CARDIOVASCULAR JOURNAL OF AFRICA: VOLUME 19, ISSUE 3, MAY 2008
- Title: Fixed drug combination in
hypertension and hyperlipidaemia in the
developing world : editorial
Authors: Seedat, Y.K.
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 124-126
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Cardiovascular disease is the leading cause of death worldwide. In 2002, it was estimated to have caused over 15 million deaths, comprising more than a quarter of all deaths that year. About 7.2 million of these deaths were due to ischaemic heart disease and 5.5 million were due to cerebrovascular disease. By 2020 it is estimated that there will be 25 million deaths from cardiovascular disease annually and that these deaths will comprise 37% of all deaths that year.
- Title: Cardiovascular effects of
mollic acid glucoside, a 1α-hydroxycycloartenoid
saponin extractive from Combretum molle R Br ex
G Don (Combretaceae) leaf : cardiovascular topic
Authors: Ojewole, J.A.O.
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 128-134
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: The cardiovascular effects of mollic acid glucoside (MAG), a 1α-hydroxycycloartenoid saponin extractive from Combretum molle R Br ex G Don (Combretaceae) leaf, have been investigated in some experimental animal paradigms. The plant extract (MAG, 5-80 µg/ml) produced concentration-dependent, significant (p < 0.05-0.001) negative inotropic and negative chronotropic effects on guinea pig isolated electrically driven left, and spontaneously beating right atrial muscle preparations, respectively. MAG also significantly reduced (p < 0.05-0.001) or abolished, in a concentration-dependent manner, the rhythmic, spontaneous contractions of portal veins isolated from healthy, normal Wistar rats.
Like acetylcholine (ACh, 10-8-10-5 M), the plant extract (5-80 µg/ml) produced concentration-related relaxations of rat isolated endothelium-containing thoracic aortic rings pre-contracted with noradrenaline (NA, 10-10-10-5 M). The vasorelaxant effects of MAG in the aortic rings were markedly inhibited or annulled by NG-nitro-L-arginine methyl ester (L-NAME, 10-5 M), a nitric oxide synthase inhibitor. Furthermore, MAG (2.5-40 mg/kg iv) caused dose-related, transient but significant reductions (p < 0.05-0.001) in the systemic arterial blood pressures and heart rates of anaesthetised normotensive and hypertensive rats.
The results of this laboratory animal study indicate that MAG caused bradycardia, vasorelaxation and hypotension in the mammalian experimental models used. The vasorelaxant action of MAG was endothelium dependent, and was therefore possibly dependent on the synthesis and release of nitric oxide (NO). The findings of this study suggest that Combretum molle leaf may be used as a natural supplementary remedy in essential hypertension and in certain cases of cardiac dysfunctions in rural African communities.
- Title: Prevention and control of
rheumatic fever and rheumatic heart disease :
the Cuban experience (1986-1996-2002) :
cardiovascular topic
Authors: Nordet, P.; Lopez, R.; Duenas, A.; Sarmiento, L.
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 135-140
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Background : Rheumatic fever (RF) and rheumatic heart disease (RHD) are still major medical and public health problems mainly in developing countries. Pilot studies conducted during the last five decades in developed and developing countries indicated that the prevention and control of RF/RHD is possible. During the 1970s and 1980s, epidemiological studies were carried out in selected areas of Cuba in order to determine the prevalence and characteristics of RF/RHD, and to test several long-term strategies for prevention of the diseases.
Methods : Between 1986 and 1996 we carried out a comprehensive 10-year prevention programme in the Cuban province of Pinar del Rio and evaluated its efficacy five years later. The project included primary and secondary prevention of RF/RHD, training of personnel, health education, dissemination of information, community involvement and epidemiological surveillance. Permanent local and provincial RF/RHD registers were established at all hospitals, poli-clinics and family physicians in the province. Educational activities and training workshops were organised at provincial, local and health facility level. Thousands of pamphlets and hundreds of posters were distributed, and special programmes were broadcast on the public media to advertise the project.
Results : There was a progressive decline in the occurrence and severity of acute RF and RHD, with a marked decrease in the prevalence of RHD in school children from 2.27 patients per 1 000 children in 1986 to 0.24 per 1 000 in 1996. A marked and progressive decline was also seen in the incidence and severity of acute RF in five- to 25-year-olds, from 18.6 patients per 100 000 in 1986 to 2.5 per 100 000 in 1996. There was an even more marked reduction in recurrent attacks of RF from 6.4 to 0.4 patients per 100 000, as well as in the number and severity of patients requiring hospitalisation and surgical care. Regular compliance with secondary prophylaxis increased progressively and the direct costs related to treatment of RF/RHD decreased with time. The implementation of the programme did not incur much additional cost for healthcare. Five years after the project ended, most of the measures initiated at the start of the programme were still in place and occurrence of RF/RHD was low.
- Title: Biological variation of
ischaemia-modified albumin in healthy subjects :
cardiovascular topic
Authors: Govender, R.; De Greef, J.; Delport, R.; Becker, P.J.; Vermaak, W.J.H.
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 141-144
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Aim : Ischaemia-modified albumin (IMA), as measured by the albumin-cobalt binding (ACB) test®, has been cleared by the US Food and Drug administration as a biomarker to exclude the presence of myocardial ischaemia in patients. Although there are a number of published studies detailing the clinical utility of IMA, data on the biological variation of IMA are still lacking. In this study we determined the analytical and biological variance components of ischaemia-modified albumin, and compared the distribution of IMA values in our patient population to those provided by the kit manufacturer.
Methods : IMA was determined once a week for five consecutive weeks on a cohort of healthy subjects using a colorimetric method, the ACB test® on a Roche modular analyser.
Results : The analytical coefficient of variation (CVA) was 5%, and the within-subject (CVI) and between-subject (CVG) biological variations were 3 and 7%, respectively. Analysis of the repeated measures with gender and race (black and Caucasian) as between-subject factors, and weeks (1-5) as the within-subject factor showed that gender had no significant effect on circulating IMA concentrations (p = 0.3146), whereas race did have a significant effect (p = 0.0062). A significant (p = 0.0185) interaction was observed between gender and race.
Conclusion : The ACB test® could bring a new dimension to the care and management of patients with acute coronary syndrome. Further studies for normal population distributions by gender and ethnicity, and an optimum cut-off value appear to be required.
- Title: William Nelson ECG Quiz :
cardiovascular topic
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 144, 154
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: This is the ECG of a 54-year-old woman with SVT.
- Title: Cardiac disease in pregnancy
: cardiovascular topic
Authors: Nqayana, T.; Moodley, J.; Naidoo, D.P.
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 145-151
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: This study was a retrospective review of patient charts of a relatively large number of patients with cardiac disease in pregnancy in a developing country. Ninety-five patients were evaluated; the majority (n = 36) were in the age group 21-25 years. Rheumatic heart disease was the commonest aetiology; eight women required balloon mitral valvuloplasty and one had a valve replacement at 32 weeks' gestation. There were no maternal deaths but morbidity was high; 13 patients were admitted in cardiac failure, nine had atrial fibrillation and three required intensive-care management. There were 86 live births of the 97 deliveries.
Cardiac disease in pregnancy is associated with high maternal morbidity and adverse foetal outcomes; this was related to late presentation and problems with anticoagulation. Clinical assessment remains a key factor in timeous referral and appropriate investigations.
- Title: Myocardial infarction
secondary to premature coronary artery disease
as the initial major manifestation of systemic
lupus erythematosus : case report
Authors: Kassaian, S.E.; Goodarzynejad, H.; Darabian, S.; Basiri, Z.
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 152-154
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: A 32-year-old woman admitted to the emergency department was diagnosed with acute anterior myocardial infarction, treated with thrombolytics and referred for angiography on the basis of her age. The patient was then referred for angioplasty with the diagnosis of an atherosclerotic lesion in the left anterior descending (LAD) coronary artery. Successful treatment of the lesion by primary stenting ensued. Laboratory findings revealed a state of hypercoagulability as well as some collagen fibre disease. The final diagnosis, confirmed by a rheumatologist, was systemic lupus erythematosus (SLE) with premature atherosclerosis of the LAD in addition to hypercoagulability.
A Medline search of the literature revealed limited previous reports of myocardial infarction due to premature coronary artery disease as the first manifestation in SLE.
- Title: Left subclavian vein
occlusion after pacemaker insertion : images in
cardiology
Authors: Vyselaar, J.R.; Michael, K.A.; Nolan, R.L.; Baranchuk, A.
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 155
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Subclavian vein thrombosis after pacemaker lead insertion is a well-described complication of pacemaker insertion. It is usually asymptomatic due to the presence of collateral venous flow but the clinical presentation is varied. This index case illustrates a typical clinical scenario and the value of computerised tomography (CT) in providing adequate delineation of the venous pathology.
- Title: Statin-induced myopathy :
cardiovascular prescriber
Authors: Gounden, R.; Blockman, M.
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 156-157
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: It was traditionally thought that, as a major adverse effect, the HMG Co-A reductase inhibitors or statins increase the risk of muscular disorders, ranging from myalgia to myopathy and even rhabdomyoloysis. Myalgia is defined as muscular pain without significant elevations of creatine kinase (less than 10 times the upper limit of normal), whereas myopathy is the presence of muscular symptoms associated with an increase in creatine kinase (CK) greater than 10 times the upper limit of normal. Rhabdomyolosis is characterised by a CK concentration of greater than 10 times the upper limit of normal, with evidence of renal impairment, or an absolute CK of 10 000 IU/l.
- Title: STRADIVARIUS : a brave trial
aimed at clarifying benefits of rimonabant
therapy : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 158-159
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: The result of the STRADIVARIUS trial of rimonabant in abdominally obese patients with coronary artery disease has shown benefit in overall cardiovascular risk factor reduction, without clearly achieving statistically significant reduction in percentage atheroma volume, although total atheroma volume was reduced.
- Title: PERISCOPE : pioglitazone
offers the right cluster of effects to confer
benefit in type 2 diabetes : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 159, 162
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: The PERISCOPE study compared the effects of pioglitazone versus glimepiride on the progression of coronary atherosclerosis in patients with established type 2 diabetes, and showed that pioglitazone has a cluster of beneficial effects, according to Dr Steve Nissen, chairman, Department of Cardiovascular Medicine at the Cleveland Clinic and lead investigator of the study.
- Title: Combination therapy with
amlodipine / benazapril (CCB / ACEI) superior to
hydrochlorothiazide / benazapril in high-risk
hypertensive patients : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 163
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: The ACCOMPLISH trial of a calcium channel blocker (CCB) and an ACE inhibitor in a fixed-dose combination versus an ACE inhibitor plus thiazide diuretic in high-risk hypertensive patients was stopped early following compelling benefit in the CCB / ACE inhibitor arm of the study.
- Title: Secondary stroke prevention
set to benefit from PRoFESS trial : drug trends
in cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 165
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: The first head-to-head study of two antiplatelet regimens recommended for the secondary prevention of ischaemic stroke, conducted in the PRoFESS study, demonstrate that the risks of recurrent stroke or the composite risk of stroke, myocardial infarction or vascular death are very similar with either extended-release dipyridamole (ER-DP) plus aspirin or clopidogrel in patients with non-cardioembolic ischaemic stroke.
- Title: Early initiation of BP
lowering with telmisartan after a stroke : drug
trends in cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 166
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Initiation of blood pressure lowering with telmisartan early after a stroke (at an average of 15 days), with a relatively short duration of therapy of 2.5 years, showed a non-statistically similar rate of stroke or other major vascular events compared to the placebo arm, according to the results of the PRoFESS trial, presented at the 17th European Stroke conference in Nice, France.
- Title: ENHANCE results : a surrogate
trial that impacts beyond size and scope : drug
trends in cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 166-168
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: The negative results from the ENHANCE trial of ezetimibe with regard to reduction of intima-media thickness in heterozygous familial hypercholesterolaemic patients provoked intense debate during a special session on the trial at the recent ACC meeting.
- Title: Antihypertensive treatment in
the very elderly shows significant mortality
benefit : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 169, 171
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: A challenging trial of hypertension in the very elderly (HYVET), which took almost 10 years to complete, has provided proof that antihypertensive therapy in older patients saves lives. Therapy using low-dose indapamide (1.5 mg sustained release daily) with added perindopril in 73% of patients in the treated group resulted in significant reduction of rates of death from any cause, and nearly significant benefit for the risk of fatal or non-fatal stroke.
- Title: Fenofibrate set to benefit
from new research on its active metabolite,
fenofibric acid : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 171-172
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Interest in fenofibrate, the only fibrate with outcomes data showing significant reduction in macro- and microvascular damage in type 2 diabetic dyslipidaemia, is increasing as a result of recent trials of a new molecule, fenofibric acid, which is an active metabolite of fenofibrate.
- Title: DUAAL : atorvastatin provided
an unexpectedly potent heart benefit in patients
with chronic stable angina : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 174
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: Results from the new study DUAAL, released at the ACC 2008 meeting, have shown the unexpected benefit of statin therapy in patients with chronic stable angina.
- Title: Symposium : Cardiac
Arrhythmias and Sudden Death : from Genes to
Prevention : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 175
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: The Hatter Institute for Cardiovascular Research at the University of Cape Town Medical School is inaugurating its cardiovascular genetics laboratory. In recognition of this, a symposium will be held in Cape Town on 15-16 August 2008.
- Title: Visit to North Africa to
stimulate interest in CVJA in francophone
countries : cardio news
From: Cardiovascular Journal of Africa, Vol 19, Issue 3, May / Jun
Published: 2008
Pages: 176
Full text: Click here to order
Full text: Click here to read online (Login Required)
Abstract: The Cardiovascular Journal of Africa (CVJA) was pleased to sponsor a visit by Prof Sinclair Wynchank to French-speaking North Africa to promote the Journal's willingness to accept scientific articles of merit in French. The articles will be peer reviewed by French speakers and, if accepted, the articles will be published in English with full-text French versions available on Pubmed.
