115 Incomplete left bundle branch block QT 346 Consider left atrial enlargement QTc 472 Abnormal ECG Axes P 81 QRS 3 T 123 His history is: ? 1. Chest pain? 2. 'Pulled my back at work'? 3. Heart racing?.94 CARDIOVASCULAR JOURNAL OF SOUTH AFRICA Vol 14, ..
'Low pressure' left ventricular tamponade in a patient with rheumatic mitral stenosis and HIV-related acute pericarditis : case reportSource: Cardiovascular Journal of South Africa 14, pp 91 –94 (2003)More Less
Source: Cardiovascular Journal of South Africa 14, pp 97 –98 (2003)More Less
Extracted from text ... CARDIOVASCULAR JOURNAL OF SOUTH AFRICA Vol 14, No. 2, March/April 2003 97 To the Editor: The authors conclude from Dr M. Munclinger et al.'s presented data that single-lead VDD pacing is a reliable method of long-term physiological pacing. It is difficult to see that this claim is consonant with their findings. The term reliable depends of course on judgement but the fact that 'significant intermittent asynchronous pacing' occurred in nearly 20% of their patients hardly supports this claim. The lack of pacing-synchronised atrial activity could be due to either under-sensing of sinus rhythm or atrial fib-rillation. It is impossible to ..
Source: Cardiovascular Journal of South Africa 14, pp 99 –100 (2003)More Less
Extracted from text ... The routine use of thromboprophylaxis in general medical practice has re-mained controversial mainly because of the diversity of patient populations studied, the limited number of patients in these trials and the different methods used to diagnose deep-vein thrombosis (DVT). A recent double-blind, placebo-con- trolled trial, performed in 60 centres in nine countries involving 866 patients, has shed important light on the value of thromboprophylaxis and the frequency of deep-vein thrombosis and pulmonary embolism in this well-defined popula-tion of acutely ill medical patients. 1 Patients included in the study were older than 70 years, were most often not hospitalised in the ..
Source: Cardiovascular Journal of South Africa 14, pp 100 –102 (2003)More Less
Extracted from text ... A Food and Drug Administration advi-sory panel unanimously recommended that carvedilol receive an indication for mortality reduction post acute myocar-dial infarction in patients with left ven-tricular ejection fraction less than 41%. However, panel chairman Jeffrey Borer, MD, chief of the Division of Cardiovascular Pathology at Weill Medical College, cautioned the agency that this recommendation should not be universally applied to other drugs. 'Ultimately, we have to consider each application on the merits and details, and the FDA should not assume that our decision here can be extrapolated to all related situations, ' Borer said. Borer's concern was based on the ..
Source: Cardiovascular Journal of South Africa 14 (2003)More Less
Extracted from text ... Policosanol, a mixture of aliphatic pri-mary alcohols that are obtained from purified sugar cane wax, has been shown to be effective as a natural cho-lesterol- lowering agent in a double-blind placebo study in patients with type 2 diabetes. In this double-blind study 1 using 10 mg policosanol per day in patients with controlled non-insulin-dependent dia-betes mellitus (NIDDM), total choles-terol was reduced by 17%, LDL-C by 21.7% and a non-significant increase (6.5%) of HDL-C was achieved. Triglyceride concentrations, glucose levels and HbA1 values remained unchanged. An earlier pilot study, achieved even better results with an LDL-C decrease of 44% and an ..
Source: Cardiovascular Journal of South Africa 14 (2003)More Less
Extracted from text ... 102 CARDIOVASCULAR JOURNAL OF SOUTH AFRICA Vol 14, No. 2, March/April 2003 Ramipril benefits over other ACE inhibitors in the treatment of ST-elevation AMI Numerous well-known clinical trials, such as SOLVD and AIRE, have shown reductions in cardiac mortality when ACE inhibitors are used in the early therapy of acute myocardial infarction (AMI). However, many clinicians have questioned whether these benefits are reproducible in ordinary clinical practice. Recent reviews of the data of patients treated in 217 hospitals in Germany and collected into the MITRA PLUS registry have resulted in a significant number of publications dealing with a variety of issues ..
Report on the SA Hypertension Congress (7-9 March 2003) : successful combination of CME and new research : drug trends in cardiologySource: Cardiovascular Journal of South Africa 14, pp 103 –106 (2003)More Less
Extracted from text ... CARDIOVASCULAR JOURNAL OF SOUTH AFRICA Vol 14, No. 2, March/April 2003 103 A well-attended 13th Congress of the SA Hypertension Society provided the opportunity for thorough profes-sional updating on the management of hypertension and the secondary pre-vention of cardiovascular disease. South African research was presented in two sessions of original contribu-tions. These will be published as abstracts in a future issue of the Cardiovascular Journal. Some of the more significant aspects are high-lighted below: Measurement of blood pressure Prof O'Brien of the Blood Pressure Unit, Beaumont Hospital, Dublin, not only stressed that 24-hour blood pres-sure monitoring had now become indispensable ..
Source: Cardiovascular Journal of South Africa 14, pp 107 –108 (2003)More Less
Extracted from text ... CARDIOVASCULAR JOURNAL OF SOUTH AFRICA Vol 14, No. 2, March/April 2003 107 Aspirin - cost effective measure to reduce heart attack and stroke Worldwide, high blood pressure is esti-mated to cause 7.1 million deaths, about 13% of the global fatality total. Across WHO regions, research indi-cates that about 62% of strokes and 49% of heart attacks are caused by high blood pressure. High cholesterol is estimated to cause about 4.4 million deaths (7.9% of total) and a loss of 40.4 mil-lion DALYs (2.8% of total), although its effects often overlap with high blood pressure. This amounts to 18% of strokes ..