Title: Lessons from the first report
of the Arrhythmogenic Right Ventricular
Cardiomyopathy Registry of South Africa :
editorial
Authors: Hendricks, Neil; Watkins, David A.;
Mayosi, Bongani M.
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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DOI: 10.5830/CVJA-2010-037
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2010-037
Abstract: The Arrhythmogenic Right Ventricular
Cardiomyopathy (ARVC) Registry of South Africa
was established in 2004, under the auspices of
the Cardiac Arrhythmia Society of Southern
Africa (CASSA). In the November 2009 supplement
of Heart Rhythm, the Registry investigators
published the first large, multicentre series of
patients with ARVC in South Africa. The report,
which is based on the first 50 participants with
a confirmed diagnosis of ARVC, has practical
implications for the clinical profile, diagnosis
and management of patients with ARVC in South
Africa.
Title: Involvement of pharmaceutical
companies at scientific meetings : from the
editor's desk
Authors: Brink, Andries
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: South Africa not infrequently hosts
high-level cardiology meetings outside the
auspices of South African professional medical
societies and associations. Well-known
cardiologists, particularly from the USA and
Europe are invited to make presentations, which
bring the best and most-recent advances in the
field to this country. This is of course of
great value to the selected group of delegates
who are invited to attend. Large sums of money
are involved because all the presenters and many
of those attending receive full financial
support for their participation.
Title: Dual effect of quercetin on
rat isolated portal vein smooth muscle
contractility : cardiovascular topics
Authors: Chiwororo, Witness D.H.; Ojewole, John
A.O.
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: This study examined the effects of
quercetin on spontaneously contracting portal
veins isolated from healthy young adult male and
female Wistar rats (250-300 g). Quercetin
(10-7-10-4 M) always produced significant
biphasic effects, comprising an initial brief
stimulant effect (rise in basal tone), followed
by a sustained, longer-lasting secondary
relaxant (inhibitory) effect on the venous
tissues. The initial brief contractions of the
venous muscle preparations were not modified by
preincubation of the tissues with prazosin (10-6
M), suggesting that the initial upsurge in basal
tone and increases in contractile frequencies of
the venous tissues were probably not mediated
via alpha1-adrenoceptor stimulation. However,
preincubation of the tissues with nifedipine
(10-7 M) significantly suppressed (p < 0.05) or
attenuated the initial stimulant effect of
quercetin, suggesting that the flavonoid might
be activating L-type voltage-dependent calcium
channels. The vasorelaxant effect of quercetin
was partially but not significantly (p > 0.05)
inhibited by L-NAME (100 µM) or indomethacin (10
µM), suggesting that the vasorelaxant effect of
the flavonoid was unlikely to be mediated via
endothelium-dependent relaxing factor (EDRF), or
through prostacyclin (PGI2) pathways.
N-p-tosyl-l-phenylalanine-chloromethyl-ketone
(TPCK, 3 µM) significantly (p < 0.01)
antagonised quercetin-induced relaxations,
suggesting that cAMP-dependent protein kinases
might have contributed, at least in part,
towards the vasorelaxant effect of quercetin on
rat isolated portal veins.
Title: Midterm results of left
atrial bipolar radiofrequency ablation combined
with a mitral valve procedure in persistent
atrial fibrillation : cardiovascular topics
Authors: Tekumit, Hayrrettin; Uzun, Kemal;
Cenal, Ali Riza; Tataroglu, Cenk; Polat, Adil;
Akinci, Esat
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: Introduction : The aim of the study
was to assess the midterm results of left atrial
bipolar radiofrequency ablation combined with a
mitral valve procedure in patients with mitral
valve disease and persistent atrial
fibrillation.
Methods : Between October 2006 and July 2009, 95
patients with mitral valve disease and
persistent atrial fibrillation underwent a
mitral valve procedure and left atrial bipolar
radiofrequency ablation. The postoperative data
of the combined procedure were collected at the
time of discharge and at one, three, six and 12
months after the operation.
Results : Hospital mortality rate was 6.3% (six
patients). Normal sinus rhythm was achieved in
77.2% of patients during the early postoperative
period in hospital, and in 73.3, 72.0 and 75% of
patients at three, six and 12 months
postoperatively, respectively. Patients were
followed up for a mean duration of 14.02 ± 5.71
months (range: 6-19 months). During this midterm
follow-up period, nine patients had late
recurrence of atrial fibrillation. No risk
factor was identified for late recurrence of
atrial fibrillation.
Conclusion : Our midterm follow-up results
suggest that the addition of left atrial bipolar
radiofrequency ablation to mitral valve surgery
is an effective and safe procedure to restore
sinus rhythm in patients with chronic atrial
fibrillation.
Title: Erythromycin as an
alternative to reduce interfering extra-cardiac
activity in myocardial perfusion imaging :
cardiovascular topics
Authors: Vorster, Mariza; Sathekge, M.M.;
Rheeder, P.
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: Objectives : We sought to determine
whether taking oral erythromycin prior to SPECT
myocardial perfusion imaging with
Tc99m-sestamibi would reduce the amount of
interfering extra-cardiac activity and improve
the image quality.
Methods : A total of 96 patients who were
routinely referred for myocardial perfusion
imaging were randomly assigned to one of two
groups. Patients in group A received 500 mg of
non-enterically coated erythromycin orally one
hour prior to image acquisition (45 patients).
Patients in group B received diluted lemon juice
which comprises the current standard of care in
our department (51 patients). A two-day protocol
was followed and study participants received the
same intervention on both days. Planar images of
both the stress and rest images were assessed
visually by three experienced nuclear medicine
physicians for the presence of interfering
extra-cardiac activity. Physicians were blinded
to the detail of the protocol and independently
assessed the images.
Results : The qualitative results favoured lemon
juice in reducing the amount of interfering
extra-cardiac activity. The overall incidence of
interfering extra-cardiac activity was 46.15% in
the lemon juice group vs 55.56% in the
erythromycin group. However, this difference was
not found to be statistically significant (p =
0.36). The use of a MYO:EXT ratio similar to the
one described by Peace and Lloyd, appeared
promising in quantifying interfering
extra-cardiac activity.
Conclusion : The difference between the effect
of erythromycin and lemon juice on interfering
extra-cardiac activity appears statistically
insignificant and erythromycin could therefore
be considered as a suitable alternative to lemon
juice.
Title: The association between
anthropometric parameters, the metabolic
syndrome and microalbuminuria in black Africans
: the SABPA study : cardiovascular topics
Authors: Hoebel, S.; De Ridder, J.H.; Malan, L.
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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DOI: 10.5830/CVJA-2010-025
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2010-025
Abstract: We aimed to determine which surface
anthropometric and metabolic syndrome (MS)
markers could be associated with the development
of microalbuminuria (MA), and assessed 200 urban
Africans (25-60 years) stratified into low (≤
0.90 and ≤ 0.85) and high (> 0.90 and > 0.85)
waist-to-hip ratio (WHR) groups from the
North-West province. Anthropometric and fasting
MS markers, such as systolic and diastolic blood
pressure (BP), and glucose, triglyceride (TG)
and high-density lipoprotein (HDL) levels, as
well as MA markers were measured.
Males revealed higher lifestyle risk factors
(body mass index, smoking, alcohol consumption,
low physical activity), anthropometric and MS
markers compared to the females. The same
overall trend was seen for high-WHR males but
not for high-WHR females compared to their
low-WHR counterparts. Both high-WHR groups
revealed increased glucose values (males, 6.34
mmol/l; females, 6.13 mmol/l). Multiple linear
regression analysis, independent of confounders,
showed positive associations between diastolic
blood pressure (DBP) (high WHR and all males),
TG, waist circumference (WC) and development of
MA in all males. In high-WHR females, positive
associations existed only between WC and the
development of MA, while neck circumference (NC)
was associated with MA development in all
females. To conclude, vascular BP, TG and WC
were associated with risk of renal impairment in
males, while in females, NC and WC
circumferences were associated with this risk.
Title: A South African national
database in cardiothoracic surgery :
cardiovascular topics
Authors: Linegar, Anthony; Smit, Francis;
Stroebel, Andrie; Schaafsma, Elizabeth
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: This article aims to update South
African cardiothoracic surgeons on the
developmental progress of the national database
in cardiac and thoracic surgery and to encourage
participation in this most important endeavour
Title: Cerebral embolism following
thrombolytic therapy for acute myocardial
infarction : the second reported case : case
report
Authors: Bostan, Mehmet; Kanat, Ayhan; Sen,
Murat; Kazdal, Hizir; Bostan, Habib
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: ST-elevation myocardial infarction
(STEMI), caused by acute occlusion of the
infarct-related coronary artery, is an emergency
condition. The primary therapy is restoration of
full antegrade flow by either percutaneus
coronary intervention (PCI) or thrombolytic
therapy (TT). Although primary PCI is superior
to TT in patients with STEMI, there are many
limitations in clinical practice. TT decreases
mortality in STEMI patients, but as experience
with thrombolytic agents grows, the potential
risks of serious side effects become more
apparent. The major complications are bleeding,
hypotension and skin rash.
We report on a case of cerebrovascular accident
(CVA) caused by cerebral emboli following TT. We
concluded that the fact that the patient was in
arterial fibrillation (AF) was a major
contributing factor to her CVA. This is an
extremely rare condition, and our case appears
to be the second one reported on in the
literature.
Title: Reconciling Q waves and late
gadolinium enhancement with no angiographic
evidence of coronary disease : cardiac
sarcoidosis presenting as decompensated heart
failure : case report
Authors: Morrissey, Ryan P.; Philip, Kiran J.;
Schwarz, Ernst R.
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: Cardiac sarcoidosis is rare and
subclinical involvement is four to five times
more common than clinical involvement. Cardiac
sarcoidosis is associated with a poor prognosis.
ECG abnormalities are the most common
presentation. However, as this case illustrates,
it can also present as acute decompensated heart
failure. Screening with cardiac positron
emission tomography (PET) or magnetic resonance
imaging (MRI) is highly suggested in patients
with suspected disease. Diagnosis allows for
early initiation of corticosteroids. Cardiac
sarcoidosis is more common than previously
thought. However, with treatment, survival may
also be better than previously reported.
Title: Soweto Cardiovascular
Research Unit : patients with heart disease
encouraged to live and eat healthily
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: The Soweto Cardiovascular Research
Unit partners with Adcock Ingram, through its
generics portfolio team, to host workshops on
disease management and cooking demonstrations on
healthy eating for heart disease patients at
Chris Hani Baragwanath Hospital.
Title: Persistent left superior vena
cava with absent right superior vena cava : a
case report and review of the literature : case
report
Authors: Ucar, Ozgul; Pasaoglu, Lale;
Cicekcioglu, Hulya; Vural, Murat; Kocaoglu,
Ibrahim; Aydogdu, Sinan
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: We report on a rare case of persistent
left superior vena cava (PLSVC) with absent
right superior vena cava (RSVC), an anomaly that
is also known as isolated PLSVC. This venous
malformation was identified incidentally in a
30-year-old woman during thoracic multi-detector
computed tomography (MDCT), which was performed
with the suspicion of intra-thoracic malignancy.
On thoracic MDCT, the RSVC was absent. A
bridging vein drained the right jugular and
right subclavian veins and joined the left
brachiocephalic vein in order to form the PLSVC,
which descended on the left side of the
mediastinum and drained into the right atrium
(RA) via a dilated coronary sinus (CS). The
patient was referred to the cardiology
department for further evaluation. Transthoracic
echocardiography revealed a dilated CS, and
agitated saline injected from the left or right
arms revealed opacification of the CS before the
RA. The patient had no additional cardiac
abnormality.
Isolated PLSVC is usually asymptomatic but it
can pose difficulties with central venous
access, pacemaker implantation and
cardiothoracic surgery. This condition is also
associated with an increased incidence of
congenital heart disease, arrhythmias and
conduction disturbances. A wide spectrum of
clinicians should be aware of this anomaly, its
variations and possible complications.
Title: Point of view on concomitant
coronary and lower-limb surgical
revascularisation : letter to the editor
Authors: Lentini, Salvatore; Benedetto, Filippo;
Carmignani, Amedeo; Gaeta, Roberto
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: We read with interest the recent paper
from Prof Suzer and co-workers on concomitant
coronary artery bypass grafting and descending
aorta-to-bifemoral artery bypass via sternotomy.
The authors are to be commended for their work.
Title: Sunshine and the
cardiovascular benefits - a dose of sunshine! :
your life and your heart
Authors: Straughan, John L.
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: Without sunlight, there would be no
life as we know it. Early human societies
rightly paid homage to the sun. Many millennia
later, and for a host of different reasons, we
are again regarding our sun with special
interest. That exposure to sunlight is capable
of generating a variety of beneficial effects in
our skin is an area of exciting discovery - not
least for the cardiovascular practitioner.
Title: CLARIFY registry launched in
South Africa : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: The CLARIFY registry (ProspeCtive
observational LongitudinAl RegIstry oF patients
with stable coronary arterY disease) is the
first and largest international registry
designed to increase knowledge and understanding
of stable coronary artery disease (CAD).
Title: Boehringer launches first
direct thrombin inhibitor : dabigatran
(Pradaxa®) : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: Dabigatran, an oral reversible direct
thrombin inhibitor, already available in Europe
and the United Kingdom, has been licensed for
anti-coagulant use in orthopaedic hip and knee
surgery in South Africa. At the launch of this
novel anticoagulant, Prof Simon Frostick,
professor of orthopaedics at Liverpool
University pointed out that experience from
clinical trials and in-practice experience has
shown dabigatran to be a safe and effective
agent in deep-vein thrombosis (DVT) prophylaxis.
Title: Fibrates consistently lower
risk of cardiovascular events across high-risk
groups : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: A recent meta-analysis of published
clinical trials conducted over the past 50 years
has confirmed that the administration of
fibrates to a broad range of high-risk patients
lowers the risk of cardiovascular events.
Title: Tirofiban shows better
platelet inhibition in diabetic patients during
PCI procedures : drug trends in cardiology
Authors: Aalbers, J.
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: The extent of platelet aggregation and
levels of C-reactive protein (CRP) released
during actual percutaneous coronary intervention
(PCI) procedures have not been well studied.
Title: Aspirin in primary prevention
: USPSTF recommendations : drug trends in
cardiology
Authors: Aalbers, J.
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: Recent clinical studies such as the
Japanese Primary Prevention trial (JPAD) and the
Aspirin for Asymptomatic Atherosclerosis study
(AAA) have resulted in considerable debate on
when and for whom aspirin should be given as
primary prevention for vascular events.
Title: Boehringer Ingelheim launches
a more affordable Micardis®
Trimega provides essential fatty acids -
cardiovascular care products : advertorial
From: Cardiovascular Journal of Africa, Vol 21,
Issue 3, May / Jun
Published: 2010
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Abstract: Boehringer Ingelheim launches a more
affordable Micardis®
Trimega provides essential fatty acids -
cardiovascular care products