CARDIOVASCULAR JOURNAL OF AFRICA: VOLUME 19, ISSUE
4, JULY 2008
- Title: Microvascular benefits of
hypertension and glucose control in type 2
diabetes : editorial
Authors: Van Rensburg, B.W.J.
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 179-180
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Abstract: When albumin starts leaking through the glomerular tuft of capillaries into the urine of diabetic patients, it is an indication of small-blood vessel disease throughout the body. The more protein found in the urine, the more damage is evident elsewhere (retinopathy and neuropathy). Our best weapon in primarily preventing this damage has been tight blood glucose control, from as early after the diagnosis of diabetes as possible, and we have good evidence of its success in type 1 diabetics.
- Title: In Memoriam : Alexander
Pappachan (1963-2008)
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 180
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Abstract: Alex Pappachan, or Dr Alex as he was affectionately known, passed away tragically on 8 June while trying to rescue his seven-year-old son in a drowning accident.
- Title: Comparison of risk variables
associated with the metabolic syndrome in pre-
and postmenopausal Bengalee women :
cardiovascular topics
Authors: Ghosh, Arnab
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 183-187
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Abstract: Background : Clustering of risk variables associated with the metabolic syndrome (MS) begins before the onset of menopause. However, studies of the factors underlying this clustering have focused on only postmenopausal women.
Aim : The present community-based, cross-sectional investigation was aimed at identifying the principal components of risk variables associated with the metabolic syndrome in pre- and postmenopausal Bengalee women.
Methods : A total of 200 (100 premenopausal women; mean age = 40.2 ± 6.5 years and 100 postmenopausal women; mean age = 55.4 ± 5.2 years) healthy adult (30 years and older) Bengalee women took part in the study. Obesity measures, metabolic profiles and blood pressures were taken. Principal components factor analysis (PCFA) was used to identify the principal components of the MS.
Results : There were significant differences between the two groups for obesity measures, metabolic profiles and blood pressure, even after adjusting for age. PCFA revealed three uncorrelated factors with a 67.1% explanation in the premenopausal women. Four factors, with overlapping between the first three factors, and a 73% explanation were evident for the postmenopausal women.
Conclusion : Since more than one factor was identified, more than one physiological mechanism could have accounted for clustering of the risk variables associated with the MS and this would warrant early intervention, well before the menopause.
- Title: ß1- and α2c-adrenoreceptor
variants as predictors of clinical aspects of
dilated cardiomyopathy in people of African
ancestry : cardiovascular topics
Authors: Woodiwiss, Angela J.; Badenhorst, Danelle; Sliwa, Karen; Brooksbank, Richard; Essop, Rafique; Sareli, Pinhas; Norton, Gavin R.
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 188-193
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Abstract: Background : Although the ß1-adrenoreceptor (AR) Gly389Arg and α2c-AR Del322-325 gene variants are associated with the response to ß-AR-blocker therapy, whether this effect is associated with the risk for heart failure, or the severity or progression of heart failure is uncertain.
Aims : To assess the relationship between Gly389Arg and Del322-325 variants and the presence, severity and progression of idiopathic dilated cardiomyopathy (IDC) in 403 black South African patients.
Methods : Genotypes were identified using a restriction fragment length polymorphism-based technique and automated sequencing. Left ventricular ejection fraction (LVEF) and dimensions were determined at baseline and in 132 patients after six months of standard medical therapy excluding ß- AR-blockers (not indicated as standard care at the time of completing this study).
Results : All patients and controls genotyped for the α2c-AR variant were homozygous for the Del322-325 (risk) allele. The Gly389Arg polymorphism was not associated with IDC (control n = 429) (Arg389 allele homozygosity : odds ratio = 1.03, confidence limits = 0.78-1.35), nor did it predict LVEF and cavity dimensions either before or after therapy.
Conclusion : in patients homozygous for the risk allele of the α2c-AR variant, the ß1-AR variant neither increased the risk for IDC nor predicted its severity or progression in patients not receiving ß-AR-blockers.
- Title: Relationship between
resistance training and lipoprotein profiles in
sedentary male smokers : cardiovascular topics
Authors: Shaw, Ina; Shaw, Brandon S.
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 194-197
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Abstract: Epidemiological studies have found plasma lipid and lipoprotein levels to be predictive of cardiovascular disease in adults. To date, regular aerobic modes of exercise have been associated with favourable alterations in lipid and lipoprotein levels. However, the effect of resistance training on lipid and lipoprotein levels is inconclusive and conflicting. Therefore, the aim of this study was to provide some clarity on whether resistance training could be used to improve sedentary male smokers' lipoprotein profiles.
The study made use of a pre-test, a treatment period and a post-test. subjects were placed into one of two groups, namely, a resistance-training (RES) group (n = 13) or a control (CON) group (n = 12). Throughout the 16-week experimental period the CON group received no treatment whatsoever. After resistance training, serum triglyceride levels were significantly decreased by 18.42% from 1.162 mmol / l (± 0.476) to 0.831 mmol / l (± 0.058) (p = 0.038) in the RES group. However, resistance training was found to have no impact on any of the other measured lipid and lipoprotein measures.
In conclusion, these findings indicate that resistance training appears to have no significant effect on lipid and lipoprotein profiles in sedentary male smokers and therefore cannot prevent the advance of CAD.
- Title: Arrhythmia is not an
important finding in H5N1 infection : letter to
the editor
Authors: Wiwanitkit, Viroj
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 193
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Abstract: Avian influenza, caused by the H5N1 influenza virus, is a problematical infectious disease. Most cases develop progressive pneumonia with severe respiratory distress, and fatality is high. The author recently performed a mini-study to document whether arrhythmia was a clinical manifestation among reported Thai and Vietnamese patients.
- Title: Cardiac Imaging : Direct
Diagnosis in Radiology Series, CD Claussen, S
Miller, M Frenchel, U Kramer, R Riessen : book
review
Authors: Viljoen, H.; Lotz, J.W.
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 197
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Abstract: Radiologists have until recently seen the heart as just an oblong shape on the chest X-ray, which is either enlarged or not, or have ignored it altogether as that blurry object in the middle of the chest CT field of view. Change is afoot. The recent rapid expansion in the field of cardiac imaging necessitates the general radiologist to familiarise him / herself with the often-alien (to the radiologist) field of cardiology.
- Title: Resolution of nodular
myocardial tuberculosis demonstrated by
contrast-enhanced magnetic resonance imaging :
case report
Authors: Syed, F.F.; Aje, A.; Ntsekhe, M.; Mayosi, B.M.; Moosa, S.; Tshifularo, M.; Smedema, J.P.
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 198-199
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Abstract: In sub-Saharan Africa, pericardial tuberculosis is frequently diagnosed in HIV sero-positive patients. Myocardial involvement has only rarely been reported. We present an HIV sero-positive patient in whom both pericardial and myocardial tuberculosis were diagnosed, and highlight the value of cardiac magnetic resonance imaging in the diagnosis and management of this condition.
- Title: Tuberculous
effusive-constrictive pericarditis : case report
Authors: Russell, J.B.W.; Syed, F.F.; Ntsekhe, M.; Mayosi, B.M.; Moosa, S.; Tshifularo, M.; Smedema, J.P.
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 200-201
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Abstract: Infection with Mycobacterium tuberculosis and the human immunodeficiency virus has reached epidemic proportions in South Africa. Cardiac involvement occurs in approximately one per cent of patients suffering from active tuberculosis. This concerns predominantly pericardial involvement, resulting in chronic pericardial effusions, cardiac tamponade and constrictive pericarditis. Effusive-constrictive pericarditis is a clinical haemodynamic syndrome in which constriction by the visceral pericardium occurs in the presence of a tense effusion in a free pericardial space. We present a patient who was diagnosed with this condition, and highlight the value of contrast-enhanced magnetic resonance imaging in demonstrating the underlying structural and functional abnormalities.
- Title: A unique case of anomalous
coronary origin detected by 64-row multislice
computed tomography coronary angiography : case
report
Authors: Kilicaslan, Baris; Ergene, Oktay; Nazli, Cem; Cakir, Cayan; Ertas, Faruk
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 202-203
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Abstract: The anomalous origin of the left coronary artery from the right sinus of valsalva is an anatomical abnormality that is usually associated with myocardial ischaemia and sudden death. We report on a case in which three different diagnostic techniques were used to find the cause of the ischaemic symptoms in a patient whose left coronary artery originated anomalously in the right sinus of valsalva and followed a course between the aorta and the pulmonary trunk. The techniques were treadmill exercise test for ischaemia, conventional angiography, which was used for the initial diagnosis, and 64-row multislice computerised tomography, used to determine the anomalous course of the artery.
- Title: Mechanical
thrombo-embolectomy in acute ischaemic stroke :
a local experience : case report
Authors: Abelson, Mark; Roos, Johan; Rymer, Marilyn
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 204-207
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Abstract: Large-vessel ischaemic strokes have a very poor natural history. Thombolysis is indicated for the treatment of ischaemic stroke but in practice is given to less than 10% of stroke sufferers, and its efficacy in large-vessel occlusion is poor. Mechanical embolectomy is a new therapy that allows attempted revascularisation up to eight hours after stroke onset. With its improved efficacy, it therefore offers some hope to patients admitted with this devastating condition.
- Title: Abnormal diastolic and
systolic septal motion following pericardiectomy
demonstrated by ciné DENSE MRI : case report
Authors: Spottiswoode, Bruce; Russell, James B.; Moosa, Sulaiman; Meintjes, Ernesta M.; Epstein, Frederick H.; Mayosi, Bongani M.
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 208-209
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Abstract: Constrictive pericarditis can lead to paradoxical interventricular septal motion. Displacement encoding with stimulated echoes (DENSE) magnetic resonance imaging(MRI) provides a method for quantifying myocardial motion and strain. A case of constrictive pericarditis is presented and the diastolic 'septal bounce' is clearly evident in both anatomical and DENSE ciné MRI images. The postoperative systolic septal wall-motion abnormality of cardiac surgery is portrayed with greater precision by DENSE than anatomical ciné MRI images.
- Title: Shift work and its effects on
the cardiovascular system : review article
Authors: Mosendane, Thabo; Mosendane, Tshinakaho; Raal, Frederick J.
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 210-215
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Abstract: The practice of shift-work scheduling has long been part of normal work duties in emergency services such as health and security. It is only recently, in the wake of growing job opportunities and booming industries, where more employees are needed to keep services running over 24-hour periods that studies on the effects of shift work on workers' health have begun to delve deeper.
The desynchronisation that occurs in circadian rhythms, with respect to sleep cycles, predisposes employees to coronary heart disease, gastrointestinal disturbances, increased risk of breast cancer and poor pregnancy outcomes. This literature review focuses on circadian rhythms, their molecular components, disturbances of these rhythms as a result of shift work and the adverse effects thereof on the cardiovascular system.
- Title: Warfarin resistance :
cardiovascular prescriber
Authors: Sinxadi, Phumla; Blockman, Marc
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 215-217
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Abstract: Warfarin, the only available oral coumarin anticoagulant in South Africa, is widely prescribed for the prevention and management of arterial and venous thrombo-embolism. It has a narrow therapeutic index and a wide inter-individual variability in therapeutic response. Genetic polymorphism of the VKORC1 and CYP2C9 genes, as well as clinical factors such as age, gender, body mass index and interacting drugs explain less than 55% of variability in warfarin dose requirements. True warfarin resistance is rare (< 0.1%) and is defined as warfarin requirements greater than 70 mg per week to maintain the international normalised ratio (INR) in the target therapeutic range. As hereditary warfarin resistance is rare, non-adherence, laboratory errors and interactions should be excluded in patients with persistent sub-therapeutic INR levels. Pharmacogenetic models to estimate individualised warfarin doses do not take into account the mutations associated with warfarin resistance. In patients with presumed warfarin resistance, higher doses that maintain the INR in the target therapeutic range should be given, and the INR closely and regularly monitored.
- Title: The South African branch of
the Crossroads Institute celebrates it second
birthday : interventional trends in
cardiovascular medicine
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 218, 220
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Abstract: The South African branch of the Crossroads Institute for Cardiac and Vascular Education recently celebrated its second birthday. The Institute is a joint initiative between Abbott Vascular, which founded the original Crossroads Institute in Brussels, and Baroque Medical, Abbott's sole agent in sub-Saharan Africa. Crossroads' primary purpose is to provide ongoing continuing medical education of an international standard to interventional cardiologists, especially those just starting out in the discipline.
- Title: Regression of atherosclerosis
demands low LDL targets and raised HDL levels :
drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 221
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Abstract: Recent statin trial results using intravascular ultrasound (IVUS) have shown the need to get LDL cholesterol levels below 1.8 mmol / l in order to achieve disease regression rather than only non-progression of the atherosclerotic process.
- Title: Cardiometabolic risk-factor
management : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 222-224
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Abstract: There is a linear relationship between increasing blood pressure (Fig. 1) and increasing risk for cardiovascular disease. However, when target-organ damage is present, this relationship is disturbed, causing the risk to increase rapidly. 'Hypertension is therefore about more than just blood pressure', Prof James Ker recently told a meeting hosted by Bayer-Schering Pharmaceuticals. 'We need to think of hypertension as having three components - blood pressure level, any sign of target-organ damage and any other cardiovascular risk factors.'
- Title: 2009 PASCAR Conference,
Nigeria
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 225
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Abstract: 2009 PASCAR Conference, Nigeria.
- Title: Hypertension arm of ADVANCE
defines extent of renal protection using
perindopril / indapamide in type 2 diabetics :
drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 226
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Abstract: New results of the ADVANCE (Action in Diabetes and VAscular disease : perindopril / indapamide and DiamicroN MR Controlled Evaluation) trial were presented at the European Society of Hypertension (ESH) meeting in Berlin in June.
- Title: Secondary prevention of
ischaemic stroke and TIA : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 229
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Abstract: 'Stroke risk is highest in the first 48 hours after a transient ischaemic attack (TIA). Seven per cent of those who suffer a stroke will have another within the first week; another 17% will have a second stroke within the next 51 weeks', so says Prof Hans-Christoph Diener, professor of Neurology at the University of Essen in Germany. He was speaking at a meeting in Johannesburg hosted by Boehringer Ingelheim to announce the results of the PRoFESS (Prevention Regimen for Effectively avoiding Second Strokes) study, in which he was one of the principal investigators.
- Title: Treating men's health
holistically : protecting endothelial function
early : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 230
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Abstract: The earliest signs of endothelial dysfunction can be related to erectile dysfunction (ED) and declining free testosterone levels in ageing men who are overweight and physically non-active.
- Title: Clopidogrel use in diabetic
patients with new stents : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 19, Issue 4, Jul / Aug
Published: 2008
Pages: 232
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Abstract: The first study to look at the clopidogrel needs of diabetic patients undergoing their first stent placement has shown that longer use of clopidogrel was associated with a reduction in death and nonfatal myocardial infarction (MI) in these patients, regardless of whether a bare metal stent (BMS) or a drug-eluting stent (DES) was used.
