Plaque formation is a complication of atherosclerosis that predisposes to thrombotic myocardial and cerebral infarction. Platelet activation, vascular stenosis and anomalous vasoconstriction are contributory factors. Hypothetically, dietary supplementation with essential fatty acids could modify the pathogenesis of atherosclerosis by inhibiting platelet function, by promoting synthesis of vasoactive eicosanoids, and by altering the composition of plasma lipids. To test this theory primates (vervet monkeys) with confirmed atherosclerosis were supplemented for 20 months so that matched individuals received 2 % of their dietary energy from either n-3 or n-6 essential fatty acids added to an atherogenic diet. In matched subsets of each essential fatty acid treatment, the atherogenic diet was changed to a therapeutic diet known to regress some components of atherosclerosis.
In an analysis of 8 cases of aortic arch anomalies in patients presenting at a tertiary care hospital in South Africa, not 1 of the cases was recognised by the referring or attending physicians. In 7 of the 8 cases there were signs on the chest radiographs suggestive of aortic arch anomalies which were missed in all but 1 case. The diagnosis of aortic arch anomalies was made with the combination of echocardiography and barium oesophagography, with the echocardiogram the major contributor. Precise anatomy was obtained either by digital subtraction angiography or cine angiography. To interpret the angiography correctly and detect all associated anomalies, a thorough knowledge of the embryology and development of aortic arches is needed. A practical classification is also proposed.
It is possible to determine left ventricular ejection fractions (LVEFs) from data acquired during the first-pass (FPASS) of the myocardial perfusion agent technetium- 99m sestamibi. This study was undertaken to determine which of three possible methods of analysis of FPASS data gave results which agreed best with the LVEFs calculated from routine gated equilibrium bloodpool studies. In the first method a time-activity curve was used with subtraction of background from a region of interest (ROI) around the left ventricle. Different ROIs were examined. The second and third methods employed a representative cycle. In the second method an extra-cardiac ROI was used for background correction and in the third method a summed frame obtained from the lung phase.
Twenty-three black African children with perinatally acquired symptomatic HIV infection were studied with cross-sectional echocardiography. The median age was 14,9 months with an age range of 2 - 70 months. Twenty (87 %) had abnormal echocardiographic findings, all of whom had poor left ventricular performance; 16 (70%) had left ventricular dilatation and 19 (83 %) pericardial effusion. Fourteen (61%) had right ventricular dilatation and hypertrophy. These findings suggest that cardiac disease, which may not be clinically apparent, is common in HIV-infected black African children. More studies are needed to improve our understanding of its aetiology and natural history.