CARDIOVASCULAR JOURNAL OF AFRICA:
VOLUME 22, ISSUE 1, FEBRUARY 2011
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- Title: Pharma Dynamics Clopidogrel
75mg - a therapy based on well established
clinical evidence
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 5
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Abstract: The aim of a recent randomized, open, comparative, prospective study was to investigate the effects of antiplatelet therapy on the clinical course in patients with Non-ST-elevation Myocardial Infarction. The comparative efficacy of the originator's Clopidogrel 75 mg and Pharma Dynamics Clopidogrel 75 mg were studied in 160 patients with unstable angina and NSTEML.
- Title: Maternal mortality :
editorial
Authors: Moodley, J.
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 6
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Abstract: Issues surrounding maternal mortality have recently been widely published in both the lay media and the health fraternity literature. Possible reasons for this are that there are only five years remaining until the 2015 deadline to have achieved the United Nations Millennium Development Goals (MDGs).
- Title: The vascular endothelium
masks the persistent inhibition of rat thoracic
arterial tone induced by S-nitrosoglutathione :
cardiovascular topics
Authors: Sarr, M.; Sar, F.B.; Gueye, L.; Kane, M.O.; Wele, A.; Diallo, A.S.; Schini-Kerth, V.; Muller, B.
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 7-13
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Abstract: Aim: In endothelium-denuded arteries, the nitric oxide (NO) donor S-nitrosoglutathione (GSNO) induced a persistent hypo-reactivity to vasoconstrictors, and low-molecular weight thiols such as N-acetyl cysteine (NAC) produced a relaxant effect. These effects were attributed to the formation of vascular NO stores. In arteries with a functional endothelium, such long-lasting effects on arterial tone have not been well characterised. In this study, we proposed to examine the possibility of storing exogenous NO when the vascular endothelium is still able to produce its own NO.
Methods: For this purpose, changes in isometric tension of isolated arteries were assessed in organ chambers, and nitrosothiol formation was characterised by confocal microscopy. Results: In rat aortic rings with endothelium pre-exposed to GSNO, the contractile response to norepinephrine (NE) was not attenuated in comparison with control rings, but NAC induced a relaxant effect. However, an attenuation of the response to NE was observed in GSNO-exposed, intact aortic rings after inhibition of NO synthase by Nw-nitro-L-arginine methylester (L-NAME) or in GSNO-denuded rings.
The relaxing effects of NAC were due to the mobilisation of NO from nitrosothiols after nitrosylation of protein SH residues. Moreover, the hypo-reactivity to NE and the relaxant effect of NAC were abolished by 1H-[1,2,4] oxadiazolo(4,3-a)quinoxalin-1-one (ODQ), an inhibitor of soluble guanylyl cyclase, and partially by the K+-sensitive channel inhibitor tetra-ethyl-ammonium (TEA).
Conclusion: These data show that endothelium-derived NO masked the persistent effect of GSNO in rat thoracic aorta. However, the ability of GSNO to form releasable NO stores without altering the vascular tone can be particularly useful in preventing endothelial dysfunction in which NO formation decreases.
- Title: The variability of baroreflex
sensitivity in juvenile, spontaneously
hypertensive rats : cardiovascular topics
Authors: Valenti, V.E.; De Abreu, L.C.; Colombari, E.; Sato, M.A.; Ferreira, C.
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 14-17
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DOI: 10.5830/CVJA-2010-007
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-007
Abstract: In this study the baroreflex sensitivity of conscious, juvenile, spontaneously hypertensive rats (SHRs) was compared. The study population consisted of 19 eight-week-old male SHRs. The baroreflex sensitivity was quantified as the derivative of the variation in heart rate (HR) and the variation of mean arterial pressure (baroreflex sensitivity = ΔHR/ΔMAP).
MAP was manipulated with sodium nitroprusside (SNP) and phenylephrine (PHE), administered via an inserted cannula in the right femoral vein. The SHRs were divided into four groups: (1) low bradycardic baroreflex (LB) where the baroreflex gain (BG) was between 0 and -1 bpm/mmHg with PHE; (2) high bradycardic baroreflex (HB), where the BG was < -1 bpm/mmHg with PHE; (3) low tachycardic baroreflex (LT) where the BG was between 0 and 3 bpm/ mmHg with SNP; (4) high tachycardic baroreflex (HT) where the BG was > 3 bpm/mmHg with SNP.
We noted that 36.8% of the rats presented with an increased bradycardic reflex, while 27.8% demonstrated an attenuated tachycardic reflex. No significant alterations were noted regarding the basal MAP and HR. There were significant differences in the baroreflex sensitivity between SHRs in the same laboratory. One should be careful when interpreting studies employing the SHR as a research model.
- Title: Smoking and vascular
dysfunction in Africans and Caucasians from
South Africa : cardiovascular topics
Authors: Zatu, M.C.; Van Rooyen, J.M.; Schutte, A.E.
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 18-24
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DOI: 10.5830/CVJA-2010-034
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-034
Abstract: Background: Smoking is an important modifiable risk factor for cardiovascular disease, with limited research having been done in Africans. We aimed to determine the association between smoking and measurements of vascular function in Africans and Caucasians.
Methods: We determined anthropometric and cardiovascular variables, serum cotinine and C-reactive protein (CRP) in African and Caucasian participants from South Africa (n = 630).
Results: Africans had significantly lower body mass index (BMI), higher blood pressure and lower socio-economic status (SES) than Caucasians. Only African smokers showed increased arterial stiffness and a significant correlation between smoking and arterial stiffness. African smokers had increased and Caucasian smokers decreased high-density lipoprotein cholesterol (HDL-C) than the non-smokers. After adjusting for confounders, smoking showed few correlations, mainly with heart rate and CRP. In Africans, smoking also correlated positively with HDL-C, with the opposite result in Caucasians.
Conclusion: African smokers had significantly increased arterial stiffness, which was not found in Caucasian smokers. Africans generally demonstrated more associations between smoking and cardiovascular dysfunction than Caucasians.
- Title: Obesity-associated genetic
variants in young Asian Indians with the
metabolic syndrome and myocardial infarction :
cardiovascular topics
Authors: Ranjith, N.; Pegoraro, R.J.; Shanmugam, R.
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 25-30
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DOI: 10.5830/CVJA-2010-036
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-036
Abstract: Objective: Associations between obesity-related polymorphisms and the metabolic syndrome in 485 young (≤ 45 years) Asian Indian patients with acute myocardial infarction (AMI), and 300 matched controls were assessed.
Methods: Genetic variants included the adiponectin 45T→G and 276G→T, LEPR K109R and Q223R, MC4R-associated C→T and FTO A→T polymorphisms.
Results: The metabolic syndrome, as defined by NCEP ATP III and IDF criteria, was diagnosed in 61 and 60% of patients, respectively. No relationship was found between the obesity-associated polymorphisms and the metabolic syndrome, or between AMI patients and controls. The MC4R-associated TT genotype occurred more frequently in patients with lower triglyceride levels (p = 0.024), while the adiponectin 45 TT genotype occurred more commonly in patients with normal fasting glucose levels (p = 0.004). The LEPR Q223R TT genotype was associated with low high-density lipoprotein (HDL) cholesterol levels (p = 0.003).
Conclusion: The metabolic syndrome occurs commonly in young Asian Indian patients with AMI. No relationship was found between any obesity-associated polymorphism and the metabolic syndrome. Particular genotypes may exert protective or disadvantageous effects on individual components of the metabolic syndrome.
- Title: Maternal deaths associated
with hypertension in South Africa : lessons to
learn from the Saving Mothers report, 2005-2007
: cardiovascular topics
Authors: Moodley, J.
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 31-35
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DOI: 10.5830/CVJA-2010-042
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-042
Abstract: From 2005-2007, there were 622 deaths associated with hypertensive disorders of pregnancy. Eclampsia was the major cause of death (n = 344; 55.3%). There were 173 (28.3%) deaths due to pre-eclampsia, and 38 (6.1%) associated with chronic hypertension. Cerebral complications were the final cause of death in 283 (45.5%), while cardiac failure and respiratory failure were the final causes in 142 (22.8%) and 158 (25.4%), respectively.
Major problems were identified in all areas of assessment. Non-attendance for antenatal care (n = 106; 19.4%) and delay in seeking help (n = 106; 19.4%) were major patient-related factors. Communication problems (n = 63; 10.8%) and lack of facilities (n = 50; 8.5%) were health administration issues. Health worker-avoidable factors included problem recognition, delay in referral and management at an inappropriate level of healthcare.
Compared to the previous report of 2002-2004, there was a reduction in deaths due to hypertension.
- Title: Coronary artery ectasia in a
patient with myocardial infarction : case report
Authors: Jesuraj, M.L.; Mukerjee, D.; Jesuraj, A.V.; Singh, R.; Agarwal, B.
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 36-37
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DOI: 10.5830/CVJA-2010-033
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-033
Abstract: We report on a case of triple-vessel coronary artery ectasia (CAE) in a young patient. This patient presented with anterior wall myocardial infarction (MI) with post-infarct angina. His coronary angiogram revealed coronary artery ectasia involving the left anterior descending, circumflex and right coronary arteries.
- Title: Letter to the Editor
Authors: Muller, Frank Otto
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 37
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Abstract: Letter to the Editor
- Title: Cardiac abnormalities in
Anderson-Fabry disease and Fabry's
cardiomyopathy : review article
Authors: Morrissey, R.P.; Philip, K.J.; Schwarz, E.R.
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 38-44
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Abstract: Fabry's disease is an X-linked lysosomal storage disease most often associated with renal dysfunction and death due to renal failure in patients' fourth and fifth decades of life. However, cardiac manifestations including arrhythmias, angina and heart failure are common and probably underrecognised. Furthermore, Fabry's disease is now recognised as also affecting female carriers, who manifest signs later than males. A variant of Fabry's has been identified that only affects cardiac tissue, which presents as an unexplained hypertrophy of the left ventricle in middle-aged patients, possibly with women more affected than men. Given that epidemiological studies report a prevalence of Fabry's cardiomyopathy among middle-aged patients with cardiac hypertrophy to be anywhere from one to 12%, it is reasonable to screen these patients for alpha-galactosidase A deficiency. Although mortality data is lacking from randomised, controlled trials of galactosidase replacement therapy, there are some reports of improvement in cardiac endpoints. Therefore patients with known Fabry's disease should be screened early for cardiac involvement, as treatment benefit may not be seen once cardiac fibrosis has developed.
- Title: Improving hypertension
control in patients at cardiovascular risk : the
case for telmisartan-based therapy : opinions in
hypertension management
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 45-46
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Abstract: Strategies to improve hypertension control are clearly warranted in light of the frequently expressed view that only 50% of treated hypertensive patients are able to meet their target blood pressure levels.
- Title: Industry news
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 48
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Abstract: Boehringer Ingelheim and Eli Lilly and Company announce strategic alliance to bring new diabetes treatments to patients worldwide
- Title: South African experts comment
on FDA approval of dabigatran in atrial
fibrillation : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 50
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Abstract: The FDA approved the standard dose of 150 mg bid (as also submitted by Boehringer Ingelheim in the European Union) without dose adjustments for tested p-GP inhibitors or for moderately renal-impaired patients.
- Title: ASCOT analysis with
atorvastatin shows limits of CRP as indicator of
cardiovascular risk : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 51
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Abstract: The addition of high-sensitivity C-reactive protein (hs-CRP) measurements did not much improve conventional risk assessments in patients with hypertension and other cardiovascular (CV) risk factors in a post hoc analysis of an Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) lipid-lowering arm.
- Title: Chronic heart failure
treatment benefits from pro-BNP-directed therapy
: drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 52
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Abstract: The PROTECT study, which was undertaken to evaluate the benefits of tailoring heart failure therapy according to NT-proBNP levels, was stopped early at the midpoint of the trial due to the early benefits of this targeted biomarker approach. Initially, the study planned to recruit 300 patients with New York Heart Association (NYHA) class II-IV systolic heart failure [left ventricular ejection fraction (LVEF) ≤ 40%] but was stopped after only 151 patients were recruited.
- Title: Fenofibrate profiled as the
fibrate with additional new data, supporting its
use with statins in the European Medicines
Agency recommendations : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 55
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Abstract: The European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) has concluded that the benefits of the four fibrates, bezafibrate, ciprofibrate, fenofibrate and gemfibrozil continue to outweigh their risks in the treatment of patients with blood lipid disorders. However, doctors should not prescribe them to newly diagnosed patients with blood lipid disorders as first-line treatment, except for those with severe hypertriglyceridaemia or patients who cannot take statins.
- Title: PACE quilt project : cardio
news
From: Cardiovascular Journal of Africa, Vol 22, Issue 1, Jan / Feb
Published: 2011
Pages: 56
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Abstract: At the 2010 South African Heart Association congress at Sun City, PACE had delegates design and/or sign squares of fabric, and they endeavoured to complete 200 original squares.
