CARDIOVASCULAR JOURNAL OF AFRICA:
VOLUME 14, ISSUE 2, MARCH 2003
Title: CVJSA e-journal publication :
editorial
Authors: Brink, A.J.
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.57-58
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Title: Abnormal serum lipoprotein
levels as a risk factor for the development of
human lenticular opacities : cardiovascular
topics
Authors: Meyer, D.; Parkin, D.; Maritz, F.J.;
Liebenberg, P.H.
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.60-64
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Abstract: Aim : To determine whether an
association exists between the different plasma
lipoprotein constituents and the prevalence of
lenticular opacities in dyslipidaemic subjects.
Methods : Adult patients (n = 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.
Results : An extremely strong association (p <
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; p = 0.001)]. An equally strong
association was found between high (> 5) LDL :
HDL ratios and the development of lens opacities
(p < 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; p
= 0.014).
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.
Title: Long-term follow-up of
single-lead VDD pacing : cardiovascular topics
Authors: Munclinger, Miroslav J.; Thornton,
Andrew S.; Dateling, Freddie
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.66-72
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Abstract: 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 ± 15 months after the implant.
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.
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.
Title: Mechanisms of opioid delta
(d) and kappa (k) receptors' cardioprotection in
ischaemic preconditioning in a rat model of
myocardial infarction : cardiovascular topics
Authors: Valtchanova-Matchouganska, A.; Ojewole,
J.A.O.
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.73-80
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Abstract: 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
d-receptor agonist (DADLE) and antagonist
(natrindole), and opioid k-receptor agonist
(U-50488H) and antagonist (nor-BNI) were used.
To clarify some of the mechanisms of IPC, we
used selective inhibitors of the anticipated
cellular systems involved. Pertussis toxin
(inhibitor of adenylate cyclase Gi / o protein),
glibenclamide (inhibitor of KATP channel) and
chelerythrine (inhibitor of PKC) were used.
Results obtained showed that :
* Both opioid d- and k-receptors were involved
in the beneficial effect of IPC, although we
were unable to differentiate between opioid
receptor subtypes (d1, d2 and k1, k2).
* Opioid d- and k-receptors displayed different
effects in IPC. After 30 minutes of left
coronary occlusion and 2-hour reperfusion,
opioid d-receptor agonist DADLE significantly
decreased (p < 0.05) the infarct size (by 66% -
from % IS / AAR 59.80 in the control, untreated
infarcted rats to % 20.40), without a
significant effect (p > 0.05) on the occurrence
of early arrhythmias. Opioid k-receptor agonist
U-50488H produced mainly antiarrhythmic effects.
It decreased % IS / AAR by 44%, reduced the
occurrence of early arrhythmias by 77%, and
decreased ventricular ectopic beats by 80%. Both
opioid d- and k-receptor agonists significantly
reduced (p < 0.05) early (2- hour) mortality by
22% and 19% respectively. The above opioid d-
and k-receptor cardiac effects were abolished by
the use of respective specific opioid d- and
k-receptor antagonists.
* The beneficial effects of opioid d- and
k-receptor agonists persisted for at least 24
hours post-infarction.
* It is most likely that both opioid d- and
k-receptors act via common cellular mechanisms
involving :
- activation of ATP-sensitive (sarcolemmal or
mitochondrial) K+ channel via Gi / o proteins
(based on the results of our experiments with
KATP channel antagonist, glibenclamide);
- phosphatidylinositol pathway via activation of
protein kinase C (judging from the results of
our experiments with the inhibitor of PKC,
chelerythrine);
- the recently proposed 'cross talk' between
b1-adrenergic and opioid receptors in cardiac
myocytes (involving inhibition of adenylate
cyclase by Gi / o proteins). Exploring the
possibility of this signaling pathway will be
the next step in our experimental studies.
Title: Dietary markers of
hypertension associated with pulse pressure and
arterial compliance in black South African
children : the THUSA Bana study : cardiovascular
topics
Authors: Schutte, A.E.; Van Rooyen, J.M.;
Huisman, H.W.; Kruger, H.S.; Malan, N.T.; De
Ridder, J.H.
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.81-89
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Abstract: 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.
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 (p ≤ 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.
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.
Title: The William Nelson ECG quiz
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.89, 94
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Title: 'Low pressure' left
ventricular tamponade in a patient with
rheumatic mitral stenosis and HIV-related acute
pericarditis : case report
Authors: Goldberg, L.; Hagios, P.; Grigorov, V.;
Mekel, J.
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.91-94
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Abstract: A case report of isolated left
ventricular tamponade in a patient with
rheumatic mitral stenosis and effusive
pericarditis is presented. The haemodynamics and
management of this under-diagnosed pathology is
discussed.
Title: Letters to the editor
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.97-98
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Title: Enoxaparin reduced DVT risks
in patients with acute medical illness : drug
trends in cardiology
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.99-100
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Title: Policosanol - effective in
lowering cholesterol in type 2 diabetes : drug
trends in cardiology
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.100
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Title: Carvedilol gets a nod for
post-AMI use : drug trends in cardiology
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.100-102
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Title: Ramipril benefits over other
ACE inhibitors in the treatment of ST-elevation
AMI
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.102
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Title: Report on the SA Hypertension
Congress (7-9 March 2003) : successful
combination of CME and new research : drug
trends in cardiology
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.103-106
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Title: Cardio news
From: Cardiovascular Journal of South Africa,
Vol 14, Issue 2, Mar / Apr
Published: 2003
Pages: p.107-108
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