CARDIOVASCULAR JOURNAL OF AFRICA: VOLUME 18, ISSUE
3, MAY 2007
- Title: South African lamb and
cardiovascular disease risk : editorial
Authors: Delport, R.; Schonfeldt, H.C.
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 136-138
Full text: Click here to order
Full text: Click here to read online (Login Required)
- Title: Dysrhythmogenic potential in
acute admissions to psychiatric hospitals and
clinics : cardiovascular topic
Authors: Grant, C.C.; Steenkamp, B.; Gauche, L.; Becker, P.J.; Ker, J.; Roos, J.L.; Viljoen, M.
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 140-144
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Co-morbidity between physical disease, especially cardiovascular, and psychological disturbances is well documented. in psychiatric patients, the potential for dysrhythmogenic incidences is increased by the fact that many psychiatric medications influence cardiovascular function.
Aim: The aim of the study was to examine the dysrhythmogenic potential of 30 psychiatric patients (group A), irrespective of diagnoses or medication, at admission to psychiatric institutions.
Methods: The dysrhythmogenic potential was determined in terms of heart rate-corrected QT intervals (QTc), heart rate-corrected JT intervals (JTc), QT and JT dispersion (QTcd and JTcd) between leads v1 and v6, and heart rate variability (HRV) as determined from lead v6 of the ECG. values were compared with 30 age- and gender-matched controls (group B). in the second part of the study the dysrhythmogenic indicators were assessed in a patient group (group C; n 5 43) with only psychiatric disorders and compared to a group with psychiatric as well as medical disorders (group D; n 5 27).
Results: The patient group A had significantly higher values than the control group for mean QTc (v6) (0.4579 + 0.0328 vs 0.4042 + 0.0326; p 5 0.0470), mean JTc (v6) (0.3883 + 0.0348 vs 0.3064 + 0.0271; p 5 0.0287) and mean QT and JT dispersion values (QTcd 5 0.0443 + 0.0203 vs 0.0039 + 0.0053 and JTcd 5 0.0546 + 0.1075 vs 0.0143 + 0.1450, p < 0.05). A statistically significant difference (p < 0.0001) was found between the patients' (group A) HRV and that of the controls (group B). No statistically significant differences were found between the values of the dysrhythmogenic indicators for patients with only psychiatric illness (group C) and those with psychiatric as well as medical disorders (group D).
Conclusions: Psychiatric patients at the point of admission to psychiatric institutions may have an increased dysrhythmogenic potential, not necessarily caused by physical disease. The potential of an augmented risk for cardiovascular incidents in psychiatric patients should be considered when treating such patients.
- Title: The William Nelson ECG Quiz
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 145, 168
Full text: Click here to order
Full text: Click here to read online (Login Required)
- Title: Long-term follow-up of
R403WMYH7 and R92WTNNT2 HCM families : mutations
determine left ventricular dimensions but not
wall thickness during disease progression :
cardiovascular topic
Authors: Revera, Miriam; Van der Merwe, Lize; Heradien, Marshall; Goosen, Althea; Corfield, Valerie A.; Brink, Paul A.; Moolman-Smook, Johanna C.
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 146-153
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Background: The clinical profile and prognosis of patients with hypertrophic cardiomyopathy, a primary cardiac muscle disease caused mostly by mutations in sarcomeric protein-encoding genes, have been linked to particular disease-causing mutations in the past. However, such associations are often based on cross-sectional observations, as longitudinal studies of the progression of the disease in genotypically defined patients are sparse. Most importantly, the relative contribution of age, gender and genetic cause to disease profile and progression has not yet been reported, and the question remains whether one or more of these factors could mask the effect of the other(s).
Methods: We previously described cross-sectional family studies of two hypertrophic cardiomyopathy (HCM)-causing mutations, R92WTNNT2 and R403WMYH7, both associated with minimal hypertrophy, but with widely different life expectancies. We re-investigated 22 and 26 R92WTNNT2 and R403WMYH7 mutation carriers in these and additional South African R92WTNNT2 families after a mean 11.08 + 2.79 years, and compared the influence of the two mutations, in the context of age and gender, on disease progression.
Results: We demonstrated a positive correlation between age and interventricular septal thickness for both mutations, with more than a third of all mutation carriers developing clinically recognised hypertrophy only after the age of 35 years. This period of hypertrophically silent HCM also coincided with the years in which most sudden cardiac deaths occurred, particularly in male R92WTNNT2 carriers. Statistical analyses indicated that the particular mutation was the strongest determinant of left ventricular remodelling; particularly, LVESD increased and Ef reduction was noted in the majority of R403WMYH7 carriers, which may require clinical follow-up over the longer term.
Conclusions: Statistical modelling of follow-up data suggests that an interplay between unidentified, possibly genderassociated factors, and the causal mutation are the determinants of eventual cardiac function and survival, but not of the extent of hypertrophy, and emphasises the need for long-term follow-up even in individuals with apparently mild disease.
- Title: Effects of enhanced external
counterpulsation on anginal symptoms and
improvements in objective measures of myocardial
ischaemia : cardiovascular topic
Authors: Yavari, M.; Montazeri, H.R.
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 154-156
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Background: Enhanced external counterpulsation (EECP) is a novel, potentially beneficial adjunct therapy used for angina pectoris. We assessed the efficacy of this method in relieving angina and improving objective measures of myocardial ischaemia.
Methods: All patients (67) who referred for EECP to Shahid Chamran Hospital, Isfahan, Iran from 2002 to 2005 were included. Demographic data, coronary artery disease (CAD) risk factors and baseline angiographic data were collected. Anginal symptoms, Canadian Cardiovascular Society (CCS) functional class, echocardiographic parameters (ejection fraction, left ventricular end-diastolic and end-systolic diameters) and exercise test duration before and after the treatment were compared.
Results: Seventy-seven per cent of patients who had undergone EECP had a positive clinical response. Exercise test duration and CCS functional class improved after the treatment. However, EECP had no significant effect on echocardiographic parameters. Efficacy was independent of age, gender, CAD risk factors, prior CCS functional class and echocardiographic parameters. Patients without left main artery involvement and those who had at least one non-obstructed artery demonstrated a greater likelihood of improvement.
Conclusion: The results of this study suggested that EECP is a safe, well tolerated, and significantly effective treatment for angina pectoris.
- Title: Mitral valve apparatus :
echocardiographic features predicting the
outcome of percutaneous mitral balloon valvotomy
: cardiovascular topic
Authors: Du Toit, R.; Brice, E.A.W.; Van Niekerk, J.D.; Doubell, A.F.
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 159-164
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Objectives: To evaluate the significance of involvement of subvalvular apparatus in the outcome of percutaneous mitral balloon valvotomy (PMBV) in patients with mitral stenosis (MS) and to determine the predictive value of chordal length compared with current echocardiographic scores.
Methods: Patients with significant MS were selected according to the Massachusetts General Hospital score (MGHS). Chordal lengths were assessed as additional markers of disease. Standard percutaneous valvotomies were performed. valve area was assessed post-procedure with follow-up over one year.
Results: Thirty-nine patients were prospectively studied. valve area increased from a mean (SD) 0.97 (0.26) cm2 to 1.52 (0.38) cm2 with procedural success in 31 (79.5%) patients. There was no correlation (r 5 0.09) between the MGHS and final valve area (FVA). There was a positive correlation between anterior chordal length and FVA (r 5 0.66; p 5 0.01). An FVA > 1.5 cm2 was associated with higher mean chordal lengths (p 5 0.01). A positive correlation wasseen between valve area pre-procedure and FVA (r 5 0.61; p < 0.01).
Conclusions: The MGHS is valuable in the selection of patients for PMBV, but fails to separate selected patients into prognostic groups. Assessment of chordal length provides useful additional information, predicting the outcome of PMBV more accurately. our data may support the earlier use of PMBV (asymptomatic patients).
- Title: Effect of heterozygous
b-thalassaemia trait on coronary atherosclerosis
via coronary artery disease risk factors : a
preliminary study : cardiovascular topic
Authors: Hashemi, M.; Shirzadi, E.; Talaei, Z.; Moghadas, L.; Shaygannia, I.; Yavari, M.; Amiri, N.; Taheri, H.; Montazeri, H.; Shamsolkottabi, H.
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 165-168
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Background: Thalassaemia is considered the most common genetic disorder worldwide. An association between the heterozygous b-thalassaemia trait and myocardial infarction has previously been observed. However, the relationship between heterozygous b-thalassaemia and atherosclerosis, considering other coronary artery disease (CAD) risk factors, has remained unclear.
Methods: A case-control study was conducted to evaluate the hypothesis that thalassaemia minor affects the likelihood of atherosclerotic plaque formation. Blood counts and blood chemistry data as well as traditional risk factors from 1 363 patients referred to heart centres for coronary angiography were recorded. Heterozygous b-thalassaemia was diagnosed by the presence of hypochoromic-microcytic anaemia, ferritin levels > 12 ng/ml and haemoglobin-A2 levels > 3.5.
Results: Chi-squared analysis showed that the prevalence of heterozygous b-thalassaemia was not significantly different between patients with and without CAD (p > 0.05). Multivariate logistic regression analysis using CAD as the dependent variable and traditional risk factors, haematocrit, ferritin levels and heterozygous b-thalassaemia as independent variables, did not show any significant difference either. independent two-tailed student's t-tests showed that haematocrit levels were statistically different (p = 0.000) between CAD+ and CAD- groups, but low-density lipids (LDL), high-density lipids (HDL), triglycerides (TG), total cholesterol and serum ferritin levels were not statistically different (p > 0.05).
Conclusion: The prevalence of heterozygous b-thalassaemia in the case group was not significantly different from the control group. This case-control study did not support the hypothesis that thalassaemia minor affects the likelihood of atherosclerotic plaque formation.
- Title: CT imaging of myocardial
viability : experimental and clinical evidence :
review article
Authors: Mahnken, Andreas H.; Muhlenbruch, Georg; Gunther, Rolf W.; Wildberger, Joachim E.
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 169-174
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: over the last decade, imaging of myocardial viability has become a well-established indication in patients suffering from myocardial infarction. Myocardial viability imaging is routinely performed using F-fluorodeoxyglucose positron emission tomography, single-photon emission computed tomography or magnetic resonance imaging. only recently have several multi-slice spiral computed tomography (MSCT) techniques been evaluated for visualisation of myocardial infarction. This review describes the different concepts of MSCT viability imaging. MSCT assessment of myocardial morphology, myocardial perfusion imaging and delayed myocardial contrast enhancement are introduced, with the latter evolving as the key concept of MSCT viability imaging. Clinical relevance of the different MSCT techniques is described.
- Title: Cardiomyopathy in Africa :
heredity versus environment : review article
Authors: Mayosi, Bongani M.; Somers, Krishna
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 175-179
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: unlike other parts of the world in which cardiomyopathy is rare, heart muscle disease is endemic in Africa. The major forms of cardiomyopathy in Africa are dilated cardiomyopathy (DCM) and endomyocardial fibrosis (EMF). Whereas DCM is a major cause of heart failure throughout the continent, EMF is restricted to the tropical regions of East, Central, and West Africa. Although epidemiological studies are lacking, hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy seem to have characteristics similar to those of other populations elsewhere in the world.
Recent advances in the genetic analysis of DCM in other parts of the world indicate that it is a genetically heterogeneous disorder in which some cases have a Mendelian cause and others have a non-genetic or multifactorial cause. This heterogeneous pattern of inheritance has been confirmed in small studies that have been conducted so far in Africa. The advent of human immunodeficiency virus infection and its association with cardiomyopathy has emphasised the role of inflammatory agents in the pathogenesis of DCM.
By contrast with DCM in which some cases have major genetic contributions, there is scanty evidence for the role of genetic factors in the aetiology of EMF. Although the pathogenesis of EMF is not fully understood, it appears that the conditioning factor may be geography (in its widest sense, to include climate and socio-economic status), the triggering factor may be an as yet unidentified infective agent, and the perpetuating factor may be eosinophilia. There is a need for renewed effort to identify genetic and non-genetic factors in EMF and other forms of heart muscle disease that are prevalent on the continent of Africa.
- Title: Thoracic aortic aneurysm :
direct sign of rupture : case report
Authors: Marijon, Eloi; Vilanculos, Alda; Tivane, Adriano; Jani, Dinesh; Mocumbi, Ana Olga; Ferreira, Beatriz; Fressonnet, Renaud
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 180-181
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Hypertension, wall thinning and aortic enlargement are the most important factors increasing wall stress and causing aortic aneurysms to rupture. Computed tomography, especially with contrast image enhancement, usually shows the aortic anatomy with great clarity and distinguishes a ruptured aortic aneurysm from an acute aortic syndrome.
- Title: Cardiovascular Healing,
editors : Johann Bauersacks, Stefan Frats : book
review
Authors: Brink, Andries
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 181
Full text: Click here to order
Full text: Click here to read online (Login Required)
- Title: Vitamin D - the forgotten
vitamin - and the cardiovascular physician :
cardiovascular prescriber
Authors: Brink, A.
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 182-184
Full text: Click here to order
Full text: Click here to read online (Login Required)
- Title: ONTARGET to provide new
treatment strategies for high-risk
cardiovascular patients : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 186-187
Full text: Click here to order
Full text: Click here to read online (Login Required)
- Title: Cardiologists set to become
obesity experts? : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 189
Full text: Click here to order
Full text: Click here to read online (Login Required)
- Title: Reduced risk of new-onset
diabetes with trandolapril / verapamil-SR in
patients with the metabolic syndrome :
drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 190
Full text: Click here to order
Full text: Click here to read online (Login Required)
- Title: Special report on the
sanofi-aventis cardiometabolic symposium : drug
trends in cardiology
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 192-195
Full text: Click here to order
Full text: Click here to read online (Login Required)
- Title: Preventing hypertensive
vascular damage - satellite symposium
Hypertension Congress 2007 sponsored by
sanofi-aventis : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 203-204
Full text: Click here to order
Full text: Click here to read online (Login Required)
- Title: FIELD study supports the
value of fenofibrate in type 2 diabetes
management : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 205
Full text: Click here to order
Full text: Click here to read online (Login Required)
- Title: New blood pressure-monitoring
approaches : cardio news
From: Cardiovascular Journal of Africa, Vol 18, Issue 3, May / Jun
Published: 2007
Pages: 208
Full text: Click here to order
Full text: Click here to read online (Login Required)
