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- Cardiovascular Journal of Africa
- OA African Journal Archive
- Volume 7, Issue 5, 1996
Cardiovascular Journal of Africa - Volume 7, Issue 5, 1996
Volumes & issues
Volume 7, Issue 5, 1996
Comparison of the uptake of radiolabelled fatty acid (123I-paraphenyl-pentadecanoic acid) with 99mTc-MIBI in patients with established transmural infarctionSource: Cardiovascular Journal of Africa 7, pp 250 –253 (1996)More Less
Single photon emission computed tomography (SPECT) metabolic imaging of the heart can be undertaken with I23I-labelled fatty acids. Among these, 123I-paraiodophenyl pentadecanoic acid (pIPPA) was used to detect myocardial ischaemia and to study viability. The purpose of this study was to compare the distribution of locally produced 123I-pIPPA (National Accelerator Centre, Faure) with the perfusion tracer 99 mTc-hexakis-2-methoxyisobutyl isonitrile (MIBI) in patients with established transmural infarction. Nine male patients scheduled for resting myocardial perfusion imaging with 99mTc-MIBI were also studied with 123I-plPPA. Tomographic short-axis slices of the left ventricle were used to obtain circumferential profiles for comparison. The percentage uptake index for 123I-pIPPA was higher than that of .9mTc-MIBI in 5 patients, while the opposite pattern was observed in 4 patients. The mean uptake of 123I-plPPA (60.2% ï¿½ 9.7%) did not differ from the 59.6% ï¿½ 9.4% obtained for 99 mTc-MIBI. The individual variations in distribution of the tracers are consistent with previous reports. Reduced 123I-pIPPA uptake (less than 99mTc-MIBI uptake) may suggest greater sensitivity to detect residual grey zone ischaemia. Better uptake in scar tissue implies maintained cytosolic uptake, i.e. viability. Different locally produced 123I-labelled fatty acids are now available to study cardiac fatty acid metabolism with SPECT.
Asymptomatic coronary artery disease in diabetics with end-stage renal failure the need for a reliable diagnostic techniqueSource: Cardiovascular Journal of Africa 7, pp 254 –257 (1996)More Less
Diabetics with end-stage renal disease have a high prevalence of silent coronary artery disease (CAD). This increased cardiovascular risk and the subsequent premature death from CAD of many diabetic renal transplant recipients are of concern, as the end result is both financial loss and allograft waste. Standard exercise stress testing is frequently inconclusive and coronary angiography may be difficult to justify in these asymptomatic patients. Dipyridamole-radionuclide imaging and dobutamine stress echocardiography are two non-invasive diagnostic techniques which may be used for the detection of CAD in patients who are unable to exercise. Further research needs to be undertaken in South Africa in order to gain expertise with these techniques and to develop guidelines for the management of these high-risk patients.
Congenital unilateral absence of a pulmonary artery as an isolated finding and UAPA with contralateral peripheral pulmonary artery stenosis two case reports with a brief literature reviewSource: Cardiovascular Journal of Africa 7, pp 258 –261 (1996)More Less
We descriptionbe the findings in a young man with unilateral absence of the right pulmonary artery and a child with unilateral absence of the left pulmonary artery and contralateral peripheral stenosis of the pulmonary artery. A brief review of the literature highlights the need to identify and correct the anomaly.
Source: Cardiovascular Journal of Africa 7, pp 262 –264 (1996)More Less
A recognised means of ensuring effective use of scarce resources is to provide clinicians with a restricted choice of drugs in the form of a formulary, and to promote rational use of such drugs by providing treatment guidelines. However, compliance with such guidelines and positive clinical outcomes resulting from their use should be demonstrated by institutional quality assurance efforts. This paper uses the results of two drug-use evaluations performed at King Edward VIII Hospital to illustrate the application of this technique to the management of hypertension. Reviews of angiotensin-converting enzyme inhibitor use and of calcium channel blocker use each revealed inappropriate choices of agents that possibly contributed to a less than optimal level of blood pressure control. Data of this nature can be used to aid formulary management at the institutional level.
Thiazide-treated hypertension or type 2 diabetes mellitus - which is the greater potenial coronary risl factor in black South AfricansSource: Cardiovascular Journal of Africa 7, pp 265 –267 (1996)More Less
Type 2 diabetes and essential hypertension are coronary risk factors that are becoming increasingly prevalent among urban black South African communities. To determine whether both disorders generate equivalent dyslipidaemia, we evaluated the serum lipoprotein profile of 50 black obese patients with long-standing hypertension who were receiving low-dose thiazide diuretics and a similar number of black obese type 2 diabetic subjects. Compared to subjects with diabetes, hypertensive patients on diuretics showed significantly higher mean total (5.40 ï¿½ 1.19 v. 4.93 ï¿½ 1.08 mmol/l; P < 0.05) and low-density-lipoprotein (3.43 ï¿½ 1.06 v. 2.90 ï¿½ 0,79 mmol/l; P < 0.01) cholesterol, although their triglyceride levels were lower (1.23 ï¿½ 0.55 v. 1.76 ï¿½ 1.07 mmol/l; P < 0.01). These cholesterol profiles were generally the reverse of trends found in white patients with the same two clinical conditions. Our findings have potential therapeutic implications and suggest that the so-called 'metabolic syndrome' requires different interpretation in an African context.
Source: Cardiovascular Journal of Africa 7, pp 268 –270 (1996)More Less
Pseudocoarctation of the aorta with aneurysmal dilatation is a rare condition. We documented a case in an asymptomatic child who presented with a widened mediastinum on chest radiography. The pseudocoarctation was documented by echocardiography and digital subtraction angiography. A review of the literature. is presented.
Author J.C. Moolman-SmookSource: Cardiovascular Journal of Africa 7, pp 271 –275 (1996)More Less