CARDIOVASCULAR JOURNAL OF AFRICA: VOLUME 15, ISSUE 4, JULY 2004
  1. Title: Recommendations for hypertension in sub-Saharan Africa : editorial
    Authors: Seedat, Y.K.
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.157-158
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  2. Title: Differences in cardiovascular function of rural and urban African males : the THUSA study : cardiovascular topics
    Authors: Schutte, Rudolph; Huisman, Hugo W.; Malan, Leone; Van Rooyen, Johannes M.; Schutte, Aletta E.; Malan, Nicolaas T.; De Ridder, Johannes H.
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.161-165
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    Abstract: Introduction: South Africa's black population has been in a process of transition from rural monocultural environments to industrialised urban environments since the early 1990s. This transition has led to an increased susceptibility to cardiovascular diseases such as hypertension, which in this group commonly leads to stroke. Besides the already observed increases in blood pressure, there is still uncertainty as to how the factors associated with urbanisation influence the cardiovascular system as a whole.
    Aim: To obtain a more complete cardiovascular profile and its association with the lipid profile and subcutaneous fat distribution of the African in transition.
    Methods: A cross-sectional epidemiological study was performed which included 433 men from the North- West Province. The Finapres apparatus and Modelflow software program were used to obtain a more elaborate cardiovascular profile. The lipid profile and subcutaneous fat were also determined.
    Results: An increase in systolic blood pressure (SBP) and diastolic blood pressure (DBP) was observed in the urban group. The heart rate (HR) did not differ while the stroke volume (SV) and cardiac output (CO) was lower in the urban group. Arterial compliance (CW) also showed a decrease in the urban group along with an increased total peripheral resistance (TPR), compared with the rural group. The lipid profile and BMI did not differ between the two groups.
    Conclusions: The factors associated with urbanisation elevate blood pressure via a peripheral mechanism. This peripheral mechanism may be due to endothelial damage associated with low-density lipoprotein cholesterol (LDL-C) and a truncal subcutaneous fat distribution.
     
  3. Title: The William Nelson ECG quiz
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.165, 181
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  4. Title: Serum lipid parameters and the prevalence of corneal arcus in a dyslipidaemic patient population : cardiovascular topics
    Authors: Meyer, D.; Liebenberg, P.H.; Maritz, F.J.
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.166-169
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    Abstract: Aim: To determine whether an association exists between plasma lipoprotein constituents and the prevalence of corneal arcus in dyslipidaemic patients.
    Methods: Adult patients (n = 115) were included if their fasting total serum cholesterol concentrations exceeded the 95th percentile or their serum low-density lipoprotein (LDL) : high density lipoprotein (HDL) ratios exceeded 5. Slit-lamp assessment of the corneas was performed.
    Results: The study group divided into a subgroup with arcus 37% (43) and a subgroup without arcus 63% (72). Total serum cholesterol and triglyceride levels were not associated with corneal arcus. A significant difference was found (p < 0.05) between the mean levels of LDL cholesterol (LDL-C) in the group without arcus (5.61 + 1.74 mmol/l) and the group with arcus (5.96 + 1.71 mmol/l). The mean serum HDL-cholesterol (HDL-C) in the group with corneal arcus was 1.04 + 0.30 mmol/l as opposed to 1.31 + 0.38 mmol/l in the group without arcus (p < 0.005 for difference). The mean LDL-C : HDL-C ratio in the group without arcus was 4.28 (SD: 1.99), and 5.73 (SD: 2.09) in the group with a corneal arcus (p < 0.05).
    Conclusions: Low HDL-C levels, high LDL-C levels and LDL-C : HDL-C ratios > 5 have been implicated as risk factors of numerous circulatory diseases. The observations in this study suggest that the presence of corneal arcus in the dyslipidaemic patient correlates strongly with these same risk indicators.
     
  5. Title: EVAR : critical applied aortic morphology relevant to type-II endoleaks following device enhancement in patients with abdominal aortic aneurysms : cardiovascular topics
    Authors: Du Toit, D.F.; Saaiman, J.A.; Labuschagne, B.C.J.; Vorster, W.; Van Beek, F.J.; Boden, B.H.; Geldenhuys, K.M.
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.170-177
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    Abstract: Endovascular repair (EVAR) of abdominal aortic aneurysms (AAA) is an established alternative option to conventional surgery for AAA, provided optimal anatomical morphology of the aneurysm sac, neck and outflow exists. In most documented series of EVAR, type-II endoleak occurrence is a universal procedural drawback. This is referred to as the Achilles heel of EVAR. This morphological study, addressing predominantly non-aneurysmal aortic anatomy, reveals the dyssynchronous origins of the renal ostia, ectopia of the superior mesenteric artery and median sacral artery, variations in the length of the infrarenal abdominal aorta, multiple mainstem renal arteries, and the presence of accessory renal arteries (in 13% of cadavers). Such potential vascular anomalies need careful consideration pre-operatively prior to EVAR.
    In a prospective, clinical study of EVAR in 163 patients over 60 months, using four different aortic stent devices, we demonstrated an intraprocedural type-II endoleak rate, before exclusion, of 3% (5/163). Most were related to patent lumbar arteries. An active policy of intraprocedural aneurysm pressure sac measurement and angiography was used to demonstrate type-I and type-II endoleaks, focusing on the applied anatomy of aortic side branches and variations. Selective intraprocedural coil embolisation and thrombin injection into the sac was utilised to thrombose persisting and large lumbar arteries that predisposed to retroleaks. We recorded a low incidence of persisting type-II endoleaks using this proactive treatment strategy by addressing variant aortic morphology and patent lumbar arteries during EVAR. One aneurysm-related death (0.6%) was observed due to late rupture after EVAR, and a single intraprocedural death was related to unpredictable aneurysm rupture.
    In conclusion, comprehensive anatomical knowledge of the abdominal aorta and its main collateral side branches, including variations, is a fundamental prerequisite if satisfactory and predictable results are to be achieved after EVAR, especially regarding prevention, diagnosis and treatment of type-II endoleaks. Intraprocedural aneurysm sac pressure monitoring, coil embolisation and the use of injection of thrombin into the aneurysm sac of selected patients is useful in reducing the incidence of post-EVAR type-II persisting endoleaks.
     
  6.  Title: Pre-operative intercostal nerve blockade for minimally invasive coronary bypass surgery : a standardised anaesthetic regimen for rapid emergence and early extubation : cardiovascular topics
    Authors: Exadaktylos, Aristomenis K.; Trampitsch, Ernst; Mares, Peter; Czerny, Martin; Grimm, Michael; Muhm, Manfred
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.178-181
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: Background: Minimally invasive direct coronary artery bypass grafting (MIDCAB) has become a popular adjunct to cardiac bypass surgery in selected patients. Although MIDCAB without cardiopulmonary bypass is considered to be a relatively noninvasive procedure, the trauma to the muscle tissue caused by the anterolateral thoracotomy often leads to more pain than that of patients undergoing routine sternotomy. The purpose of our study was to evaluate the pre-operative application of an intercostal nerve blockade, combined with general anaesthesia for peri- and postoperative pain control, and its efficacy for early extubation.
    Methods and Results: Nine consecutive patients undergoing MIDCAB surgery were evaluated. Pre-operative ipsilateral intercostal nerve blockade was employed in all patients. After induction, isofluran (0.4-0.8%) and nitrous oxide in combination with the pre-operative nerve blockade provided sufficient anaesthesia throughout the procedure (mean operative time: 147 min). Only 2/9 patients required additional small doses of narcotics. All patients could be safely extubated within 15 minutes of skin suture. Postoperative discomfort and pain were minimal.
    Conclusion: From our initial experience with preoperative intercostal nerve blockade for the MIDCAB procedure, we concluded that it provides profound somatic analgesia as an effective adjunct to general anaesthesia with reduced doses of narcotics and sedatives. MIDCAB impresses with its ease of technical performance, its reliability and safety. The minimised chest-wall pain improves patients' chances of early tracheal extubation. In accordance with the minimally invasive surgical approach, it provides a contribution towards 'minimally invasive anaesthesia'. The surgeons' and the patients' acceptance is excellent.
    Because the results of this study are based on observation and verbalisation of the investigators' impressions, and no objective measurements were made which would have allowed a comparison between the MIDCAB technique and the golden standard of general anaesthesia with opioid analgesia, a further study should be conducted to prove our theory.
     
  7. Title: Diaphragmatic hernia mimicking an atrial mass : a two-dimensional echocardiographic pitfall and a cause of postprandial syncope : case report
    Authors: Ker, J.; Van Beljon, J.
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.182-183
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: A large hiatal hernia constitutes a form of posterior mediastinal mass that can encroach on the posterior aspects of the heart. During two-dimensional echocardiography this phenomenon may be confused with an intra-atrial mass or various other posterior mediastinal masses. Furthermore, such a large hiatal hernia encroaching on the heart may cause syncope. We present such a case and the various possible mechanisms of syncope, as well as review the two-dimensional echocardiographic pitfalls in these patients.
     
  8. Title: Old dogmas and new hearts : a role for adult stem cells in cardiac repair? : review article
    Authors: Niesler, Carola U.
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.184-189
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
    Abstract: The vast developmental repertoire of embryonic stem cells is well recognised. These primitive stem cells can differentiate in vivo and in vitro into cells of all three embryonic germ layers (endoderm, mesoderm, ectoderm), making them attractive potential agents to target for enhanced tissue repair and regeneration. Adult stem cells on the other hand are considered more restricted in their lineage differentiation capabilities. Recent research has challenged this dogma with the finding that bone marrow-derived stem cells can differentiate into a wide variety of cell types including muscle (skeletal and cardiac). Furthermore, although the myocardium has for decades been regarded as a post-mitotic organ, a series of studies has indicated that a population of stem cells exists which is capable of at least partial reconstitution of the myocardium following an ischaemic insult. It is therefore now accepted that adult stem cells could be used to enhance myocardial repair. This review discusses the current status of adult stem cell research in the light of its potential for improving myocardial repair.
     
  9. Title: LDL cholesterol goals rapidly achieved at various starting doses of Pfizer's atorvastatin : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.190
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
     
  10. Title: VALUE study highlights the need for aggressive BP lowering in high-risk patients : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.191-192
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
     
  11. Title: Comments by a South African cardiologist at the meeting
    Authors: Moodley, Rajen
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.194-195
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
     
  12. Title: INVEST study adds important data for clinical practice in new-onset diabetes : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.195
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
     
  13. Title: Aggressive cholesterol-lowering treatment in type 2 diabetes mellitus : an update : drug trends in cardiology
    Authors: Delport, Rhena
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.195-196
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
     
  14. Title: Added benefits of nifedipine (Adalat(R) GITS) beyond lowering blood pressure : drug trends in cardiology
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.198-199
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
     
  15. Title: Cardio news
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.200
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
     
  16. Title: ISHR Satellite Abstracts : Cellular Injury in Ischaemia : supplement
    From: Cardiovascular Journal of South Africa, Vol 15, Issue 4, Jul / Aug
    Published: 2004
    Pages: p.ii-iv, 1-15
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    Notes: Continues as Cardiovascular Journal of Africa from Volume 18, Issue 3, May/Jun 2007, ISSN 10159657.
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