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  1. Foundations for Health Promotion with Youth: A Review of Observations from the Bogalusa Heart Study.

    Science.gov (United States)

    Nicklas, Theresa; And Others

    1995-01-01

    Presents findings from the Bogalusa Heart Study that describe the early natural history of coronary artery disease and hypertensive cardiovascular disease, noting the benefits of early, regular, comprehensive school health education. A discussion of cholesterol, hypertension, diabetes, obesity, smoking, oral contraception, drinking, and diet…

  2. Bogalusa Heart Study: a long-term community study of a rural biracial (Black/White) population.

    Science.gov (United States)

    Berenson, G S

    2001-11-01

    The Bogalusa Heart Study, a long-term population study with a continued relationship with a community, addresses the problem of capacity building in minority health research. The study was originally funded as a Specialized Center of Research-Arteriosclerosis (SCOR-A) by the National Heart Lung and Blood Institute (NHLBI). These centers were to conduct research on atherosclerosis, coronary artery disease (CAD), hypertension, diabetes mellitus, and complications of cardiovascular-renal disease as the major causes of deaths in the United States. From earlier research on atherosclerosis, we became interested in the underlying characteristics in early life that would eventually lead to clinical morbidity and mortality from heart disease. An observation at autopsy showed the degree of atherosclerotic involvement in human aortas, from young to older individuals (Figure 1). For example, at age 40 years, marked individual variability occurred in the severity and involvement with atherosclerotic disease. Some individuals showed very little disease, while almost 70% of the surface was diseased in others. Further studies on arterial wall matrix showed aortas from young individuals varied with the extent of disease and its chemical composition. This background stimulated an interest in studying children for early clinical evidence of major adult heart diseases. The Bogalusa Heart Study was begun in 1972 as an epidemiology study of cardiovascular risk factors in children and adolescents; it eventually evolved into observations of young adults. Bogalusa, LA, is a biracial (black/white) rural community 70 miles north of New Orleans, comparable to many other communities in southeastern United States.

  3. Transitions of cardiovascular risk from adolescence to young adulthood--the Bogalusa Heart Study: I. Effects of alterations in lifestyle.

    Science.gov (United States)

    Croft, J B; Foster, T A; Parker, F C; Cresanta, J L; Hunter, S M; Webber, L S; Srinivasan, S R; Berenson, G S

    1986-01-01

    Adolescence and young adulthood represents a transition period for biologic and lifestyle characteristics. In a preliminary investigation of young adults (ages 18-20 years), the Bogalusa Heart Study documented patterns of alcohol, tobacco, and oral contraceptive use, as well as changes in education, occupational, marital and parenting status. Such behaviors accelerate the cardiovascular disease process and may differentially influence risk factor patterns of race and sex groups. Adverse levels of systolic blood pressure and alpha-lipoprotein cholesterol were more frequent in married vs single men; elevated triglyceride levels were more frequent in married vs single whites. However adverse levels of beta- and alpha-lipoprotein cholesterol were more frequent in nonparents than in parents. Cigarette smoking and oral contraceptive use were independently related to elevated beta-lipoprotein cholesterol and decreased alpha-lipoprotein cholesterol levels of young white women. Alcohol consumption was highest among white males, with 32% reporting daily consumption of the equivalent of two or more beers or one mixed drink. Alcohol consumption was negatively correlated with blood pressure in white males and positively correlated with alpha-lipoprotein cholesterol in black males. Since such lifestyle factors are related to physiologic risk factors that result in heart disease and adult cardiovascular morbidity and mortality in the older ages, early targeting during adolescence and young adulthood is important.

  4. The Relationship between Birthweight and Longitudinal Changes of Blood Pressure Is Modulated by Beta-Adrenergic Receptor Genes: The Bogalusa Heart Study

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2010-01-01

    Full Text Available This study examines the genetic influence of β-adrenergic receptor gene polymorphisms (β2-AR Arg16Gly and β3-AR Trp64Arg on the relationship of birthweight to longitudinal changes of blood pressure (BP from childhood to adulthood in 224 black and 515 white adults, aged 21–47 years, enrolled in the Bogalusa Heart Study. Blacks showed significantly lower birthweight and frequencies of β2-AR Gly16 and β3-AR Trp64 alleles and higher BP levels and age-related trends than whites. In multivariable regression analyses using race-adjusted BP and birthweight, low birthweight was associated with greater increase in age-related trend of systolic BP (standardized regression coefficient β=−0.09, P=.002 and diastolic BP (β=−0.07, P=.037 in the combined sample of blacks and whites, adjusting for the first BP measurement in childhood, sex, age, and gestational age. Adjustment for the current body mass index strengthened the birthweight-BP association. Importantly, the strength of the association, measured as regression coefficients, was modulated by the combination of β2-AR and β3-AR genotypes for systolic (P=.042 for interaction and diastolic BP age-related trend (P=.039 for interaction, with blacks and whites showing a similar trend in the interaction. These findings indicate that the intrauterine programming of BP regulation later in life depends on β-AR genotypes.

  5. Differential effect of elevated blood pressure on left ventricular geometry types in black and white young adults in a community (from the Bogalusa Heart Study).

    Science.gov (United States)

    Wang, Jian; Chen, Wei; Ruan, Litao; Toprak, Ahmet; Srinivasan, Sathanur R; Berenson, Gerald S

    2011-03-01

    Hypertension and left ventricular (LV) hypertrophy are both more common in blacks than in whites. The aim of the present study was to test the hypothesis that blood pressure (BP) has a differential effect on the LV geometry types in black versus white asymptomatic young adults. As a part of the Bogalusa Heart Study, echocardiography and cardiovascular risk factor measurements were performed in 780 white and 343 black subjects (aged 24 to 47 years). Four LV geometry types were identified as normal, concentric remodeling, eccentric, and concentric hypertrophy. Compared to the white subjects, the black subjects had a greater prevalence of eccentric (15.7% vs 9.1%, p <0.001) and concentric (9.3% vs 4.1%, p <0.001) hypertrophy. On multivariate logistic regression analyses, adjusting for age, gender, body mass index, lipids, and glucose, the black subjects showed a significantly stronger association of LV concentric hypertrophy with BP (systolic BP, odds ratio [OR] 3.74, p <0.001; diastolic BP, OR 2.86, p <0.001) than whites (systolic BP, OR 1.50, p = 0.037; and diastolic BP, OR 1.35, p = 0.167), with p values for the race difference of 0.007 for systolic BP and 0.026 for diastolic BP. LV eccentric hypertrophy showed similar trends for the race difference in the ORs; however, the association between eccentric hypertrophy and BP was not significant in the white subjects. With respect to LV concentric remodeling, its association with BP was not significant in either blacks or whites. In conclusion, elevated BP levels have a greater detrimental effect on LV hypertrophy patterns in the black versus white young adults. These findings suggest that blacks might be more susceptible than whites to BP-related adverse cardiac remodeling.

  6. Rate of change in adiposity and its relationship to concomitant changes in cardiovascular risk variables among biracial (black-white) children and young adults: The Bogalusa Heart Study.

    Science.gov (United States)

    Srinivasan, S R; Myers, L; Berenson, G S

    2001-03-01

    To assess the annual rate of change in adiposity and its relationship to concomitant changes in cardiovascular risk variables during childhood and young adulthood, serial data on black and white children (n = 3,459; initial and follow-up mean age, 8.1 and 14.4 years) and young adults (n = 1,263; initial and follow-up mean age, 22.5 and 30.9 years) enrolled in the Bogalusa Heart Study were examined. Body mass index (BMI) and sum of subscapular and triceps skinfolds were used as indicators of adiposity. In addition, measurements were made of systolic and diastolic blood pressure and fasting levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, insulin, and glucose. Annualized rate of change for each variable was estimated. The rate of increase in adiposity was significantly more pronounced during childhood versus adulthood. Race difference (blacks > whites) in the rate of increase in adiposity was seen only among females. Females, black females in particular, displayed greater rate of increase in adiposity than males. In a multivariate analysis, the rate of increase in adiposity was related independently of baseline age and baseline adiposity to adverse changes in measured cardiovascular risk variables, except glucose. Many of these associations were modulated significantly by race, sex, and age group. The impact was relatively greater for blood pressure and LDL cholesterol in adults and for triglycerides in children. The changes in blood pressure, LDL cholesterol, and HDL cholesterol were greater in whites, while the rate of increase in insulin was greater in blacks. Females displayed greater changes in blood pressure, HDL cholesterol, and insulin. On the other hand, the rate of increase in triglycerides was greater in males. These results indicate that increases in adiposity regardless of initial status of body fatness alter cardiovascular risk variables towards increased risk beginning in childhood, and

  7. Impact of Adiposity on Incident Hypertension Is Modified by Insulin Resistance in Adults: Longitudinal Observation From the Bogalusa Heart Study.

    Science.gov (United States)

    Zhang, Tao; Zhang, Huijie; Li, Shengxu; Li, Ying; Liu, Yaozhong; Fernandez, Camilo; Harville, Emily; Bazzano, Lydia; He, Jiang; Chen, Wei

    2016-01-01

    Adiposity and insulin resistance are closely associated with hypertension. This study aims to investigate whether the association between adiposity and hypertension is modified by insulin resistance. The cohort consisted of 1624 middle-aged normotensive black and white adults aged 18 to 43 years at baseline who followed for 16 years on average. Overweight/obesity at baseline was defined as body mass index (BMI) ≥25, and insulin resistance was measured using homeostasis model assessment of insulin resistance. Prevalence of incident hypertension was compared between the insulin-sensitive adiposity and insulin-resistant adiposity groups. The prevalence of incident hypertension was higher in the insulin-resistant adiposity than in the insulin-sensitive adiposity group (32.1% versus 22.1%, Phypertension (odds ratio, 1.9; P=0.008). Odds ratios did not differ between blacks and whites (P=0.238). Of note, the odds ratios of BMI associated with hypertension significantly increased with increasing quartiles of baseline homeostasis model assessment (odds ratio, 1.3, 1.1, 1.5, and 2.5 in quartiles I, II, III, and IV, respectively; P=0.006 for trend). Slopes of increasing follow-up blood pressure with baseline BMI, measured as regression coefficients (β), were significantly greater in insulin-resistant than in insulin-sensitive individuals (β=0.74 versus β=0.35 for systolic blood pressure, P=0.004 for difference; β=0.51 versus β=0.23 for diastolic blood pressure, P=0.001 for difference). These findings suggest that insulin resistance has a synergistic effect on the obesity-hypertension association in young adults, indicating that the role of adiposity in the development of hypertension is modified by insulin resistance.

  8. Candy consumption in childhood is not predictive of weight, adiposity measures or cardiovascular risk factors in young adults: the Bogalusa Heart Study

    Science.gov (United States)

    There are limited data available on the longitudinal relationship between candy consumption by children on weight and other cardiovascular risk factors (CVRF) in young adults. The present study investigated whether candy consumption in children was predictive of weight and CVRF in young adults. A lo...

  9. Long-term Impact of Temporal Sequence from Childhood Obesity to Hyperinsulinemia on Adult Metabolic Syndrome and Diabetes: The Bogalusa Heart Study

    Science.gov (United States)

    Zhang, Tao; Zhang, Huijie; Li, Ying; Li, Shengxu; Fernandez, Camilo; Bazzano, Lydia; He, Jiang; Xue, Fuzhong; Chen, Wei

    2017-01-01

    This study aims to delineate the temporal relations between body mass index (BMI) and insulin in childhood and their impact on adult metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM).The longitudinal cohort consisted of 609 whites and 339 blacks who had BMI and fasting insulin measured twice in childhood (mean age = 10.5 years at baseline and 15.9 years at follow-up). Incident MetS and T2DM were identified in adulthood (mean age = 30.5 years). Cross-lagged panel and mediation analysis models were used. After adjusting for age, race, gender, and follow-up years, the cross-lagged path coefficient of BMI → insulin (β = 0.326, p < 0.001) was significantly greater than that of insulin → BMI (β = −0.023, p = 0.207) in childhood, with p < 0.001 for the difference in βs. The path coefficient for BMI → insulin was significantly greater in MetS than in non-MetS groups (0.510 vs 0.190, p < 0.001), and greater in hyperglycemia than in normoglycemia groups (0.503 vs 0.285, p = 0.026). The mediation effect of childhood insulin on the BMI-MetS and BMI-hyperglycemia associations was estimated at 19.2% (p < 0.001) and 18.3% (p < 0.001), respectively. These findings provide evidence that higher BMI levels precede hyperinsulinemia during childhood, and this one-directional relation plays a significant role in the development of MetS and T2DM in adult life. PMID:28230104

  10. Racial Contrasts in Hemoglobin Levels and Dietary Patterns Related to Hematopoiesis in Children: The Bogalusa Heart Study.

    Science.gov (United States)

    Nicklas, Theresa A.; And Others

    1987-01-01

    Racial differences in hemoglobin were explored in pre-adolescent and adolescent children. After controlling for variations in dietary patterns, race accounted for a notable proportion of hemoglobin variance in both age groups. These differences exist independently of nutrient intake and maturational changes. (Author/VM)

  11. Dietary patterns associated with metabolic syndrome, sociodemographic and lifestyle factors in young adults: the Bogalusa Heart Study

    Science.gov (United States)

    Our objective was to examine the association between dietary patterns (DP) and risk for metabolic syndrome (MetS); and to identify differences in DP by socio-economic, demographic and lifestyle factors. Dietary intake (from an FFQ), anthropometric/biochemical parameters and sociodemographic/lifestyl...

  12. Smoking Thickens Heart Wall, Leading to Heart Failure: Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160932.html Smoking Thickens Heart Wall, Leading to Heart Failure: Study ... 13, 2016 TUESDAY, Sept. 13, 2016 (HealthDay News) -- Smoking leads to heart failure by causing thickened heart ...

  13. CLINICAL STUDY OF HEART DISEASE COMPLICATING PREGNANCY

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    Richa

    2014-07-01

    Full Text Available Introduction-Heart disease complicating pregnancy is considered as a high risk situation. Increased cardiac demands during the course of pregnancy potentially increase morbidity and mortality in women with underlying heart disease. AIM: To determine maternal and fetal outcome in women with heart disease complicating pregnancy, To emphasize on proper protocol for managing pregnancy complicated by heart disease, To correlate the time of booking & NYHA grading with maternal & fetal outcome. Risk of adverse outcome is more in rural population as compared to its urban counterpart. METHOD: A prospective clinical study of 25 cases of pregnancy complicated by heart disease, reporting to tertiary care hospital for delivery, was carried out to find out the incidence and maternal and fetal outcome. RESULTS: The incidence of heart disease in pregnancy in the present study was 0.6%. Most of the women (91% belonged to low socioeconomic class in the rural population. Rheumatic heart lesions constituted 77% of the cases. Mitral stenosis was the commonest lesion in 40% of cases. Ten (40% women delivered spontaneously vaginally at term. Cesarean section was performed in 14 cases (56%. There were 5 maternal deaths. There were no perinatal deaths. CONCLUSION: Early diagnosis of heart disease, regular antenatal check-up, institutional delivery, limiting family size can reduce the maternal and perinatal mortality and morbidity associated with heart disease

  14. Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: The Bogalusa Heart Study

    Directory of Open Access Journals (Sweden)

    Xu Jihua

    2010-10-01

    Full Text Available Abstract Background Body Mass Index (BMI is widely used to assess the impact of obesity on cardiometabolic risk in children but it does not always relate to central obesity and varies with growth and maturation. Waist-to-Height Ratio (WHtR is a relatively constant anthropometric index of abdominal obesity across different age, sex or racial groups. However, information is scant on the utility of WHtR in assessing the status of abdominal obesity and related cardiometabolic risk profile among normal weight and overweight/obese children, categorized according to the accepted BMI threshold values. Methods Cross-sectional cardiometabolic risk factor variables on 3091 black and white children (56% white, 50% male, 4-18 years of age were used. Based on the age-, race- and sex-specific percentiles of BMI, the children were classified as normal weight (5th - 85th percentiles and overweight/obese (≥ 85th percentile. The risk profiles of each group based on the WHtR ( Results 9.2% of the children in the normal weight group were centrally obese (WHtR ≥0.5 and 19.8% among the overweight/obese were not (WHtR Conclusion WHtR not only detects central obesity and related adverse cardiometabolic risk among normal weight children, but also identifies those without such conditions among the overweight/obese children, which has implications for pediatric primary care practice.

  15. Heart Smart: a school health program meeting the 1990 Objectives for the Nation.

    Science.gov (United States)

    Butcher, A H; Frank, G C; Harsha, D W; Serpas, D C; Little, S D; Nicklas, T A; Hunter, S M; Berenson, G S

    1988-01-01

    The importance of health promotion is recognized throughout the nation. The Surgeon General's report of 1980, Promoting Health/Preventing Disease, delineates objectives for intervention in 15 health priority areas. Approximately one-third of the objectives relate directly to the health of children, and many are addressed by a comprehensive cardiovascular (CV) health promotion program for elementary school children--Heart Smart. Priority areas addressed by this program are high blood pressure control, nutrition, fluoridation and dental health, smoking, misuse of alcohol and drugs, physical fitness and exercise, and control of stress and violence. Heart Smart is a cognitive behavioral intervention designed to address health enabling and reinforcing factors within the school environment. It is based on data from the Bogalusa Heart Study which clearly document the need for CV health intervention beginning early in life. Heart Smart includes a longitudinal classroom curriculum, an aerobic fitness program taught within physical education classes, a school lunch program offering CV healthy foods, and a teacher staff development program. The goal is to reduce CV risk factors in children. With health-enhancing behavior change of the students, family, and elementary school staff, objectives for CV risk reduction in our nation can be achieved.

  16. Leonardo da Vinci's studies of the heart.

    Science.gov (United States)

    Shoja, Mohammadali M; Agutter, Paul S; Loukas, Marios; Benninger, Brion; Shokouhi, Ghaffar; Namdar, Husain; Ghabili, Kamyar; Khalili, Majid; Tubbs, R Shane

    2013-08-20

    Leonardo da Vinci's detailed drawings are justly celebrated; however, less well known are his accounts of the structures and functions of the organs. In this paper, we focus on his illustrations of the heart, his conjectures about heart and blood vessel function, his experiments on model systems to test those conjectures, and his unprecedented conclusions about the way in which the cardiovascular system operates. In particular, da Vinci seems to have been the first to recognize that the heart is a muscle and that systole is the active phase of the pump. He also seems to have understood the functions of the auricles and pulmonary veins, identified the relationship between the cardiac cycle and the pulse, and explained the hemodynamic mechanism of valve opening and closure. He also described anatomical variations and changes in structure and function that occurred with age. We outline da Vinci's varied career and suggest ways in which his personality, experience, skills and intellectual heritage contributed to these advances in understanding. We also consider his influence on later studies in anatomy and physiology.

  17. STUDY ON THE RELATIONSHIP AMONG THE HEART MERIDIAN,CARDIAC REFERRED PAIN AND THE HEART

    Institute of Scientific and Technical Information of China (English)

    RONGPeijing; ZHUBing

    2002-01-01

    Purpose:The referred pain of the somatic structure,a response of the visceralgia,is often seen in clinic.But ist underlying mechanisms are poorly understood.It is interested that cardiac referred pain ofter appears along the running course of the Heart Meridian(HM),while acupuncture of the acupoints of HM can effectively relieve cardiac pain.In the present study,the neural basis of the relationship among the HM,cardiac referred pain and the heart is investigated by using tri-labeling technique.Methods:Wistar rats are used in the present study.Three fluorescent dyes,fast blue(FB),propidium lodide(PI) and bibenzimide(Bb)are respectively injected into the pericardial sac,the left and right medial-middle band (HM) or lateral sides[rung Meridian(LM),used for control] of the rat forearms.Results:Examination of the sections of the dorsal ganglions shows that more doubly labeled neurons are found in the ipsilateral dorsal root ganglions of C8-T3 nerve segments from HM and the heart,while fewer double-labeled neurons found from LM and the heart.The facts provide direct evidence for existence of dichotomizing fibers of the ganglion neurons.There exists a relative specific connection between the HM and the heart.It also provides a morphological explanation for cardiogenic referred pain and for the specific interrelation between the heart Meridian and the heart of traditional Chinese medicine.

  18. Genome-wide association studies and resting heart rate

    DEFF Research Database (Denmark)

    Oskari Kilpeläinen, Tuomas

    2016-01-01

    Genome-wide association studies (GWASs) have revolutionized the search for genetic variants regulating resting heart rate. In the last 10 years, GWASs have led to the identification of at least 21 novel heart rate loci. These discoveries have provided valuable insights into the mechanisms...... and pathways that regulate heart rate and link heart rate to cardiovascular morbidity and mortality. GWASs capture majority of genetic variation in a population sample by utilizing high-throughput genotyping chips measuring genotypes for up to several millions of SNPs across the genome in thousands...... of individuals. This allows the identification of the strongest heart rate associated signals at genome-wide level. While GWASs provide robust statistical evidence of the association of a given genetic locus with heart rate, they are only the starting point for detailed follow-up studies to locate the causal...

  19. Isolated heart models: cardiovascular system studies and technological advances.

    Science.gov (United States)

    Olejnickova, Veronika; Novakova, Marie; Provaznik, Ivo

    2015-07-01

    Isolated heart model is a relevant tool for cardiovascular system studies. It represents a highly reproducible model for studying broad spectrum of biochemical, physiological, morphological, and pharmaceutical parameters, including analysis of intrinsic heart mechanics, metabolism, and coronary vascular response. Results obtained in this model are under no influence of other organ systems, plasma concentration of hormones or ions and influence of autonomic nervous system. The review describes various isolated heart models, the modes of heart perfusion, and advantages and limitations of various experimental setups. It reports the improvements of perfusion setup according to Langendorff introduced by the authors.

  20. Heart of darkness: a symbolic study Heart of darkness: a symbolic study

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    Reynaldo Gonçalves

    2008-04-01

    Full Text Available In this paper, I intend to conduct a study of the symbolic meaning of Joseph Conrad's Heart of Darkness by isolating and interpreting a net of symbols, which is very deftly manipulated by its author for the creation of a short, but superb, artistic expression of his appraisal of man's option for a tragic existence. In the process of this essay I shall examine the following symbolic elements: setting and characters. I shall endeavor to establish meanings for the river, forest, town, etc. As to characters, I shall concentrate on Kurtz's, but I shall also point out important differences and similarities between his character and those of the savages, of Marlow and of the Intended. I shall use other texts written by Conrad in order to supply further evidence for interpretations offered to elements of Heart of Darkness. In this paper, I intend to conduct a study of the symbolic meaning of Joseph Conrad's Heart of Darkness by isolating and interpreting a net of symbols, which is very deftly manipulated by its author for the creation of a short, but superb, artistic expression of his appraisal of man's option for a tragic existence. In the process of this essay I shall examine the following symbolic elements: setting and characters. I shall endeavor to establish meanings for the river, forest, town, etc. As to characters, I shall concentrate on Kurtz's, but I shall also point out important differences and similarities between his character and those of the savages, of Marlow and of the Intended. I shall use other texts written by Conrad in order to supply further evidence for interpretations offered to elements of Heart of Darkness.

  1. Associations of heart failure with sleep quality: The rotterdam study

    NARCIS (Netherlands)

    L.A. Zuurbier (Lisette); A.I. Luik (Annemarie); M.J.G. Leening (Maarten); A. Hofman (Albert); R. Freak-Poli (Rosanne); O.H. Franco (Oscar); B.H. Stricker; H.W. Tiemeier (Henning)

    2015-01-01

    textabstractStudy Objectives: The prevalence of sleep disturbances and heart failure increases with age. We aimed to evaluate the associations of incident heart failure and cardiac dysfunction with changes in sleep quality. Methods: This prospective population-based study was conducted in the Rotter

  2. STUDY ON THE RELATIONSHIP AMONG THE HEART MERIDIAN,CARDIAC REFERRED PAIN AND THE HEART

    Institute of Scientific and Technical Information of China (English)

    RONG Peijing; ZHU Bing

    2002-01-01

    @@ Purpose: The referred pain of the somatic structure, a response of the visceralgia, is often seen in clinic. But its underlying mechanisms are poorly understood. It is interested that cardiac referred pain often appears along the running course of the Heart Meridian (HM), while acupuncture of the acupoints of HM can effectively relieve cardiac pain. In the present study, the neural basis of the relationship among the HM, cardiac referred pain and the heart is investigated by using tri-labeling technique.

  3. Study the relationship between adiponectin and coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Xue-Hui Yang; Li-Xin Zhao; Yan-Hong Lu; Xiao-Jun Li; Jun Shi

    2015-01-01

    Objective: To study whether adiponectin in serum of patients with coronary heart disease is reduced, and compare with the test results in total cholesterol (TC), Triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), blood glucose (GLU), C-reactive protein (CRP). Method: We selected 80 cases of coronary heart disease patients as the experimental group, 50 healthy subjects as control group. The coronary heart disease group compared with the control group, we know the changes of adiponectin in coronary heart disease group and compared coronary heart disease group with control group in test results of blood lipid, blood glucose, C-reactive protein. Results: Adiponectin in coronary heart disease group was (0.47±0.09) mg/L, which decreased significantly comparing to control group’s level (t=-18.4, P<0.001), HDL-C in coronary heart disease group was (1.24±0.04) mmol/L, which decreased significantly comparing to control group’s level (t=-27.67, P<0.001). The difference was statistically significant (P<0.05). Conclusion: The level’s adiponectin in patients of coronary heart disease dropped, which lead to hypoadiponectinemia, Hypoadiponectinemia may be one of the risk factors of coronary heart disease.

  4. [Broader indication for treatment with statins; the 'heart protection study'

    NARCIS (Netherlands)

    Stalenhoef, A.F.H.; Stuyt, P.M.J.

    2002-01-01

    The introduction of statins has been a breakthrough in the treatment of hypercholesterolaemia. Statins are safe and effective in reducing the risk of coronary heart disease in the general population. The 'Heart protection study' has provided evidence for the benefit of statin treatment in much broad

  5. Body Cooling Little Help to Kids When Heart Stops: Study

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163215.html Body Cooling Little Help to Kids When Heart Stops: Study ... 2017 TUESDAY, Jan. 24, 2017 (HealthDay News) -- Body cooling offers no advantage over normal temperature control in ...

  6. Study Ties Alcohol Abuse to Increased Heart Risks

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_162836.html Study Ties Alcohol Abuse to Increased Heart Risks Association similar to that ... 2009. About 2 percent had been diagnosed with alcohol abuse. The researchers adjusted statistics so they wouldn't ...

  7. Adherence to self-care in patients with heart failure in the HeartCycle study

    Directory of Open Access Journals (Sweden)

    Stut W

    2015-08-01

    Full Text Available Wim Stut,1 Carolyn Deighan,2 John G Cleland,3 Tiny Jaarsma4 1Philips Research Europe, Eindhoven, the Netherlands; 2The Heart Manual Department, NHS Lothian, Edinburgh, UK; 3National Heart and Lung Institute, Royal Brompton and Harefield Hospitals Imperial College, London, UK; 4Department of Social and Welfare studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden Purpose: The purpose of this study was to evaluate a novel online education and coaching program to promote self-care among patients with heart failure. In this program, education and coaching content is automatically tailored to the knowledge and behavior of the patient. Patients and methods: The evaluation of the program took place within the scope of the HeartCycle study. This multi-center, observational study examined the ability of a third generation telehealth system to enhance the management of patients recently (<60 days admitted to the hospital for worsening heart failure or outpatients with persistent New York Heart Association (NYHA Functional Classification III/IV symptoms. Self-reported self-care behavior was assessed at baseline and study-end by means of the 9-item European Heart Failure Self-care Behavior scale. Adherence to daily weighing, blood pressure monitoring, and reporting of symptoms was determined by analyzing the system’s database. Results: Of 123 patients enrolled, the mean age was 66±12 years, 66% were in NYHA III and 79% were men. Self-reported self-care behavior scores (n=101 improved during the study for daily weighing, low-salt diet, physical activity (P<0.001, and fluid restriction (P<0.05. Average adherence (n=120 to measuring weight was 90%±16%, to measuring blood pressure was 89%±17% and to symptom reporting was 66%±32%. Conclusion: Self-reported self-care behavior scores improved significantly during the period of observation, and the objective evidence of adherence to daily weight and blood pressure measurements was

  8. Prospective studies on diet and coronary heart disease

    NARCIS (Netherlands)

    Oomen, C.M.

    2001-01-01

    In this thesis, the results of prospective studies on fatty acids, B-vitamins and arginine and the occurrence of coronary heart disease have been described. The results presented are mainly based on the Zutphen Elderly Study. In this study of 939 men aged 64-84 years, detailed information was availa

  9. Turkish Heart Study: lipids, lipoproteins, and apolipoproteins.

    Science.gov (United States)

    Mahley, R W; Palaoğlu, K E; Atak, Z; Dawson-Pepin, J; Langlois, A M; Cheung, V; Onat, H; Fulks, P; Mahley, L L; Vakar, F

    1995-04-01

    We examined the plasma lipids, lipoproteins, and selected apolipoproteins in approximately 9,000 men and women from six different regions of Turkey with markedly different diets, ranging from an Aegean coast diet high in olive oil (plasma cholesteryl ester fatty acids enriched in monounsaturated fatty acids) to an inland Anatolian diet high in meat and dairy products (plasma cholesteryl esters enriched in saturated fatty acids). The rural population consuming an olive oil-rich diet had the lowest plasma cholesterol levels (men, 149 mg/dl; women, 150 mg/dl). The urban populations of Istanbul and Adana had higher plasma cholesterol levels (men, 202 and 184 mg/dl, respectively; women, 181 and 190 mg/dl, respectively). Affluent men had the highest cholesterol levels (207 mg/dl). The low density lipoprotein (LDL) cholesterol levels tended to parallel the total cholesterol levels (highest for Istanbul men at 136 mg/dl and lowest for Aegean coast men and women at approximately 100 mg/dl). Strikingly, the Turkish people were found to have very low levels of high density lipoprotein (HDL) cholesterol (HDL-C) (mean values for all six regions: men, 34-38 mg/dl; women, 37-45 mg/dl) and total cholesterol/HDL-C ratios that were high (mean values for all six regions: men, 4.5-5.5; women, 3.9-5.0). The low HDL-C levels appear to be caused, at least in part, by a genetic factor. Triglyceride levels also tended to be high in Turkish men (approximately 120-150 mg/dl) and women (approximately 90-110 mg/dl). Thus, even though the total plasma cholesterol levels are not excessively elevated in comparison to those in other populations, the presence of low HDL-C or low HDL-C coupled with mildly elevated triglyceride levels may represent a significant risk factor for heart disease in the Turkish population. Affluence and higher education were associated with higher cholesterol levels. Lack of physical activity, smoking, and alcohol consumption also tended to be associated with a

  10. Thromboembolism and mechanical heart valves : A randomized study revisited

    NARCIS (Netherlands)

    Kuntze, CEE; Blackstone, EH; Ebels, T

    1998-01-01

    Background. This study was designed to revise and substantiate previous inferences, based on short-term follow-up, about differences in the incidence of anticoagulant-related events after heart valve replacement among patients who had been randomly assigned to receive either a Bjork-Shiley, Edwards-

  11. Design of the RELAXin in Acute Heart Failure Study

    NARCIS (Netherlands)

    Ponikowski, Piotr; Metra, Marco; Teerlink, John R.; Unemori, Elaine; Felker, G. Michael; Voors, Adriaan A.; Filippatos, Gerasimos; Greenberg, Barry; Teichman, Sam L.; Severin, Thomas; Mueller-Velten, Guenther; Cotter, Gad; Davison, Beth A.

    2012-01-01

    Background Acute heart failure (AHF) remains a major public health burden with a high prevalence and poor prognosis. Relaxin is a naturally occurring peptide hormone that increases cardiac output, arterial compliance, and renal blood flow during pregnancy. The RELAX-AHF-1 study will evaluate the eff

  12. Worsening Heart Failure Following Admission for Acute Heart Failure A Pooled Analysis of the PROTECT and RELAX-AHF Studies

    NARCIS (Netherlands)

    Davison, Beth A.; Metra, Marco; Cotter, Gad; Massie, Barry M.; Cleland, John G. F.; Dittrich, Howard C.; Edwards, Christopher; Filippatos, Gerasimos; Givertz, Michael M.; Greenberg, Barry; Ponikowski, Piotr; Voors, Adriaan A.; O'Connor, Christopher M.; Teerlink, John R.

    2015-01-01

    OBJECTIVES These studies conducted analyses to examine patient characteristics and outcomes associated with worsening heart failure (WHF). BACKGROUND WHF during an admission for acute heart failure (AHF) represents treatment failure and is a potential therapeutic target for clinical trials of AHF. M

  13. In-vitro calcification study of polyurethane heart valves.

    Science.gov (United States)

    Boloori Zadeh, Parnian; Corbett, Scott C; Nayeb-Hashemi, Hamid

    2014-02-01

    Tri-leaflet polyurethane heart valves have been considered as a potential candidate in heart valve replacement surgeries. In this study, polyurethane (Angioflex(®)) heart valve prostheses were fabricated using a solvent-casting method to evaluate their calcification resistance. These valves were subjected to accelerated life testing (continuous opening and closing of the leaflets) in a synthetic calcification solution. Results showed that Angioflex(®) could be considered as a potential material for fabricating prosthetic heart valves with possibly a higher calcification resistance compared to tissue valves. In addition, calcification resistance of bisphosphonate-modified Angioflex(®) valves was also evaluated. Bisphosphonates are considered to enhance the calcification resistance of polymers once covalently bonded to the bulk of the material. However, our in-vitro results showed that bisphosphonate-modified Angioflex(®) valves did not improve the calcification resistance of Angioflex(®) compared to its untreated counterparts. The results also showed that cyclic loading of the valves' leaflets resulted in formation of numerous cracks on the calcified surface, which were not present when calcification study did not involve mechanical loading. Further study of these cracks did not result in enough evidence to conclude whether these cracks have penetrated to the polymeric surface.

  14. Heart rate awareness in patients with chronic stable heart failure. A multi-center observational study.

    LENUS (Irish Health Repository)

    Moran, D

    2014-08-23

    We assessed adherence to European Society of Cardiology heart rate guidelines (i.e. heart rates less than 70bpm) in patients with chronic stable heart failure. We also investigated the percent of patients on target doses of rate controlling drugs.

  15. Consent for Genetic Research in the Framingham Heart Study

    OpenAIRE

    2010-01-01

    Extensive efforts have been aimed at understanding the genetic underpinnings of complex diseases that affect humans. Numerous genome-wide association studies have assessed the association of genes with human disease; including the Framingham Heart Study (FHS), which genotyped 550,000 SNPs in 9,000 participants. The success of such efforts requires high rates of consent by participants, which is dependent on ethical oversight, communications, and trust between research participants and investi...

  16. Engineered heart tissue: a novel tool to study the ischemic changes of the heart in vitro.

    Directory of Open Access Journals (Sweden)

    Rajesh G Katare

    Full Text Available BACKGROUND: Understanding the basic mechanisms and prevention of any disease pattern lies mainly on development of a successful experimental model. Recently, engineered heart tissue (EHT has been demonstrated to be a useful tool in experimental transplantation. Here, we demonstrate a novel function for the spontaneously contracting EHT as an experimental model in studying the acute ischemia-induced changes in vitro. METHODOLOGY/PRINCIPAL FINDINGS: EHT was constructed by mixing cardiomyocytes isolated from the neonatal rats and cultured in a ring-shaped scaffold for five days. This was followed by mechanical stretching of the EHT for another one week under incubation. Fully developed EHT was subjected to hypoxia with 1% O(2 for 6 hours after treating them with cell protective agents such as cyclosporine A (CsA and acetylcholine (ACh. During culture, EHT started to show spontaneous contractions that became more synchronous following mechanical stretching. This was confirmed by the increased expression of gap junctional protein connexin 43 and improved action potential recordings using an optical mapping system after mechanical stretching. When subjected to hypoxia, EHT demonstrated conduction defects, dephosphorylation of connexin-43, and down-regulation of cell survival proteins identical to the adult heart. These effects were inhibited by treating the EHT with cell protective agents. CONCLUSIONS/SIGNIFICANCE: Under hypoxic conditions, the EHT responds similarly to the adult myocardium, thus making EHT a promising material for the study of cardiac functions in vitro.

  17. Studies of Genes Involved in Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Tushar K. Ghosh

    2014-05-01

    Full Text Available Congenital heart disease (CHD affects the intricate structure and function of the heart and is one of the leading causes of death in newborns. The genetic basis of CHD is beginning to emerge. Our laboratory has been engaged in identifying mutations in genes linked to CHD both in families and in sporadic cases. Over the last two decades, we have employed linkage analysis, targeted gene sequencing and genome wide association studies to identify genes involved in CHDs. Cardiac specific genes that encode transcription factors and sarcomeric proteins have been identified and linked to CHD. Functional analysis of the relevant mutant proteins has established the molecular mechanisms of CHDs in our studies.

  18. Early complications of stenting in patients with congenital heart disease : a multicentre study

    NARCIS (Netherlands)

    van Gameren, Menno; Witsenburg, Maarten; Takkenberg, Johanna J. M.; Boshoff, Derize; Mertens, Luc; van Oort, Anton M.; de Wolf, DanieL; Freund, Matthias; Sreeram, Narayanswani; Bokenkamp, Regina; Talsma, Melle D.; Gewillig, Marc

    2006-01-01

    Aims Stenting has become an established interventional cardiology procedure for congenital heart disease. Although most stent procedures are completed successfully, complications may occur. This multicentre study evaluated early complications after stenting in patients with congenital heart disease,

  19. Charting a roadmap for heart failure biomarker studies.

    Science.gov (United States)

    Ahmad, Tariq; Fiuzat, Mona; Pencina, Michael J; Geller, Nancy L; Zannad, Faiez; Cleland, John G F; Snider, James V; Blankenberg, Stephan; Adams, Kirkwood F; Redberg, Rita F; Kim, Jae B; Mascette, Alice; Mentz, Robert J; O'Connor, Christopher M; Felker, G Michael; Januzzi, James L

    2014-10-01

    Heart failure is a syndrome with a pathophysiological basis that can be traced to dysfunction in several interconnected molecular pathways. Identification of biomarkers of heart failure that allow measurement of the disease on a molecular level has resulted in enthusiasm for their use in prognostication and selection of appropriate therapies. However, despite considerable amounts of information available on numerous biomarkers, inconsistent research methodologies and lack of clinical correlations have made bench-to-bedside translations rare and left the literature with countless publications of varied quality. There is a need for a systematic and collaborative approach aimed at definitively studying the clinical benefits of novel biomarkers. In this review, on the basis of input from academia, industry, and governmental agencies, we propose a systematized approach based on adherence to specific quality measures for studies looking to augment current prediction model or use biomarkers to tailor therapeutics. We suggest that study quality, rather than results, should determine publication and propose a system for grading biomarker studies. We outline the need for collaboration between clinical investigators and statisticians to introduce more advanced statistical methodologies into the field of biomarkers that would allow for data from a large number of variables to be distilled into clinically actionable information. Lastly, we propose the creation of a heart failure biomarker consortium that would allow for a comprehensive list of biomarkers to be concomitantly analyzed in a pooled sample of randomized clinical trials and hypotheses to be generated for testing in biomarker-guided trials. Such a consortium could collaborate in sharing samples to identify biomarkers, undertake meta-analyses on completed trials, and spearhead clinical trials to test the clinical utility of new biomarkers.

  20. Comparative study on cerebral injury after open heart surgery in patients with congenital and rheumatic heart disease

    Institute of Scientific and Technical Information of China (English)

    WANG Yong; XIAO Ying-bin; CHEN Lin; ZHONG Qian-jin; WANG Xue-feng

    2005-01-01

    Objective: To comparatively study the different effects of open heart surgery on brain tissues of patients with congenital and rheumatic heart disease. Methods: Forty patients with congenital heart disease (CHD, CHD group, n=20) or rheumatic heart disease (RHD, RHD group, n=20) underwent on-pump (cardiopulmonary bypass, CPB) heart-beating open heart surgery. Blood samples before CPB, and 20 minutes, 1 hour, 24 hours and 7 days after CPB were collected, and the levels of neuron-specific enolase (NSE) and protein S-100b in the plasma were determined with enzyme-linked immunoadsorbent assay (ELISA), respectively. All the patients were examined with electroencephalogram (EEG) before and 1 week after operation. The changes of NSE, S-100b and EEG compared to verify the difference of postoperative cerebral injury between CHD cases and RHD cases. Results: The plasma level of S-100b increased significantly 20 minutes after CPB and was still higher than the preoperative level at 24 hours after operation in both groups (P<0.01). The plasma level of NSE increased more significantly in the CHD group than in the RHD group 20 minutes after CPB and it returned to the normal level 24 hours after CPB in the CHD group but remained at a high level in the RHD group (P<0.01). The levels of NSE and S-100b returned to the normal levels on the 7th day after CPB. Abnormal EEG was found in 75% of the patients in the CHD group and 60% in the RHD group. Conclusions: On-pump heart-beating open heart surgery can cause certain cerebral injury in the patients with CHD or RHD. The injury was more severe and recovered more quickly in the CHD group than in the RHD group.

  1. Lifestyle modification with diet and exercise in obese patients with heart failure - A pilot study

    Science.gov (United States)

    There is a paucity of data regarding intentional weight loss in obese heart failure patients. This study sought to ascertain the safety and effectiveness of a lifestyle modification program in patients with systolic heart failure and metabolic syndrome. Patients (n=20) with systolic heart failure (e...

  2. Hypercholesterolaemia and risk of coronary heart disease in the elderly: impact of age: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Iversen, Allan; Jensen, Jan Skov; Scharling, Henrik

    2008-01-01

    CHD decreases with age in a healthy population. METHODS: Within the Copenhagen City Heart Study in 1981-1983, 4647 men and 5829 women, aged 40-93 years, underwent a cardiovascular health examination including measurement of plasma-cholesterol. The cohort was followed with respect to incident CHD until......BACKGROUND: Population and interventional studies have shown that high plasma-cholesterol is a risk factor of coronary heart disease (CHD). However, in most of the studies elderly people were excluded. AIM: This paper assesses whether the effect of total plasma-cholesterol on the risk of incident...

  3. Building Collaborative Health Promotion Partnerships: The Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Clifton C. Addison

    2015-12-01

    Full Text Available Building Collaborative Health Promotion Partnerships: The Jackson Heart Study. Background: Building a collaborative health promotion partnership that effectively employs principles of community-based participatory research (CBPR involves many dimensions. To ensure that changes would be long-lasting, it is imperative that partnerships be configured to include groups of diverse community representatives who can develop a vision for long-term change. This project sought to enumerate processes used by the Jackson Heart Study (JHS Community Outreach Center (CORC to create strong, viable partnerships that produce lasting change. Methods: JHS CORC joined with community representatives to initiate programs that evolved into comprehensive strategies for addressing health disparities and the high prevalence of cardiovascular disease (CVD. This collaboration was made possible by first promoting an understanding of the need for combined effort, the desire to interact with other community partners, and the vision to establish an effective governance structure. Results: The partnership between JHS CORC and the community has empowered and inspired community members to provide leadership to other health promotion projects. Conclusion: Academic institutions must reach out to local community groups and together address local health issues that affect the community. When a community understands the need for change to respond to negative health conditions, formalizing this type of collaboration is a step in the right direction.

  4. Living with an unfixable heart: a qualitative study exploring the experience of living with advanced heart failure.

    LENUS (Irish Health Repository)

    Ryan, Marie

    2012-02-01

    BACKGROUND: Nurses working with patients with advanced heart failure need knowledge that will help us to help patients cope with their situations of chronic illness. However, our knowledge bank is deficient due to the scarcity of inquiry that takes the affected person\\'s point of view as its central focus. AIM: The aim of this study was to describe patients\\' experiences of living with advanced heart failure. METHODS: The study sample (N=9) consisted of male (N=6) and female (N=3) patients with advanced (NYHA classes III-IV) heart failure. The design was qualitative and open unstructured interviews were audio-taped and transcribed verbatim during 2006. RESULTS: Four main themes emerged: Living in the Shadow of Fear; Running on Empty; Living a Restricted life; and Battling the System. The experience of living with advanced heart failure was described as a fearful and tired sort of living characterised by escalating impotence and dependence. CONCLUSIONS: The findings suggest that there may be an illogical but enduring ethos of \\'cure\\' pervading health care worker\\'s attitudes to advanced heart failure care. This mindset might be working to hinder the application of additional or alternative therapies, which might better palliate the physical and psychosocial distress of patients.

  5. Spatial registration of echocardiographic and positron emission tomographic heart studies

    Energy Technology Data Exchange (ETDEWEB)

    Savi, A. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Gilardi, M.C. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Rizzo, G. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Pepi, M. [Centro Cardiologico, Fondazione I. Monzino, Milan (Italy); Landoni, C. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Rossetti, C. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Lucignani, G. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Bartorelli, A. [Centro Cardiologico, Fondazione I. Monzino, Milan (Italy); Fazio, F. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy)

    1995-03-01

    A method has been developed to match corresponding heart regions from functional echocardiographic (Echo) and metabolic fluorine-18-fluoro-2-deoxy-D-glucose ([18F]FDG) positron emission tomography (PET) studies in individual patients. Echo and PET images are spatially correlated by determining homologous anatomical landmarks (the two papillary muscles and the inferior junction of the right ventricle), identifiable in images obtained by both acquisition modalities. Echo-PET image registration is first performed in the plane identified by the three landmarks, using a rigid rotate-translate scale model. The registration parameters are then used to transform the whole PET volume. This allows a consistent Echo-PET regional analysis, according to a segmental subdivision of the heart. The technique was tested on patients. The overlay of Echo and PET registered images proved the reliability of realignment of the three markers and a good spatial correlation of myocardial walls. This approach to image registration could be applied to other acquisition modalities (such as magnetic resonance imaging and single-photon emission tomography), provided that the three anatomical landmarks are visualized. (orig.)

  6. Tissue Doppler echocardiography in persons with hypertension, diabetes, or ischaemic heart disease: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Mogelvang, Rasmus; Sogaard, Peter; Pedersen, Sune A

    2009-01-01

    AIMS: To test the hypothesis that echocardiographic tissue Doppler imaging (TDI) reveals reduced myocardial function in hypertension, diabetes, and ischaemic heart disease (IHD) in the general population. METHODS AND RESULTS: Within a large, community-based population study, cardiac function.......001] compared with controls [n = 533; LD 11.4 (+/-SD 2.0 mm); E/e' 9.0 (x/SD 1.3)]. This pattern remained significant after adjusting for age, sex, body mass index, heart rate, and the results of conventional echocardiography. CONCLUSION: In the general population, persons with hypertension, diabetes, or IHD...

  7. MORPHOLOGICAL STUDY OF CORONARY SINUS IN HUMAN CADAVERIC HEARTS

    Directory of Open Access Journals (Sweden)

    R. Manoranjitham

    2015-09-01

    Full Text Available Background: The coronary sinus is a dilated venous channel opening into the right atrium of the heart. The coronary venous system has gained importance in recent years for electrophysiological procedures like arrhythmia ablation, biventricular pacing and implantation of cardiac pacemakers. The present study aims to study the formation and tributaries of coronary sinus and also the morphology of thebesian valve. Materials and Methods: 30 formalin fixed cadaveric hearts available in the department of Anatomy, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil nadu, was used for the study. The formation and tributaries of coronary sinus were noted. The length of coronary sinus in millimeters was measured from the union of great cardiac vein and left marginal vein upto the opening of the coronary sinus in the right atrium with vernier calipers. The width of the coronary ostium in the right atrium was measured in millimeters with vernier calipers. Results: In 93.33% specimens the coronary sinus was formed by the union of great cardiac vein and left marginal vein. In 3.33% specimens it was formed by the union of great cardiac vein and posterior vein of left ventricle, and in 3.33% specimens it was formed by the union of great cardiac vein and oblique vein of left atrium. The left marginal vein was absent in 2 specimens and small cardiac vein was absent in 1 specimen. The mean length of coronary sinus was 54.98 + 12.2mm. The mean width of coronary sinus ostium was 9.35 + 3.24mm. The Thebesian valve was present in 93.33% specimens and it was semilunar in shape. Conclusion: The knowledge of coronary sinus anatomy will be helpful during electrophysiological procedures.

  8. Transient global amnesia and neurological events: the Framingham Heart Study

    Directory of Open Access Journals (Sweden)

    Jose Rafael Romero

    2013-05-01

    Full Text Available Background/ objective: Transient global amnesia (TGA is a temporary amnestic syndrome characterized by lack of other focal neurological deficits. Cerebrovascular disease, migraine and seizures have been suggested as underlying mechanisms. TGA may be a risk factor for cerebrovascular or other neurological events. We studied the relation of TGA, vascular risk factors, brain magnetic resonance imaging (MRI indices of subclinical ischemia and neurological events in a community-based sample. Design/setting: A total of 12 TGA cases were ascertained using standard criteria by experienced neurologists, and matched to 41 stroke- and seizure-free controls. Vascular risk factors, brain MRI findings, and subsequent cerebrovascular or seizure events were compared in cases and controls. Participants: Framingham Heart Study (FHS original and offspring cohort participants were included.Results: No significant differences between the groups were observed in the prevalence of vascular risk factors, or brain MRI measures. Few incident stroke/transient ischemic attacks (TIA (1 event among the cases and 4 in controls or subsequent seizures occurred in either group. Head CT during the acute event (n=11 and brain MRI (n=7 were negative for acute abnormalities. Electroencephalograms (EEG (n=5 were negative for epileptiform activity. Extracranial vascular studies were negative for significant stenosis in all cases.Conclusions: In our community-based study TGA was not related to traditional vascular risk factors, or cerebrovascular disease. However, our study is limited by small sample size and power, and larger studies are required to exclude an association.

  9. A longitudinal study of resting heart rate and violent criminality in more than 700000 men

    OpenAIRE

    Latvala, A.; Kuja-Halkola, R; Almqvist, C.; Larsson, H.; Lichtenstein, P

    2015-01-01

    IMPORTANCE Low resting heart rate is a well-replicated physiological correlate of aggressive and antisocial behavior in children and adolescents, but whether low resting heart rate increases the risk of violence and other antisocial and risk-taking behaviors in adulthood has not been studied in representative samples. OBJECTIVE To study the predictive association of resting heart rate with violent and nonviolent criminality and with fatal and nonfatal injuries owing to assaul...

  10. Divorce and death: forty years of the Charleston Heart Study.

    Science.gov (United States)

    Sbarra, David A; Nietert, Paul J

    2009-01-01

    Forty years of follow-up data from the Charleston Heart Study (CHS) were used to examine the risk for early mortality associated with marital separation or divorce in a sample of more than 1,300 adults assessed on several occasions between 1960 and 2000. Participants who were separated or divorced at the start of the study evidenced significantly elevated rates of early mortality, and these results held after adjusting for baseline health status and other demographic variables. Being separated or divorced throughout the CHS follow-up window was one of the strongest predictors of early mortality. However, the excess mortality risk associated with separation or divorce was completely eliminated when participants who had ever experienced a marital separation or divorce during the study were compared with all other participants. These findings suggest that a key predictor of early death is the amount of time people live as separated or divorced. It is possible that the mortality risk conferred by marital dissolution is due to dimensions of personality that predict divorce as well as a decreased likelihood of future remarriage.

  11. THE STUDY OF PREVALENCE AND CLINICAL PROFILE OF VALVULAR HEART DISEASES IN A TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Radha Krishnan

    2015-04-01

    Full Text Available Valvular heart disease is still a common causes of mortality and morbidity in India and rheumatic heart disease is still far more frequent. AIMS AND OBJECTIVES: To study the prevalence and clinical profile of rheumatic and non - rheumatic valvular heart dise ase in patients attending to Government General Hospital, Kakinada. MATERIALS AND METHODS: 100 Adult patients with valvular abnormalities attending to the Medicine and Cardiology Units of Government General Hospital, Kakinada from Nov 2011 - May 2013 were studied. C linical history including various symptoms, past history of rheumatic fever, followed by systemic examination was done. A detailed cardiovascular examination with relevant investigations and evaluation was done. OBSERVATIONS AND RESULTS: The most common cause of acquired valvular heart disease is Rheumatic Heart Disease. Mitral valve involvement is the most common valve involvement with Mitral regurgitation as the most common valvular lesion. Mitral stenosis is the most common valvular lesion amon g rheumatic valvular heart disease. The most common complaint is breathlessness and the most common complication is Congestive heart failure. Multi valvular lesion is the most common valve involvement in patients presenting with congestive heart failure an d infective endocarditis. Patients having atrial fibrillation are noted to have mitral stenosis more commonly. Mitral stenosis is the valve abnormality commonly noted in patients presenting with haemoptysis, respiratory tract infection and chorea. Left sid ed hemiplegia is common in patients with acquired valvular heart disease. CONCLUSIONS: Though the incidencen of rheumatic valvular disease is decreased in modern era, still continuing in our country. The analysis of the present study gives us insight into the various types of presentation of acquired valvular heart disease and to increase awareness besides early detection of valvular diseases clinically. It also helps in planning of

  12. [Histoautoradiographic study of the heart in experimental myocardial ischemia].

    Science.gov (United States)

    Makhova, A N; Shliapnikov, V N

    1979-01-01

    Autoradiographic examinations of the heart muscle in experimental myocardial necroses using 3H-thymidine, revealed a high DNA synthesis in the connective tissue cells in the zone of necrosis in the acute period of infarction and its subsequent decrease. Deviations from this regularity were observed when relapses of necrosis developed. The activation of DNA synthesis occurred to a lesser extent in stromal cells of the periinfarction and remote zones of the heart. Muscle cells incorporated 3H-thymidine extremely rarely. When myocardial infarction was combined with aterosclerosis, relapses of necrosis occurred frequently, and morphological changes in many arteries and veins were accompanied by 3H-thymidine incorporation into the nuclei of the endothelium, smooth cells and adventitial cells. Inhibition of DNA synthesis in connective tissue cells of various heart zones was observed in cases of combined myocardial infarction and aterosclerosis and hypertension.

  13. Studies on the Relationship between the Embryonic Heart Development and the Amnion Folding in Chick

    Directory of Open Access Journals (Sweden)

    Yongqing Li

    2006-01-01

    Full Text Available As a model animal for developmental biology, chick embryo is easy to control and observe during embryo development period and therefore it is widely used in the study of cardiac development. The application of proteomics has opened the door for large-scale studies to dissect both protein expression, regulation and function during chick heart developing stages. The proteomics study requires to quickly separate a large number of chick heart samples with the same developing stage. However, the traditional morphological standards based on Hamburger-Hamilton and Witschi stages are difficult to fulfill this requirement. Herein, we suppose a new standard for distinguishing chick heart morphology in different developing stages based on the relationship between the embryonic heart development and the amnion folding in chick. Based on this standard, we can accelerate the speed of embryonic heart sample separation and guarantee the quantity and quality of the sample more reliably.

  14. Effect of repeated intracoronary injection of bone marrow cells in patients with ischaemic heart failure the Danish stem cell study - congestive heart failure trial (DanCell-CHF)

    DEFF Research Database (Denmark)

    Diederichsen, A.C.; Møller, Jacob Eifer; Thayssen, P.;

    2008-01-01

    BACKGROUND: It has been suggested that myocardial regeneration may be achieved by a single intracoronary bone marrow derived stem cell infusion in selected patients with ischaemic heart disease. The effect is uncertain in patients with chronic ischaemic heart failure and it is not known whether...... repeated infusions would have additional positive effects. AIMS: To assess whether two treatments of intracoronary infusion of bone marrow stem cells, administered 4 months apart, could improve left ventricular (LV) systolic function in patients with chronic ischaemic heart failure. METHODS: The study......, NYHA class improved (pstem cell treatment in patients with chronic ischaemic heart failure Udgivelsesdato: 2008/7...

  15. Diagnostic Utility of ANG in Coronary Heart Disease Complicating Chronic Heart Failure: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Peng Yu

    2016-01-01

    Full Text Available Angiogenin (ANG has been shown to be elevated in several cardiovascular diseases. To detect its levels and diagnostic capacity in coronary heart disease (CHD patients complicating chronic heart failure (CHF, we performed this cross-sectional study and enrolled 616 CHD patients and 53 healthy controls. According to complicating CHF or not, the patients were divided into CHF group (n=203 and CHD disease controls (n=413, in which the CHF group was subdivided as heart failure with reduced ejection fraction (HFrEF group or heart failure with preserved ejection fraction (HFpEF group on the basis of left ventricular ejection fraction (LVEF, or as different NYHA class group. Their plasma ANG levels were detected using enzyme-linked immunosorbent assay (ELISA. Plasma ANG was 342.8 (IQR [273.9,432.9], 304.5 (IQR [254.0,370.5], and 279.7 (IQR [214.4,344.0] ng/mL in the CHF group, CHD disease controls, and healthy controls, respectively, significantly higher in the CHF group compared with the others. Furthermore, among CHF group, ANG is dramatically higher in the HFrEF patients compared with the HFpEF patients. As for the diagnostic capacity of ANG, the area under the receiver operating characteristic curve was 0.71 (95% CI 0.63–0.78. We concluded that plasma ANG is elevated in CHD complicating CHF patients and may be a moderate discriminator of CHF from CHD or the healthy.

  16. Diagnostic Utility of ANG in Coronary Heart Disease Complicating Chronic Heart Failure: A Cross-Sectional Study

    Science.gov (United States)

    Liu, Ming; Yang, Xue; Yu, Ying; Zhao, Ji; Zhang, Lei; Tong, Rui; Zou, Yunzeng; Ge, Junbo

    2016-01-01

    Angiogenin (ANG) has been shown to be elevated in several cardiovascular diseases. To detect its levels and diagnostic capacity in coronary heart disease (CHD) patients complicating chronic heart failure (CHF), we performed this cross-sectional study and enrolled 616 CHD patients and 53 healthy controls. According to complicating CHF or not, the patients were divided into CHF group (n = 203) and CHD disease controls (n = 413), in which the CHF group was subdivided as heart failure with reduced ejection fraction (HFrEF) group or heart failure with preserved ejection fraction (HFpEF) group on the basis of left ventricular ejection fraction (LVEF), or as different NYHA class group. Their plasma ANG levels were detected using enzyme-linked immunosorbent assay (ELISA). Plasma ANG was 342.8 (IQR [273.9,432.9]), 304.5 (IQR [254.0,370.5]), and 279.7 (IQR [214.4,344.0]) ng/mL in the CHF group, CHD disease controls, and healthy controls, respectively, significantly higher in the CHF group compared with the others. Furthermore, among CHF group, ANG is dramatically higher in the HFrEF patients compared with the HFpEF patients. As for the diagnostic capacity of ANG, the area under the receiver operating characteristic curve was 0.71 (95% CI 0.63–0.78). We concluded that plasma ANG is elevated in CHD complicating CHF patients and may be a moderate discriminator of CHF from CHD or the healthy. PMID:27872509

  17. Methods for Retrospective Geocoding in Population Studies: The Jackson Heart Study

    OpenAIRE

    Robinson, Jennifer C.; Wyatt, Sharon B; Hickson, Demarc; Gwinn, Danielle; Faruque, Fazlay; Sims, Mario; Sarpong, Daniel; Taylor, Herman A.

    2009-01-01

    The increasing use of geographic information systems (GIS) in epidemiological population studies requires careful attention to the methods employed in accomplishing geocoding and creating a GIS. Studies have provided limited details, hampering the ability to assess validity of spatial data. The purpose of this paper is to describe the multiphase geocoding methods used to retrospectively create a GIS in the Jackson Heart Study (JHS). We used baseline data from 5,302 participants enrolled in th...

  18. Comorbid Depression and Heart Failure: A Community Cohort Study.

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    Bhautesh Dinesh Jani

    Full Text Available To examine the association between depression and clinical outcomes in heart failure (HF in a community cohort.HF patients in Minnesota, United States completed depression screening using the 9-item Patient Health Questionnaire (PHQ-9 between 1st Oct 2007 and 1st Dec 2011; patients with PHQ-9≥5 were labelled "depressed". We calculated the risk of death and first hospitalization within 2 years using Cox regression. Results were adjusted for 10 commonly used prognostic factors (age, sex, systolic blood pressure, estimated glomerular filtration rate, serum sodium, ejection fraction, blood urea nitrogen, brain natriuretic peptide, presence of diabetes and ischaemic aetiology. Area under the curve (AUC, integrated discrimination improvement (IDI and net reclassification improvement (NRI compared depression as a predictor against the aforementioned factors.425 patients (mean age 74, 57.6% males were included in the study; 179 (42.1% had PHQ-9≥5. The adjusted hazard ratio of death was 2.02 (95% CI 1.34-3.04 and of hospitalization was 1.42 (95% CI 1.13-1.80 for those with compared to those without depression. Adding depression to the models did not appreciably change the AUC but led to statistically significant improvements in both the IDI (p = 0.001 and p = 0.005 for death and hospitalization, respectively and NRI (for death and hospitalization, 35% (p = 0.002 and 27% (p = 0.007 were reclassified correctly, respectively.Depression is frequent among community patients with HF and associated with increased risk of hospitalizations and death. Risk prediction for death and hospitalizations in HF patients can be improved by considering depression.

  19. Effect of heart rate on the hemodynamics of bileaflet mechanical heart valves' prostheses (St. Jude Medical) in the aortic position and in the opening phase: A computational study.

    Science.gov (United States)

    Jahandardoost, Mehdi; Fradet, Guy; Mohammadi, Hadi

    2016-03-01

    To date, to the best of the authors' knowledge, in almost all of the studies performed around the hemodynamics of bileaflet mechanical heart valves, a heart rate of 70-72 beats/min has been considered. In fact, the heart rate of ~72 beats/min does not represent the entire normal physiological conditions under which the aortic or prosthetic valves function. The heart rates of 120 or 50 beats/min may lead to hemodynamic complications, such as plaque formation and/or thromboembolism in patients. In this study, the hemodynamic performance of the bileaflet mechanical heart valves in a wide range of normal and physiological heart rates, that is, 60-150 beats/min, was studied in the opening phase. The model considered in this study was a St. Jude Medical bileaflet mechanical heart valve with the inner diameter of 27 mm in the aortic position. The hemodynamics of the native valve and the St. Jude Medical valve were studied in a variety of heart rates in the opening phase and the results were carefully compared. The results indicate that peak values of the velocity profile downstream of the valve increase as heart rate increases, as well as the location of the maximum velocity changes with heart rate in the St. Jude Medical valve model. Also, the maximum values of shear stress and wall shear stresses downstream of the valve are proportional to heart rate in both models. Interestingly, the maximum shear stress and wall shear stress values in both models are in the same range when heart rate is valve model when heart rate is >90 beats/min (up to ~40% growth compared to that of the native valve). The findings of this study may be of importance in the hemodynamic performance of bileaflet mechanical heart valves. They may also play an important role in design improvement of conventional prosthetic heart valves and the design of the next generation of prosthetic valves, such as percutaneous valves.

  20. A STUDY ON CLINICAL AND AETIOLOGICAL PROFILE OF HEART FAILURE AT KBN TEACHING AND GENERAL HOSPITAL

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    Chandrakala Guruprasad Yelwanti

    2016-10-01

    Full Text Available BACKGROUND The heart failure is a worldwide health problem with ever increasing proportion and is a major health problem in elderly persons. It has many aetiological factors. It is one of the most frequently encountered illnesses in day-to-day practice and most common cause of death in patients with cardiac disease. This study was done to determine the age and sex distribution and to evaluate clinical features and aetiological factors in patients admitted with heart failure at Khaja Banda Nawaz Teaching and General Hospital, Gulbarga, on the basis of clinical assessment, electrocardiography and echocardiography. MATERIALS AND METHODS A prospective study was done in Department of General Medicine at Khaja Banda Nawaz Teaching and General Hospital, Gulbarga, from January 2015 to June 2016 on patients with heart failure to determine the clinical and aetiological profile. A total of 100 cases above the age of 20 years were included in the study. The patients below the age of 20 years and known cases of congenital heart disease were excluded. RESULTS Out of 100 patients, the heart failure was seen more commonly in men than in women between the age groups of 46-65 years of age. Breathlessness was the most common presentation followed by pedal oedema, orthopnoea, etc. In our study, the primary aetiology for heart failure was found to be coronary artery disease (47% followed by dilated cardiomyopathy (20%, hypertension (14%, rheumatic heart disease (7%, anaemia (6%, cor pulmonale (4% and others (2%. Dyslipidaemia was the common risk factor followed by obesity and smoking. CONCLUSION The heart failure commonly occurs in elderly people and the incidence was higher in men than in women. The commonest presentation was breathlessness followed by pedal oedema. The commonest cause of heart failure was coronary artery disease followed by dilated cardiomyopathy and then hypertension combined with ischaemic heart disease.

  1. A genome-wide association study of pulmonary function measures in the Framingham Heart Study.

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    Jemma B Wilk

    2009-03-01

    Full Text Available The ratio of forced expiratory volume in one second to forced vital capacity (FEV(1/FVC is a measure used to diagnose airflow obstruction and is highly heritable. We performed a genome-wide association study in 7,691 Framingham Heart Study participants to identify single-nucleotide polymorphisms (SNPs associated with the FEV(1/FVC ratio, analyzed as a percent of the predicted value. Identified SNPs were examined in an independent set of 835 Family Heart Study participants enriched for airflow obstruction. Four SNPs in tight linkage disequilibrium on chromosome 4q31 were associated with the percent predicted FEV(1/FVC ratio with p-values of genome-wide significance in the Framingham sample (best p-value = 3.6e-09. One of the four chromosome 4q31 SNPs (rs13147758; p-value 2.3e-08 in Framingham was genotyped in the Family Heart Study and produced evidence of association with the same phenotype, percent predicted FEV(1/FVC (p-value = 2.0e-04. The effect estimates for association in the Framingham and Family Heart studies were in the same direction, with the minor allele (G associated with higher FEV(1/FVC ratio levels. Results from the Family Heart Study demonstrated that the association extended to FEV(1 and dichotomous airflow obstruction phenotypes, particularly among smokers. The SNP rs13147758 was associated with the percent predicted FEV(1/FVC ratio in independent samples from the Framingham and Family Heart Studies producing a combined p-value of 8.3e-11, and this region of chromosome 4 around 145.68 megabases was associated with COPD in three additional populations reported in the accompanying manuscript. The associated SNPs do not lie within a gene transcript but are near the hedgehog-interacting protein (HHIP gene and several expressed sequence tags cloned from fetal lung. Though it is unclear what gene or regulatory effect explains the association, the region warrants further investigation.

  2. [Longitudinal studies in the prevention of cardiovascular diseases].

    Science.gov (United States)

    Balaguer Vintró, Ignacio

    2004-01-01

    Longitudinal studies of well defined cohorts have contributed to the identification of risk factors of coronary heart disease and other clinical complications of atherosclerosis. After commenting on the conclusions of experimental atherosclerosis and risk factors suggested by the study of a series of myocardial infarction in young adults and their matched controls, we discuss the methodology, management and results of longitudinal studies carried out in the United States since 1949: Twin Cities, Framingham, Pooling Project, Western Collaborative, Puerto Rico Evans County, NI-IION-SAN, San Francisco, Harvard, Bogalusa and CARDIA. Special attention is given to the hypothesis proposed at the beginning of the Framingham Study and the obstacles and changes to continue the project after the first twenty-four years. We also expose the Seven Countries Study, designed and managed by Ancel Keys, as the first study performed with centralized methodology in various countries, and the studies in various European countries: Whitehall, Manresa, Paris, British Regional, Northwick Park, Caerphilly, Speedwell and PROCAM. We analyse the role of the longitudinal studies in the methodology of later studies: sons and daughters of the Framingham participants, longitudinal studies based on questionnaires, studies of the other risk factors, prevalence of risk factors in retrospective studies, trials of primary prevention (MRFIT, WHO European Collaborative Trial and Gotenburg Study) and the participation of the trained teams in the MONICA Project. We present the issues still under debate in connection with the methodology and results of the longitudinal studies: problems in the periodic examination of the participants in the epidemiologic studies, changes in definition of the new cases of acute cardiovascular events, use and selection of risk functions based on coronary charts to calculate the individual risk and cardiovascular risk factors as yet unknown.

  3. Modeling study of the failing heart and its interaction with an implantable rotary blood pump.

    Science.gov (United States)

    Ramachandran, Deepa P; Luo, Chuan; Ma, Tony S; Clark, John W

    2011-01-01

    The effectiveness of clinical diagnosis and treatment of heart failure is a direct function of clinical signs that can be measured in a patient within cost and safety constraints. Large-scale mathematical modeling can be a key tool in revealing important, measurable clinical signs of heart failure, furthering medical understanding and development of treatment. In the first part of this study we have created two models of left heart failure--diastolic and systolic, using our human cardiovascular-respiratory system (H-CRS) model, and we present a comparison of the two types with emphasis on novel and differentiating clinical signs, such as tricuspid flow and septal motion. In the event of compromised left ventricular performance, mechanical left ventricular assist devices (LVAD) are often implanted to augment or completely replace the pumping action of the left ventricle (LV). One such type is the implantable rotary blood pump (iRBP). Several design issues related to the iRBP are difficult to study experimentally due to procedure complexity and limitations in animal models of heart failure [2]. Therefore, modeling has become a key tool in iRBP development. In the second part of this study, we have introduced an iRBP model based on [1]-[2] in the systolic failing heart to study the interactions. We consider optimal motor settings for different levels of LV assistance, the effects of the iRBP on the right heart, septum, and pulmonary circulation. Our model results align with those reported in [1]-[2]. Improvement in cardiac output, pulmonary congestion, and heart work are seen with the iRBP. We observe lowered septal assistance to RV and LV ejection with increasing pump speeds, elevating right ventricular (RV) work, reducing LVET, and causing ventricular mechanical dyssynchrony in ejection. These results suggest right heart compromise via the septum's reduced role with the introduction of an iRBP. This work emphasizes the critical role of modeling in heart failure and

  4. High-Dose Vitamin D Failed to Curb Heart Disease in Study

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_164472.html High-Dose Vitamin D Failed to Curb Heart Disease in Study ... 5, 2017 (HealthDay News) -- Taking high doses of vitamin D once a month won't lower your ...

  5. Clinical characteristics and outcome of heart failure and captagon amphetamine use: An observational prospective study

    Directory of Open Access Journals (Sweden)

    Abdelfatah A. Elasfar

    2014-03-01

    Conclusios: Captagon use was found to be an independent risk factor of death and other morbidities in patients presented with cardiomyopathy and acute heart failure. Our study underscores the importance of improving education concerning the cardiac risks of captagon use.

  6. Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD.

    Science.gov (United States)

    Imeraj, Lindita; Antrop, Inge; Roeyers, Herbert; Deschepper, Ellen; Bal, Sarah; Deboutte, Dirk

    2011-08-01

    Previous studies suggest an altered circadian regulation of arousal in children with attention-deficit hyperactivity disorder (ADHD) as measured by activity, circadian preference, and sleep-wake patterns. Although heart rate is an important measure to evaluate arousal profiles, to date it is unknown whether 24-h heart rate patterns differentiate between children with and without ADHD. In this study, 24-h heart rate data were collected in 30 non-medicated children with ADHD (aged 6-11) and 30 sex-, class-, and age-matched normal controls in their naturalistic home and school setting, during 5 days. Simultaneously, 24-h activity patterns were registered. Confounding effects of demographic variables (e.g., age, sex, BMI, pubertal stage) and comorbid internalizing and externalizing problems on heart rate levels were additionally assessed. Longitudinal analysis showed that heart rate levels were overall higher in the ADHD group (p children with ADHD showed higher activity levels during daytime (especially early afternoon), but not during nighttime (p children with ADHD as compared to controls, with higher heart rate levels in the ADHD group. Nighttime tachycardia in this group could not be explained by nighttime activity levels or comorbid externalizing/internalizing problems. Further research on autonomic functioning in ADHD is recommended because of the major impact of higher resting heart rate on health outcomes.

  7. Renal Hemodynamic Effects of Serelaxin in Patients With Chronic Heart Failure A Randomized, Placebo-Controlled Study

    NARCIS (Netherlands)

    Voors, Adriaan A.; Dahlke, Marion; Meyer, Sven; Stepinska, Janina; Gottlieb, Stephen S.; Jones, Andrew; Zhang, Yiming; Laurent, Didier; Slart, Riemer H. J. A.; Navis, Gerjan J.

    2014-01-01

    Background-Serelaxin is a promising therapy for acute heart failure. The renal hemodynamic effects of serelaxin in patients with chronic heart failure are unknown. Methods and Results-In this double-blind, randomized, placebo-controlled, multicenter study, patients with New York Heart Association Cl

  8. Community-based case-control study of childhood stroke risk associated with congenital heart disease

    OpenAIRE

    Fox, CK; Sidney, S.; Fullerton, HJ

    2015-01-01

    © 2015 American Heart Association, Inc. BACKGROUND AND PURPOSE - : A better understanding of the stroke risk factors in children with congenital heart disease (CHD) could inform stroke prevention strategies. We analyzed pediatric stroke associated with CHD in a large community-based case-control study. METHODS - : From 2.5 million children (aged 30-fold (odds ratio, 31; confidence interval 4-241) increased risk of stroke in children with CHD when compared with controls. After excluding periop...

  9. Defective support network: a major obstacle to coping for patients with heart failure: a qualitative study

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    Parvin Mangolian Shahrbabaki

    2016-04-01

    Full Text Available Background: Heart failure as a chronic disease poses many challenges for a patient in his or her everyday life. Support in various aspects of life positively affects coping strategies and influences the well-being and health outcomes of heart failure patients. Inadequate support may lead to a worsening of symptoms, increased hospital readmissions, psychological disorders, and a reduced quality of life. Objective: This study explored obstacles to coping related to support for heart failure patients as viewed by the patients themselves and their family members and caregivers. Design: This qualitative study was conducted using content analysis. The 20 Iranian participants included 11 patients with heart failure, three cardiologists, three nurses, and three family members of heart failure patients selected through purposive sampling. Data were collected through semi-structured interviews and analyzed using the Lundman and Graneheim qualitative content analysis method. Results: During data analysis, ‘defective support network’ developed as the main theme along with four other categories of ‘inadequate family performance’, ‘inadequate support by the healthcare team’, ‘distorted societal social support’, and ‘inadequate welfare support’. Conclusion: The findings of the current study can assist health authorities and planners in identifying the needs of patients with heart failure so as to focus and plan on facilitating their coping as much as possible by obviating the existing obstacles.

  10. The effect of competition on heart rate during kart driving: A field study

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    Yamakoshi Takehiro

    2011-09-01

    Full Text Available Abstract Background Both the act of competing, which can create a kind of mental stress, and participation in motor sports, which induces physical stress from intense g-forces, are known to increase heart rate dramatically. However, little is known about the specific effect of competition on heart rate during motor sports, particularly during four-wheel car driving. The goal of this preliminary study, therefore, was to investigate whether competition increases heart rate under such situations. Findings The participants drove an entry-level formula kart during two competitive races and during solo driving against the clock while heart rate and g-forces were measured. Analyses showed that heart rate values during the races (168.8 beats/min were significantly higher than those during solo driving (140.9 beats/min and rest (75.1 beats/min. Conclusions The results of this preliminary study indicate that competition heightens heart rate during four-wheel car driving. Kart drivers should be concerned about maintaining good health and developing physical strength.

  11. General practitioners' reasoning when considering the diagnosis heart failure: a think-aloud study

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    Bring Johan

    2005-01-01

    Full Text Available Abstract Background Diagnosing chronic heart failure is difficult, especially in mild cases or early in the course of the disease, and guidelines are not easily implemented in everyday practice. The aim of this study was to investigate general practitioners' diagnostic reasoning about patients with suspected chronic heart failure in comparison with recommendations in European guidelines. Methods Think-aloud technique was used. Fifteen general practitioners reasoned about six case vignettes, representing authentic patients with suspected chronic heart failure. Information about each case was added successively in five steps. The general practitioners said their thoughts aloud while reasoning about the probability of the patient having chronic heart failure, and tried to decide about the diagnosis. Arguments for and against chronic heart failure were analysed and compared to recommendations in guidelines. Results Information about ejection fraction was the most frequent diagnostic argument, followed by information about cardiac enlargement or pulmonary congestion on chest X-ray. However, in a third of the judgement situations, no information about echocardiography was utilized in the general practitioners' diagnostic reasoning. Only three of the 15 doctors used information about a normal electrocardiography as an argument against chronic heart failure. Information about other cardio-vascular diseases was frequently used as a diagnostic argument. Conclusions The clinical information was not utilized to the extent recommended in guidelines. Some implications of our study are that 1 general practitioners need more information about how to utilize echocardiography when diagnosing chronic heart failure, 2 guidelines ought to give more importance to information about other cardio-vascular diseases in the diagnostic reasoning, and 3 guidelines ought to treat the topic of diastolic heart failure in a clearer way.

  12. Reduced Dietary Sodium Intake Increases Heart Rate. A Meta-Analysis of 63 Randomized Controlled Trials Including 72 Study Populations

    DEFF Research Database (Denmark)

    Graudal, Niels A; Hubeck-Graudal, Thorbjørn; Jürgens, Gesche

    2016-01-01

    Reduced dietary sodium intake (sodium reduction) increases heart rate in some studies of animals and humans. As heart rate is independently associated with the development of heart failure and increased risk of premature death a potential increase in heart rate could be a harmful side......-effect of sodium reduction. The purpose of the present meta-analysis was to investigate the effect of sodium reduction on heart rate. Relevant studies were retrieved from an updated pool of 176 randomized controlled trials (RCTs) published in the period 1973-2014. Sixty-three of the RCTs including 72 study...... populations reported data on heart rate. In a meta-analysis of these data sodium reduction increased heart rate with 1.65 beats per minute [95% CI: 1.19, 2.11], p sodium reduction...

  13. The Framingham Heart Study, on its way to becoming the gold standard for Cardiovascular Genetic Epidemiology?

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    Jaquish Cashell E

    2007-10-01

    Full Text Available Abstract The Framingham Heart Study, founded in 1948 to examine the epidemiology of cardiovascular disease in a small town outside of Boston, has become the worldwide standard for cardiovascular epidemiology. It is among the longest running, most comprehensively characterized multi-generational studies in the world. Such seminal findings as the effects of smoking and high cholesterol on heart disease came from the Framingham Heart Study. At the time of publication these were novel cardiovascular disease (CVD risk factors, now they are the basis of treatment and prevention in the US. Is the Framingham study now on it's way to becoming the gold standard for genetic epidemiology of CVD? Will the novel genetic findings of today become the health care standards of tomorrow? The accompanying articles summarizing the results of genome-wide association studies (GWAS give the reader a first glimpse into the possibilities.

  14. A Hospital-Based Study on Causes Peculiar to Heart Failure

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    Muhammad Hafizullah

    2009-03-01

    Full Text Available Background: We sought to determine the frequency of the risk factors for congestive cardiac failure (CCF in a tertiary care hospital in Peshawar, Pakistan. Methods: This retrospective, observational study was conducted in the department of cardiology, Postgraduate Medical Institute, Lady Reading Hospital Peshawar, from March 2005 to September 2007. Relevant information regarding the risk factors of CCF was recorded on questionnaires, devised in accordance with the objectives of the study. Results: This study recruited 1019 patients with an established diagnosis of CCF on the basis of clinical findings and pertinent investigations. The study population comprised 583 (57.12% men and 436 (42.78% women. The patients’ age ranged from 6 years to 82 years with a mean age of 48.5 years and a mode of age of 45 years. The distribution of the causative factors of CCF was as follows: ischemic heart disease in 38.56%; hypertension in 26.30%; dilated cardiomyopathies in 10.10%; obstructive and restrictive cardiomyopathies in 5.39%; valvular heart diseases in 9.32%; congenital heart diseases like ventricular septal defects and atrial septal defects in 4.41% and 0.58%, respectively; constrictive pericarditis in 1.07%; pericardial effusion in 0.68%; chronic obstructive pulmonary disease and pulmonary hypertension in 1.47%; thyrotoxicosis in 0.68%; complete heart block in 0.29%; and Paget’s disease in 0.09% of the cases.Conclusion: Ischemic heart disease, hypertension, cardiomyopathy, valvular heart disease, and congenital heart disease were the major contributors to CCF in our patients.

  15. Reduced Dietary Sodium Intake Increases Heart Rate. A Meta-Analysis of 63 Randomized Controlled Trials Including 72 Study Populations

    DEFF Research Database (Denmark)

    Graudal, Niels A; Hubeck-Graudal, Thorbjørn; Jürgens, Gesche

    2016-01-01

    Reduced dietary sodium intake (sodium reduction) increases heart rate in some studies of animals and humans. As heart rate is independently associated with the development of heart failure and increased risk of premature death a potential increase in heart rate could be a harmful side...... increases heart rate by as much (2.4%) as it decreases blood pressure (2.5%). This side-effect, which may cause harmful health effects, contributes to the need for a revision of the present dietary guidelines....

  16. Alcohol consumption and risk of atrial fibrillation in men and women: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Mukamal, KJ; Tolstrup, JS; Friberg, J;

    2005-01-01

    and incident atrial fibrillation among 16,415 women and men enrolled in the Copenhagen City Heart Study. We ascertained use of beer, wine, and spirits individually at up to 3 study visits with a structured questionnaire. We identified cases of atrial fibrillation by routine study ECGs and a validated...... not attenuate the association (hazard ratio 1.63; 95% CI 1.15 to 2.31). CONCLUSIONS: Heavy alcohol consumption is associated with a higher risk of atrial fibrillation, at least among men. This relationship does not appear to be related to the adverse effects of heavy drinking on coronary heart disease or blood...

  17. Observed Prevalence of Congenital Heart Defects From a Surveillance Study in China

    Science.gov (United States)

    Zhang, Yali; Riehle-Colarusso, Tiffany; Correa, Adolfo; Li, Song; Feng, Xinheng; Gindler, Jacqueline; Lin, Hui; Webb, Catherine; Li, Wei; Trines, Jean; Berry, Robert J.; Yeung, Lorraine; Luo, Ying; Jiang, Meifang; Chen, Hua; Sun, Xiamei; Li, Zhu

    2015-01-01

    Objectives The purpose of this study was to estimate the prevalence of major and minor congenital heart defects among fetuses and neonates using sonography in a general population of 4 areas surrounding Shanghai, China. Methods Pregnant women were recruited between April 2004 and December 2005 in Jiaxing City, Suzhou City, Changshu County, and Haining County. All participants could have 3 sonographic examinations performed by specially trained physicians regardless of medical indication: a fetal sonographic screen and fetal echocardiography between 20 and 28 weeks’ gestation and neonatal echocardiography. Diagnoses of congenital heart defects were made on the basis of review of all available scans by an international group of experts in pediatric cardiology. Prevalence rates were calculated per 1000 births. Results Among 4006 scanned fetuses and neonates, there were 75 congenital heart defects, including 12 major defects. The observed prevalence for all congenital heart defects was 18.7 (95% confidence interval, 14.8–23.5) per 1000 births, and the prevalence for major defects was 3.0 (95% confidence interval, 1.6–5.2) per 1000 births. The most common defects were ventricular septal defects (n = 47 [62.7%]), atrial septal defects (n = 14 [18.7%]), tetralogy of Fallot (n = 4 [5.3%]), and hypoplastic left heart syndrome (n = 3 [4.0%]). Conclusions The prevalence of all congenital heart defects in the 4 areas of China studied was higher than that reported in other countries, with ventricular septal defects being the most frequent defects. Our data likely reflect a better estimate of the total prevalence of congenital heart defects in China than reported previously. PMID:21705732

  18. Therapeutic patient education in heart failure: do studies provide sufficient information about the educational programme?

    Science.gov (United States)

    Albano, Maria Grazia; Jourdain, Patrick; De Andrade, Vincent; Domenke, Aukse; Desnos, Michel; d'Ivernois, Jean-François

    2014-05-01

    Therapeutic patient education programmes on heart failure have been widely proposed for many years for heart failure patients, but their efficiency remains questionable, partly because most articles lack a precise programme description, which makes comparative analysis of the studies difficult. To analyse the degree of precision in describing therapeutic patient education programmes in recent randomized controlled trials. Three major recent recommendations on therapeutic patient education in heart failure inspired us to compile a list of 23 relevant items that an 'ideal' description of a therapeutic patient education programme should contain. To discover the extent to which recent studies into therapeutic patient education in heart failure included these items, we analysed 19 randomized controlled trials among 448 articles published in this field from 2005 to 2012. The major elements required to describe a therapeutic patient education programme were present, but some other very important pieces of information were missing in most of the studies we analysed: the patient's educational needs, health literacy, projects, expectations regarding therapeutic patient education and psychosocial status; the educational methodology used; outcomes evaluation; and follow-up strategies. Research into how therapeutic patient education can help heart failure patients will be improved if more precise descriptions of patients, educational methodology and evaluation protocols are given by authors, ideally in a standardized format.

  19. Experiences of Patients Living With Heart Failure: A Descriptive Qualitative Study.

    Science.gov (United States)

    Seah, Alvin Chuen Wei; Tan, Khoon Kiat; Huang Gan, Juvena Chew; Wang, Wenru

    2016-07-01

    The purpose of this study was to explore the experiences, needs, and coping strategies of patients living with heart failure in Singapore. A descriptive qualitative design was used. A purposive sample of 15 informants was recruited from two cardiology wards of a tertiary public hospital in Singapore. Individual face-to-face interviews were conducted with a semistructured interview guideline that was developed based on a review of the literature and a pilot study. Content analysis was adopted to analyze the data, and four main categories were identified: perceived causes, manifestations, and prognosis; enduring emotions; managing the condition; and needs from health care professionals. The informants were overwhelmed with the experience of living with heart failure due to the disruptive and uncertain nature of the condition. This study offers health care professionals practical and useful suggestions when providing holistic care for patients with heart failure.

  20. NMR Study of Damage on Isolated Perfused Rat Heart Exposed to Ischemia and Hypoxia

    Institute of Scientific and Technical Information of China (English)

    罗雪春; 闫永彬; 张日清; 王小寅; 范礼理

    2001-01-01

    Myocardial ischemia is the most common and primary cause of myocardium damage. Numerous conventional techniques and methods have been developed for ischemia and reperfusion studies. However, because of damage to the heart sample, most of these techniques can not be used to continuously monitor the full dynamic course of the myocardial metabolic pathway. The nuclear magnetic resonnance (NMR) surface coil technique, which overcomes the limitations of conventional instrumentation, can be used to quantitatively study every stage of the perfused heart (especially after perfusion stoppage) continuously, dynamically, and without damage under normal or designed physiological conditions at the molecular level. In this paper, 31p-NMR was used to study the effects of ischemia and hypoxia on isolated perfused hearts. The results show that complete hypoxia caused more severe functional damage to the myocardial cells than complete ischemia.

  1. Characteristics and outcomes for right heart endocarditis: six-year cohort study.

    Science.gov (United States)

    Wang, Tom Kai Ming; Oh, Timothy; Voss, Jamie; Pemberton, James

    2014-07-01

    Right heart endocarditis makes up 5-10% of all infective endocarditis involving valvular, congenital and artificial structures. Given the limited literature in this area, we reviewed the characteristics, management and outcomes of this condition in this retrospective cohort study. Thirty-five patients with right heart endocarditis admitted to Auckland City Hospital during 2005-2010 were followed-up for 3.4+/-2.5 years. In-hospital mortality was 11.4% (4), all occurring in those treated medically (20.0% (4) vs 0.0% (0), P=0.119). Surgical intervention was independently associated with reduced long-term mortality (HR 0.078, 95%CI 0.010-0.609, P=0.015) in multivariate analysis, while concurrent left heart endocarditis predicted both in-hospital mortality (HR 11.0, 95%CI 1.18-102, P=0.027) and long-term mortality (HR 3.20, 95%CI 1.03-9.92, P=0.044). Our study showed that surgical intervention and concomitant left heart endocarditis are positive and negative prognostic factors for outcomes after right heart endocarditis.

  2. Heart rate changes during partial seizures: A study amongst Singaporean patients

    Directory of Open Access Journals (Sweden)

    Lim Shih-Hui

    2001-09-01

    Full Text Available Abstract Introduction Studies in Europe and America showed that tachycardia, less often bradycardia, frequently accompanied partial seizures in Caucasian patients. We determine frequency, magnitude and type of ictal heart rate changes during partial seizures in non-Caucasian patients in Singapore. Methods Partial seizures recorded during routine EEGs performed in a tertiary hospital between 1995 and 1999 were retrospectively reviewed. All routine EEGs had simultaneous ECG recording. Heart rate before and during seizures was determined and correlated with epileptogenic focus. Differences in heart rate before and during seizures were grouped into 4 types: (1 >10% decrease; (2 -10 to +20% change; (3 20–50% increase; (3 >50% increase. Results Of the total of 37 partial seizures, 18 were left hemisphere (LH, 13 were right hemisphere (RH and 6 were bilateral (BL in onset. 51% of all seizures showed no significant change in heart rate (type 2, 22% had moderate sinus tachycardia (type 3, 11% showed severe sinus tachycardia (type 4, while 16% had sinus bradycardia (type 1. Asystole was recorded in one seizure. Apart from having more tachycardia in bilateral onset seizures, there was no correlation between side of ictal discharge and heart rate response. Compared to Caucasian patients, sinus tachycardia was considerably less frequent. Frequency of bradycardia was similar to those recorded in the literature. Conclusions Significant heart rate changes during partial seizures were seen in half of Singaporean patients. Although sinus tachycardia was the most common heart rate change, the frequency was considerably lower compared to Caucasian patients. This might be due to methodological and ethnic differences. Rates of bradycardia are similar to those recorded in the literature.

  3. [Pharmacotherapy of patients with chronic heart failure. Analysis of multicenter international studies].

    Science.gov (United States)

    Chekman, I S

    2008-01-01

    Leterature data and own investigations are summarized in the article. New experimental facts about mechanism of action of cardiac glycosides (especially digoxin) were obtained last year. It was shown that in human organism there are endogenous cardiosteroids (digitalis-like substances, endogenous oubain and other). They are in different organs (adrenal glands, hypothalamus, pituitary gland) and have influence on different organs and systems. Indications, contraindications, side effects, interactions with other drugs have been studied by cardiologists. Results of international multicentere studies demonstrate high efficacy of digoxin in treatment of chronic heart failure caused by compromised contractile activity of myocardium, atrium fibrillation and is used for controlling number of heart contractions and supraventricular paroxysmal tachycardia. More than 200 years history of scientific researches and clinical use of cardiac glycosides show that this group of medicine may be applied in a combine pharmacotherapy of chronic heart failure together with antihypertensive drugs.

  4. The contribution of observational studies to the knowledge of drug effectiveness in heart failure

    NARCIS (Netherlands)

    Dobre, Daniela; van Veldhuisen, Dirk J.; deJongste, Mike J. L.; van Sonderen, Eric; Klungel, Olaf H.; Sanderman, Robbert; Ranchor, Adelita V.; Haaijer-Ruskamp, Flora M.

    2007-01-01

    Randomized controlled trials (RCTs) are the golden standard for the assessment of drug efficacy. Little is known about the add-on value of observational studies in heart failure (HF). We aimed to assess the contribution of observational studies to actual knowledge regarding the effectiveness of angi

  5. Metabolomic Profiling in Relation to New-Onset Atrial Fibrillation (from the Framingham Heart Study)

    NARCIS (Netherlands)

    Ko, Darae; Riles, Eric M.; Marcos, Ernaldo G.; Magnani, Jared W.; Lubitz, Steven A.; Lin, Honghuang; Long, Michelle T.; Schnabel, Renate B.; McManus, David D.; Ellinor, Patrick T.; Ramachandran, Vasan S.; Wang, Thomas J.; Gerszten, Robert E.; Benjamin, Emelia J.; Yin, Xiaoyan; Rienstra, Michiel

    2016-01-01

    Previous studies have shown several metabolic biomarkers to be associated with prevalent and incident atrial fibrillation (AF), but the results have not been replicated.. We investigated metabolite profiles of 2,458 European ancestry participants from the Framingham Heart Study without AF at the ind

  6. Cognition and Incident Coronary Heart Disease in Late Midlife: The Whitehall II Study

    Science.gov (United States)

    Singh-Manoux, Archana; Sabia, Severine; Kivimaki, Mika; Shipley, Martin J.; Ferrie, Jane E.; Marmot, Michael G.

    2009-01-01

    The purpose of this study was to investigate whether cognitive function in midlife predicts incident coronary heart disease (CHD), followed up over 6 years. Data on 5292 (28% women, mean age 55) individuals free from CHD at baseline were drawn from the British Whitehall II study. We used Cox regression to model the association between cognition…

  7. Effects of Nesiritide and Predictors of Urine Output in Acute Decompensated Heart Failure Results From ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure)

    NARCIS (Netherlands)

    Gottlieb, Stephen S.; Stebbins, Amanda; Voors, Adriaan A.; Hasselblad, Vic; Ezekowitz, Justin A.; Califf, Robert M.; O'Connor, Christopher M.; Starling, Randall C.; Hernandez, Adrian F.

    2013-01-01

    Objectives This study sought to determine if nesiritide increases diuresis in congestive heart failure patients. Background In the ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure), 7,141 patients hospitalized with acute decompensated heart failure (ADHF

  8. Functional Study of the Heart using MRI and Multi-slice CT (MSCT

    Directory of Open Access Journals (Sweden)

    "Sh. Akhlaghpour

    2005-08-01

    Full Text Available Introduction & Background: By using newer imaging techniques (MRI and MSCT, it is possible to perform functional studies of the heart including, wall mo-tion, chamber volume evaluation, and myocardial mass and wall thickness. While MRI had recently been introduced as the gold standard method for the morphological and functional studies of the heart, recent advances in the number of detectors, rotation time, and reconstruction protocols made Multislice CT (MSCT another new application for functional studies of the heart too. Ordinary raw data for coro-nary CT angiography is sufficient for these functional studies. Apart from the point that which technique is to be used to get a standard and reproducible meas-urement, a proper imaging strategy is necessary. To use MSCT, various softwares are available for these studies. By the use of these two modalities, valvular evaluations are also possible as addressed in many recent publications. In this article the strategy for functional study of the heart is presented and some case studies are also discussed.

  9. Profile and risk factors for congenital heart defects: A study in a tertiary care hospital

    Science.gov (United States)

    Abqari, Shaad; Gupta, Akash; Shahab, Tabassum; Rabbani, MU; Ali, S Manazir; Firdaus, Uzma

    2016-01-01

    Introduction: Congenital heart defects (CHDs) are an important cause of mortality and morbidity in children representing a major global health burden. It is thus important to determine their prevalence and spectrum and identify risk factors associated with the development of heart defects. Materials and Methods: A case-control study was carried out in the Department of Pediatrics and Center of Cardiology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, from February 2014 to August 2015. All patients referred with complaints or clinical examination suggestive of CHDs were further evaluated with echocardiography. On Echocardiography, patients having CHDs were included as cases and those having a normal echocardiographic study were included as controls. Healthy controls were also included. 400 cases and 400 controls were thus identified; preterms having patent ductus arteriosus and patent foramen ovale and those with acquired heart defects were excluded. Risk factors among cases and controls were further studied. Results: Acyanotic heart defects were 290 (72.50%) of the total heart defects, whereas the contribution of cyanotic heart defects was 110 (27.50%). Out of all CHDs, ventricular septal defect was the most common lesion with contribution of 152 (38%) cases, whereas among the cyanotic heart defects, Tetralogy of Fallot was the most common lesion (18% of total cases). Out of the total 400 cases, 261 were males (65.25%). On univariate analysis, paternal age (odds ratio, OR, 2.01), bad obstetric history (OR, 2.65), antenatal febrile illness (OR, 4.12), and advanced maternal age (OR, 3.28) were found to increase the risk of CHD whereas intake of multivitamin (OR, 3.02) was found to be protective. The risk factors were further analyzed with multivariate logistic regression analysis and all the above factors were found to be significantly associated. Conclusion: We noted that the profile of CHD in our population was similar

  10. Self-reported stress and risk of stroke: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Truelsen, Thomas; Nielsen, Naja; Boysen, Gudrun;

    2003-01-01

    the association between self-reported stress frequency and intensity and risk of stroke. METHODS: Data from the second examination, 1981 to 1983, of participants in the Copenhagen City Heart Study were analyzed with Cox regression after a mean of 13 years of follow-up. A total of 5604 men and 6970 women were...

  11. Predictors of arrhythmic sudden cardiac death in heart failure patients in the CARE-HF study

    DEFF Research Database (Denmark)

    Uretsky, B.; Cleland, J.G.F.; Freemantle, N.

    2006-01-01

    Topic(s):Rsynchronisation therapy   Cardiac resynchronization therapy (CRT) has become an important modality to improve symptoms, exercise performance, and survival in patients with severe heart failure and left ventricular dyssynchrony. The CARE-HF study showed that CRT reduced mortality in syst...

  12. Adiponectin: an independent risk factor for coronary heart disease in men in the Framingham Offspring Study

    Science.gov (United States)

    Our aim was to determine whether plasma adiponectin levels were an independent predictor of coronary heart disease (CHD) risk. Plasma adiponectin levels were measured in 3,188 male and female participants from cycle 6 of the Framingham Offspring Study (mean age: 57 years in both men and women; BMI:...

  13. Prevalence of heart failure and left ventricular dysfunction in the general population; The Rotterdam Study

    NARCIS (Netherlands)

    A. Mosterd (Arend); A.W. Hoes (Arno); M.C. de Bruyne (Martine); D.T. Linker (David); D.E. Grobbee (Diederick); J.W. Deckers (Jaap); A. Hofman (Albert)

    1999-01-01

    textabstractAIMS: To determine the prevalence of heart failure and symptomatic as well as asymptomatic left ventricular systolic dysfunction in the general population. METHODS AND RESULTS: In 5540 participants of the Rotterdam Study (age 68.9+/-8.7 years, 2251 men) aged

  14. Psychosocial risk factors and heart failure hospitalization: a prospective cohort study

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Andersen, Ingelise; Prescott, Eva

    2011-01-01

    ,670 participants of the Copenhagen City Heart Study (Denmark) were asked comprehensive questions on major life events, work-related stress, social network, vital exhaustion, and sleep medication and were followed in nationwide registries until 2007, with less than 0.2% loss to follow-up. Almost one...

  15. A longitudinal study in youth of heart rate variability at rest and in response to stress

    NARCIS (Netherlands)

    Li, Zhibin; Snieder, Harold; Su, Shaoyong; Ding, Xiuhua; Thayer, Julian F.; Treiber, Frank A.; Wang, Xiaoling

    2009-01-01

    Background: Few longitudinal studies have examined ethnic and sex differences, predictors and tracking stabilities of heart rate variability (HRV) at rest and in response to stress in youths and young adults. Methods: Two evaluations were performed approximately 1.5 years apart on 399 youths and you

  16. Troponin I in acute decompensated heart failure : insights from the ASCEND-HF study

    NARCIS (Netherlands)

    Felker, G. Michael; Hasselblad, Vic; Tang, W. H. Wilson; Hernandez, Adrian F.; Armstrong, Paul W.; Fonarow, Gregg C.; Voors, Adriaan A.; Metra, Marco; McMurray, John J. V.; Butler, Javed; Heizer, Gretchen M.; Dickstein, Kenneth; Massie, Barry M.; Atar, Dan; Troughton, Richard W.; Anker, Stefan D.; Califf, Robert M.; Starling, Randall C.; O'Connor, Christopher M.

    2012-01-01

    We examined the prognostic importance of cardiac troponin I (cTnI) in a cohort of patients enrolled in the ASCEND-HF study of nesiritide in acute decompensated heart failure (ADHF). Circulating troponins are a prognostic marker in patients with ADHF. Contemporary assays with greater sensitivity requ

  17. Study on hemodynamic status in congenital heart disease. 2. Volume study and amplitude study by radionuclide angiocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Hamada, Rousei; Nonaka, Zenji; Kan, Zuishou

    1987-01-01

    Hemodynamic characteristics of congenital heart disease with left to right shunt were studied by gated blood-pool studies in 45 children with congenital heart disease (19 cases of atrial septal defect: ASD, 20 cases of ventricular septal defect: VSD, and 16 cases of patent ductus arteriosus: PDA) and 20 cases with normal cardiac function as a control group. Volume ratio (VR) was culculated as the ratio of right/left ventricular radioactivity counts. Amplitude ratio (AR) was culculated as the ratio of right/left ventricular mean amplitudes. In control group VR was 0.96 +- 0.16 (mean value +- standard deviation), and AR was 0.63 +- 0.10. In ASD group VR was 1.50 +- 0.32, and AR was 0.75 +- 0.14. In VSD group VR was 0.64 +- 0.14, and AR was 0.52 +- 0.11. In PDA group VR was 0.42 +- 0.13, and AR was 0.52 +- 0.11. Statistical analyses showed that there were significant differences among four groups about VR and AR respectively. In conclusion, radionuclide angiocardiography is noninvasive and valuable for hemodyanmic studies of children with congenital heart disease, especially for differential diagnoses among them.

  18. Benefits of exercise training in the treatment of heart failure: study with a control group

    Directory of Open Access Journals (Sweden)

    Silva Mário Sérgio Vaz da

    2002-01-01

    Full Text Available OBJECTIVE: Exercise training programs have been proposed as adjuncts to treatment of heart failure. The effects of a 3-month-exercise-training-program with 3 exercise sessions per week were assessed in patients with stable systolic chronic heart failure. METHODS: We studied 24 patients with final left ventricle diastolic diameter of 70±10mm and left ventricular ejection fraction of 37±4%. Mean age was 52±16 years. Twelve patients were assigned to an exercise training group (G1, and 12 patients were assigned to a control group (G2. Patients underwent treadmill testing, before and after exercise training, to assess distance walked, heart rate, systolic blood pressure, and double product. RESULTS: In G2 group, before and after 3 months, we observed, respectively distance walked, 623±553 and 561± 460m (ns; peak heart rate, 142±23 and 146± 33b/min (ns; systolic blood pressure, 154±36 and 164±26 mmHg (ns; and double product, 22211± 6454 and 24293±7373 (ns. In G1 group, before and after exercise, we observed: distance walked, 615±394 and 970± 537m (p<0.003 peak heart rate, 143±24 and 143±29b/min (ns; systolic blood pressure, 136±33 and 133±24 mmHg (ns; and double product, 19907± 7323 and 19115±5776, respectively. Comparing the groups, a significant difference existed regarding the variation in the double product, and in distance walked. CONCLUSION: Exercise training programs in patients with heart failure can bring about an improvement in physical capacity.

  19. Physical fitness and telomere length in patients with coronary heart disease: findings from the Heart and Soul Study.

    Directory of Open Access Journals (Sweden)

    Jeffrey Krauss

    Full Text Available BACKGROUND: Short telomere length (TL is an independent predictor of mortality in patients with coronary heart disease (CHD. However, the relationship between physical fitness and TL has not been explored in these patients. METHODS: In a cross sectional study of 944 outpatients with stable CHD, we performed exercise treadmill testing, assessed self-reported physical activity, and measured leukocyte TL using a quantitative PCR assay. We used generalized linear models to calculate mean TL (T/S ratio, and logistic regression models to compare the proportion of patients with short TL (defined as the lowest quartile, among participants with low, medium and high physical fitness, based on metabolic equivalent tasks achieved (METs. RESULTS: 229 participants had low physical fitness (7 METS. Mean ± T/S ratio ranged from 0.86±0.21 (5349±3781 base pairs in those with low physical fitness to 0.95±0.23 (5566±3829 base pairs in those with high physical fitness (p<.001. This association remained strong after adjustment for numerous patient characteristics, including measures of cardiac disease severity and physical inactivity (p = 0.005. Compared with participants with high physical fitness, those with low physical fitness had 2-fold greater odds of having TL in the lowest quartile (OR 2.39, 95% CI 1.60-3.55; p<.001. This association was similar after multivariable adjustment (OR 1.94, 95%CI, 1.18-3.20; p = 0.009. Self-reported physical inactivity was associated with shorter TL in unadjusted analyses, but not after multivariable adjustment. CONCLUSIONS: We found that worse objectively-assessed physical fitness is associated with shorter leukocyte telomere length in patients with CHD. The clinical implications of this association deserve further study.

  20. Heart rate variability and particulate exposure in vehicle maintenance workers: a pilot study.

    Science.gov (United States)

    Eninger, Robert M; Rosenthal, Frank S

    2004-08-01

    The association between occupational exposure to PM(2.5) and heart rate variability was investigated in a repeated measures, longitudinal study of vehicle maintenance workers occupationally exposed to automobile emissions. Five subjects were monitored for occupational exposure to fine particulate matter (PM(2.5)) on 6 workdays using an aerosol photometer, validated with side-by-side sampling with a gravimetric method. End-of-day heart rate variability statistics were derived using short-term electrocardiogram recordings for each participant. Workplace carbon monoxide and outdoor, ambient fine particulate matter were also monitored. Regression statistics were used to investigate associations between same-day PM(2.5) levels and heart rate variability statistics using mixed-effects multiple regression of pooled data. No statistically significant associations were observed between occupational PM(2.5) and measures of heart rate variability. A statistically significant increase in total spectral power was associated with ambient PM(2.5) (p < 0.05). The data suggest a threshold below which no degradation in cardiac autonomic control of healthy workers occurs when challenged by occupational PM(2.5) exposure. This study was limited in population, exposure level, and type of particulate exposures. Additional studies are recommended on broader occupational populations.

  1. NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve : a multicentre PROSTAVA study

    NARCIS (Netherlands)

    Schoonbeek, R C; Pieper, P G; van Slooten, Y J; Freling, H G; Sieswerda, G T; van Dijk, A. P. J.; Jongbloed, M R M; Post, M. C.; Bouma, B. J.; Berger, R M F; Ebels, T; van Melle, J P

    2016-01-01

    OBJECTIVES: N-terminal B‑type natriuretic peptide (NT-proBNP) is an important biomarker for the detection of heart failure. Adults with congenital heart disease (ACHD) and a prosthetic heart valve are at risk for heart failure. This study aimed to determine the value of NT-proBNP in ACHD patients wi

  2. Heart Health - Brave Heart

    Science.gov (United States)

    ... Robert's (left) three heart attacks, he and his wife Sue began volunteering for The Mended Hearts, a ... arrest. "It scared the heck out of my wife," Robert remembers. He was operated on and doctors ...

  3. Sugar Companies Shifted Focus to Fat as Heart Harm: Study

    Science.gov (United States)

    ... sugar increased, a trade group for the sugar industry -- the Sugar Research Foundation -- commissioned a research review by Harvard ... also served on scientific advisory boards for the sugar industry, the authors of the new study said. Besides ...

  4. Barriers and facilitators to palliative care of patients with chronic heart failure in Germany: a study protocol

    Directory of Open Access Journals (Sweden)

    Stefan Köberich

    2015-07-01

    Full Text Available Background. Despite its high prevalence, similar symptoms and symptom burden, people suffering from chronic heart failure receive less palliative care than patients with malignant diseases. Internationally, numerous barriers to palliative care of patients with chronic heart failure are known, however, there are no credible data regarding barriers and facilitators to palliative care of people suffering from chronic heart failure available for Germany. Design and Methods. Tripartite study. First part of this study evaluates health care providers’ (physicians and nurses perceived barriers and facilitators to palliative care of patients with chronic heart failure using a qualitative approach. At least 18 persons will be interviewed. In the second part, based on the results of part one, a questionnaire about barriers and facilitators to palliative care of patients with chronic heart failure will be designed and applied to at least 150 physicians and nurses. In the last part a classic Delphi method will be used to develop specific measures to improve the palliative care for chronic heart failure patients. Expected Impact for Public Health. The results of this study will help to understand why patients with heart failure are seldom referred to palliative care and will provide solutions to overcome these barriers. Developed solutions will be the first step to improve palliative care in patients with heart failure in Germany. In addition, the results will help health care providers in other countries to take action to improve palliative care situations for heart failure patients.

  5. A case-control study of determinants for the occurrence of gouty arthritis in heart failure patients

    NARCIS (Netherlands)

    Hueskes, B.A.; Willems, F.F.; Leen, A.C.; Ninaber, P.A.; Westra, R.; Mantel-Teeuwisse, A.K.; Janssens, H.; Lisdonk, E.H. van de; Roovers, E.A.; Janssen, M.

    2012-01-01

    AIMS: Gouty arthritis is a frequent and disabling complication in heart failure patients. This study aimed to investigate which factors are associated with the occurrence of gouty arthritis in these patients. METHODS AND RESULTS: A case-control study was performed in heart failure patients (February

  6. Risk of Coronary Heart Disease among HIV-Infected Patients: A Multicenter Study in Brazil

    Directory of Open Access Journals (Sweden)

    Sandra C. Fuchs

    2013-01-01

    Full Text Available Cardiovascular disease has emerged as a crescent problem among HIV-infected population. This study aimed to determine the 10-year risk of coronary heart disease using the Framingham risk score among HIV-infected patients from three regions of Brazil. This is a pooled analysis of three cohort studies, which enrolled 3,829 individuals, 59% were men, 66% had white skin color, and mean age 39.0 ± 9.9 years. Comparisons among regions showed that there were marked differences in demographic, socioeconomic, clinical, and HIV-related characteristics. Prevalence of Framingham score ≥10 was 4.5% in the Southern, 4.2% in the Midwest, and 3.9% in the Northeast of Brazil. The Framingham score ≥10 was similar between regions for males, patients aged ≥60 years, with obesity, central obesity, hypertension, and diabetes mellitus. Women were three times more likely to have coronary heart disease in 10 years than men. Hypertension and diabetes increased more than four times the risk of coronary heart disease, followed by central obesity, obesity, and prehypertension. The use of antiretroviral agents and time since HIV diagnosis were not risk factors for coronary artery disease in 10 years. In conclusion, hypertension and diabetes are the strongest independent predictors of 10-year risk of coronary heart disease among HIV-infected population.

  7. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008275 Relationship of calcineure in mRNA level in peripheral blood and cardiac muscle of patients with heart failure.WANG Mengmeng(王萌萌),et al.Dept Cardiol,Shandong Prov Hosp,Shandong Univ,Jinan 250021.Chin Cir J 2008;23(2):113-116.Objective To study the relationship of calcineurin mRNA level between peripheral lymphocytes and cardiac muscles of patients with chronic heart failure.Methods

  8. Diabetes and Cardiovascular Disease: Original Insights from the Framingham Heart Study

    OpenAIRE

    Qazi, Mohammad U.; Malik, Shaista

    2013-01-01

    The role of diabetes in the pathogenesis of cardiovascular disease (CVD) was unclear until 1979 when Kannel et al used data from the Framingham Heart Study (FHS) to identify diabetes as a major cardiovascular risk factor. It was also one of the first studies to demonstrate the higher risk of CVD in women with diabetes compared to men with diabetes. Since then, multiple studies have been done to recognize and curtail cardiovascular risk factors such as smoking, obesity, hypertension, hyperlipi...

  9. Studies of citric acid metabolism in heart muscle

    NARCIS (Netherlands)

    Meduski, J.W.

    1950-01-01

    1. The pentabromoacetone method for the determination of citric acid was studied; a modification of the procedure of Natelson, Lugovoy and Pincus was used. 2. Two tissue preparations were obtained. The first by washing with water, the second by washing with water and then with 0.5% sodium bicarbo

  10. Vitamin D biology and heart failure : Clinical and experimental studies

    NARCIS (Netherlands)

    Meems, Laura

    2015-01-01

    In the last decade, vitamin D biology has been studied more extensively than ever before.. The use of vitamin D supplements is common, and so is determination of plasma vitamin D status. Besides its role in bone homeostasis, vitamin D is thought to be an important player in the development and treat

  11. Positive Affect and Survival in Patients With Stable Coronary Heart Disease : Findings From the Heart and Soul Study

    NARCIS (Netherlands)

    Hoen, Petra W.; Denollet, Johan; de Jonge, Peter; Whooley, Mary A.

    2013-01-01

    Objective: Positive affect can improve survival, but the mechanisms responsible for this association are unknown. We sought to evaluate the association between positive affect and mortality in patients with stable coronary heart disease and to determine biological and behavioral factors that might e

  12. Insulin sensitivity and clustering of coronary heart disease risk factors in young adults. The Northern Ireland Young Hearts Study

    DEFF Research Database (Denmark)

    Andersen, Lars Bo; Boreham, Colin A.G.; Young, Ian S.;

    2006-01-01

    Background. Coronary heart disease (CHD) is usually associated with "clustering" of risk factors. Insulin resistance may cause deleterious changes in several CHD risk factors and is of potential interest in the aetiology of clustered risk. We analyzed how glucose and insulin variables were associ...

  13. Depression and Leukocyte Telomere Length in Patients With Coronary Heart Disease : Data From The Heart and Soul Study

    NARCIS (Netherlands)

    Hoen, Petra W.; de Jonge, Peter; Na, Bee Ya; Farzaneh-Far, Ramin; Epel, Elissa; Lin, Jue; Blackburn, Elizabeth; Whooley, Mary A.

    2011-01-01

    Objective: Shortened telomere length has been associated with mortality in patients with coronary heart disease (CHD) and is considered as an emerging marker of biologic age. Whether depression is associated with telomere length or trajectory has not been evaluated in patients with CHD. Methods: In

  14. Heart rate variability biofeedback as a method for assessing baroreflex function: a preliminary study of resonance in the cardiovascular system.

    Science.gov (United States)

    Vaschillo, Evgeny; Lehrer, Paul; Rishe, Naphtali; Konstantinov, Mikhail

    2002-03-01

    This study describes the use of a biofeedback method for the noninvasive study of baroreflex mechanisms. Five previously untrained healthy male participants learned to control oscillations in heart rate using biofeedback training to modify their heart rate variability at specific frequencies. They were instructed to match computer-generated sinusoidal oscillations with oscillations in heart rate at seven frequencies within the range of 0.01-0.14 Hz. All participants successfully produced high-amplitude target-frequency oscillations in both heart rate and blood pressure. Stable and predictable transfer functions between heart rate and blood pressure were obtained in all participants. The highest oscillation amplitudes were produced in the range of 0.055-0.11 Hz for heart rate and 0.02-0.055 Hz for blood pressure. Transfer functions were calculated among sinusoidal oscillations in the target stimuli, heart rate, blood pressure, and respiration for frequencies at which subjects received training. High and low target-frequency oscillation amplitudes at specific frequencies could be explained by resonance among various oscillatory processes in the cardiovascular system. The exact resonant frequencies differed among individuals. Changes in heart rate oscillations could not be completely explained by changes in breathing. The biofeedback method also allowed us to quantity characteristics of inertia, delay, and speed sensitivity in baroreflex system. We discuss the implications of these findings for using heart rate variability biofeedback as an aid in diagnosing various autonomic and cardiovascular system disorders and as a method for treating these disorders.

  15. Dietary magnesium intake and coronary heart disease risk: A study from Serbia

    Directory of Open Access Journals (Sweden)

    Slavica Stevanović

    2011-08-01

    Full Text Available Aim To assess the relationship between dietary magnesium intakeand the risk of coronary heart disease (CHD. Methods A conducted case-control study included 290 randomly selected cases (mean age 59.98 +/- 10.03 years with first event of an acute coronary syndrome and 290 selected controls paired by sex, age and region (mean age 59.43 +/- 10.10 years admitted to the same hospitals without any suspicion of coronary disease. A diet was assessed by an interviewer-administered semi-quantitative food frequency questionnaire, and magnesium intake was derived from the nutrient database. Results Subjects with coronary heart disease had significantly lower intake of foods containing high levels of magnesium like whole grain (p<0.0001, legumes (p<0.05 and nuts (p<0.05. Lower dietary magnesium intake was found to be positively associated with risk of coronary heart disease (0.027. Conclusion Our findings suggest that dietary intake of magnesium was associated with reduced risk of coronary heart disease among Serbian population.

  16. A comparative study of contractility of the heart ventricle in some ectothermic vertebrates

    Directory of Open Access Journals (Sweden)

    Sergey Kharin

    2009-07-01

    Full Text Available The purpose of this study was to analyze contractility of the heart ventricle in selected reptilian and amphibian species having the same ventricular excitation pattern. Systolic time intervals and indices of contractility of the heart ventricle were measured in anaesthetized frogs, snakes, and tortoises by use of polycardiography. The electromechanical delay was significantly shorter in tortoises compared with the other two species. The isovolumetric contraction time in frogs was approximately twofold longer than in reptiles. The pre-ejection period was the longest in frogs and the shortest in tortoises, whereas snakes were intermediate. The ejection time was slightly longer in tortoises compared with the other two species. The greatest isovolumetric contraction index and the smallest myocardial tension index corresponded to the frog and tortoise heart ventricle, respectively. The intrasystolic index in tortoises was significantly greater than in frogs, whereas quite similar to that in snakes. The frog ventricle had lower contractility compared with the reptilian one. Although ventricular contractility tended to be lower in snakes compared with tortoises, this difference was not statistically significant. Possible causes for these differences are discussed. We suppose a large variety in ventricular contractility among amphibian and reptilian species having the same ventricular activation pattern. This variety may be conditioned by heart anatomy, intracardiac shunting, lifestyles, and habitats. It can only be hypothesized that on the average, ventricular contractility is higher in reptiles compared with amphibians and in chelonians compared with snakes.

  17. [Study of cytotoxicity of bioprosthetic heart valve material and its store solution].

    Science.gov (United States)

    Cheng, S; Shi, Y; Liang, W; Li, W

    1999-09-01

    This study compared the cytotoxicities of bioprosthetic heart valve materials crosslinked by glutaraldehyde, stored in 4% formaldehyde or Hank's solution. Human embryonic pulmonary fibroblasts or L-929 cell culture in vitro were used. Cell proliferative inhibition index(CP II) was calculated for bioprosthetic heart valve materials using different store methods in different rinse periods(before, 10 days, 20 days, 30 days). The results demonstrate: (1) bioprosthetic heart valve materials stored in 4% formaldehyde or in Hank's solution both have significant cytotoxicity, and the longer the rinse time continues, the lower the cytotoxicity declines; (2) HEL cell is more sensitive than L-929 cell in detecting the cytotoxicity of toxic biomaterials but for weak toxic biomaterials the two cell lines are not significanth different; (3) formatldehyde solution increases the cytotoxicity of biomaterials stored in it, but the enhanced cytotoxicity can be easily relieved by rinse. The authors conclude that bioprosthetic heart valve materials have long term significant cytotoxicity and the biomaterial cytotoxicity test using human fibroblasts is more sensitive and precise than other tests.

  18. Depression in primary care patients with coronary heart disease: baseline findings from the UPBEAT UK study.

    Directory of Open Access Journals (Sweden)

    Paul Walters

    Full Text Available An association between depression and coronary heart disease is now accepted but there has been little primary care research on this topic. The UPBEAT-UK studies are centred on a cohort of primary patients with coronary heart disease assessed every six months for up to four years. The aim of this research was to determine the prevalence and associations of depression in this cohort at baseline.Participants with coronary heart disease were recruited from general practice registers and assessed for cardiac symptoms, depression, quality of life and social problems.803 people participated. 42% had a documented history of myocardial infarction, 54% a diagnosis of ischaemic heart disease or angina. 44% still experienced chest pain. 7% had an ICD-10 defined depressive disorder. Factors independently associated with this diagnosis were problems living alone (OR 5.49, 95% CI 2.11-13.30, problems carrying out usual activities (OR 3.71, 95% CI 1.93-7.14, experiencing chest pain (OR 3.27, 95% CI 1.58-6.76, other pains or discomfort (OR 3.39, 95% CI 1.42-8.10, younger age (OR 0.95 per year 95% CI 0.92-0.98.Problems living alone, chest pain and disability are important predictors of depression in this population.

  19. Primary care REFerral for EchocaRdiogram (REFER) in heart failure: a diagnostic accuracy study

    Science.gov (United States)

    Taylor, Clare J; Roalfe, Andrea K; Iles, Rachel; Hobbs, FD Richard; Barton, P; Deeks, J; McCahon, D; Cowie, MR; Sutton, G; Davis, RC; Mant, J; McDonagh, T; Tait, L

    2017-01-01

    Background Symptoms of breathlessness, fatigue, and ankle swelling are common in general practice but deciding which patients are likely to have heart failure is challenging. Aim To evaluate the performance of a clinical decision rule (CDR), with or without N-Terminal pro-B type natriuretic peptide (NT-proBNP) assay, for identifying heart failure. Design and setting Prospective, observational, diagnostic validation study of patients aged >55 years, presenting with shortness of breath, lethargy, or ankle oedema, from 28 general practices in England. Method The outcome was test performance of the CDR and natriuretic peptide test in determining a diagnosis of heart failure. The reference standard was an expert consensus panel of three cardiologists. Results Three hundred and four participants were recruited, with 104 (34.2%; 95% confidence interval [CI] = 28.9 to 39.8) having a confirmed diagnosis of heart failure. The CDR+NT-proBNP had a sensitivity of 90.4% (95% CI = 83.0 to 95.3) and specificity 45.5% (95% CI = 38.5 to 52.7). NT-proBNP level alone with a cut-off need to be revised. PMID:27919937

  20. Association Between Toxoplasma gondii Exposure and Heart Disease: A Case-Control Study

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Salcedo-Jaquez, Misael; Sanchez-Anguiano, Luis Francisco; Hernandez-Tinoco, Jesus; Rabago-Sanchez, Elizabeth; Beristain-Garcia, Isabel; Liesenfeld, Oliver; Estrada-Martinez, Sergio; Perez-Alamos, Alma Rosa; Alvarado-Soto, Ediyair

    2016-01-01

    Background The parasite Toxoplasma gondii causes infections all around the world. Infections with T. gondii are systemic and the parasite can persist in the heart muscle. Very little is known about the impact of T. gondii on patients with heart disease. We determined the association between T. gondii exposure and patients suffering from heart diseases attending in a public hospital in Durango, Mexico; the association of T. gondii exposure with socio-demographic, behavioral, and clinical characteristics of these patients was also investigated. Methods Through a case-control study, we examined the seroprevalence of anti-T. gondii IgG and IgM antibodies in 400 patients with heart diseases and 400 age- and gender-matched controls using enzyme-linked immunoassays. In addition, we analyzed the association of patient characteristics as determined by a standardized questionnaire with T. gondii exposure by bivariate and multivariate analyses. Results Fifty-five (13.8%) of 400 patients and 32 (8.0%) of 400 controls had anti-T. gondii IgG antibodies (odds ratio (OR) = 1.83; 95% confidence interval (CI): 1.15 - 2.90; P = 0.01). High anti-T. gondii IgG levels (> 150 IU/mL) were found in 28 (50.9%) of the 55 positive cases and in 14 (43.8%) of the 32 positive controls (P = 0.51). Anti-T. gondii IgM antibodies were found in 13 (23.6%) of the 55 anti-T. gondii IgG positive patients and in 19 (59.4%) of 32 anti-T. gondii IgG positive controls (OR = 0.21; 95% CI: 0.08 - 0.54; P = 0.0008). Multivariate analysis showed that T. gondii exposure was positively associated with being born out of Durango State (OR = 2.93; 95% CI: 1.40 - 6.13; P = 0.004), and with consumption of alcohol (OR = 2.04; 95% CI: 1.01 - 4.12; P = 0.04). Conclusions Results obtained in this study indicate that T. gondii infection is associated with heart disease, and suggest that heart disease might be related with a chronic infection. This is the first report of an association of T. gondii exposure with alcohol

  1. Congenital Heart Diseases in the Newborns of Diabetic Mothers: an Echocardiographic Study

    Directory of Open Access Journals (Sweden)

    S Rahimpour

    2011-10-01

    Full Text Available Introduction: Despite the discovery of insulin and current improvement in diabetics care, congenital malformations in diabetics are still more frequent than in the general population. The aim of this study was to identify congenital heart dieases (CHD in the newborns of diabetic mothers (IDMS. Methods: In our prospective study, color doppler echocardiography was performed in 75 consecutive full- term newborns of diabetic mothers by GE Vivid3 echocardiographic device. Newborns were classified into two subgroups according to the type of the mothers’ diabetes: pre-gestational and gestational. They were also those were classified into three subgroups according to their birth weight: appropriate, large and small for gestational age. Data analysis was made by Fisher exact test and Chi-Square test. Results: Forty nine (65% and thirty six (35% of subjects were infants of gestational (IGDM and pre-gestational diabetic mothers (IPDM, respectively. Fifty five Newborns (73% were apropriate, fourteen (19% were large and six (8% were small for gestational age. The most common echocardiographic findings included: patent ductus arteriosus (PDA: 54.7%, hypertrophic cardiomyopathy (HCMP: 24%, ventricular septal defect (VSD: 4%, atrial septal defect (ASD: 2.7%, transposition of great arteries (TGA: 1.3% and coarctation of the Aorta (COA: 1.3%. Overall incidence of congenital heart diseases was 9.3 after exclusion of PDA and HCMP cases. The incidence of congenital heart diseases was higher in macrosomic than nonmacrosomic infants of diabetic mothers (P<0.001. Congenital heart diseases were more common in infants of pre-gestational than gestational diabetic mothers (P=0.004. Conclusion: Our results showed that diabetic mothers are at increased risk of giving birth to a newborn with congenital heart disease, and transthoracic echocardiography is recommended for all infants of diabetic mothers.

  2. Fundamental and clinical studies on imaging of adrenergic nervous system of the heart, using radioiodinated metaiodobenzylguanidine

    Energy Technology Data Exchange (ETDEWEB)

    Matsunari, Ichiro (Kanazawa Univ. (Japan). School of Medicine)

    1991-04-01

    The purpose of this study was to investigate the myocardial distribution of radioiodonated metaiodobenzylguanidine (MIBG) in normal and reserpinized rats and to evaluate myocardial adrenergic innervation and function in patients with hypertrophic cardiomyopathy (HCM). The distribution of MIBG in the rat heart was higher in the right ventricle, basal segment and epicardial segment, which is mostly compatible with previous reports on the distribution and uptake of norepinephrine in the heart. The increased uptake of MIBG in the epicardial segment was a new finding, which seemed to indicate the difference of innervation between the epicardial and endocardial segments of the left ventricle in the rat heart. The uptake of MIBG was decreased in the reserpinized rats by 64% compared with that of the control, indicating there was MIBG uptake into intra-ventricular sites. Dual isotope autoradiogram also showed a decreased uptake of MIBG into the endocardium. The dual isotope autoradiogram revealed a significant decrease of MIBG uptake and a homogeneous distribution of {sup 201}Tl in the denervated myocardium, induced by phenol application. Single photon emission computerized tomography (SPECT) with {sup 123}I-MIBG and {sup 201}Tl was performed in 29 patients with HCM. In the visual evaluation of the SPECT images, the {sup 123}I-MIBG uptake was substantially lower than the {sup 201}Tl uptake in the hypertrophied septum in the early (20 minutes after infection) image in 48% of the HCM patients, suggesting less extraneuronal uptake in the human heart than in the rat heart. The septal {sup 123}I-MIBG/{sup 201}Tl uptake ratio at 20 minutes and 3 hours after injection inversely related with the septal thickness (R=-0.49 and R=-0.53). Significant positive correlation was observed between the septal MIBG clearance and the septal thickness (R=0.51). The MIBG clearance and uptake in conjunction with the {sup 201}Tl study seemed to reflect the severity of hypertrophy in HCM. (J.P.N.).

  3. Methylome-wide Association Study of Atrial Fibrillation in Framingham Heart Study

    Science.gov (United States)

    Lin, Honghuang; Yin, Xiaoyan; Xie, Zhijun; Lunetta, Kathryn L.; Lubitz, Steven A.; Larson, Martin G.; Ko, Darae; Magnani, Jared W.; Mendelson, Michael M.; Liu, Chunyu; McManus, David D.; Levy, Daniel; Ellinor, Patrick T.; Benjamin, Emelia J.

    2017-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia, but little is known about the molecular mechanisms associated with AF arrhythmogenesis. DNA methylation is an important epigenetic mechanism that regulates gene expression and downstream biological processes. We hypothesize that DNA methylation might play an important role in the susceptibility to develop AF. A total of 2,639 participants from the Offspring Cohort of Framingham Heart Study were enrolled in the current study. These participants included 183 participants with prevalent AF and 220 with incident AF during up to 9 years follow up. Genome-wide methylation was profiled using the Illumina Infinium HumanMethylation450 BeadChip on blood-derived DNA collected during the eighth examination cycle (2005–2008). Two CpG sites were significantly associated with prevalent AF, and five CpGs were associated with incident AF after correction for multiple testing (FDR < 0.05). Fourteen previously reported genome-wide significant AF-related SNP were each associated with at least one CpG site; the most significant association was rs6490029 at the CUX2 locus and cg10833066 (P = 9.5 × 10−279). In summary, we performed genome-wide methylation profiling in a community-based cohort and identified seven methylation signatures associated with AF. Our study suggests that DNA methylation might play an important role in AF arrhythmogenesis. PMID:28067321

  4. Heart failure patients' experiences with continuity of care and its relation to medication adherence: a cross-sectional study

    NARCIS (Netherlands)

    Uijen, A.A.; Bosch, M.; Bosch, W.J. van den; Bor, H.; Wensing, M.J.P.; Schers, H.J.

    2012-01-01

    ABSTRACT: BACKGROUND: A growing number of health care providers are nowadays involved in heart failure care. This could lead to discontinuity and fragmentation of care, thus reducing trust and hence poorer medication adherence. This study aims to explore heart failure patients' experiences with cont

  5. Use of quinine and mortality-risk in patients with heart failure--a Danish nationwide observational study

    DEFF Research Database (Denmark)

    Gjesing, Anne; Gislason, Gunnar H; Christensen, Stefan B;

    2015-01-01

    PURPOSE: Leg cramps are common in patients with heart failure. Quinine is frequently prescribed in low doses to these patients, but safety of this practice is unknown. We studied the outcomes associated with use of quinine in a nationwide cohort of patients with heart failure. METHODS: Through in...

  6. Study on ultrasound evaluation of carotid atherosclerosis and its predicting value for coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Peng-Hui Jian; Li-Fen Xu; Tie-Jun Zhang

    2016-01-01

    Objective:To study the ultrasound features of carotid atherosclerosis and its predicting value for coronary heart disease.Methods: A total of 55 cases of patients with coronary heart disease were selected as coronary heart disease group, 55 cases of healthy subjects were selected as control group, carotid artery ultrasound was used to detect intima-media thickness and judge the degree of coronary artery lesion, and plasma was collected to detect blood lipid metabolism indicators (FFA, LDL-C and HDL-C) and inflammation indicators (CCL21, CCR7, sCD40L, MFG-E8 and IL-10). Results:Carotid artery IMT of CHD group was significantly higher than that of control group, and the more the number of coronary artery lesions, the higher the IMT; plasma FFA, LDL-C, CCL21, CCR7 and sCD40L content of CHD group were higher than those of control group, and HDL-C, MFG-E8 and IL-10 content as well as HDL-C/LDL-C ratio were lower than those of control group; blood lipid metabolism indicators and inflammation indicators of coronary heart disease patients with different IMT were different, and the thicker the IMT, the higher the plasma FFA, LDL-C, CCL21, CCR7 and sCD40L content, the lower the HDL-C, MFG-E8 and IL-10 content as well as HDL-C/LDL-C ratio. Conclusion:Carotid artery IMT of patients with coronary heart disease significantly thickens and can assess the number of coronary artery lesions, blood lipid metabolism and degree of inflammation.

  7. Electrophysiological and structural remodeling in heart failure modulate arrhythmogenesis. 2D simulation study.

    Directory of Open Access Journals (Sweden)

    Juan F Gomez

    Full Text Available Heart failure is operationally defined as the inability of the heart to maintain blood flow to meet the needs of the body and it is the final common pathway of various cardiac pathologies. Electrophysiological remodeling, intercellular uncoupling and a pro-fibrotic response have been identified as major arrhythmogenic factors in heart failure.In this study we investigate vulnerability to reentry under heart failure conditions by incorporating established electrophysiological and anatomical remodeling using computer simulations.The electrical activity of human transmural ventricular tissue (5 cm × 5 cm was simulated using the human ventricular action potential model Grandi et al. under control and heart failure conditions. The MacCannell et al. model was used to model fibroblast electrical activity, and their electrotonic interactions with myocytes. Selected degrees of diffuse fibrosis and variations in intercellular coupling were considered and the vulnerable window (VW for reentry was evaluated following cross-field stimulation.No reentry was observed in normal conditions or in the presence of HF ionic remodeling. However, defined amount of fibrosis and/or cellular uncoupling were sufficient to elicit reentrant activity. Under conditions where reentry was generated, HF electrophysiological remodeling did not alter the width of the VW. However, intermediate fibrosis and cellular uncoupling significantly widened the VW. In addition, biphasic behavior was observed, as very high fibrotic content or very low tissue conductivity hampered the development of reentry. Detailed phase analysis of reentry dynamics revealed an increase of phase singularities with progressive fibrotic components.Structural remodeling is a key factor in the genesis of vulnerability to reentry. A range of intermediate levels of fibrosis and intercellular uncoupling can combine to favor reentrant activity.

  8. Original article What does it mean to live after heart transplantation? The lived experience of heart transplant recipients. A qualitative study

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    Anna Cierpka

    2015-03-01

    Full Text Available Background Despite significant improvements in physical state after heart transplantation, the majority of adult patients struggle with continuous psychological distress. The aim of the study was to explore the lived experiences of adult heart transplant recipients in order to understand the inner background of these difficulties. Participants and procedure Unstructured, in-depth interviews, based on the Life Story Interview of D. P. McAdams, were performed with 8 adults, aged between 50 and 60 years, who had undergone heart transplantation a year before the research was conducted. Interviews were tape recorded and transcribed verbatim. Data were analysed using narrative methods. Results The central themes of the patients’ lived experience were the illness itself and the feeling of being very different from others and from oneself remembered in the past – the times before the transplantation. The experienced discordance between their inner world and the expectations to get better presented by other people (the family, health care workers, etc. implies that these patients struggle with others’ lack of understanding and therefore suffer from a lack of effective psychological support. Conclusions This study shows that the life stories of patients after heart transplantation are in fact stories of their illness and the consequences it brought. It seems important to take this into consideration when constructing rehabilitation programmes for these patients in order to offer them the most effective support possible.

  9. The relation of ambulatory heart rate with all-cause mortality among middle-aged men: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Mette Korshøj

    Full Text Available The aim of this study was to investigate the association between average 24-hour ambulatory heart rate and all-cause mortality, while adjusting for resting clinical heart rate, cardiorespiratory fitness, occupational and leisure time physical activity as well as classical risk factors. A group of 439 middle-aged male workers free of baseline coronary heart disease from the Belgian Physical Fitness Study was included in the analysis. Data were collected by questionnaires and clinical examinations from 1976 to 1978. All-cause mortality was collected from the national mortality registration with a mean follow-up period of 16.5 years, with a total of 48 events. After adjustment for all before mentioned confounders in a Cox proportional hazards regression analysis, a significant increased risk for all-cause mortality was found among the tertile of workers with highest average ambulatory heart rate compared to the tertile with lowest ambulatory heart rate (Hazard ratio = 3.21, 95% confidence interval: 1.22-8.44. No significant independent association was found between resting clinic heart rate and all-cause mortality. The study indicates that average 24-hour ambulatory heart rate is a strong predictor of all-cause mortality independent from resting clinic heart rate, cardiorespiratory fitness, occupational and leisure time physical activity and other classical risk factors among healthy middle-aged workers.

  10. Reduced Dietary Sodium Intake Increases Heart Rate. A Meta-Analysis of 63 Randomized Controlled Trials Including 72 Study Populations.

    Science.gov (United States)

    Graudal, Niels A; Hubeck-Graudal, Thorbjørn; Jürgens, Gesche

    2016-01-01

    Reduced dietary sodium intake (sodium reduction) increases heart rate in some studies of animals and humans. As heart rate is independently associated with the development of heart failure and increased risk of premature death a potential increase in heart rate could be a harmful side-effect of sodium reduction. The purpose of the present meta-analysis was to investigate the effect of sodium reduction on heart rate. Relevant studies were retrieved from an updated pool of 176 randomized controlled trials (RCTs) published in the period 1973-2014. Sixty-three of the RCTs including 72 study populations reported data on heart rate. In a meta-analysis of these data sodium reduction increased heart rate with 1.65 beats per minute [95% CI: 1.19, 2.11], p sodium reduction increases heart rate by as much (2.4%) as it decreases blood pressure (2.5%). This side-effect, which may cause harmful health effects, contributes to the need for a revision of the present dietary guidelines.

  11. Level of education and risk of heart failure: a prospective cohort study with echocardiography evaluation

    DEFF Research Database (Denmark)

    Mogelvang, Rasmus; Heitmann, Merete; Prescott, Eva;

    2011-01-01

    Aims With increasing socioeconomic disparity in cardiovascular risk factors, there is a need to assess the role of socioeconomic factors in chronic heart failure (CHF) and to what extent this is caused by modifiable risk factors. Methods and results In a prospective cohort of 18 616 men and women...... without known myocardial infarction or CHF examined in 1976–78, 1981–83, 1991–94, and 2001–03 in the Copenhagen City Heart Study, we studied the effect of education on CHF incidence. During a median follow-up of 21 years (range 0–31), 2190 participants were admitted to hospital for CHF. Age......-adjusted hazard ratio (HR) for intermediary (8–10 years) and high level of education (>10 years) with low (

  12. Experimental and clinical studies of fast three-dimensional MR imaging of the heart

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Shuhei [Okayama Univ. (Japan). School of Medicine

    1999-07-01

    MRI has been utilized since its inception to study the anatomy and physiology of the heart. However, the sensitivity of MRI to motion has always posed a major challenge in imaging this organ. The purpose of this study was to develop a 3D MP-RAGE technique for the heart, and to apply it clinically. In the experimental study, data acquisition timing was discussed by normal volunteers. Changes in magnetization recovery time affected imaging contrast very little in the phantom study. Fourteen adults and 21 children were examined. In the adults, MP-RAGE images were rated as high in quality in the visual estimation. In the quantitative estimation, the images provided almost the same anatomical information as those of cine MRI. In the children, MP-RAGE was useful for cases of partial anomalous pulmonary venous drainage, particularly in the evaluation of abnormal pulmonary veins. The 3D MP-RAGE technique was useful in imaging the heart because it was possible to obtain continuous views in the same cardiac cycle and to reconstruct views from any direction after the examination. (author)

  13. Pulsatile flow in the aorta of the LVAD supported heart studied using particle image velocimetry

    Science.gov (United States)

    Moyedi, Zahra

    Currently many patients die because of the end-stage heart failure, mainly due to the reduced number of donor heart transplant organs. Studies show that a permanent left ventricular assist device (LVAD), a battery driven pump which is surgically implanted, increased the survival rate of patients with end-stage heart failure and improved considerably their quality of life. The inlet conduit of the LVAD is attached to the left ventricle and the outflow conduit anastomosed to the ascending aorta. The purpose of LVAD support is to help a weakened heart to pump blood to the rest of the body. However LVAD can cause some alterations of the natural blood flow. When your blood comes in contact with something that isn't a natural part of your body blood clots can occur and disrupt blood flow. Aortic valve integrity is vital for optimal support of left ventricular assist LVAD. Due to the existence of high continuous transvalvular pressure on the aortic valve, the opening frequency of the valve is reduced. To prevent the development of aortic insufficiency, aortic valve closure during LVAD implantation has been performed. However, the closed aortic valve reduces wash out of the aortic root, which causes blood stagnation and potential thrombus formation. So for this reason, there is a need to minimize the risks of occurring blood clot, by having more knowledge about the flow structure in the aorta during LVAD use. The current study focuses on measuring the flow field in the aorta of the LVAD assisted heart with two different types of aortic valve (Flat and Finned) using the SDSU cardiac simulator. The pulsatile pump that mimics the natural pulsing action of the heart also added to the system. The flow field is visualized using Particle Image Velocimetry (PIV). Furthermore, The fluid mechanics of aorta has been studied when LVAD conduit attached to two different locations (proximal and distal to the aortic valve) with pump speeds of 8,000 to 10,000 revolutions per minute (RPM

  14. Methods for retrospective geocoding in population studies: the Jackson Heart Study.

    Science.gov (United States)

    Robinson, Jennifer C; Wyatt, Sharon B; Hickson, DeMarc; Gwinn, Danielle; Faruque, Fazlay; Sims, Mario; Sarpong, Daniel; Taylor, Herman A

    2010-01-01

    The increasing use of geographic information systems (GIS) in epidemiological population studies requires careful attention to the methods employed in accomplishing geocoding and creating a GIS. Studies have provided limited details,hampering the ability to assess validity of spatial data. The purpose of this paper is to describe the multiphase geocoding methods used to retrospectively create a GIS in the Jackson Heart Study (JHS). We used baseline data from 5,302 participants enrolled in the JHS between 2000 and 2004 in a multiphase process to accomplish geocoding2 years after participant enrollment. After initial deletion of ungeocodable addresses(n=52), 96% were geocoded using ArcGIS. An interactive method using data abstraction from participant records, use of additional maps and street reference files,and verification of existence of address, yielded successful geocoding of all but 13 addresses. Overall, nearly 99% (n=5,237) of the JHS cohort was geocoded retrospectively using the multiple strategies for improving and locating geocodable addresses. Geocoding validation procedures revealed highly accurate and reliable geographic data. Using the methods and protocol developed provided a reliable spatial database that can be used for further investigation of spatial epidemiology. Baseline results were used to describe participants by select geographic indicators, including residence in urban or rural areas, as well as to validate the effectiveness of the study's sampling plan. Further, our results indicate that retrospectively developing a reliable GIS for a large, epidemiological study is feasible. This paper describes some of the challenges in retrospectively creating a GIS and provides practical tips that enhanced the success.

  15. Overweight, resting heart rate, and prediabetes/diabetes: A population-based prospective cohort study among Inner Mongolians in China.

    Science.gov (United States)

    Zhang, Shao Yan; Wu, Jia Hui; Zhou, Jing Wen; Liang, Zhu; Qiu, Qiao Yan; Xu, Tian; Zhang, Ming Zhi; Zhong, Chong Ke; Jiang, Wei; Zhang, Yong Hong

    2016-03-31

    We aimed to investigate the cumulative effect of overweight and resting heart rate on prediabetes/diabetes incidence in an 10-year follow-up study in Inner Mongolians. Among 1729 participants who were free from prediabetes and diabetes at baseline, 503 and 155 subjects developed prediabetes and diabetes, respectively. We categorized the participants into 4 subgroups according to overweight and resting heart rate status. The multivariate-adjusted OR (95% CI) in normal weight with heart rate ≥80 bpm, overweight with heart rate overweight with heart rate ≥80 bpm were 1.24 (0.95-1.61), 1.83 (1.29-2.61), 2.20 (1.41-3.45) for prediabetes and 1.52 (0.97-2.40), 3.64 (2.21-6.01), 4.61 (2.47-8.61) for diabetes, respectively, compared with normal weight with heart rate overweight and resting heart rate, along with conventional factors (AUC = 0.751), was significantly (P = 0.003) larger than the one containing only conventional factors (AUC = 0.707). Our study indicated that overweight was an independent risk factor of prediabetes and diabetes, and overweight with faster resting heart rate might further increase the risk of prediabetes and diabetes.

  16. Indirect narration : a case study of Conrad's Heart of darkness and Fitzgerald's The Great Gatsby

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    Majda Šavle

    2007-12-01

    Full Text Available Joseph Conrad's narrative style bas influenced many writers, including F. Scott Fitzgerald. The objective of my study on verbs used in discourse in Conrad's Heart of Darkness and Fitzgerald's The Great Gatsby was to confirm  the speculation  that besides Conrad's innovative technique of indirect narration there were other techniques (such as careful selection of imagistic detail Fitzgerald learned from Conrad.

  17. Morphological study of human heart and placenta in the first trimester of prenatal period of ontogenesis

    OpenAIRE

    Abdul-Ogly L.V.

    2008-01-01

    Probability of abnormal development is high in certain periods when the increased sensitiveness of embryo and fetus takes place. Influence of damaging factors as maternal infection and, consequently, fetal infection is a reason of abnormal development. Morphological characteristics of heart and placenta were studied during the first trimester of prenatal period of ontogenesis. 17 embryos, fetuses and placenta of 4-12 weeks were used. Abortions were made according to medical statements or mate...

  18. Central Nervous System Changes in Pediatric Heart Failure: A Volumetric Study

    OpenAIRE

    Menteer, Jondavid; Macey, Paul M.; Woo, Mary A.; Panigrahy, Ashok; Harper, Ronald M.

    2010-01-01

    Autonomic dysfunction, mood disturbances, and memory deficits appear in pediatric and adult heart failure (HF). Brain areas controlling these functions show injury in adult HF patients, many of whom have comorbid cerebrovascular disease. We examined whether similar brain pathology develops in pediatric subjects without such comorbidities. In this study, high-resolution T1 brain magnetic resonance images were collected from seven severe HF subjects age (age 8–18 years [mean 13]; left ventricul...

  19. Caffeine and Heart Disease

    Science.gov (United States)

    ... Healthy Workplace Food and Beverage Toolkit Caffeine and Heart Disease Updated:Aug 17,2015 Caffeine has many metabolic ... high caffeine intake increases the risk of coronary heart disease is still under study. Many studies have been ...

  20. Facilitators and Threats to the Patient Dignity in Hospitalized Patients with Heart Diseases: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Fariba Borhani

    2016-01-01

    Full Text Available Background: Patient’s dignity is an important issue which is highlighted in nursing It is an issue that is highly dependent on context and culture. Heart disease is the most common disease in Iran and the world. Identification of facilitator and threatening patient dignity in heart patients is vital. This study aimed to explore facilitator and threatening patient dignity in hospitalized patients with heart disease. Methods: This qualitative content analysis study was performed in 2014 in Kerman, Iran. 20 patients admitted to coronary care units and 5 personnel were selected using purposeful sampling in semi-structured and in depth interviews. Researchers also used documentation and field notes until data saturation. Qualitative data analysis was done constantly and simultaneously with data collection Results: Three central themes emerged: a Care context which includes human environment and physical environment, b Holistic safe care including meeting the needs of patients both in the hospital and after discharge, c Creating a sense of security and an effective relationship between patient and nurse, including a respectful relationship and account the family in health team. Conclusion: The results of this study showed that care context is important for patient dignity as well as physical environment and safe holistic care.

  1. In vivo carbon-13 nuclear magnetic resonance studies of heart metabolism.

    Science.gov (United States)

    Neurohr, K J; Barrett, E J; Shulman, R G

    1983-03-01

    Guinea pig heart metabolism was studied in vivo by 13C NMR at 20.18 MHz. High-quality proton-decoupled 13C NMR spectra with excellent signal-to-noise ratios and resolution could be obtained in 6 min. Natural-abundance spectra showed resonances that could be assigned to fatty acids, but glycogen was not seen. During intravenous infusion of D-[1-13C]glucose and insulin, the time course of myocardial glycogen synthesis was followed serially for up to 4 hr. Anoxia resulted in degradation of the labeled glycogen within 6 min and appearance of 13C label in lactic acid. Infusion of sodium [2-13C]acetate resulted in incorporation of label into the C-4, C-2, and C-3 positions of glutamate and glutamine, reflecting "scrambling" of the label expected from tricarboxylic acid cycle activity. Examination of the 31P NMR spectrum of the guinea pig heart in vivo demonstrated no change in the high-energy phosphates during the time periods of the 13C NMR experiments. Our studies indicate that 13C NMR is a unique non-destructive tool for the study of heart metabolism in vivo.

  2. A CORRELATION STUDY BETWEEN CONVENTIONAL LIPID PARAMETERS AND HS - CRP IN CORONARY HEART DISEASE

    Directory of Open Access Journals (Sweden)

    Rangaswamy

    2015-05-01

    Full Text Available BACKGROUND: Coronary heart disease (CHD is the most common form of heart disease. Changes in lifestyle, decreased physical activity, dietary modifications etc., in indian population is considered to be the major risk factor. By 2020 it is estimated that it will be th e major cause of death in the world. High sensitivity CRP (hs - CRP test measures very small amounts of CRP in the blood and is helpful even in healthy individuals to assess their potential risk for heart ailments. The hs - CRP levels are directly proportiona l to extent source of CHD which indicates that the hs - CRP has positive correlation with the disease burden. Hence the present study was undertaken. MATERIAL AND METHODS: The study was done by taking two groups controls and cases between the ages 25 - 60 year s. Fasting blood samples were collected and analysed for estimation of triglycerides, cholesterol, LDL - cholesterol, HDL - cholesterol and hs - crp levels. RESULT: Serum levels of cholesterol, TG, LDL - C, and hs - CRP (p - value 0.0001 were significantly increased and HDL - C (p - value 0.0002 was significantly decreased in cases as compared to healthy controls. CONCLUSION: It is seen that hs - CRP level is significantly elevated in cases (MI patients than the normal controls. So the present study shows a significant a nd positive correlation with conventional lipid profile parameters.

  3. Potential of Hybrid Computational Phantoms for Retrospective Heart Dosimetry After Breast Radiation Therapy: A Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Moignier, Alexandra, E-mail: alexandra.moignier@irsn.fr [Institut de Radioprotection et de Surete Nucleaire, Fontenay-aux-Roses (France); Derreumaux, Sylvie; Broggio, David; Beurrier, Julien [Institut de Radioprotection et de Surete Nucleaire, Fontenay-aux-Roses (France); Chea, Michel; Boisserie, Gilbert [Groupe Hospitalier Pitie Salpetriere, Service de Radiotherapie, Paris (France); Franck, Didier; Aubert, Bernard [Institut de Radioprotection et de Surete Nucleaire, Fontenay-aux-Roses (France); Mazeron, Jean-Jacques [Groupe Hospitalier Pitie Salpetriere, Service de Radiotherapie, Paris (France)

    2013-02-01

    Purpose: Current retrospective cardiovascular dosimetry studies are based on a representative patient or simple mathematic phantoms. Here, a process of patient modeling was developed to personalize the anatomy of the thorax and to include a heart model with coronary arteries. Methods and Materials: The patient models were hybrid computational phantoms (HCPs) with an inserted detailed heart model. A computed tomography (CT) acquisition (pseudo-CT) was derived from HCP and imported into a treatment planning system where treatment conditions were reproduced. Six current patients were selected: 3 were modeled from their CT images (A patients) and the others were modelled from 2 orthogonal radiographs (B patients). The method performance and limitation were investigated by quantitative comparison between the initial CT and the pseudo-CT, namely, the morphology and the dose calculation were compared. For the B patients, a comparison with 2 kinds of representative patients was also conducted. Finally, dose assessment was focused on the whole coronary artery tree and the left anterior descending coronary. Results: When 3-dimensional anatomic information was available, the dose calculations performed on the initial CT and the pseudo-CT were in good agreement. For the B patients, comparison of doses derived from HCP and representative patients showed that the HCP doses were either better or equivalent. In the left breast radiation therapy context and for the studied cases, coronary mean doses were at least 5-fold higher than heart mean doses. Conclusions: For retrospective dose studies, it is suggested that HCP offers a better surrogate, in terms of dose accuracy, than representative patients. The use of a detailed heart model eliminates the problem of identifying the coronaries on the patient's CT.

  4. Frequency of angina pectoris and secondary events in patients with stable coronary heart disease (from the Heart and Soul Study).

    Science.gov (United States)

    Beatty, Alexis L; Spertus, John A; Whooley, Mary A

    2014-10-01

    The extent to which angina pectoris (AP) predicts secondary cardiovascular events beyond independent of measures of disease severity is unknown. We evaluated the association between AP frequency and secondary events in patients with stable coronary heart disease (CHD). We administered the Seattle Angina Questionnaire to 1,023 participants with stable CHD enrolled from September 2000 to December 2002 and followed for a median of 8.9 years. We used Cox proportional hazards to evaluate the association of AP frequency with death and subsequent hospitalization for AP, revascularization, myocardial infarction (MI), or heart failure. At enrollment, 633 (62%) participants reported no AP, 279 (27%) reported monthly AP, and 111 (11%) reported daily or weekly AP. During follow-up, 396 participants died, 204 were hospitalized for AP, 194 for revascularization, 140 for MI, and 188 for heart failure. Compared with participants without AP, participants with daily or weekly AP were more likely to be hospitalized for AP (hazard ratio [HR] 3.3; 95% confidence interval [CI] 2.3 to 4.7; p<0.001), revascularization (HR 2.0; 95% CI 1.3 to 2.9; p=0.001), or heart failure (HR 1.6; 95% CI 1.0 to 2.5; p=0.03) and more likely to die (HR 1.5; 95% CI 1.1 to 2.0; p=0.01). AP was not independently associated with MI (HR 1.3; 95% CI 0.8 to 2.3; p=0.29). After adjusting for demographics, co-morbidities, treadmill exercise capacity, ejection fraction, and inducible ischemia, frequency of AP remained independently associated with hospitalization for AP (HR 2.4; 95% CI 1.6 to 3.6; p<0.001), revascularization (HR 1.7; 95% CI 1.1 to 2.7; p=0.02), and death (HR 1.4; 95% CI 1.0 to 2.0; p=0.045). In conclusion, in outpatients with stable CHD, AP frequency predicts higher rates of secondary cardiovascular events and death, independent of objective measures of disease severity.

  5. Individually Coded Telemetry: a Tool for Studying Heart Rate and Behaviour in Reindeer Calves

    Directory of Open Access Journals (Sweden)

    Pudas T

    2002-09-01

    Full Text Available The aim of the study was to test the performance of a silver wire modified version of the coded telemetric heart rate monitor Polar Vantage NV™ (PVNV and to measure heart rate (HR in a group of captive reindeer calves during different behaviour. The technical performance of PVNV HR monitors was tested in cold conditions (-30°C using a pulse generator and the correlation between generated pulse and PVNV values was high (r = 0.9957. The accuracy was tested by comparing the HR obtained with the PVNV monitor with the standard ECG, and the correlation was significant (r = 0.9965. Both circadian HR and HR related to behavioural pattern were recorded. A circadian rhythm was observed in the HR in reindeer with a minimum during night and early morning hours and maximum at noon and during the afternoon, the average HR of the reindeer calves studied being 42.5 beats/min in February. The behaviour was recorded by focal individual observations and the data was synchronized with the output of the HR monitors. Running differed from all other behavioural categories in HR. Inter-individual differences were seen expressing individual responses to external and internal stimuli. The silver wire modified Polar Vantage NV™ provides a suitable and reliable tool for measuring heart rate in reindeer, also in natural conditions.

  6. DIETARY SODIUM INTAKE IN A SAMPLE OF ADULT MALE POPULATION IN SOUTHERN ITALY.Results of the Olivetti Heart Study

    OpenAIRE

    Strazzullo, P; Venezia, Antonella; Barba, Gianvincenzo; Russo, Ornella; Capasso, Clemente; De Luca, Viviana; Farinaro, Eduardo; Cappuccio, Francesco P; Galletti, Ferruccio; Rossi, Giovanni

    2010-01-01

    Abstract Objective: To assess dietary habitual sodium intake, the association between daily sodium intake and anthropometric indices, food habits and hypertension in the sample of adult male population participating in the Olivetti Heart Study. Design, Setting and Participants: The study population was composed of 940 men participating in the 2002-04 follow-up examination of the Olivetti Heart Study. Blood pressure, anthropometric indices, biochemical parameters and sodium excre...

  7. The Jackson Heart KIDS Pilot Study: Theory-Informed Recruitment in an African American Population.

    Science.gov (United States)

    Beech, Bettina M; Bruce, Marino A; Crump, Mary E; Hamilton, Gina E

    2017-04-01

    Recruitment for large cohort studies is typically challenging, particularly when the pool of potential participants is limited to the descendants of individuals enrolled in a larger, longitudinal "parent" study. The increasing complexity of family structures and dynamics can present challenges for recruitment in offspring. Few best practices exist to guide effective and efficient empirical approaches to participant recruitment. Social and behavioral theories can provide insight into social and cultural contexts influencing individual decision-making and facilitate the development strategies for effective diffusion and marketing of an offspring cohort study. The purpose of this study was to describe the theory-informed recruitment approaches employed by the Jackson Heart KIDS Pilot Study (JHKS), a prospective offspring feasibility study of 200 African American children and grandchildren of the Jackson Heart Study (JHS)-the largest prospective cohort study examining cardiovascular disease among African American adults. Participant recruitment in the JHKS was founded on concepts from three theoretical perspectives-the Diffusion of Innovation Theory, Strength of Weak Ties, and Marketing Theory. Tailored recruitment strategies grounded in participatory strategies allowed us to exceed enrollment goals for JHKS Pilot Study and develop a framework for a statewide study of African American adolescents.

  8. Can Destination Therapy be implemented in children with heart failure? A study of provider perceptions.

    Science.gov (United States)

    Char, Danton S; Lee, Sandra S-J; Ikoku, Alvan A; Rosenthal, David; Magnus, David

    2016-09-01

    DT is an established final therapeutic choice in adult patients with severe heart failure who do not meet criteria for cardiac transplantation. Patients are given VADs, without the prospect of care escalation to transplantation. VADs are now established therapy for children and are currently used as a bridge until transplantation can be performed or heart failure improves. For children who present in severe heart failure but do not meet transplantation criteria, the question has emerged whether DT can be offered. This qualitative study aimed to elicit the perspectives of early adopters of DT at one of the few institutions where DT has been provided for children. Responses were recorded and coded and themes extracted using grounded theory. Interviewees discussed: envisioning of the DT candidate; approach to evaluation for DT; contraindications to choosing DT; and concerns about choosing DT. Providers articulated two frameworks for conceptualizing DT: as a long bridge through resolution of problems that would initially contraindicate transplantation or, alternatively, as a true destination instead of transplantation. True destination, however, may not be the lasting concept for long-term VAD use in children given improvement in prognosis for current medical contraindications and improving VAD technology.

  9. Acute electromyostimulation decreases muscle sympathetic nerve activity in patients with advanced chronic heart failure (EMSICA Study.

    Directory of Open Access Journals (Sweden)

    Marc Labrunée

    Full Text Available BACKGROUND: Muscle passive contraction of lower limb by neuromuscular electrostimulation (NMES is frequently used in chronic heart failure (CHF patients but no data are available concerning its action on sympathetic activity. However, Transcutaneous Electrical Nerve Stimulation (TENS is able to improve baroreflex in CHF. The primary aim of the present study was to investigate the acute effect of TENS and NMES compared to Sham stimulation on sympathetic overactivity as assessed by Muscle Sympathetic Nerve Activity (MSNA. METHODS: We performed a serie of two parallel, randomized, double blinded and sham controlled protocols in twenty-two CHF patients in New York Heart Association (NYHA Class III. Half of them performed stimulation by TENS, and the others tested NMES. RESULTS: Compare to Sham stimulation, both TENS and NMES are able to reduce MSNA (63.5 ± 3.5 vs 69.7 ± 3.1 bursts / min, p < 0.01 after TENS and 51.6 ± 3.3 vs 56.7 ± 3.3 bursts / min, p < 0, 01 after NMES. No variation of blood pressure, heart rate or respiratory parameters was observed after stimulation. CONCLUSION: The results suggest that sensory stimulation of lower limbs by electrical device, either TENS or NMES, could inhibit sympathetic outflow directed to legs in CHF patients. These properties could benefits CHF patients and pave the way for a new non-pharmacological approach of CHF.

  10. The Congenital Heart Disease Genetic Network Study: rationale, design, and early results.

    Science.gov (United States)

    Gelb, Bruce; Brueckner, Martina; Chung, Wendy; Goldmuntz, Elizabeth; Kaltman, Jonathan; Kaski, Juan Pablo; Kim, Richard; Kline, Jennie; Mercer-Rosa, Laura; Porter, George; Roberts, Amy; Rosenberg, Ellen; Seiden, Howard; Seidman, Christine; Sleeper, Lynn; Tennstedt, Sharon; Kaltman, Jonathan; Schramm, Charlene; Burns, Kristin; Pearson, Gail; Rosenberg, Ellen

    2013-02-15

    Congenital heart defects (CHD) are the leading cause of infant mortality among birth defects, and later morbidities and premature mortality remain problematic. Although genetic factors contribute significantly to cause CHD, specific genetic lesions are unknown for most patients. The National Heart, Lung, and Blood Institute-funded Pediatric Cardiac Genomics Consortium established the Congenital Heart Disease Genetic Network Study to investigate relationships between genetic factors, clinical features, and outcomes in CHD. The Pediatric Cardiac Genomics Consortium comprises 6 main and 4 satellite sites at which subjects are recruited, and medical data and biospecimens (blood, saliva, cardiovascular tissue) are collected. Core infrastructure includes an administrative/data-coordinating center, biorepository, data hub, and core laboratories (genotyping, whole-exome sequencing, candidate gene evaluation, and variant confirmation). Eligibility includes all forms of CHD. Annual follow-up is obtained for probands age is 5.5 years. The one third enrolled at age <1 year are contacted annually for follow-up information. The distribution of CHD favors more complex lesions. Approximately, 11% of probands have a genetic diagnosis. Adequate DNA is available from 97% and 91% of blood and saliva samples, respectively. Genomic analyses of probands with heterotaxy, atrial septal defects, conotruncal, and left ventricular outflow tract obstructive lesions are underway. The scientific community's use of Pediatric Cardiac Genomics Consortium resources is welcome.

  11. Relation of ventricular premature complexes to heart failure (from the Atherosclerosis Risk In Communities [ARIC] Study).

    Science.gov (United States)

    Agarwal, Sunil K; Simpson, Ross J; Rautaharju, Pentti; Alonso, Alvaro; Shahar, Eyal; Massing, Mark; Saba, Samir; Heiss, Gerardo

    2012-01-01

    Analogous to rapid ventricular pacing, frequent ventricular premature complexes (VPCs) can predispose over time to cardiomyopathy and subsequent heart failure (HF). We examined the association of frequent VPCs with HF incidence in a population-based cohort, free of HF and coronary heart disease at baseline. At study baseline (1987 to 1989), ≥1 VPC on a 2-minute rhythm electrocardiographic strip was seen in 5.5% (739 of 13,486) of the middle-age (45 to 64 years old at baseline) white and black, men and women of the Atherosclerosis Risk In Communities cohort. Incident HF was defined as the first appearance of International Classification of Diseases code 428.x in the hospital discharge record or death certificate through 2005. During an average follow-up of 15.6 years, incident HF was seen in 10% the participants (19.4% of those with VPCs vs 9.4% of those without). The age-, race-, and gender-adjusted hazard ratio of HF for VPCs was 1.89 (95% confidence interval 1.59 to 2.24). After multivariable adjustment for potential confounders, the hazard ratio of HF for those with any VPC versus no VPC was 1.63 (95% confidence interval 1.36 to 1.96). After additional adjustment for incident coronary heart disease as a time-varying covariate, the hazard ratio was 1.71 (95% confidence interval 1.42 to 2.08). Those with a greater frequency of VPCs or complex VPCs had similar rates of HF compared to those with a single VPC and all had rates greater than those with no VPC. In conclusion, in this large population-based cohort, the presence of VPCs was associated with incident HF, independent of incident coronary heart disease.

  12. Sex differences and heritability of two indices of heart rate dynamics: a twin study.

    Science.gov (United States)

    Snieder, Harold; van Doornen, Lorenz J P; Boomsma, Dorret I; Thayer, Julian F

    2007-04-01

    We investigated whether women show larger heart rate variability (HRV) than men after controlling for a large number of health-related covariates, using two indices of HRV, namely respiratory sinus arrhythmia (RSA) and approximate entropy (ApEn). In a twin design, the heritability of both indices was examined. The covariation between RSA and ApEn, a measure of heart rate dynamics derived from nonlinear dynamical systems theory, was decomposed into genetic and environmental components. Subjects were 196 male and 210 female middle-aged twins. Females showed larger HRV than men before (ApEn: p RSA: p = .052) and after adjustment for covariates (ApEn: p RSA: p = .015). This sex difference was confirmed by significant intrapair differences in the opposite-sex twin pairs for both ApEn (p RSA (p = .03). In addition to sex, only heart period and age (both p RSA was also influenced by respiration rate and smoking (both p RSA and ApEn, respectively. Oral contraceptive use and menopausal status had no effect on HRV. Genetic model fitting yielded moderate heritability estimates for RSA (30%) and ApEn (40%) for both males and females. The correlation between RSA and ApEn (r = .60) could be attributed to genetic factors (48%), environmental factors (36%) and age (16%). The present study found support for a gender difference in HRV with women having greater HRV than men even after controlling for a large number of potential confounders. Indices of heart rate dynamics derived from nonlinear dynamical systems theory are moderately heritable and may be more sensitive than traditional indices of HRV to reveal subtle sex differences with important implications for health and disease.

  13. Elastic extracellular matrix of the embryonic chick heart: an immunohistological study using laser confocal microscopy.

    Science.gov (United States)

    Hurle, J M; Kitten, G T; Sakai, L Y; Volpin, D; Solursh, M

    1994-08-01

    The "elastic matrix" constitutes a specialized component of the extracellular matrix which confers resiliency to tissues and organs subjected to repeated deformations. The role of the elastic matrix in living organisms appears to be of key importance since diseases characterized by expression of defective inherited genes which encode components of the elastic matrix lead to premature death. While the elastic matrix of adult organs has received a great deal of attention, little is known about when it first appears in embryonic tissues or its possible role in developing organs. In the present study we have performed an immunohistochemical study of the distribution of elastin and three additional components often associated with elastic matrices in adult tissues (i.e., fibrillin, emilin, and type VI collagen) during the development of the chicken embryonic heart. The three-dimensional arrangement of these components was established through the observation of whole-amount specimens with scanning laser confocal microscopy. Our results revealed three different periods of heart development regarding the composition of the elastic matrix. Prior to stage 21 the embryonic heart lacks elastin but exhibits a matrix scaffold of fibrillin and emilin associated with the endocardium and the developing cardiac jelly. Between stages 22 and 29 the heart shows a transient elastic scaffold in the outflow tract which contains elastin, fibrillin, and emilin. Elastin-positive fibrillar material is also observed during these stages in the base of the atrioventricular cushion adjacent to the myocardial wall. In addition, emilin-positive material appears to be associated with the zones of formation of ventricular trabeculae. Collagen type VI was not detected during these early stages. From stage 30 to stage 40 a progressive modification of the pattern of distribution of elastin, fibrillin, emilin, and collagen type VI is observed in association with the formation of the definitive four

  14. Studies on heart development in normal and cardiac mutant axolotls, Ambystoma Mexicanum, using cellular and molecular biology

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@ The Mexican axolotl (Ambystoma mexicanum) provides and excellent model for studying heart development since it carries a simple recessive cardiac lethal mutation that results in a failure of mutant embryonic myocardium to contract.

  15. COMPARATIVE STUDY OF HEART FAILURE WITH PRESERVED EJECTION FRACTION VERSUS DECREASED EJECTION FRACTION

    Directory of Open Access Journals (Sweden)

    Chandrashekar

    2015-03-01

    Full Text Available BACKGROUND AND OBJECTIVES : To study the socio demographic profile , risk factors , clinical presentation and comorbidies in patients with heart failure. To compare the socio demographic profile , risk factors , clinical presentation and comorbidities in patients with Heart failure with normal ejection fraction (HFnEF and Heart failure with reduced ejection fraction (HFrEF. METHODS: The primary study population consisted of 100 cases of adult men and women aged more than 18 years with symptoms of Hea rt failure diagnosed by Framingham’s criteria . The study population was selected from inpatients and outpatients attending Department of Medicine of KIMS hospital between January to December 2012. The study was a hospital based observatory and comparative study. RESULTS: Out of 100 cases included in our study 50% cases had HFrEF & 50% cases had HFnEF as confirmed by echocardiographic parameters. There was no statistically significant difference between the two groups with respect to age and sex. However the re were significant statistical significant differences between the groups with respect to clinical features , risk factors and co morbidities. Clinical features like oedema , hepatomegaly and rales were common in HFrEF group (P<0.05. Also LVESD & LVEDD wer e increased in patients with HFrEF. Risk factors like prior MI/IHD were more common in patients with HfrEF (P<0.05 . History of hypertension and left ventricular hypertrophy were common in patients with HFnEF (P< 0.05. Among the comorbidities: IHD Conduct ion abnormalities were common in HFrEF group. Pericardial effusion was more common in HFnEFgroup.

  16. Risk Factors of Congenital Heart Diseases: A Case-Control Study in Northwest Iran

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    Naghavi-Behzad Mohammad

    2013-03-01

    Full Text Available Introduction: Congenital heart diseases are of immense importance and also a high prevalence. Contributing factors to developing these defects have not been abundantly studied. Therefore, the current study was conducted aiming at determining the effective factors on Congenital Heart Disease (CHD in newborn infants of Northwest Iran. Methods: A case-control study was carried out in North-West of Iran from 2002 to 2012 and a total of 473 infants entered the study. Required data were obtained through check lists completed by the information of hospital records and interview with mothers of 267 newborn infants with CHD together with medical records of mothers as the case group, and 206 medical records of healthy infants at the same period all together with those of their mothers as the control group. The obtained data were statistically analyzed using descriptive statistical methods, T-test, Spearman’s correlation coefficient, and Multi-variable Logistic Regression Model (OR with 95% CI, using SPSS.19. In the present study, P value less than 0.05 was considered statistically significant. Results: Based on the results of univariable analyses, the number of previous cesarean sections, past medical history of diseases, gestational age (GA, fetal weight at birth, diastolic blood pressure, fetal heart rate, pulse rate, fetal hemoglobin and hematocrit levels, and fetal head circumference at birth have significant relationship with incidence of congenital abnormalities (P<0.05. Family history, past cesarean sections history, past medical history and GA had significant relationship with CHD incidence. Conclusion: Based on the results of present study, in order to control and reduce the cases of CHD, it is crucial to make proper decisions and implement policies for reducing cesarean cases, lowering consanguineous marriages, providing proper pre-marriage counseling, prompt treatment of mothers’ illnesses, improving pregnancy health care and mothers

  17. Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF Study

    Institute of Scientific and Technical Information of China (English)

    Bin Zheng; Qin Ma; Li-Hong Zheng; Qiang Yong; Yi-Hua He; Jing-Hua Liu

    2015-01-01

    Background:Previous data are controversial about the association of renal artery stenosis (RAS) with clinical outcome in patients with heart failure.Definition of RAS in previous studies might not be appropriate.By definition of RAS with renal duplex sonography,we investigated the association of RAS with clinical outcome in patients with heart failure.Methods:In this retrospective study,we identified 164 patients with heart failure (New York Heart Association classification ≥Ⅱ;left ventricular ejection fraction <50%) who had received renal duplex sonography during hospital stay.RAS was defined as renal-aortic ratio ≥3.5 or a peak systolic velocity ≥200 cm/s (or both),or occlusion of the renal artery.Categorical data of patients were compared using the Chi-square test or Fisher's exact test.Cox proportional hazards regression modeling technique was used to investigate the prognostic significance of possible predictors.Results:Finally,143 patients were enrolled.Median follow-up time was 32 months (1-53 months).Twenty-two patients were diagnosed as RAS by renal duplex sonography,including 13 unilateral RAS (3 left RAS,10 right RAS) and 9 bilateral RAS.There were more all-cause mortality and cardiovascular death in patients with RAS than patients without RAS.By multivariate analysis,RAS was a significant predictor for all-cause death and cardiovascular death (hazard ratio [HR] =4.155,95% confidence interval [CI]:1.546-11.164,P =0.005;and HR =3.483,95% CI:1.200-10.104,P =0.022,respectively).As for composite endpoint events,including death,nonfatal myocardial infarction,ischemic stroke or intracranial hemorrhage,rehospitalization for cardiac failure,and renal replacement therapy,only angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker was significant predictor.RAS was not a significant predictor for composite endpoint events.Conclusions:Our data suggested that RAS is associated with a poorer clinical outcome in patients with heart

  18. Heart rate monitoring on the stroke unit. What does heart beat tell about prognosis? An observational study

    Directory of Open Access Journals (Sweden)

    Stypmann Jörg

    2011-04-01

    Full Text Available Abstract Background Guidelines recommend maintaining the heart rate (HR of acute stroke patients within physiological limits; data on the frequency and predictors of significant deviations from these limits are scarce. Methods Demographical data, stroke risk factors, NIH stroke scale score, lesion size and location, and ECG parameters were prospectively assessed in 256 patients with ischemic stroke. Patients were continuously monitored for at least 24 hours on a certified stroke unit. Tachycardia (HR ≥120 bpm and bradycardia (HR Results HR ≥120 bpm occurred in 39 patients (15%. Stroke severity (larger lesion size/higher NIHSS-score on admission, atrial fibrillation and HR on admission predicted its occurrence. HR Conclusions Significant tachycardia and bradycardia are frequent phenomena in acute stroke; however they do not independently predict clinical course or outcome. Continuous monitoring allows detecting rhythm disturbances in stroke patients and allows deciding whether urgent medical treatment is necessary.

  19. Bridging the gap in heart failure prevention: rationale and design of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study

    DEFF Research Database (Denmark)

    Carrington, Melinda J; Stewart, Simon; de Courten, Barbora

    2010-01-01

    AIMS: The primary objective of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study is to develop a programme of care that cost-effectively prevents the development of chronic heart failure (CHF). Methods NIL-CHF is a randomized controlled trial of a hybrid, home- and clinic......-based, nurse-led multidisciplinary intervention targeting hospitalized patients at risk of developing CHF. A target of 750 patients aged >/=45 years will be exposed to usual post-discharge care or the NIL-CHF intervention. The composite primary endpoint is all-cause mortality or CHF-related admission during 3......-5 years of follow-up. After 12 months recruitment, approximately 300 eligible patients (40% of target) have been randomized. Overall, 73% are male and the mean age is 65 +/- 10 years. The most common antecedents for CHF thus far are hypertension (70%, 95% CI, 64-75%), coronary artery disease (51%, 95% CI...

  20. Long-Term Nationwide Follow-Up Study of Simple Congenital Heart Disease Diagnosed in Otherwise Healthy Children

    DEFF Research Database (Denmark)

    Videbæk, Jørgen; Laursen, Henning Bækgaard; Olsen, Morten;

    2016-01-01

    BACKGROUND: Systematic follow-up is currently not recommended for patients with simple congenital heart disease; however, only a few data exist on the long-term prognosis of simple congenital heart disease. METHODS AND RESULTS: We undertook a nationwide follow-up study of a cohort of 1241 simple...... congenital heart disease patients, diagnosed from 1963 through 1973, in otherwise healthy children and alive at 15 years of age. We identified 10 age- and sex-matched general population controls per patient. We followed the study population through Danish public registries from the age of 15 years up...... with simple congenital heart disease in the 1960s have substantially increased long-term mortality and cardiac morbidity compared with the general population. Further studies on the effectiveness of systematic medical follow-up programs appear warranted....

  1. A STUDY OF CLINICAL PROFILE OF ISCHEMIC HEART DISEASE AMONG SOUTH INDIAN WOMEN IN A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Lokesh

    2015-05-01

    Full Text Available INTRODUCTION : Our study was done to study in detail the clinical profile of cases admitted with ischemic heart diseases in women at ICCU VIMS Bellary . Objectives : are. (1 To study the clinical profile of ischemic heart diseases in women. ( 2 To identify the influence of well - defined risk factors in wome n with ischemic heart diseases. (3 To identify if there are any risk factors specific to wom en with ischemic heart diseases. MATERIAL AND METHODS : Ours is a clinical , prospective , observational and open study. The study subjects were women admitted in Intensive Coronary Care Unit of Vijayanagara institute of medical sciences hospital , Bellary with signs and symptoms suggestive of ischemic heart diseases. After obtaining a detailed history and clinical examinati on the patients were subjected to relevant investigations. The complete data was collected in specially designed case recording form and transferred into a Master chart which is then subjected to statistical analysis. RESULTS AND DISCUSSION : We studied 100 cases of ischemic heart diseases in women , out of which 82 patients presented with Acute MI , 14 patients with Unstable angina and 4 patients with stable angina , most of which were observed in post - menopausal women. Prognosis was good in patients who recei ved intensive care within 6 hours of onset of symptoms. Chest pain was the most common symptom of presentation. CONCLUSION : Our study had highlighted the fact that ischemic heart disease no longer remains gender neutral and has been found to be a principle killer in women and they suffer from IHD on account of preventable diseases like hypertension , diabetes mellitus , obesity. KEYWORDS : Ischemic heart disease ; Hypertension ; Acute MI ; Unstable angina.

  2. Heart Rate Variability and Wavelet-based Studies on ECG Signals from Smokers and Non-smokers

    Science.gov (United States)

    Pal, K.; Goel, R.; Champaty, B.; Samantray, S.; Tibarewala, D. N.

    2013-12-01

    The current study deals with the heart rate variability (HRV) and wavelet-based ECG signal analysis of smokers and non-smokers. The results of HRV indicated dominance towards the sympathetic nervous system activity in smokers. The heart rate was found to be higher in case of smokers as compared to non-smokers ( p 90 % was achieved. The wavelet decomposition of the ECG signal was done using the Daubechies (db 6) wavelet family. No difference was observed between the smokers and non-smokers which apparently suggested that smoking does not affect the conduction pathway of heart.

  3. Engineered heart tissues and induced pluripotent stem cells: Macro- and microstructures for disease modeling, drug screening, and translational studies.

    Science.gov (United States)

    Tzatzalos, Evangeline; Abilez, Oscar J; Shukla, Praveen; Wu, Joseph C

    2016-01-15

    Engineered heart tissue has emerged as a personalized platform for drug screening. With the advent of induced pluripotent stem cell (iPSC) technology, patient-specific stem cells can be developed and expanded into an indefinite source of cells. Subsequent developments in cardiovascular biology have led to efficient differentiation of cardiomyocytes, the force-producing cells of the heart. iPSC-derived cardiomyocytes (iPSC-CMs) have provided potentially limitless quantities of well-characterized, healthy, and disease-specific CMs, which in turn has enabled and driven the generation and scale-up of human physiological and disease-relevant engineered heart tissues. The combined technologies of engineered heart tissue and iPSC-CMs are being used to study diseases and to test drugs, and in the process, have advanced the field of cardiovascular tissue engineering into the field of precision medicine. In this review, we will discuss current developments in engineered heart tissue, including iPSC-CMs as a novel cell source. We examine new research directions that have improved the function of engineered heart tissue by using mechanical or electrical conditioning or the incorporation of non-cardiomyocyte stromal cells. Finally, we discuss how engineered heart tissue can evolve into a powerful tool for therapeutic drug testing.

  4. Pharmacodynamics and pharmacokinetics of oral levosimendan and its metabolites in patients with severe congestive heart failure: a dosing interval study.

    Science.gov (United States)

    Põder, Pentti; Eha, Jaan; Sundberg, Stig; Antila, Saila; Heinpalu, Marika; Loogna, Imbrit; Planken, Ulle; Rantanen, Satu; Lehtonen, Lasse

    2004-10-01

    The objective of this study was to explore the pharmacodynamics and pharmacokinetics of oral levosimendan in patients with severe congestive heart failure. This was a randomized, parallel-group, double-blind, placebo-controlled trial. Oral levosimendan 2 to 8 mg daily or placebo was administered to 25 patients with New York Heart Association class III-IV congestive heart failure for 4 weeks. Pharmacodynamic variables consisted of heart rate-corrected electromechanical systole, heart rate, and systolic and diastolic blood pressure. The pharmacokinetics of levosimendan and its metabolites, OR-1855 and OR-1896, was assessed. The 4- to 8-mg daily doses of oral levosimendan showed moderate inotropic effects. Blood pressure remained unchanged with all doses. A moderate increase in heart rate was observed except with the 2-mg dose. Pharmacokinetic parameters of the metabolites increased linearly with the dose (P < or = .002 for Cmax and AUC0-8h for both treatment groups). It was concluded that oral levosimendan has inotropic and chronotropic effects in patients with severe congestive heart failure. Plasma concentrations of its metabolites increase dose dependently.

  5. A prospective population study of resting heart rate and peak oxygen uptake (the HUNT Study, Norway.

    Directory of Open Access Journals (Sweden)

    Javaid Nauman

    Full Text Available OBJECTIVES: We assessed the prospective association of resting heart rate (RHR at baseline with peak oxygen uptake (VO(2peak 23 years later, and evaluated whether physical activity (PA could modify this association. BACKGROUND: Both RHR and VO(2peak are strong and independent predictors of cardiovascular morbidity and mortality. However, the association of RHR with VO(2peak and modifying effect of PA have not been prospectively assessed in population studies. METHODS: In 807 men and 810 women free from cardiovascular disease both at baseline (1984-86 and follow-up 23 years later, RHR was recorded at both occasions, and VO(2peak was measured by ergospirometry at follow-up. We used Generalized Linear Models to assess the association of baseline RHR with VO(2peak, and to study combined effects of RHR and self-reported PA on later VO(2peak. RESULTS: There was an inverse association of RHR at baseline with VO(2peak (p<0.01. Men and women with baseline RHR greater than 80 bpm had 4.6 mL.kg(-1.min(-1 (95% confidence interval [CI], 2.8 to 6.3 and 1.4 mL.kg(-1.min(-1 (95% CI, -0.4 to 3.1 lower VO(2peak at follow-up compared with men and women with RHR below 60 bpm at baseline. We found a linear association of change in RHR with VO(2peak (p=0.03, suggesting that a decrease in RHR over time is likely to be beneficial for cardiovascular fitness. Participants with low RHR and high PA at baseline had higher VO(2peak than inactive people with relatively high RHR. However, among participants with relatively high RHR and high PA at baseline, VO(2peak was similar to inactive people with relatively low RHR. CONCLUSION: RHR is an important predictor of VO(2peak, and serial assessments of RHR may provide useful and inexpensive information on cardiovascular fitness. The results suggest that high levels of PA may compensate for the lower VO(2peak associated with a high RHR.

  6. AN ANATOMICAL STUDY OF CORONARY ARTERY DOMINANCE IN HUMAN CADAVERIC HEARTS

    Directory of Open Access Journals (Sweden)

    Natasha

    2015-07-01

    Full Text Available CONTEXT: With ever increasing incidence of coronary heart disease, a thorough study of the coronary arteries is the need of time. AIM: The aim of the present study is to evaluate the coronary dominance pattern which will help the cardiac physicians and surgeons for better diagnosis and management of coronary arte ry disease. MATERIALS AND METHODS: The study undertaken in the Department of Anatomy, Assam Medical College included 75 perinatal and 15 adult cadaveric human hearts which were preserved in 10% formaldehyde solution after simple dissecting procedure and the dominance was noted. RESULTS: In the present study, out of total of 90 cases the right coronary dominance was found to be present in 58 cases (64.44%.This included 34(60.71% males and 24(70.59% females. Total cases of left coronary dominance were fo und to be 22(24.45%. Among these, 15(26.79% were males and 7(20.59% were females. Finally 10(11.11% co - dominant cases were found, of which 7 cases (12.50% were males and 3 cases (8.82% were females. CONCLUSION : Thus the study revealed that most of th e cases were having right coronary predominance. KEYWORDS : Coronary arteries, Dominance .

  7. Obesity, mortality and cardiovascular disease in the Münster Heart Study (PROCAM).

    Science.gov (United States)

    Schulte, H; Cullen, P; Assmann, G

    1999-05-01

    In the Münster Heart Study (PROCAM), 16,288 men aged 40.6 +/- 11.3 years (mean +/- S.D.) and 7328 women aged 36.0 +/- 12.3 years were enrolled between 1979 and 1991. Mean body mass indices (BMIs) were 25.6 +/- 3.3 and 23.8 +/- 4.1 kg/m2 in men and women, respectively. There was a graded and continuous positive interaction in both men and women between BMI, age and serum total cholesterol, low density lipoprotein (LDL) cholesterol, and blood pressure (both systolic and diastolic). High density lipoprotein (HDL) cholesterol tended to increase with age, but decreased in graded fashion with increases in BMI in both sexes. Triglyceride increased with BMI in both sexes and with age in women, but decreased in the older age groups of overweight and obese men. Though fasting blood glucose increased with age and BMI in both sexes, the increase was more marked in women. Among the 10,856 men aged 36-65 years at study entry, 313 deaths occurred within a follow-up period of 7.1 +/- 2.4 years. Among these men, increased mortality was seen at high BMIs in both smokers and non-smokers and was caused by coronary heart disease (CHD). Increased mortality at low BMI was seen in smokers but not in non-smokers and was due to an increase in cancer deaths. The BMI-associated increase in CHD death was completely accounted for by the factors contained in the Münster Heart Study (PROCAM) risk algorithm, indicating that the effect of overweight and obesity on CHD is mediated via other risk factors.

  8. Elevated Heart Rate is Associated with Cardiac Denervation in Patients with Heart Failure: A 123-Iodine-MIBG Myocardial Scintigraphy Study

    Science.gov (United States)

    Villacorta, Aline Sterque; Villacorta, Humberto; de Souza, Jenne Serrão; Teixeira, José Antônio Caldas; Muradas, Maria Clara S. S. S.; Alves, Christiane Rodrigues; Precht, Bernardo Campanário; Porto, Pilar; Ubaldo, Letícia; Mesquita, Cláudio Tinoco; da Nóbrega, Antônio Cláudio Lucas

    2016-01-01

    Background In the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT), heart rate (HR) reduction with ivabradine was associated with improved survival and reduced hospitalizations in patients with heart failure (HF). The mechanisms by which elevated HR increases mortality are not fully understood. Objective To assess the relationship of baseline HR with clinical, neurohormonal and cardiac sympathetic activity in patients with chronic HF and elevated HR. Method Patients with chronic HF who were in sinus rhythm and had resting HR>70 bpm despite optimal medical treatment were included in a randomized, double-blind study comparing ivabradine versus pyridostigmine. This report refers to the baseline data of 16 initial patients. Baseline HR (before randomization to one of the drugs) was assessed, and patients were classified into two groups, with HR below or above mean values. Cardiac sympathetic activity was assessed by 123-iodine-metaiodobenzylguanidine myocardial scintigraphy. Results Mean HR was 83.5±11.5 bpm (range 72 to 104), and seven (43.7%) patients had HR above the mean. These patients had lower 6-min walk distance (292.3±93 vs 465.2±97.1 m, p=0.0029), higher values of N-Terminal-proBNP (median 708.4 vs 76.1, p=0.035) and lower late heart/mediastinum rate, indicating cardiac denervation (1.48±0.12 vs 1.74±0.09, p<0.001). Conclusion Elevated resting HR in patients with HF under optimal medical treatment was associated with cardiac denervation, worse functional capacity, and neurohormonal activation. PMID:27982270

  9. Elevated Heart Rate is Associated with Cardiac Denervation in Patients with Heart Failure: A 123-Iodine-MIBG Myocardial Scintigraphy Study

    Directory of Open Access Journals (Sweden)

    Aline Sterque Villacorta

    Full Text Available Abstract Background: In the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT, heart rate (HR reduction with ivabradine was associated with improved survival and reduced hospitalizations in patients with heart failure (HF. The mechanisms by which elevated HR increases mortality are not fully understood. Objective: To assess the relationship of baseline HR with clinical, neurohormonal and cardiac sympathetic activity in patients with chronic HF and elevated HR. Method: Patients with chronic HF who were in sinus rhythm and had resting HR>70 bpm despite optimal medical treatment were included in a randomized, double-blind study comparing ivabradine versus pyridostigmine. This report refers to the baseline data of 16 initial patients. Baseline HR (before randomization to one of the drugs was assessed, and patients were classified into two groups, with HR below or above mean values. Cardiac sympathetic activity was assessed by 123-iodine-metaiodobenzylguanidine myocardial scintigraphy. Results: Mean HR was 83.5±11.5 bpm (range 72 to 104, and seven (43.7% patients had HR above the mean. These patients had lower 6-min walk distance (292.3±93 vs 465.2±97.1 m, p=0.0029, higher values of N-Terminal-proBNP (median 708.4 vs 76.1, p=0.035 and lower late heart/mediastinum rate, indicating cardiac denervation (1.48±0.12 vs 1.74±0.09, p<0.001. Conclusion: Elevated resting HR in patients with HF under optimal medical treatment was associated with cardiac denervation, worse functional capacity, and neurohormonal activation.

  10. Heart rate distribution and predictors of resting heart rate after initiation of beta-blocker treatment in patients with coronary artery disease: REsults of Sympathetic Evaluation And Research of China(RESEARCH) study

    Institute of Scientific and Technical Information of China (English)

    ZHAO Ying-xin; LI Yue-ping; GAO Fei; MA Han-ying; WANG Zhi-jian; HAN Hong-ya; SHEN Hua

    2013-01-01

    Background The importance of heart rate as secondary prevention strategies for patients with coronary artery disease (CAD) is emphasized by multiple guidelines.However,limited information is available on the heart rate distribution and the change patterns of resting heart rate when initiating beta-blocker therapy among Chinese patients with CAD.Methods The REsults of Sympathetic Evaluation And Research of China (RESEARCH) study is a multi-centre,prospective,observational study involving 147 centers in 23 cities across China.All eligible beta-blocker naive patients were prescribed with metroprolol succinate.Initial dosage and target heart rate were selected at the discretion of their physicians in charge according to their usual institutional practice.The heart rate distribution and the change patterns of resting heart rate after initiation of beta-blocker therapy were observed.Results The majority of patients (63.6%) were prescribed with 47.5 mg metroprolol succinate.At baseline,there were only 17.4% of patients whose heart rate was less than 70 beats per minute,and the proportion reached 42.5% and 79.1%,one month and two months after initiation of beta-blockers,respectively.Multivariate linear regression analysis showed that baseline heart rate (B=0.900,SE=0.006,t=141.787,P<0.0001) and the dosage (B=-0.007,SE=0.002,t=-3.242,P=0.001) were independent predictors of resting heart rate 2 months after beta-blocker therapy.Conclusions Resting heart rate is not optimally controlled in a broadly representative cohort of Chinese outpatients with CAD even after initiation of β-blocker therapy,and baseline heart rate and the dosage of beta-blocker are both independent predictors of resting heart rate after β-blocker therapy.

  11. How do patients at risk portray candidates for coronary heart disease? A qualitative interview study

    DEFF Research Database (Denmark)

    Frich, J.C.; Malterud, K.; Fugelli, P.

    2007-01-01

    OBJECTIVE: To explore how patients at risk of coronary heart disease (CHD) portray candidates for CHD. DESIGN: Qualitative interview study. SETTING: Norway. SUBJECTS: A total of 20 men and 20 women diagnosed with heterozygous familial hypercholesterolemia (FH) recruited through a lipid clinic. MAIN...... the coronary candidate as someone who was different from themselves. Among those who mentioned gender, all presented the candidate as a man. Some women said that they had to reconcile themselves to being at risk of CHD, since they at first had conceived CHD as a man's disease. While some participants...

  12. ORIGINAL ARTICLE: Case Control Study To Assess Association Between Periodontal Infection And Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Jyoti Mohitey

    2012-07-01

    Full Text Available Background: Coronary heart disease is the leading cause of adult mortality and morbidity throughout the world. Well known risk factors independently or combined are involved in both atherosclerosis and myocardial infarction. Recent data have shown that viral and bacterial infections may also contribute to acute thromboembolic events; hence a case control study was carried out. Aims and Objective: To investigate the possible association between periodontal health and coronary artery disease, in patients with Acute Myocardial Infarction (AMI and Coronary Heart Disease (CHD. Material and Methods: 150 patients, 75 with AMI and 75 with CHD were included in the study. Data on hypertension, diabetes, smoking status and alcohol consumption were recorded. AMI patients were clinically examined 3-4 days after admission to the coronary care unit. Clinical examination of CHD patients was carried out during the hospital stay. All teeth excluding third molars were studied and clinical data were recorded regarding Plaque Index, Simplified Oral Hygiene Index, Gingival Index, Gingival Bleeding Index, Probing Depth and Clinical Attachment Loss. Results: Percentage of sites exhibiting bleeding on probing and the number of sites with more probing depth were significantly higher among AMI patients than those with CHD (P=0.05 and p=0.001 respectively.There was abundant plaque and debris around all tooth surfaces in AMI patients (p=0.001. Conclusion: Overall result of this case control study showed an association between periodontitis and acute myocardial infarction.

  13. [Heart disorders secondary to cerebral ischemic infarct. A clinical study of 20 patients and diagnostico-therapeutic considerations].

    Science.gov (United States)

    Cosentino, F; Salvati, M; Artizzu, S; Caruso, R; Fiorenza, F; Ramundo, E O; Cosentino, F

    1990-01-01

    The role of heart disorders in the onset of stroke has been examined in depth, but scarce attention has been paid to the relationship between cerebral ischemic stroke and subsequent heart disorders. The paper reports the results of a study of this relationship. The present state of knowledge is outlined together with the possible risk factors which might be useful in constructing a suitable therapeutic-prophylactic protocol to reduce the cardiological risks of "acute" neurosurgical treatment.

  14. The Danish Heart Registry

    DEFF Research Database (Denmark)

    Özcan, Cengiz; Juel, Knud; Lassen, Jens Flensted

    2016-01-01

    AIM: The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research. STUDY POPULATION: All adult (≥15 years) patients...

  15. Implementing a Graduate Certificate Program in Cardiovascular Epidemiology: The Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Brenda W. Campbell Jenkins

    2015-12-01

    Full Text Available The Jackson Heart Study (JHS is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC has initiated the Daniel Hale Williams Scholar (DHWS program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1 an enrichment curriculum; (2 a learning community; (3 quarterly seminars; and (4 a Summer Institute. Students attend enrichment activities comprising: (1 Applied Biostatistics; (2 Cardiovascular Disease Epidemiology; (3 Social Epidemiology; (4 Emerging Topics; and (5 Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs.

  16. Implementing a Graduate Certificate Program in Cardiovascular Epidemiology: The Jackson Heart Study.

    Science.gov (United States)

    Campbell Jenkins, Brenda W; Addison, Clifton; Wilson, Gregory; Young, Lavon; Fields, Regina; Woodberry, Clevette; Payton, Marinelle

    2015-12-22

    The Jackson Heart Study (JHS) is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC) has initiated the Daniel Hale Williams Scholar (DHWS) program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1) an enrichment curriculum; (2) a learning community; (3) quarterly seminars; and (4) a Summer Institute. Students attend enrichment activities comprising: (1) Applied Biostatistics; (2) Cardiovascular Disease Epidemiology; (3) Social Epidemiology; (4) Emerging Topics; and (5) Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs.

  17. QUALITY OF LIFE IN PATIENTS HOSPITALIZED WITH HEART FAILURE: A NOVEL TWO QUESTIONNAIRE STUDY

    Directory of Open Access Journals (Sweden)

    Z. N. Hatmi

    2007-09-01

    Full Text Available Heart failure (HF is a common disease with high health care costs and high mortality rate Knowledge of the health-related quality of life (QOL outcomes of HF may guide decision making and be useful in assessing new therapies for population. Yet little is known about QOL of HF patients in Iran. Objectives: To assess health related QOL of patients with HF with two different instrument and to correlate these two measures and to assess the role of relevant factors. Analytic cross sectional study was conducted involving 230 adult patients hospitalized with HF, demographic data and health -related quality of life were determined by interview; for assessing of quality of life was used SF-36 and Minnesota questionnaires. Simple random sampling from ward patients list choose patients. Patients had no other man diseases that affected their quality of life. Results: 118 female (53.3% and 112 male (48.7% with mean age of 51.4 +/-13.18 were collected. 61 patients (26.5% were smoker and 100 patients (43.5% had positive familial hearth disease history. Quality of life in some subscale: Physical functioning, Role physical and vitality, and Minnesota scare affected from patients age. Male patients had better quality of life than female in Minnesota scale and physical functioning, body pain, general health, vitality and emotional well-being. Duration of diagnosis affected Minnesota scale and role physical. Positive familial heart disease history affected physical functioning. Iranian patients have worse quality of life than other patients. This shows patients age, sex, duration of diagnosis, smoking and positive familial hearth disease history affected quality of life in heart failure patients.

  18. Nesiritide, Renal Function, and Associated Outcomes During Hospitalization for Acute Decompensated Heart Failure Results From the Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure (ASCEND-HF)

    NARCIS (Netherlands)

    van Deursen, Vincent M.; Hernandez, Adrian F.; Stebbins, Amanda; Hasselblad, Vic; Ezekowitz, Justin A.; Califf, Robert M.; Gottlieb, Stephen S.; O'Connor, Christopher M.; Starling, Randall C.; Tang, W. H. Wilson; McMurray, John J.; Dickstein, Kenneth; Voors, Adriaan A.

    2014-01-01

    Background-Contradictory results have been reported on the effects of nesiritide on renal function in patients with acute decompensated heart failure. We studied the effects of nesiritide on renal function during hospitalization for acute decompensated heart failure and associated outcomes. Methods

  19. An Electromechanical Left Ventricular Wedge Model to Study the Effects of Deformation on Repolarization during Heart Failure

    Directory of Open Access Journals (Sweden)

    B. M. Rocha

    2015-01-01

    Full Text Available Heart failure is a major and costly problem in public health, which, in certain cases, may lead to death. The failing heart undergo a series of electrical and structural changes that provide the underlying basis for disturbances like arrhythmias. Computer models of coupled electrical and mechanical activities of the heart can be used to advance our understanding of the complex feedback mechanisms involved. In this context, there is a lack of studies that consider heart failure remodeling using strongly coupled electromechanics. We present a strongly coupled electromechanical model to study the effects of deformation on a human left ventricle wedge considering normal and hypertrophic heart failure conditions. We demonstrate through a series of simulations that when a strongly coupled electromechanical model is used, deformation results in the thickening of the ventricular wall that in turn increases transmural dispersion of repolarization. These effects were analyzed in both normal and failing heart conditions. We also present transmural electrograms obtained from these simulations. Our results suggest that the waveform of electrograms, particularly the T-wave, is influenced by cardiac contraction on both normal and pathological conditions.

  20. Heart Disease

    Science.gov (United States)

    ... daily aspirin to prevent heart attack? Does taking birth control pills increase my risk for heart disease? Does using ... tells you to. Return to top Does taking birth control pills increase my risk for heart disease? Taking birth ...

  1. A 3D velocimetry study of the flow through prosthetic heart valves

    Science.gov (United States)

    Ledesma, R.; Zenit, R.; Pulos, G.; Sanchez, E.; Juarez, A.

    2006-11-01

    Blood damage commonly appears in medical valve prothesis. It is a mayor concern for the designers and surgeons. It is well known that this damage and other complications result from the modified fluid dynamics through the replacement valve. To evaluate the performance of prosthetic heart valves, it is necessary to study the flow through them. To conduct this study , we have built a flow channel that emulates cardiac conditions and allows optical access such that a 3D-PIV velocimetry system could be used. The experiments are aimed to reconstruct the downstream structure of the flow through a mechanical and a bio-material tricuspid heart valve prothesis. Preliminary results show that the observed coherent structures can be related with haemolysis and trombosis, illnesses commonly found in valve prothesis recipients. The mean flow, the levels of strain rate and the turbulence intensity generated by the valves can also be directly related to blood damage. In general, bio-material made valves tend to reduce these complications.

  2. Ischaemic Heart Disease: Accuracy of the Prehospital Diagnosis—A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Louise Houlberg Hansen

    2013-01-01

    Full Text Available Purpose. Correct prehospital diagnosis of ischaemic heart disease (IHD may accelerate and improve the treatment. We sought to evaluate the accuracy of prehospital diagnoses of ischemic heart diseases assigned by physicians. Methods. The Mobile Emergency Care Unit (MECU in Odense, Denmark, services a population of 260.000. All admissions in 2009 concerning patients diagnosed in the IHD category were assessed. Outcome and diagnosis of each patient were manually validated in accordance to the final diagnosis established following admission to hospital, using the discharge summary from the relevant department as reference. Results. 428 MECU runs with a prehospital diagnosis of IHD were registered. 422 of these were included in the study and 354 of those patients were suitable for this analysis. 73,4% of the patients hospitalized with a prehospital diagnosis of IHD were initially admitted to the relevant ward. Of these patients, 40,0% had their preliminary diagnosis of IHD confirmed. 14,1% of all patients admitted to the hospital were diagnosed with nonheart conditions. Preliminary diagnoses of STEMI had an accuracy of 87,5%. Conclusions. The preliminary IHD diagnoses assigned by the MECU physicians were acceptable. In case of STEMI patients the diagnostic accuracy was excellent. In this study there was an apparent overtriage.

  3. The Association between Work-Related Rumination and Heart Rate Variability: A Field Study

    Science.gov (United States)

    Cropley, Mark; Plans, David; Morelli, Davide; Sütterlin, Stefan; Inceoglu, Ilke; Thomas, Geoff; Chu, Chris

    2017-01-01

    The objective of this study was to examine the association between perseverative cognition in the form of work-related rumination, and heart rate variability (HRV). We tested the hypothesis that high ruminators would show lower vagally mediated HRV relative to low ruminators during their leisure time. Individuals were classified as being low (n = 17) or high ruminators (n = 19), using the affective scale on the work-related rumination measure. HRV was assessed using a wrist sensor band (Microsoft Band 2). HRV was sampled between 8 pm and 10 pm over three workday evenings (Monday to Wednesday) while individuals carried out their normal evening routines. Compared to the low ruminators, high affective ruminators demonstrated lower HRV in the form of root mean square successive differences (RMSSDs), relative to the low ruminators, indicating lower parasympathetic activity. There was no significant difference in heart rate, or activity levels between the two groups during the recording periods. The current findings of this study may have implications for the design and delivery of interventions to help individuals unwind post work and to manage stress more effectively. Limitations and implications for future research are discussed. PMID:28197087

  4. Clinical evaluation of magnetic resonance imaging in coronary heart disease: The CE-MARC study

    Directory of Open Access Journals (Sweden)

    Sculpher Mark

    2009-07-01

    Full Text Available Abstract Background Several investigations are currently available to establish the diagnosis of coronary heart disease (CHD. Of these, cardiovascular magnetic resonance (CMR offers the greatest information from a single test, allowing the assessment of myocardial function, perfusion, viability and coronary artery anatomy. However, data from large scale studies that prospectively evaluate the diagnostic accuracy of multi-parametric CMR for the detection of CHD in unselected populations are lacking, and there are few data on the performance of CMR compared with current diagnostic tests, its prognostic value and cost-effectiveness. Methods/design This is a prospective diagnostic accuracy cohort study of 750 patients referred to a cardiologist with suspected CHD. Exercise tolerance testing (ETT will be preformed if patients are physically able. Recruited patients will then undergo CMR and single photon emission tomography (SPECT followed in all patients by invasive X-ray coronary angiography. The order of the CMR and SPECT tests will be randomised. The CMR study will comprise rest and adenosine stress perfusion, cine imaging, late gadolinium enhancement and whole-heart MR coronary angiography. SPECT will use a gated stress/rest protocol. The primary objective of the study is to determine the diagnostic accuracy of CMR in detecting significant coronary stenosis, as defined by X-ray coronary angiography. Secondary objectives include an assessment of the prognostic value of CMR imaging, a comparison of its diagnostic accuracy against SPECT and ETT, and an assessment of cost-effectiveness. Discussion The CE-MARC study is a prospective, diagnostic accuracy cohort study of 750 patients assessing the performance of a multi-parametric CMR study in detecting CHD using invasive X-ray coronary angiography as the reference standard and comparing it with ETT and SPECT. Trial Registration Current Controlled Trials ISRCTN77246133

  5. Depressive Symptoms, Health Behaviors, and Subsequent Inflammation in Patients With Coronary Heart Disease : Prospective Findings From the Heart and Soul Study

    NARCIS (Netherlands)

    Duivis, Hester E.; de Jonge, Peter; Penninx, Brenda W.; Na, Bee Ya; Cohen, Beth E.; Whooley, Mary A.

    2011-01-01

    Objective: Depression has been associated with inflammation in patients with coronary heart disease. However, it is uncertain whether depressive symptoms lead to inflammation or vice versa. Method: The authors evaluated 667 outpatients with established coronary heart disease from the Heart and Soul

  6. Diabetes, Glycemic Control, and New-Onset Heart Failure in Patients With Stable Coronary Artery Disease Data from the Heart and Soul Study

    NARCIS (Netherlands)

    van Melle, Joost P.; Bot, Marisica; De Jonge, Peter; De Boer, Rudolf A.; van Veldhuisen, Dirk J.; Whooley, Mary A.

    2010-01-01

    OBJECTIVE- Diabetes is a predictor of both coronary artery disease (CAD) and heart failure. It is unknown to what extent the association between diabetes and heart failure is influenced by other risk factors for heart failure. RESEARCH DESIGN AND METHODS- We evaluated the association of diabetes and

  7. Diabetes, glycemic control, and new-onset heart failure in patients with stable coronary artery disease : data from the heart and soul study

    NARCIS (Netherlands)

    van Melle, J.P.; Bot, M.; de Jonge, P.; de Boer, R.A.; van Veldhuisen, D.J.; Whooley, M.A.

    2010-01-01

    OBJECTIVE Diabetes is a predictor of both coronary artery disease (CAD) and heart failure. It is unknown to what extent the association between diabetes and heart failure is influenced by other risk factors for heart failure. RESEARCH DESIGN AND METHODS We evaluated the association of diabetes and A

  8. Psychosocial work environment and risk of ischaemic heart disease in women: the Danish Nurse Cohort Study

    DEFF Research Database (Denmark)

    Allesøe, Karen; Hundrup, Yrsa Andersen; Thomsen, Jane Frølund

    2010-01-01

    OBJECTIVES: To investigate the effect of work pressure and job influence on the development of ischaemic heart disease (IHD) in women. METHODS: The effect of work pressure and job influence on the 15-year incidence of IHD in women participating in the Danish Nurse Cohort Study was prospectively...... studied. A total of 12 116 participants, aged 45-64 years, were examined in 1993 using a questionnaire and were followed by individual linkage in the National Register of Hospital Discharges to the beginning of 2008. Work pressure, job influence, occupational characteristics, demographic factors and known......: In this study we find that work pressure that is too high is a significant risk factor for IHD in younger female employees (results should be taken into account in the planning of primary prevention....

  9. A study of cholesterol/phospholipid ratio and triene/tetraene ratio in coronary heart disease

    Directory of Open Access Journals (Sweden)

    Tanksale K

    1978-01-01

    Full Text Available The biochemical assessment of coronary heart diseases (CHD is done by studying serum lipids. This is usually done to under-stand the pathogenesis o f atherosclerosis which is the cause o f CHD. Indoor patients suffering from CHD were studied for their serum cholesterol, phospholipids, total fatty acids and polyunsaturated fatty acids (PUFA. Cholesterol/phospholipid and triene/tetraene ratios were calculated. It was observed that there was no significant difference in any of the parameters studied on the basis of dietary habit or body size. It was further observed on the basis of triene/tetraene ratio that the patients were ingesting adequate amounts of linoleate, there were high levels of cholesterol, phospholipids and c/p ratio in all the groups. This paradox may be due to disturbed PUFA metabolism and particularly of linoleate so that there is no influence o f linoleate on cholesterol and phospholipid synthesis.

  10. Alcohol consumption and risk of atrial fibrillation in men and women: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Mukamal, Kenneth J; Tolstrup, Janne S; Friberg, Jens

    2005-01-01

    BACKGROUND: The relationship of the full range of alcohol consumption with risk of incident atrial fibrillation has been inconsistent in previous, mainly case-control studies. METHODS AND RESULTS: In a prospective cohort study, we studied the association between self-reported alcohol use...... not attenuate the association (hazard ratio 1.63; 95% CI 1.15 to 2.31). CONCLUSIONS: Heavy alcohol consumption is associated with a higher risk of atrial fibrillation, at least among men. This relationship does not appear to be related to the adverse effects of heavy drinking on coronary heart disease or blood...... nationwide registry of all hospitalizations. A total of 1071 cases occurred during follow-up. Among both women and men, alcohol consumption throughout the moderate range was not associated with risk of atrial fibrillation. However, consumption of 35 or more drinks per week among men was associated...

  11. Cardiac remodeling as a consequence of atrial fibrillation: An anatomical study of perfusion-fixed human heart specimens

    Institute of Scientific and Technical Information of China (English)

    Christopher D Rolfes; Stephen A Howard; Ryan P Goff; Paul A Iaizzo

    2011-01-01

    Background Atrial fibrillation(AF)causes a continuum of atrial anatomical remodeling.Methods Using a library of perfusion-fixed human hearts,specimens with AF were compared to controls.During this preliminary assessment study,direct measurements were taken of atrial volume,pulmonary vein(PV)circumference,and left atrial(LA)wall thicknesses.Results Hearts with AF typically had larger atrial volumes,as well as a much larger variation in volume compared to controls(range of 59.6-227.1 mL in AF hearts compared to 65.1-115.9 mL in controls).For all hearts,right PVs were larger than left PVs(mean: 171.4±84.6 mm' for right and 118.2±50.1 mm2 for left P<0.005).LA wall thicknesses ranged from 0.7 mm to 3.1 min for both AF and control hearts.Conclusions Hearts with AF had a large range of sizes which is consistent with the progression of atrial remodeling during AF.The large range of thicknesses will influence the amount of energy needed to create transmural lesions during ablation procedures.

  12. Clinical evaluation of the centrifugal pump in open heart surgery: a comparative study of different pumps.

    Science.gov (United States)

    Takarabe, K; Yoshikai, M; Murayama, J; Hamada, M; Ito, T

    1997-07-01

    The centrifugal pump is now widely used in open heart surgery for its clinical benefits related to the blood elements and the coagulation system. The purpose of this study was to compare the clinical performances of and the outcomes offered by 4 types of centrifugal pumps. For each pump, we investigated the effects on the blood elements, coagulation system, complements, and immunoglobulins during open heart surgery. Four types of centrifugal pumps were used: the HPM-15 (Nikkiso Co.), the Capiox (Terumo Co.), the Lifestream (St. Jude Medical Co.), and the BP-80 (Medtronic, BioMedicus Co.). The platelet count, lactate dehydrogenase (LDH), antithrombin III (AT III), thrombin-antithrombin complex (TAT), complements (C3, C4, and CH50), and immunoglobulins (IgG, IgA, and IgM) were measured before and after cardiopulmonary bypass (CPB). The platelet count was decreased more significantly by the HPM-15 than by any of the other pumps. The other parameters showed no difference among the 4 pumps. In clinical use, each of the 4 types of centrifugal pumps was safe.

  13. Association of chronic mucus hypersecretion with FEV1 decline and chronic obstructive pulmonary disease morbidity. Copenhagen City Heart Study Group

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E; Lange, P

    1996-01-01

    The aim of this study was to examine the association between chronic mucus hypersecretion, and FEV1 decline, and subsequent hospitalization from chronic obstructive pulmonary disease (COPD). We used data from The Copenhagen City Heart Study on 5,354 women and 4,081 men 30 to 79 yr of age with ass......The aim of this study was to examine the association between chronic mucus hypersecretion, and FEV1 decline, and subsequent hospitalization from chronic obstructive pulmonary disease (COPD). We used data from The Copenhagen City Heart Study on 5,354 women and 4,081 men 30 to 79 yr of age...

  14. Multi-wave cohort study of sedentary work and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Møller, Simone Visbjerg; Hannerz, Harald; Hansen, Aase Marie

    2016-01-01

    OBJECTIVES: This study aimed to investigate whether sedentary work is a distinct risk factor for ischemic heart disease (IHD) when the effect of occupational sitting is disentangled from that of occupational physical activity. METHODS: Data on occupational sitting time and several covariates were...... status, no difference in risk of IHD was observed between sedentary and non-sedentary employees [hazard ratio (HR) 0.95, 95% confidence interval (95% CI) 0.78-1.16]. During 44 949 and 42 456 person-years of follow-up among men and and women, respectively, 1263 men and 1364 women purchased IHD......-related medication. No differences in risk were observed between sedentary and non-sedentary participants, either for men or women. A dose-response relationship between occupational sitting time and the risk of IHD was also not detected. CONCLUSIONS: This study could not confirm the hypothesis that sedentary work...

  15. Ventricular function during the acute rejection of heterotopic transplanted heart: Gated blood pool studies

    Energy Technology Data Exchange (ETDEWEB)

    Valette, H.; Bourguignon, M.H.; Desruennes, M.; Merlet, P.; Le Guludec, D. (Hopital de Bicetre, 94 - Le Kremlin-Bicetre (France). Lab. d' Explorations Cardiovasculaires CEA, 91 - Orsay (France). Service Hospitalier Frederic Joliot); Gregoire, M.C.; Agostini, D.; Rigaud, M.; Gandjbakhch, I.; Cabrol, A.; Cabrol, C. (Hopital La Pitie, 75 - Paris (France)); Syrota, A. (Hopital A. Pare, 92 - Boulogne (France))

    1991-11-01

    Twenty patients who had undergone a heterotopic heart transplant were studied prospectively to determine the relationship between rejection and ventricular dysfunction assessed from gated blood pool studies. A fully automated method for detecting ventricular edges was implemented; its success rate for the grafted left and right ventricles was 94% and 77%, respectively. The parameters, peak ejection and filling rates, were calculated pixel per pixel using a two-harmonic Fourier algorithm and then averaged over the ventricular region of interest. Peak filling and ejection rates were closely related with the severity of the rejection, while the left ventricular ejection fraction was not. Peak filling rates of both ventricles were the indices closely related to the presence of moderate rejection. Despite the low number of patients, these data suggested that gated blood pool derived indices of ventricular function are associated with ventricular dysfunction resulting from myocarditis rejection. Radionuclide ventriculography provides parametric data which are accurate and reliable for the diagnosis of rejection. (orig.).

  16. The Danish Heart Registry

    DEFF Research Database (Denmark)

    Özcan, Cengiz; Juel, Knud; Flensted Lassen, Jens;

    2016-01-01

    AIM: The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research. STUDY POPULATION: All adult (≥15 years) patients...... undergoing coronary angiography (CAG), percutaneous coronary intervention (PCI), coronary artery bypass grafting, and heart valve surgery performed across all Danish hospitals were included. MAIN VARIABLES: The DHR contains a subset of the data stored in the Eastern and Western Denmark Heart Registries (EDHR...

  17. Influence of the heart rate on mean circumferential shortening velocity: echocardiographic study of 183 normal subjects.

    Science.gov (United States)

    Mangiarotti, R; Martinotti, R; Monzani, V; Sardella, F; Pierini, A; Pastori, M; Randazzo, A

    1986-01-01

    Echocardiography was used to explore the influence of independent variables (age, body surface area and heart rate) on the mean circumferential shortening velocity (MVCF) in 183 healthy subjects. Multiple stepwise regression analysis shows that heart rate is the only variable of the three just mentioned that influences MVCF. A regression equation is evolved and proposed as an index of MVCF correction for varying heart rates.

  18. Early pregnancy exposure to antihistamines and risk of congenital heart defects : results of two case-control studies

    NARCIS (Netherlands)

    Smedts, Huberdina P. M.; de Jonge, Linda; Bandola, Sarah J. G.; Baardman, Marlies E.; Bakker, Marian K.; Stricker, Bruno H. C.; Steegers-Theunissen, Regine P. M.

    2014-01-01

    UNLABELLED: We aimed to study the association between use of antihistamines in early pregnancy and congenital heart defects (CHD) in the offspring. DESIGN: Two case-control studies. SETTING: HAVEN study, Erasmus MC, University Medical Centre, Rotterdam, and Eurocat Northern Netherlands (NNL), Univer

  19. Anaemia and long term mortality in heart failure patients: a retrospective study

    DEFF Research Database (Denmark)

    Charlot, Mette; Torp-Pedersen, Christian; Valeur, Nana;

    2010-01-01

    Anaemia has been demonstrated as a risk factor in patients with heart failure over periods of a few years, but long term data are not available. We examined the long-term risk of anaemia in heart failure patients during 15 years of follow-up.......Anaemia has been demonstrated as a risk factor in patients with heart failure over periods of a few years, but long term data are not available. We examined the long-term risk of anaemia in heart failure patients during 15 years of follow-up....

  20. [Study on treatment of irritable bowel syndrome: based on relationship between heart and intestines].

    Science.gov (United States)

    Wang, Su-Na; Wang, Zu-Hong; Xie, Su-Juan; Han, Li-Bing; Yi, Rong

    2010-11-01

    The article puts forward the treatment of irritable bowel syndrome through regulating heart vitality since it is held that the pathological factors of the disease lay in dysfunction of heart and intestines as well as disorder of qi circulation. At the same time, the internal-external relationship between the heart the small intestine is discussed from the theory of Brain-gut Axis in modern medicine, which provides theoretical base of modern medicine for the treatment of irritable bowel syndrome through regulation of the heart functions.

  1. Prevalence and correlates of coronary heart disease: first population-based study in Lebanon

    Directory of Open Access Journals (Sweden)

    Zeidan RK

    2016-03-01

    Full Text Available Rouba Karen Zeidan,1 Rita Farah,2 Mirna N Chahine,3 Roland Asmar,3 Hassan Hosseini,4,5 Pascale Salameh,6,7 Atul Pathak8 1Doctoral School of Biology Health and Biotechnologies, Toulouse III University, Toulouse, 2Doctoral School of Life and Health Sciences, Paris-Est University, Creteil, France; 3Foundation-Medical Research Institutes, F-MRI®, Beirut, Lebanon; 4Department of Neurology, Henri Mondor Hospital AP-HP, 5EA 4391, Nerve Excitability and Therapeutics, Université Paris-Est, Creteil, France; 6School of Pharmacy, Lebanese American University, Byblos, 7Laboratory of Clinical and Epidemiology Research, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon; 8Department of Cardiovascular Medicine, Hypertension, Risk Factors and Heart Failure Unit, Clinique Pasteur, Toulouse, France Background: Lebanon is experiencing a growing epidemic of coronary heart diseases (CHDs, as most low- and middle-income countries currently are. However, this growth can be attenuated if effective preventive strategies are adopted. Purpose: To provide the first national population-based prevalence of CHD and to describe the profile of Lebanese adults with prevalent CHD. Methods: We carried out a cross-sectional study using a multistage cluster sample across Lebanon. We interviewed residents aged 40 years and older using a questionnaire that captured the presence of CHDs and their risk factors (RFs. Results: Our study showed that 13.4% of the Lebanese population aged ≥40 years suffer from a prevalent CHD. CHD seemed to appear more prematurely than in developed countries, and males seemed to be more subject to CHD than females until a certain age. CHD was associated with older age, male sex, a lower economic situation, hypercholesterolemia, hypertension, having a family history of premature cardiovascular diseases, and suffering from diabetes. However, smoking and waist circumference did not seem to have an independent effect on CHD, but rather an effect

  2. Combined analysis of six lipoprotein lipase genetic variants on triglycerides, high-density lipoprotein, and ischemic heart disease: cross-sectional, prospective, and case-control studies from the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Wittrup, HH; Andersen, RV; Tybjærg-Hansen, A

    2006-01-01

    . SETTING: The study was performed in the Danish general population (the Copenhagen City Heart Study). PARTICIPANTS: IHD was angina pectoris or myocardial infarction. MAIN OUTCOME MEASURES: Triglycerides, HDL, and IHD were the main outcome measures. RESULTS: Cross-sectionally, triglycerides varied...

  3. The stem-cell application in ischemic heart disease: Basic principles, specifics and practical experience from clinical studies

    Directory of Open Access Journals (Sweden)

    Banović Marko

    2015-01-01

    Full Text Available Longer life duration, different clinical presentations of coronary disease, as well as high incidence of comorbidity in patients with ischemic heart disease have led to an increase in the incidence of ischemic heart failure. Despite numerous and new treatment methods that act on different pathophysiological mechanisms that cause heart failure, and whose aim is to slowdown or stop the progression of this devastating disease, morbidity and mortality in these patients remain high. These facts have firstly led to the introduction of the experimental, and then clinical studies with the application of stem cells in patients with ischemic heart disease. Previous studies have shown that the application of stem cells is a feasible and safe method in patients with acute coronary syndrome, as well as in patients with chronic ischemic cardiomyopathy, but the efficacy of these methods in both of the abovementioned clinical syndromes has yet to be established. This review paper outlines the basic principles of treatment of ischemic heart disease with stem cells, as well as the experience and knowledge gained in previous clinical studies.

  4. Heart rate response to breathing

    DEFF Research Database (Denmark)

    Mehlsen, J; Pagh, K; Nielsen, J S

    1987-01-01

    Heart rate responses to stepwise and periodic changes in lung volume were studied in seven young healthy males. Stepwise inspiration and expiration both resulted in an increase in heart rate followed by a rapid decrease in heart rate. The fastest heart rate was reached in 1.6 +/- 0.5 s and in 3.6...

  5. Heart Diseases

    Science.gov (United States)

    ... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the U.S. ... of disability. There are many different forms of heart disease. The most common cause of heart disease is ...

  6. Heart Transplantation

    Science.gov (United States)

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  7. A New Model to Perform Electrophysiological Studies in the Early Embryonic Mouse Heart

    Directory of Open Access Journals (Sweden)

    Anna Kornblum

    2013-07-01

    Full Text Available Background: The first electrocardiograms (ECGs have been recorded with a capillary electrometer in the late 19th century by John Burdon Sanderson and Augustus Waller. In 1903 Willem Einthoven used the much more sensitive string galvanometer and was awarded Nobel Price in Medicine for this discovery. Though the physical principles of that era are still in use, there have been many advances but also challenges in cardiac electrophysiology over the last decades. One challenge is to record electrocardiograms of rather small animals such as mice and even smaller organisms such as their embryos. As mice belong to the most routinely used laboratory animals it is important to better understand their physiology and specific diseases. We therefore aimed to study whether it is feasible to measure electrical activities of embryonic mouse hearts. Methods and Results: For our studies we used substrate-integrated Microelectrode Arrays combined with newly developed stimulation electrodes to perform electrophysiological studies in these hearts. The system enabled us to perform ECG-like recordings with atrio-ventricular (anterograde and ventriculo-atrial (retrograde stimulation. The functional separation of atria and ventricles, indicated by a stable atrio-ventricular conduction time, occurred clearly earlier than the morphological separation. Electrical stimulation induced a reversible prolongation of the anterograde and retrograde conduction up to atrio-ventricular conduction blocks at higher frequencies. Conclusion: These results yield new insight into functional aspects of murine cardiac development, and may help as a new diagnostic tool to uncover the functional and electrophysiological background of embryonic cardiac phenotypes of genetically altered mice.

  8. Chocolate consumption and prevalence of metabolic syndrome in the NHLBI Family Heart Study

    Science.gov (United States)

    Tokede, Oluwabunmi A.; Ellison, Curtis R.; Pankow, James S.; North, Kari E.; Hunt, Steven C.; Kraja, Aldi T.; Arnett, Donna K.; Djoussé, Luc

    2014-01-01

    SUMMARY Background & aims Previous studies have suggested that cocoa products, which are rich sources of flavonoids, may lower blood pressure, serum cholesterol, fasting blood glucose and improve endothelial function. However, it is unclear whether consumption of cocoa products including chocolate influences the risk of metabolic syndrome (MetS). In a cross-sectional design, we sought to examine the association between chocolate consumption and the prevalence of MetS. Methods We studied 4098 participants from the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study aged 25–93 years. Chocolate consumption was assessed using a semi-quantitative food-frequency questionnaire. MetS was defined using the NCEP III criteria. Generalized estimating equations were used to estimate prevalence odds ratios of MetS according to frequency of chocolate intake. Results Of the 4098 participants (mean age 51.7 y) included in the analyses, 2206 (53.8%) were female. The prevalence of metabolic syndrome in our population was 30.2%. Compared with those who did not consume any chocolate, multivariate adjusted odds ratios (95% CI) for MetS were 1.26 (0.94, 1.69), 1.15 (0.85, 1.55), and 0.99 (0.66, 1.51) among women who reported chocolate consumption of 1–3 times/ month, 1–4 times/week, and 5+ times/week, respectively. Corresponding values for men were: 1.13 (0.82, 1.57), 1.02 (0.74, 1.39), and 1.21 (0.79, 1.85). Conclusion These data do not support an association between chocolate intake and the prevalence of MetS in US adult men and women. PMID:25126517

  9. Heart failure in a cohort of patients with chronic kidney disease: the GCKD study.

    Directory of Open Access Journals (Sweden)

    Hanna Beck

    Full Text Available Chronic kidney disease (CKD is a risk factor for development and progression of heart failure (HF. CKD and HF share common risk factors, but few data exist on the prevalence, signs and symptoms as well as correlates of HF in populations with CKD of moderate severity. We therefore aimed to examine the prevalence and correlates of HF in the German Chronic Kidney Disease (GCKD study, a large observational prospective study.We analyzed data from 5,015 GCKD patients aged 18-74 years with an estimated glomerular filtration rate (eGFR of 500 mg/d. We evaluated a definition of HF based on the Gothenburg score, a clinical HF score used in epidemiological studies (Gothenburg HF, and self-reported HF. Factors associated with HF were identified using multivariable adjusted logistic regression. The prevalence of Gothenburg HF was 43% (ranging from 24% in those with eGFR >90 to 59% in those with eGFR<30 ml/min/1.73m2. The corresponding estimate for self-reported HF was 18% (range 5%-24%. Lower eGFR was significantly and independently associated with the Gothenburg definition of HF (p-trend <0.001. Additional significantly associated correlates included older age, female gender, higher BMI, hypertension, diabetes mellitus, valvular heart disease, anemia, sleep apnea, and lower educational status.The burden of self-reported and Gothenburg HF among patients with CKD is high. The proportion of patients who meet the criteria for Gothenburg HF in a European cohort of patients with moderate CKD is more than twice as high as the prevalence of self-reported HF. However, because of the shared signs, symptoms and medications of HF and CKD, the Gothenburg score cannot be used to reliably define HF in CKD patients. Our results emphasize the need for early screening for HF in patients with CKD.

  10. THE ROLE OF PHYSICAL THERAPY IN DIMINISHING THE EFFECTS OF THE CONGENITAL HEART DEFECT - CASE STUDY

    Directory of Open Access Journals (Sweden)

    Croitoru Ramona

    2014-03-01

    Full Text Available In ROMANIA, fetal abnormalities are the cause of 20-30% of infant mortality, being second only to prematurity - 53% in 2005. The restriction of the fetal growth represents the main cause for intrauterine fetal death (60-70%, and the second cause of neonatal deaths - 41%. Perinatal mortality is caused by 6 obstetrical complications: prematurity, multiple pregnancy, pregnancy-induced hypertension, uteroplacental apoplexy, placenta praevia, pelvic presentation. The termination of pregnancy for prenatally diagnosed fetal abnormalities is excluded from the perinatal mortality statistics, according to the epidemiological information. The motivation for choosing a physical therapy intervention in the case of the pediatric congenital heart defect is represented by its number of pediatric cases, and by the problems confronted by the medical teams, the professional literature not being always very clear about the situations encountered in the everyday practice. As the number of congenital heart and blood vessels defects is the highest among pediatric cardiovascular pathologies, they represent a field of maximum interest for rehabilitation in pediatric cardiology.Several modern medicine studies show that physical therapy plays an important role in the rehabilitation of cardiovascular patients.Starting from several cases we researched in relation to our theme, but also from the consulted professional literature, we chose this theme to highlight the importance of this malformative syndrome, and the difficulties that can appear during functional rehabilitation.In conclusion, the results obtained after conducting this study allow us to say that our hypotheses, stating that through a correct and complete assessment of the motor potential one can intervene, using physical therapy means, to reestablish a lost function, and by selecting correctly the means and methods based on the extremely complex diagnosis of the case study, one can contribute to the improvement

  11. Mobile biofeedback of heart rate variability in patients with diabetic polyneuropathy: a preliminary study.

    Science.gov (United States)

    Druschky, Katrin; Druschky, Achim

    2015-09-01

    Biofeedback of heart rate variability (HRV) was applied to patients with diabetic polyneuropathy using a new mobile device allowing regularly scheduled self-measurements without the need of visits to a special autonomic laboratory. Prolonged generation of data over an eight-week period facilitated more precise investigation of cardiac autonomic function and assessment of positive and negative trends of HRV parameters over time. Statistical regression analyses revealed significant trends in 11 of 17 patients, while no significant differences were observed when comparing autonomic screening by short-term HRV and respiratory sinus arrhythmia at baseline and after the 8 weeks training period. Four patients showed positive trends of HRV parameters despite the expected progression of cardiac autonomic dysfunction over time. Patient compliance was above 50% in all but two patients. The results of this preliminary study indicate a good practicality of the handheld device and suggest a potential positive effect on cardiac autonomic neuropathy in patients with type 2 diabetes.

  12. Coronary heart disease and associated risk factors in Qazvin: a population-based study.

    Science.gov (United States)

    Fakhrzadeh, H; Bandarian, F; Adibi, H; Samavat, T; Malekafzali, H; Hodjatzadeh, E; Larijani, B

    2008-01-01

    In a cross-sectional study in Qazvin, Islamic Republic of Iran, 846 residents (425 men and 421 women) aged > or = 25 years were assessed for coronary heart disease and its associated risk factors comparing ischaemic and non-ischaemic groups. The age-adjusted prevalence of possible myocardial infarction, ischaemic ECG changes and angina pectoris were 4.2%, 36.8% and 2.2% respectively. There was no difference in the mean systolic and diastolic blood pressure and body mass index between ischaemic and non-ischaemic groups. There was a significant association between possible myocardial infarction and hypertension, type 2 diabetes, and smoking in women. There was also a significant association between ischaemic ECG changes and waist-hip ratio in women and between ischaemic ECG changes and hypertension in men.

  13. Dietary intakes of macronutrients among Mexican Americans and Anglo Americans: the San Antonio heart study.

    Science.gov (United States)

    Haffner, S M; Knapp, J A; Hazuda, H P; Stern, M P; Young, E A

    1985-12-01

    Twenty-four-hour dietary recalls were obtained on 1254 Mexican Americans (MA) and 916 Anglo Americans (AA), aged 25 to 64, as part of the San Antonio heart study, a population-based survey of cardiovascular risk factors from 1979 to 1982. In order to separate the effects of ethnicity from those of socioeconomic status (SES), we sampled subjects in three distinct neighborhoods: a low income MA neighborhood (barrio), a middle income neighborhood, and an upper income, predominantly Anglo, neighborhood. Intakes of protein, fat, and carbohydrate were similar to those found in other dietary surveys (NHANES, LRC). MA females living in the barrio consumed more cholesterol than either Anglos or MAs living in the other two neighborhoods. In MA males, the rise in the Hegsted Score with increasing SES paralleled the rise in LDL cholesterol with rising SES reported previously by our group. Females consumed a less atherogenic diet than males.

  14. Autonomic dysfunction in HIV patients on antiretroviral therapy: studies of heart rate variability

    DEFF Research Database (Denmark)

    Lebech, Anne-Mette; Kristoffersen, Ulrik Sloth; Mehlsen, Jesper;

    2007-01-01

    BACKGROUND: The presence of autonomic dysfunction in HIV patients is largely unknown. Early studies found autonomic dysfunction in patients with AIDS. Introduction of highly active antiretroviral combination therapy (ART) has dramatically changed the course of the disease and improved prognosis...... and decreased morbidity. At present it is not known whether introduction of ART also has decreased autonomic dysfunction. AIM: To evaluate whether autonomic dysfunction is present in an ART-treated HIV population. METHODS: HIV patients receiving ART for at least 3 years (n = 16) and an age-matched control group...... guidelines and data reported as median (interquartile range). RESULTS: The resting heart rate was higher in HIV patients compared with controls [69 (62-74) versus 57 (52-60); PHIV group compared with the controls...

  15. Cardiac rehabilitation program in patients with Chagas heart failure: a single-arm pilot study

    Directory of Open Access Journals (Sweden)

    Mauro Felippe Felix Mediano

    2016-06-01

    Full Text Available Abstract: INTRODUCTION: The benefit of a cardiac rehabilitation (CR program for patients with Chagas heart failure (CHF remains unclear. Therefore, we aimed to investigate the effects of CR for CHF patients. METHODS: A single-arm pilot study, including 12 patients with CHF, was performed. Patients participated in an 8-month physical exercise intervention, comprising aerobic, strength, and stretching exercises (3 times per week, 60 minutes per session. Nutritional and pharmaceutical counseling were also performed. Functional capacity (cardiopulmonary exercise test, muscle respiratory strength (manovacuometry, and body composition (anthropometry and skinfolds were evaluated at baseline, and after 4 and 8 months of intervention. Cardiac function (echocardiography, biomarkers (lipid profile, glucose, and glycated hemoglobin and quality of life (Minnesota Living with Heart Failure Questionnaire were assessed at baseline and at the end of the intervention. RESULTS: Seven of 12 patients included in the study completed the 8-month follow-up period. Only 2 moderate adverse events occurred during the exercise training. Functional capacity improved after 4 months of CR, while left ventricular ejection fraction (LVEF and respiratory strength improved after 8 months. Patients with right ventricular (RV dysfunction at baseline exhibited an improvement in functional capacity after 4 months, and improvements in left ventricular (LV diastolic pressure, respiratory strength, and quality of life at the end of follow-up. Conversely, those with normal baseline RV function demonstrated LVEF increases that were not observed in patients with RV dysfunction. CONCLUSIONS: CR was feasible, safe, and has important clinical benefits for patients with CHF, specifically for cardiac function and muscle respiratory strength.

  16. Depressive symptoms and white blood cell count in coronary heart disease patients : Prospective findings from the Heart and Soul Study

    NARCIS (Netherlands)

    Duivis, Hester E.; Kupper, Nina; Penninx, Brenda W.; Na, Beeya; de Jonge, Peter; Whooley, Mary A.

    2013-01-01

    Background: Depression has been associated with elevated white blood cell (WBC) count - indicative of systemic inflammation - in cross-sectional studies, but no longitudinal study has evaluated whether depressive symptoms predict subsequent WBC count or vice versa. We sought to evaluate the bidirect

  17. In situ Raman study of redox state changes of mitochondrial cytochromes in a perfused rat heart

    DEFF Research Database (Denmark)

    Brazhe, Nadezda; Treiman, Marek; Faricelli, Barbara;

    2013-01-01

    surface of the isolated heart at normal and hypoxic conditions. Raman spectra of the heart under normal pO2 demonstrate unique peaks attributable to reduced c-and b-type cytochromes and oxymyoglobin (oMb). The cytochrome peaks decreased in intensity upon FCCP treatment, as predicted from uncoupling...

  18. Drug therapy in heart failure : studies on prescribing, drug induced problems and compliance

    NARCIS (Netherlands)

    Bouvy, M.L.

    2003-01-01

    Due to the ageing of the population and increased survival of patients with acute coronary artery disease, an ‘epidemic’ of heart failure is emerging, illustrated by increasing rates of hospitalisations for heart failure and resulting in a considerable increase in the cost of care for these patients

  19. The Study of Chlamydia Pneumoniae DNA in the Peripheral Blood Mononuclear Cell of Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    Li Tao; Xu Xiang Guang; Zhang Guo Liang; Fang Weihua

    2004-01-01

    Objectives To detection of chlamydia pneumoniae (Cpn) DNA in the circulating mononuclear cell fractions of coronary heart disease and to investigate the association between infection with chlamydia pneumoniae and coronary heart disease (CHD) and prospectively whether blood -based nested polymerase chain reaction ( nPCR ) is useful in identifying Cpn infection. Methods The peripheral blood mononuclear cell (PBMC) Cpn DNA was examined using nPCR technique and confirmed by electrophoresis in 150 patients with CHD. Select 55 patients with clinical suspected CHD but angiography result are normal as control group (CG). Then we conducted a prospective , randomized, double - blind, placebo -controlled study of 6 months of azithromycin and placebo treatment in CHD group. Patients with Cpn DNA positive were then randomized to receive azithromycin or placebo. After treatment blood sample were collected for repeated measurement . Results Chlamydia pneumoniae DNA was detected in 49(32.7% ) of 150persons with CHD and in 1 ( 1.8% ) of 55 persons with control group,odds ratio 26.2, 95% confidence interva13.52 - 194.98. The positivity rates of nPCR in CHD groups were higher than those in control group. 16 cases (29. 1% ) in latent coronary heart diseases(LCHD) group , 19 cases (39.6%) in unstable angina(UAP) group ,and 14 cases (29.9%) in acute myocardial infarction (AMI)group were Cpn positive by nPCR. There were no significant difference among in AMIUAP and LCHD group. There were significiant difference in Cpn DNA negative rates after the azithromycin and the placebo treatment. Conclusions Chlamydia pneumoniae is present in PBMC of a significant proportion of persons with CHD. The potential role of chlamydia pneumoniae in coronary atherosclerosis may therefore be more related to acceleration of disease or systemic effects by persistent infection than to sudden initiation of progressive coronary artery disease by acute infection. The detection of Cpn DNA in PBMC with nPCR may be

  20. Literature-based genetic risk scores for coronary heart disease : the Cardiovascular Registry Maastricht (CAREMA) Prospective Cohort Study

    NARCIS (Netherlands)

    Vaathorst, A.A.; Lu Yingchang (Kevin), Y.; Heijmans, B.T.; Dolle, M.E.; Bohringer, S.; Putter, de H.; Imholz, S.; Merry, A.H.; Greevenbroek, M.M.; Jukema, J.W.; Gorgels, A.P.; Brandt, van den P.A.; Muller, M.R.; Schouten, L.J.; Feskens, E.J.M.; Boer, J.M.A.; Slagboom, P.E.

    2012-01-01

    Background-Genome-wide association studies (GWAS) have identified many single-nucleotide polymorphisms (SNPs) associated with coronary heart disease (CHD) or CHD risk factors (RF). Using a case-cohort study within the prospective Cardiovascular Registry Maastricht (CAREMA) cohort, we tested if genet

  1. The Potentially Modifiable Burden of Incident Heart Failure Due to Obesity: The Atherosclerosis Risk in Communities Study

    OpenAIRE

    Loehr, Laura R; Rosamond, Wayne D.; Poole, Charles; McNeill, Ann Marie; Chang, Patricia P.; Deswal, Anita; Aaron R. Folsom; Heiss, Gerardo

    2010-01-01

    The authors estimated the generalized impact fraction (GIF) for heart failure (HF) related to obesity, representing the proportion of incident HF events that could be prevented from reductions in obesity and/or overweight. The Atherosclerosis Risk in Communities Study is a biracial population-based cohort study of persons aged 45–64 years from 4 US communities with a median 14 ye...

  2. First-Trimester Use of Paroxetine and Congenital Heart Defects : A Population-Based Case-Control Study

    NARCIS (Netherlands)

    Bakker, Marian K.; Kerstjens-Frederikse, Wilhelmina S.; Buys, Charles H. C. M.; de Walle, Hermien E. K.; de Jong-van den Berg, Lolkje T. W.

    2010-01-01

    BACKGROUND: There is a need for case-control studies of the effect of paroxetine on the occurrence of specific heart defects. METHODS: We performed a case-control study with data from a population-based birth defects registry in the Netherlands. All the children born between 1997 and 2006 were selec

  3. Low Lymphocyte Ratio as a Novel Prognostic Factor in Acute Heart Failure : Results from the Pre-RELAX-AHF Study

    NARCIS (Netherlands)

    Milo-Cotter, Olga; Teerlink, John R.; Metra, Marco; Felker, G. Michael; Ponikowski, Piotr; Voors, Adriaan A.; Edwards, Christopher; Weatherley, Beth Davison; Greenberg, Barry; Filippatos, Gerassimos; Unemori, Elaine; Teichman, Sam L.; Cotter, Gad

    2010-01-01

    Background: Previous studies have suggested that a lower lymphocyte ratio (Ly%) in the white blood cell (WBC) differential count is related to worse outcomes in patients with acute heart failure (AHF) and other cardiovascular disorders. Methods: In the Pre-RELAX-AHF study, 234 patients with AHF, sys

  4. Cell-cell interaction in blood flow in patients with coronary heart disease (in vitro study)

    Science.gov (United States)

    Malinova, Lidia I.; Simonenko, Georgy V.; Denisova, Tatyana P.; Tuchin, Valery V.

    2007-02-01

    Blood cell-cell and cell-vessel wall interactions are one of the key patterns in blood and vascular pathophysiology. We have chosen the method of reconstruction of pulsative blood flow in vitro in the experimental set. Blood flow structure was studied by PC integrated video camera with following slide by slide analysis. Studied flow was of constant volumetric blood flow velocity (1 ml/h). Diameter of tube in use was comparable with coronary arteries diameter. Glucose solution and unfractured heparin were used as the nonspecial irritants of studied flow. Erythrocytes space structure in flow differs in all groups of patients in our study (men with stable angina pectoris (SAP), myocardial infarction (MI) and practically healthy men (PHM). Intensity of erythrocytes aggregate formation was maximal in patients with SAP, but time of their "construction/deconstruction" at glucose injection was minimal. Phenomena of primary clotting formation in patients with SAP of high function class was reconstructed under experimental conditions. Heparin injection (10 000 ED) increased linear blood flow velocity both in patients with SAP, MI and PHP but modulated the cell profile in the flow. Received data correspond with results of animal model studies and noninvasive blood flow studies in human. Results of our study reveal differences in blood flow structure in patients with coronary heart disease and PHP under irritating conditions as the possible framework of metabolic model of coronary blood flow destabilization.

  5. Effectiveness of a multidisciplinary heart failure disease management programme on 1-year mortality: Prospective cohort study.

    Science.gov (United States)

    Laborde-Castérot, Hervé; Agrinier, Nelly; Zannad, Faiez; Mebazaa, Alexandre; Rossignol, Patrick; Girerd, Nicolas; Alla, François; Thilly, Nathalie

    2016-09-01

    We performed a multicenter prospective observational cohort study (Epidémiologie et Pronostic de l'Insuffisance Cardiaque Aiguë en Lorraine, Epidemiology and Prognosis of Acute Heart Failure in Lorraine [EPICAL2]) to evaluate the effectiveness on mortality of a community-based multidisciplinary disease management programme (DMP) for heart failure (HF) patients.Between October 2011 and October 2012, 1816 patients, who were hospitalized for acute HF or who developed acute HF during a hospitalization, were included from 21 hospitals in a northeast region of France. At hospital admission, their mean age was 77.3 (standard deviation [SD] 11.6) years and mean left ventricular ejection fraction was 45.0 (SD 16.0)%. A subset of patients were enrolled in a multidimensional DMP for HF (n = 312, 17.2%), based on structured patient education, home monitoring visits by HF-trained nurses, and automatic alerts triggered by significant clinical and biological changes to the patient. The DMP involved general practitioners, nurses, and cardiologists collaborating via an individual web-based medical electronic record. The outcome was all-cause mortality from the 3rd to the 12th month after discharge. During the follow-up, a total of 377 (20.8%) patients died: 321 (21.3%) in the control group and 56 (17.9%) in the DMP group. In a propensity score analysis, DMP was associated with lower 1-year all-cause mortality (hazard ratio 0.65, 95% CI 0.46-0.92). Instrumental variable analysis gave similar results (hazard ratio 0.56, 0.27-1.16).In a real world setting, a multidimensional DMP for HF with structured patient education, home nurse monitoring, and appropriate physician alerts may improve survival when implemented after discharge from hospitalization due to worsening HF.

  6. Risk of heart failure after community acquired pneumonia: prospective controlled study with 10 years of follow-up.

    Science.gov (United States)

    Eurich, Dean T; Marrie, Thomas J; Minhas-Sandhu, Jasjeet K; Majumdar, Sumit R

    2017-02-13

    Objective To determine the attributable risk of community acquired pneumonia on incidence of heart failure throughout the age range of affected patients and severity of the infection.Design Cohort study.Setting Six hospitals and seven emergency departments in Edmonton, Alberta, Canada, 2000-02.Participants 4988 adults with community acquired pneumonia and no history of heart failure were prospectively recruited and matched on age, sex, and setting of treatment (inpatient or outpatient) with up to five adults without pneumonia (controls) or prevalent heart failure (n=23 060).Main outcome measures Risk of hospital admission for incident heart failure or a combined endpoint of heart failure or death up to 2012, evaluated using multivariable Cox proportional hazards analyses.Results The average age of participants was 55 years, 2649 (53.1%) were men, and 63.4% were managed as outpatients. Over a median of 9.9 years (interquartile range 5.9-10.6), 11.9% (n=592) of patients with pneumonia had incident heart failure compared with 7.4% (n=1712) of controls (adjusted hazard ratio 1.61, 95% confidence interval 1.44 to 1.81). Patients with pneumonia aged 65 or less had the lowest absolute increase (but greatest relative risk) of heart failure compared with controls (4.8% v 2.2%; adjusted hazard ratio 1.98, 95% confidence interval 1.5 to 2.53), whereas patients with pneumonia aged more than 65 years had the highest absolute increase (but lowest relative risk) of heart failure (24.8% v 18.9%; adjusted hazard ratio 1.55, 1.36 to 1.77). Results were consistent in the short term (90 days) and intermediate term (one year) and whether patients were treated in hospital or as outpatients.Conclusion Our results show that community acquired pneumonia substantially increases the risk of heart failure across the age and severity range of cases. This should be considered when formulating post-discharge care plans and preventive strategies, and assessing downstream episodes of

  7. Heart wall is thicker on postmortem computed tomography than on antemortem [corrected] computed tomography: the first longitudinal study.

    Directory of Open Access Journals (Sweden)

    Hidemi Okuma

    Full Text Available OBJECTIVE: To evaluate the postmortem changes of the heart wall on postmortem (PM computed tomography (CT in comparison with those on ante mortem CT (AMCT, and in comparison with the pathological findings, obtained in the same patients. MATERIALS AND METHODS: We studied 57 consecutive patients who had undergone AMCT, PMCT, and pathological autopsy in our tertiary care hospital between April 2009 and December 2010. PMCT was performed within 20 hours after death, followed by pathological autopsy. The cardiac chambers were measured at five sites on both AMCT and PMCT by two board-certified radiologists who were not provided with clinical information. The differences in heart wall thickness between AMCT with and without contrast medium, between AMCT and PMCT, and between PMCT and pathological anatomy were evaluated statistically. Confounding factors of postmortem change such as gender, presence of arteriosclerosis, the organ related to cause of death, age, and elapsed time since death were examined statistically. RESULTS: No significant differences were observed on AMCT in comparison of contrasted and non-contrasted images. The heart wall was significantly thicker on PMCT than on AMCT (p < 0.0001 at all five measurement sites. The heart wall was significantly thicker on PMCT than on pathology specimens when measured in accordance with pathological standard mensuration. However, no significant difference was observed between PMCT measurements and those of pathology specimens at any site when the papillary muscles and epicardial fat were included. No significant association was found between postmortem change in heart wall thickness and gender, presence of arteriosclerosis, the organ related to cause of death, age, or elapsed time since death. CONCLUSION: This is the first longitudinal study to confirm greater thickness of heart wall on postmortem images compared with ante mortem images, in the same patients. Furthermore, the postmortem changes on CT

  8. High resolution MR imaging of the fetal heart with cardiac triggering: a feasibility study in the sheep fetus

    Energy Technology Data Exchange (ETDEWEB)

    Yamamura, Jin; Frisch, Michael; Adam, Gerhard; Wedegaertner, Ulrike [University Hospital Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Schnackenburg, Bernhard; Kooijmann, Hendrik [Philips Medical Systems, Hamburg (Germany); Hecher, Kurt [University Hospital Hamburg-Eppendorf, Department of Obstetrics and Fetal Medicine, Hamburg (Germany)

    2009-10-15

    The aim of this study was to perform fetal cardiac magnetic resonance imaging (MRI) with triggering of the fetal heart beat in utero in a sheep model. All experimental protocols were reviewed and the usage of ewes and fetuses was approved by the local animal protection authorities. Images of the hearts of six pregnant ewes were obtained by using a 1.5-T MR system (Philips Medical Systems, Best, Netherlands). The fetuses were chronically instrumented with a carotid catheter to measure the fetal heart frequency for the cardiac triggering. Pulse wave triggered, breath-hold cine-MRI with steady-state free precession (SSFP) was achieved in short axis, two-, four- and three-chamber views. The left ventricular volume and thus the function were measured from the short axis. The fetal heart frequencies ranged between 130 and 160 bpm. The mitral, tricuspid, aortic, and pulmonary valves could be clearly observed. The foramen ovale could be visualized. Myocardial contraction was shown in cine sequences. The average blood volume at the end systole was 3.4{+-}0.2 ml ({+-} SD). The average volume at end diastole was 5.2{+-}0.2 ml; thus the stroke volumes of the left ventricle in the systole were between 1.7 and 1.9 ml with ejection fractions of 38.6% and 39%, respectively. The pulse wave triggered cardiac MRI of the fetal heart allowed evaluation of anatomical structures and functional information. This feasibility study demonstrates the applicability of MRI for future evaluation of fetuses with complex congenital heart defects, once a noninvasive method has been developed to perform fetal cardiac triggering. (orig.)

  9. Spirituality, Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study.

    Science.gov (United States)

    Bruce, Marino A; Beech, Bettina M; Griffith, Derek M; Thorpe, Roland J

    2016-01-01

    Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12-19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07-1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02-1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors.

  10. Association of Helicobacter pylori infection with lipid profiles: The Persian Gulf Healthy Heart Study

    Directory of Open Access Journals (Sweden)

    Hussain Darabi

    2014-10-01

    Full Text Available Background: Helicobacter pylori (H.pylori infection may contribute to the development of extra-gastrointestinal manifestations like cardiovascular diseases. Detection of Helicobacter pylori in Athrosclerotic plaques is a strong evidence for this association which may play a role in pathogenesis of atherosclerosis with classic cardiovascular risk factor such as hypertension and lipid profile. The aim of this study was to explore the influence of H. pylori infection on lipid profiles in a large community- based study. Material and Methods: A total of 1754 (50.8% Female & 49.2% male subjects (age >25 years old were selected randomely from Monica Healthy Heart Study project. H. pylori status was determined by IgG ELISA method. Subjects with titers > 30 Iu/ml were cansidered seropositive. Data were analazed by using statistical software Spss version 18 and probability values 0.05 Conclusion: According to this large – scale population- based study in large northern cities of Persian Gulf, there was no significant association between H.pylori IgG seropositivity and lipid profiles in both men and women.

  11. Automatic identification of type 2 diabetes, hypertension, ischaemic heart disease, heart failure and their levels of severity from Italian General Practitioners' electronic medical records: a validation study

    Science.gov (United States)

    Schuemie, Martijn J; Mazzaglia, Giampiero; Lapi, Francesco; Francesconi, Paolo; Pasqua, Alessandro; Bianchini, Elisa; Montalbano, Carmelo; Roberto, Giuseppe; Barletta, Valentina; Cricelli, Iacopo; Cricelli, Claudio; Dal Co, Giulia; Bellentani, Mariadonata; Sturkenboom, Miriam; Klazinga, Niek

    2016-01-01

    Objectives The Italian project MATRICE aimed to assess how well cases of type 2 diabetes (T2DM), hypertension, ischaemic heart disease (IHD) and heart failure (HF) and their levels of severity can be automatically extracted from the Health Search/CSD Longitudinal Patient Database (HSD). From the medical records of the general practitioners (GP) who volunteered to participate, cases were extracted by algorithms based on diagnosis codes, keywords, drug prescriptions and results of diagnostic tests. A random sample of identified cases was validated by interviewing their GPs. Setting HSD is a database of primary care medical records. A panel of 12 GPs participated in this validation study. Participants 300 patients were sampled for each disease, except for HF, where 243 patients were assessed. Outcome measures The positive predictive value (PPV) was assessed for the presence/absence of each condition against the GP's response to the questionnaire, and Cohen's κ was calculated for agreement on the severity level. Results The PPV was 100% (99% to 100%) for T2DM and hypertension, 98% (96% to 100%) for IHD and 55% (49% to 61%) for HF. Cohen's kappa for agreement on the severity level was 0.70 for T2DM and 0.69 for hypertension and IHD. Conclusions This study shows that individuals with T2DM, hypertension or IHD can be validly identified in HSD by automated identification algorithms. Automatic queries for levels of severity of the same diseases compare well with the corresponding clinical definitions, but some misclassification occurs. For HF, further research is needed to refine the current algorithm. PMID:27940627

  12. Dietary fiber intake in relation to coronary heart disease and all-cause mortality over 40 y: the Zutphen Study

    NARCIS (Netherlands)

    Streppel, M.T.; Ocke, M.C.; Boshuizen, H.C.; Kok, F.J.; Kromhout, D.

    2008-01-01

    Background: Little is known about the effects of dietary fiber intake on long-term mortality. Objective: We aimed to study recent and long-term dietary fiber intake in relation to coronary heart disease and all-cause mortality. Design: The effects of recent and long-term dietary fiber intakes on mor

  13. Mediation of sensation seeking and behavioral inhibition on the longitudinal relationship between heart rate and antisocial behavior : The TRAILS Study

    NARCIS (Netherlands)

    Sijtsema, Jelle J.; Veenstra, Rene; Lindenberg, Siegwart; van Roon, Arie M.; Verhulst, Frank C.; Ormel, Johan; Riese, Harriette

    2010-01-01

    Objective: Why is low resting heart rate (HR) associated with antisocial behavior (ASB), i.e., aggression and rule breaking, in adolescence? Theory suggests that personality traits mediate this relationship but differently with age. In the present study this age-effect hypothesis is tested; we expec

  14. Longitudinal association between dairy consumption and changes of body weight and waist circumference: the Framingham Heart Study

    Science.gov (United States)

    Dairy foods are nutrient dense and may be protective against long-term weight gain. We aimed to examine the longitudinal association between dairy consumption and annualized changes in weight and waist circumference (WC) in adults. Members of the Framingham Heart Study Offspring Cohort who participa...

  15. Low blood pressure predicts increased mortality in very old age even without heart failure: the Leiden 85-plus Study

    NARCIS (Netherlands)

    Poortvliet, R.K.; Blom, J.W.; Craen, A.J. de; Mooijaart, S.P.; Westendorp, R.G.J.; Assendelft, W.J.J.; Gussekloo, J.; Ruijter, W. de

    2013-01-01

    AIMS: To investigate whether low systolic blood pressure is predictive for increased mortality risk in 90-year-old subjects without heart failure, defined by low levels of NT-proBNP, as well as in 90-year-old subjects with high levels of NT-proBNP. METHODS AND RESULTS: This study was embedded in the

  16. Lipoprotein(a) levels, apo(a) isoform size, and coronary heart disease risk in the Framingham Offspring Study

    Science.gov (United States)

    The aim of this study was to assess the independent contributions of plasma levels of lipoprotein(a) [Lp(a)], Lp(a) cholesterol, and of apo(a) isoform size to prospective coronary heart disease (CHD) risk. Plasma Lp(a) and Lp(a) cholesterol levels, and apo(a) isoform size were measured at examinati...

  17. Prosthetic valves in adult patients with congenital heart disease : Rationale and design of the Dutch PROSTAVA study

    NARCIS (Netherlands)

    Freling, H. G.; van Slooten, Y. J.; van Melle, J. P.; Mulder, B. J. M.; van Dijk, A. P. J.; Hillege, H. L.; Post, M. C.; Sieswerda, G. Tj; Jongbloed, M. R. M.; Willems, T. P.; Pieper, P. G.

    2012-01-01

    Data on long-term complications in adult patients with congenital heart disease (ACHD) and a prosthetic valve are scarce. Moreover, the influence of prosthetic valves on quality of life (QoL) and functional outcome in ACHD patients with prosthetic valves has not been studied. The primary objective o

  18. Determinants of heart failure self-care behaviour in community-based patients: a cross-sectional study

    NARCIS (Netherlands)

    Peters-Klimm, F.; Freund, T.; Kunz, C.; Laux, G.; Frankenstein, L.; Muller-Tasch, T.; Szecsenyi, J.

    2013-01-01

    Background: Self-care behaviour in patients with heart failure (HF) represents a series of specific actions that patients should take, as an important treatment component. Aims: The aim of this study was to identify potential determinants of HF self-care in ambulatory patients with stable systolic H

  19. STUDY AND APPLICATION ABOUT COMPUTED SYSTEM FOR EXTERNAL CARDIAC MASSAGE,MONITOR OF HEART AND BODY TEMPERATURE

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To make and study computed system for external cardiac massage, monitor of heart and body temperature and observe its clinical effect. Method: The system was made and applied. Result: The effect of system was obvious. Conclusion: The system was an effective clinical equipment in treatment of patient with cardiac arrest.

  20. Dietary Patterns Predict Subsequent Coronary Heart Disease Risk In Postmenopausal Women : The Women’s Health Initiative Observational Cohort Study

    Science.gov (United States)

    Background: Evidence suggests that dietary patterns predispose to the development of coronary heart disease (CHD). The relationship between dietary patterns and CHD risk was assessed in postmenopausal women participating in the Women’s Health Initiative Observational Study (WHI-OS). Methods: Case-co...

  1. Relationship between common lipoprotein lipase gene sequence variants, hyperinsulinemia, and risk of ischemic heart disease: A population-based study

    DEFF Research Database (Denmark)

    Jeppesen, Jørgen; Hansen, Tine Willum; Torp-Pedersen, Christian;

    2010-01-01

    Hyperinsulinemia and lipoprotein lipase (LPL) are important determinants of fasting and postprandial plasma triglyceride levels. High insulin and high triglyceride levels are associated with an increased risk of ischemic heart disease (IHD). This study aimed to find out whether common LPL gene...

  2. Prosthetic valves in adult patients with congenital heart disease: Rationale and design of the Dutch PROSTAVA study

    NARCIS (Netherlands)

    Freling, H.G.; Slooten, Y.J. van; Melle, J.P. van; Mulder, B.J.; Dijk, A.P. van; Hillege, H.L.; Post, M.C.; Sieswerda, G.T.; Jongbloed, M.R.; Willems, T.P.; Pieper, P.G.

    2012-01-01

    BACKGROUND: Data on long-term complications in adult patients with congenital heart disease (ACHD) and a prosthetic valve are scarce. Moreover, the influence of prosthetic valves on quality of life (QoL) and functional outcome in ACHD patients with prosthetic valves has not been studied. OBJECTIVES:

  3. Prospective associations of coronary heart disease loci in African Americans using the MetaboChip : The PAGE study

    NARCIS (Netherlands)

    N. Franceschini (Nora); Hu, Y. (Yijuan); A. Reiner (Alexander); S. Buyske (Steven); M.A. Nalls (Michael); L.R. Yanek (Lisa); Y. Li (Yun); L.A. Hindorff (Lucia A); Cole, S.A. (Shelley A.); Howard, B.V. (Barbara V.); J.M. Stafford (Jeanette M.); C. Carty (Cara); P. Sethupathy (Praveen); Martin, L.W. (Lisa W.); D.Y. Lin (Dan); Johnson, K.C. (Karen C.); L.C. Becker (Lewis); K.E. North (Kari); A. Dehghan (Abbas); J.C. Bis (Joshua); Y. Liu (Yongmei); P. Greenland (Philip); J.E. Manson (Joann); Maeda, N. (Nobuyo); M.E. Garcia (M.); T.B. Harris (Tamara); D.M. Becker (Diane); C.J. O'Donnell (Christopher); G. Heiss (Gerardo); C. Kooperberg (Charles); E.A. Boerwinkle (Eric)

    2014-01-01

    textabstractBackground: Coronary heart disease (CHD) is a leading cause of morbidity and mortality in African Americans. However, there is a paucity of studies assessing genetic determinants of CHD in African Americans. We examined the association of published variants in CHD loci with incident CHD,

  4. Implementation of case management to reduce cardiovascular disease risk in the Stanford and San Mateo Heart to Heart randomized controlled trial: study protocol and baseline characteristics

    Directory of Open Access Journals (Sweden)

    Stafford Randall S

    2006-09-01

    Full Text Available Abstract Background Case management has emerged as a promising alternative approach to supplement traditional one-on-one sessions between patients and doctors for improving the quality of care in chronic diseases such as coronary heart disease (CHD. However, data are lacking in terms of its efficacy and cost-effectiveness when implemented in ethnic and low-income populations. Methods The Stanford and San Mateo Heart to Heart (HTH project is a randomized controlled clinical trial designed to rigorously evaluate the efficacy and cost-effectiveness of a multi-risk cardiovascular case management program in low-income, primarily ethnic minority patients served by a local county health care system in California. Randomization occurred at the patient level. The primary outcome measure is the absolute CHD risk over 10 years. Secondary outcome measures include adherence to guidelines on CHD prevention practice. We documented the study design, methodology, and baseline sociodemographic, clinical and lifestyle characteristics of 419 participants. Results We achieved equal distributions of the sociodemographic, biophysical and lifestyle characteristics between the two randomization groups. HTH participants had a mean age of 56 years, 63% were Latinos/Hispanics, 65% female, 61% less educated, and 62% were not employed. Twenty percent of participants reported having a prior cardiovascular event. 10-year CHD risk averaged 18% in men and 13% in women despite a modest low-density lipoprotein cholesterol level and a high on-treatment percentage at baseline. Sixty-three percent of participants were diagnosed with diabetes and an additional 22% had metabolic syndrome. In addition, many participants had depressed high-density lipoprotein (HDL cholesterol levels and elevated values of total cholesterol-to-HDL ratio, triglycerides, triglyceride-to-HDL ratio, and blood pressure. Furthermore, nearly 70% of participants were obese, 45% had a family history of CHD or

  5. Tobacco Use and Cardiovascular Disease among American Indians: The Strong Heart Study

    Directory of Open Access Journals (Sweden)

    Thomas K. Welty

    2010-10-01

    Full Text Available Tobacco use among American Indians has a long and complicated history ranging from its utilization in spiritual ceremonies to its importance as an economic factor for survival. Despite this cultural tradition and long history, there are few studies of the health effects of tobacco in this population. The Strong Heart Study is a prospective observational study of cardiovascular disease (CVD in 13 American Indian tribes in Arizona, Oklahoma, and North and South Dakota with 4,549 participants. Baseline examinations were followed by two examinations at regular intervals and 16 years of morbidity and mortality follow-up. Hazard ratios (HRs for non-fatal CVD for current smokers vs. non-smokers after adjusting for other risk factors were significant in women (HR = 1.94, 95% CI 1.54 to 2.45 and men (HR = 1.59, 95% CI 1.16 to 2.18. Hazard ratios for fatal CVD for current smokers vs. non-smokers after adjusting for other risk factors were significant in women (HR = 1.64, 95% CI 1.04 to 2.58, but not in men. Individuals who smoked and who were diagnosed with diabetes mellitus, hypertension or renal insufficiency were more likely to quit smoking than those without these conditions. On average, American Indians smoke fewer cigarettes per day than other racial/ethnic groups; nevertheless, the ill effects of habitual tobacco use are evident in this population.

  6. A comparative study of the palliative care needs of heart failure and cancer patients.

    LENUS (Irish Health Repository)

    O'Leary, Norma

    2012-02-01

    AIMS: Studies suggest that patients with advanced heart failure (HF) have unmet palliative care (PC) needs. However, many of these studies have been retrospective or based on patients receiving poorly coordinated ad hoc care. We aimed to demonstrate whether the PC needs of patients with advanced HF receiving specialist multidisciplinary coordinated care are similar to cancer patients deemed to have specialist PC needs; thereby justifying the extension of specialist PC services to HF patients. METHODS AND RESULTS: This was a cross-sectional comparative cohort study of 50 HF patients and 50 cancer patients, using quantitative and qualitative methods. Both patient cohorts were statistically indistinguishable in terms of symptom burden, emotional wellbeing, and quality-of-life scores. HF patients had good access to community and social support. HF patients particularly valued the close supervision, medication monitoring, ease of access to service, telephone support, and key worker provided at the HF unit. A small subset of patients had unmet PC needs. A palliative transition point is described. CONCLUSION: HF patients should not be excluded from specialist PC services. However, the majority of their needs can be met at a HF unit. Recognition of the palliative transition point may be key to ensuring that end-of-life issues are addressed. The palliative transition point needs further evaluation.

  7. Tobacco Use and Cardiovascular Disease among American Indians: The Strong Heart Study

    Science.gov (United States)

    Eichner, June E.; Wang, Wenyu; Zhang, Ying; Lee, Elisa T.; Welty, Thomas K.

    2010-01-01

    Tobacco use among American Indians has a long and complicated history ranging from its utilization in spiritual ceremonies to its importance as an economic factor for survival. Despite this cultural tradition and long history, there are few studies of the health effects of tobacco in this population. The Strong Heart Study is a prospective observational study of cardiovascular disease (CVD) in 13 American Indian tribes in Arizona, Oklahoma, and North and South Dakota with 4,549 participants. Baseline examinations were followed by two examinations at regular intervals and 16 years of morbidity and mortality follow-up. Hazard ratios (HRs) for non-fatal CVD for current smokers vs. non-smokers after adjusting for other risk factors were significant in women (HR = 1.94, 95% CI 1.54 to 2.45) and men (HR = 1.59, 95% CI 1.16 to 2.18). Hazard ratios for fatal CVD for current smokers vs. non-smokers after adjusting for other risk factors were significant in women (HR = 1.64, 95% CI 1.04 to 2.58), but not in men. Individuals who smoked and who were diagnosed with diabetes mellitus, hypertension or renal insufficiency were more likely to quit smoking than those without these conditions. On average, American Indians smoke fewer cigarettes per day than other racial/ethnic groups; nevertheless, the ill effects of habitual tobacco use are evident in this population. PMID:21139862

  8. Human heart sarcolemmal sheath antibodies in children with non-suppurative sequelae of group A streptococcal infections: a follow up study.

    OpenAIRE

    1991-01-01

    The kinetics of the human heart sarcolemmal sheath antibody were studied in children with acute rheumatic fever who had no carditis, children with acute rheumatic fever who had carditis and developed rheumatic heart disease, and in children with acute poststreptococcal glomerulonephritis. The children with rheumatic fever and those who developed valvular heart disease were given continuous secondary antistreptococcal prophylaxis. The titre of antibody at onset was significantly higher than th...

  9. Heart Failure

    Science.gov (United States)

    ... heart failure due to systolic dysfunction. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ... patient with heart failure or cardiomyopathy. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ...

  10. Heart palpitations

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  11. Heart pacemaker

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  12. Study protocol: systematic review of the burden of heart failure in low- and middle-income countries

    Directory of Open Access Journals (Sweden)

    Bennett Derrick A

    2012-11-01

    Full Text Available Abstract Background Setting priorities for the prevention and management of heart failure requires an empirical understanding of the pattern of disease burden. We aim to describe the methods for a systematic review of the literature on burden of heart failure in low- and middle-income countries (LMIC and how this information will be synthesized to produce useful estimates that can inform policy and practice. Methods We will conduct a comprehensive search strategy for articles published between 1995 and April 2012 related to incidence, prevalence and treatment of heart failure in LMIC. Populations will be coded as urban, rural, or combined and studies classified as national, sub-national, healthcare system-based, or community level. Details from eligible studies will be extracted independently by two reviewers using a pre-designed data extraction form that will cover information on demographics, diagnostic criteria including disease incidence and prevalence, medical history, medication history, and hospital- or community-based management and outcomes. We will assess the reporting and methodological quality of the included studies and conduct a quantitative summary of reported outcomes where appropriate. Discussion Currently, there are important gaps in our knowledge on the burden of heart failure in LMIC and this systematic review aims to provide useful information that improves our knowledge in this field. Results are expected to be publicly available in early 2013.

  13. Bioengineering approach to study the role of cell migration during zebrafish heart regneration

    OpenAIRE

    Tekeli, Işil

    2016-01-01

    [eng] Zebrafish heart regeneration remains one of the most interesting phenomena of the 21st century. Considering the extremely high rate of deaths due to cardiovascular diseases in the developed countries, 1 out of every 3 people, understanding natural cardiac regeneration would address a worldwide challenge. Even though many aspects of zebrafish heart regeneration have been elucidated, there are still many open questions to be answered. Among these, the work presented here focuses on unders...

  14. Bioengineering approach to study the role of cell migration during zebrafish heart regneration

    OpenAIRE

    Tekeli, Işil

    2016-01-01

    Zebrafish heart regeneration remains one of the most interesting phenomena of the 21st century. Considering the extremely high rate of deaths due to cardiovascular diseases in the developed countries, 1 out of every 3 people, understanding natural cardiac regeneration would address a worldwide challenge. Even though many aspects of zebrafish heart regeneration have been elucidated, there are still many open questions to be answered. Among these, the work presented here focuses on understandin...

  15. A study on prevalence and etiology of heart failure in Qatari residents: Data analysis from a tertiary hospital

    Directory of Open Access Journals (Sweden)

    Barman M, Djamel B.

    2014-07-01

    Full Text Available Objective: Heart failure is a multi-faceted syndrome with diverse etiologies. Knowledge of the cause can be crucial to therapy and management including long term strategy planning. The aim of this study is to analyze the prevalence and etiology of heart failure present in Qatari residents, which is a mix of multiple ethnicities. Qatar is today one of the leading growing economies of the world and witnessing a population boom. It is currently undergoing major lifestyle changes, which comes with aplenty due to recently discovered vast natural resources. Enhanced knowledge of disease incidence/prevalence in the Qatari environment can have a prospect of developing and evaluating novel and more effective approaches for disease prevention, diagnosis and treatment in the future. Methods: Our study was conducted in a total of 50 patients over a period of 21 months in a tertiary care institute. Detailed clinical history, followed by examination and laboratory tests were performed to identify the etiology and data analyzed to study the prevalence. Results: Our study revealed that in all cases of HF admitted in our hospital, 52% were males and 48% were females. The occurrence of Congestive Heart Failure (CHF was highest between 50 and 80 years in both males and females. The relation of CHF to various etiologies has been discussed. The data has also been compared with select international studies and the variations discussed. Conclusion: Major etiology of CHF was a combination of lifestyle disease, Hypertension, Diabetes Mellitus and Ischemic heart disease. Minor causes included Valvular heart disease, chronic arrhythmias, and myocarditis and conduction system disease.

  16. Neighborhood safety and adipose tissue distribution in African Americans: the Jackson Heart Study.

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    Do Quyen Pham

    Full Text Available OBJECTIVE: Patterns of fat distribution are heavily influenced by psychological stress, sex, and among women, by menopause status. Emerging evidence suggests the lack of perceived neighborhood safety due to crime may contribute to psychological stress and obesity among exposed residents. Our objective is to determine if perceived neighborhood safety is associated with abdominal adiposity among African-American men and women, and among pre- and postmenopausal women in the Jackson Heart Study. DESIGN AND METHODS: We examined associations between perceived neighborhood safety, fat distribution, and other individual-level covariates among Jackson Heart Study participants (N = 2,881. Abdominal adiposity was measured via computed tomography scans measuring the volumes of visceral, subcutaneous and total adipose tissue. We also measured body mass index (BMI, and waist circumference. Multivariable regression models estimated associations between perceived neighborhood safety, adiposity, and covariates by sex and menopause status. RESULTS: Adjusting for all covariates, women who strongly disagreed their neighborhood was safe from crime had a higher BMI compared to women who felt safe [Std B 0.083 95% CI (0.010, 0.156]. Premenopausal women who felt most unsafe had higher BMI, waist circumference, and volumes of visceral and total adipose tissue than those who felt safe [Std B 0.160 (0.021, 0.299, Std B 0.142 (0.003, 0.280, Std B 0.150 (0.014, 0.285, Std B 0.154 (0.019, 0.290, respectively]. We did not identify associations between neighborhood safety and adiposity among men and postmenopausal women. CONCLUSIONS: Our data suggest that abdominal adipose tissue distribution patterns are associated with perceived neighborhood safety in some groups, and that patterns may differ by sex and menopause status, with most associations observed among pre-menopausal women. Further research is needed to elucidate whether there are causal mechanisms underlying sex

  17. Heart rate variability during treatment of breakthrough pain in patients with advanced cancer: a pilot study

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    Masel EK

    2016-12-01

    Full Text Available Eva Katharina Masel, Patrick Huber, Tobias Engler, Herbert Hans WatzkeClinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria Background: Decisions on the intensity of analgesic therapy and judgments regarding its efficacy are difficult at the end of life, when many patients are not fully conscious and pain is a very common symptom. In healthy individuals and in postoperative settings, nociception and subsequent pain relief have been shown to induce changes in the autonomic nervous system (ANS, which can be detected by measuring heart rate variability (HRV. Objectives: The changes in the ANS were studied by measuring HRV during opioid therapy for cancer breakthrough pain (CBTP in palliative-care patients with cancer and compared these changes with patient-reported pain levels on a numeric rating scale (NRS. Patients and methods: The study included ten patients with advanced cancer and baseline opioid therapy. In each patient, a 24-hour peak-to-peak HRV measurement with a sampling rate of 4,000 Hz was performed. High frequency (HF, low frequency (LF, total power, pNN50 (indicating parasympathetic activity, and log LF/HF were obtained in two intervals prior to therapy and in four intervals thereafter. Intensity of CBTP was recorded using a patient-reported NRS prior to therapy and 30 minutes afterward. Results: CBTP occurred in seven patients (three males and four females; mean age: 62 ± 5.2 years and was treated with opioids. A highly significant positive correlation was found between opioid-induced reduction in patient-reported pain intensity based on NRS and changes in log LF/HF (r > 0.700; p < 0.05. Log LF/HF decreased in patients who had a reduction in pain of >2 points on the NRS but remained unchanged in the other patients. Conclusion: Our data suggest that log LF/HF may be a useful surrogate marker for alleviation of CBTP in patients with advanced cancer and might

  18. Raynaud phenomenon and mortality: 20+ years of follow-up of the Charleston Heart Study cohort

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    Nietert PJ

    2015-02-01

    Full Text Available Paul J Nietert,1 Stephanie R Shaftman,1 Richard M Silver,2 Bethany J Wolf,1 Brent M Egan,3 Kelly J Hunt,1 Edwin A Smith2 1Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA; 2Department of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA; 3Greenville Health System, Care Coordination Institute, Greenville, SC, USA Background: Raynaud phenomenon (RP is a temporary vasoconstrictive condition that often manifests itself in the fingers in response to cold or stress. It often co-occurs with certain chronic diseases that impact mortality. Our objective was to determine whether RP has any independent association with survival. Methods: From 1987–1989, a total of 830 participants of the Charleston Heart Study cohort completed an in-person RP screening questionnaire. Two definitions of RP were used: a broad definition that included both blanching (pallor and cyanotic color changes and a narrow definition that included only blanching. All-cause and cardiovascular disease (CVD mortality were compared between subjects with and without RP using race-specific survival models that adjusted for age, sex, baseline CVD, and 10-year risk of coronary heart disease. Results: Using the narrow RP definition, we identified a significant interaction between older age and the presence of RP on all-cause mortality. In the broad RP definition model, the presence of RP was not associated with CVD mortality among blacks; however, among whites, the presence of RP was associated with a 1.6-fold increase in the hazard associated with CVD-related death (hazard ratio: 1.55, 95% confidence interval: 1.10–2.20, P=0.013. Conclusion: RP was independently associated with mortality among older adults in our cohort. Among whites, RP was associated with increased CVD-related death. It is possible that RP may be a sign of undiagnosed vascular disease. Keywords: Raynaud disease

  19. Association of Kidney Disease Measures with Cause-Specific Mortality: The Korean Heart Study.

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    Yejin Mok

    Full Text Available The link of low estimated glomerular filtration rate (eGFR and high proteinuria to cardiovascular disease (CVD mortality is well known. However, its link to mortality due to other causes is less clear.We studied 367,932 adults (20-93 years old in the Korean Heart Study (baseline between 1996-2004 and follow-up until 2011 and assessed the associations of creatinine-based eGFR and dipstick proteinuria with mortality due to CVD (1,608 cases, cancer (4,035 cases, and other (non-CVD/non-cancer causes (3,152 cases after adjusting for potential confounders.Although cancer was overall the most common cause of mortality, in participants with chronic kidney disease (CKD, non-CVD/non-cancer mortality accounted for approximately half of cause of death (47.0%for eGFR <60 ml/min/1.73m2 and 54.3% for proteinuria ≥1+. Lower eGFR (<60 vs. ≥60 ml/min/1.73m2 was significantly associated with mortality due to CVD (adjusted hazard ratio 1.49 [95% CI, 1.24-1.78] and non-CVD/non-cancer causes (1.78 [1.54-2.05]. The risk of cancer mortality only reached significance at eGFR <45 ml/min/1.73m2 when eGFR 45-59 ml/min/1.73m2 was set as a reference (1.62 [1.10-2.39]. High proteinuria (dipstick ≥1+ vs. negative/trace was consistently associated with mortality due to CVD (1.93 [1.66-2.25], cancer (1.49 [1.32-1.68], and other causes (2.19 [1.96-2.45]. Examining finer mortality causes, low eGFR and high proteinuria were commonly associated with mortality due to coronary heart disease, any infectious disease, diabetes, and renal failure. In addition, proteinuria was also related to death from stroke, cancers of stomach, liver, pancreas, and lung, myeloma, pneumonia, and viral hepatitis.Low eGFR was associated with CVD and non-CVD/non-cancer mortality, whereas higher proteinuria was consistently related to mortality due to CVD, cancer, and other causes. These findings suggest the need for multidisciplinary prevention and management strategies in individuals with CKD

  20. Heart rate is associated with markers of fatty acid desaturation: the GOCADAN study

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    Sven O.E. Ebbesson

    2012-03-01

    Full Text Available Objectives: To determine if heart rate (HR is associated with desaturation indexes as HR is associated with arrhythmia and sudden death. Study design: A community based cross-sectional study of 1214 Alaskan Inuit. Methods: Data of FA concentrations from plasma and red blood cell membranes from those ≥35 years of age (n = 819 were compared to basal HR at the time of examination. Multiple linear regression with backward stepwise selection was employed to analyze the effect of the desaturase indexes on HR, after adjustment for relevant covariates. Results: The Δ5 desaturase index (Δ5-DI measured in serum has recently been associated with a protective role for cardiovascular disease. This index measured here in plasma and red blood cells showed a negative correlation with HR. The plasma stearoyl-CoA-desaturase (SCD index, previously determined to be related to cardiovascular disease (CVD mortality, on the other hand, was positively associated with HR, while the Δ6 desaturase index (Δ6-DI had no significant effect on HR. Conclusion: Endogenous FA desaturation is associated with HR and thereby, in the case of SCD, possibly with arrhythmia and sudden death, which would at least partially explain the previously observed association between cardiovascular mortality and desaturase activity.

  1. Heart rate variability (HRV) and posttraumatic stress disorder (PTSD): a pilot study.

    Science.gov (United States)

    Tan, Gabriel; Dao, Tam K; Farmer, Lorie; Sutherland, Roy John; Gevirtz, Richard

    2011-03-01

    Exposure to combat experiences is associated with increased risk of developing Post Traumatic Stress Disorder. Prolonged exposure therapy and cognitive processing therapy have garnered a significant amount of empirical support for PTSD treatment; however, they are not universally effective with some patients continuing to struggle with residual PTSD symptoms. Heart rate variability (HRV) is a measure of the autonomic nervous system functioning and reflects an individual's ability to adaptively cope with stress. A pilot study was undertaken to determine if veterans with PTSD (as measured by the Clinician-Administered PTSD Scale and the PTSD Checklist) would show significantly different HRV prior to an intervention at baseline compared to controls; specifically, to determine whether the HRV among veterans with PTSD is more depressed than that among veterans without PTSD. The study also aimed at assessing the feasibility, acceptability, and potential efficacy of providing HRV biofeedback as a treatment for PTSD. The findings suggest that implementing an HRV biofeedback as a treatment for PTSD is effective, feasible, and acceptable for veterans. Veterans with combat-related PTSD displayed significantly depressed HRV as compared to subjects without PTSD. When the veterans with PTSD were randomly assigned to receive either HRV biofeedback plus treatment as usual (TAU) or just TAU, the results indicated that HRV biofeedback significantly increased the HRV while reducing symptoms of PTSD. However, the TAU had no significant effect on either HRV or symptom reduction. A larger randomized control trial to validate these findings appears warranted.

  2. Gene by Sex Interaction for Measures of Obesity in the Framingham Heart Study

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    Benjamin, Ashlee M.; Suchindran, Sunil; Pearce, Kaela; Rowell, Jennifer; Lien, Lillian F.; Guyton, John R.; McCarthy, Jeanette J.

    2011-01-01

    Obesity is an increasingly prevalent and severe health concern with a substantial heritable component and marked sex differences. We sought to determine if the effect of genetic variants also differed by sex by performing a genome-wide association study modeling the effect of genotype-by-sex interaction on obesity phenotypes. Genotype data from individuals in the Framingham Heart Study Offspring cohort were analyzed across five exams. Although no variants showed genome-wide significant gene-by-sex interaction in any individual exam, four polymorphisms displayed a consistent BMI association (P-values .00186 to .00010) across all five exams. These variants were clustered downstream of LYPLAL1, which encodes a lipase/esterase expressed in adipose tissue, a locus previously identified as having sex-specific effects on central obesity. Primary effects in males were in the opposite direction from females and were replicated in Framingham Generation 3. Our data support a sex-influenced association between genetic variation at the LYPLAL1 locus and obesity-related traits. PMID:21253498

  3. Gene by Sex Interaction for Measures of Obesity in the Framingham Heart Study

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    Ashlee M. Benjamin

    2011-01-01

    Full Text Available Obesity is an increasingly prevalent and severe health concern with a substantial heritable component and marked sex differences. We sought to determine if the effect of genetic variants also differed by sex by performing a genome-wide association study modeling the effect of genotype-by-sex interaction on obesity phenotypes. Genotype data from individuals in the Framingham Heart Study Offspring cohort were analyzed across five exams. Although no variants showed genome-wide significant gene-by-sex interaction in any individual exam, four polymorphisms displayed a consistent BMI association (P-values .00186 to .00010 across all five exams. These variants were clustered downstream of LYPLAL1, which encodes a lipase/esterase expressed in adipose tissue, a locus previously identified as having sex-specific effects on central obesity. Primary effects in males were in the opposite direction from females and were replicated in Framingham Generation 3. Our data support a sex-influenced association between genetic variation at the LYPLAL1 locus and obesity-related traits.

  4. Geographical variation in cardiovascular incidence: results from the British Women's Heart and Health Study

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    Ebrahim Shah

    2010-11-01

    Full Text Available Abstract Background Prevalence of cardiovascular disease (CVD in women shows regional variations not explained by common risk factors. Analysis of CVD incidence will provide insight into whether there is further divergence between regions with increasing age. Methods Seven-year follow-up data on 2685 women aged 59-80 (mean 69 at baseline from 23 towns in the UK were available from the British Women's Heart and Health Study. Time to fatal or non-fatal CVD was analyzed using Cox regression with adjustment for risk factors, using multiple imputation for missing values. Results Compared to South England, CVD incidence is similar in North England (HR 1.05 (95% CI 0.84, 1.31 and Scotland (0.93 (0.68, 1.27, but lower in Midlands/Wales (0.85 (0.64, 1.12. Event severity influenced regional variation, with South England showing lower fatal incident CVD than other regions, but higher non-fatal incident CVD. Kaplan-Meier plots suggested that regional divergence in CVD occurred before baseline (before mean baseline age of 69. Conclusions In women, regional differences in CVD early in adult life do not further diverge in later life. This may be due to regional differences in early detection, survivorship of women entering the study, or event severity. Targeting health care resources for CVD by geographic variation may not be appropriate for older age-groups.

  5. Coherence of heart rate variability and local physical fields in monitoring studies

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    Tuzhilkin, D. A.; Borodin, A. S.

    2015-11-01

    Technological advances have led to a substantial modification of the physical fields of the environment, which could affect the status of living organisms under their constant exposure. In this study, the activity of human cardiovascular system under the influence of a complex natural physical environmental factors investigated. The study was conducted on a representative homogeneous sample (44 persons aged 19 to 22 years) by simultaneous monitoring of electrocardiograms and natural physical fields in Tomsk (geomagnetic field, meteorological parameters - temperature, pressure and humidity, surface wind speed, the parameters of the Schumann resonance - amplitude, frequency and quality factor of the first four modes in the range of 6 to 32 Hz, the power spectral density infrasonic background in the range of from 0,5 to 32 Hz). It was shown that among the set of parameters of physical fields present field that can resonate in the functioning of the human organism. The greatest coherence with heart rate variability detect variations eastern component of the geomagnetic field.

  6. Accuracy of a Wrist-Worn Wearable Device for Monitoring Heart Rates in Hospital Inpatients: A Prospective Observational Study

    Science.gov (United States)

    Kroll, Ryan R; Boyd, J Gordon

    2016-01-01

    Background As the sensing capabilities of wearable devices improve, there is increasing interest in their application in medical settings. Capabilities such as heart rate monitoring may be useful in hospitalized patients as a means of enhancing routine monitoring or as part of an early warning system to detect clinical deterioration. Objective To evaluate the accuracy of heart rate monitoring by a personal fitness tracker (PFT) among hospital inpatients. Methods We conducted a prospective observational study of 50 stable patients in the intensive care unit who each completed 24 hours of heart rate monitoring using a wrist-worn PFT. Accuracy of heart rate recordings was compared with gold standard measurements derived from continuous electrocardiographic (cECG) monitoring. The accuracy of heart rates measured by pulse oximetry (Spo2.R) was also measured as a positive control. Results On a per-patient basis, PFT-derived heart rate values were slightly lower than those derived from cECG monitoring (average bias of −1.14 beats per minute [bpm], with limits of agreement of 24 bpm). By comparison, Spo2.R recordings produced more accurate values (average bias of +0.15 bpm, limits of agreement of 13 bpm, P<.001 as compared with PFT). Personal fitness tracker device performance was significantly better in patients in sinus rhythm than in those who were not (average bias −0.99 bpm vs −5.02 bpm, P=.02). Conclusions Personal fitness tracker–derived heart rates were slightly lower than those derived from cECG monitoring in real-world testing and not as accurate as Spo2.R-derived heart rates. Performance was worse among patients who were not in sinus rhythm. Further clinical evaluation is indicated to see if PFTs can augment early warning systems in hospitals. Trial Registration ClinicalTrials.gov NCT02527408; https://clinicaltrials.gov/ct2/show/NCT02527408 (Archived by WebCite at  http://www.webcitation.org/6kOFez3on) PMID:27651304

  7. Examining the Relationship between Heart Rate and Problem Behavior: A Case Study of Severe Skin Picking in Prader-Willi Syndrome

    Science.gov (United States)

    Hall, Scott S.; Hammond, Jennifer L.; Hustyi, Kristin M.

    2013-01-01

    Few studies have examined the relationship between heart rate and self-injurious behavior (SIB) shown by individuals with IDD (intellectual and developmental disabilities). In this single-case study, we simultaneously monitored heart rate and activity levels during a functional analysis of severe skin picking behavior exhibited by a young man with…

  8. Heart Attack

    Science.gov (United States)

    ... a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get ... It's important to know the symptoms of a heart attack and call 9-1-1 if someone ...

  9. Heart Truth

    Science.gov (United States)

    ... Public » Educational Campaigns & Programs » The Heart Truth Español Home About The Heart Truth ® Program Background The Red Dress ® All of Our Stories Are Red The Heart Truth ® Founding Ambassador Founding Ambassador Photographs Program Launch Program ...

  10. Impact of Pacemaker Lead Characteristics on Pacemaker Related Infection and Heart Perforation: A Nationwide Population-Based Cohort Study.

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    Yu-Sheng Lin

    Full Text Available Several risk factors for pacemaker (PM related complications have been reported. However, no study has investigated the impact of lead characteristics on pacemaker-related complications.Patients who received a new pacemaker implant from January 1997 to December 2011 were selected from the Taiwan National Health Insurance Database. This population was grouped according to the pacemaker lead characteristics in terms of fixation and insulation. The impact of the characteristics of leads on early heart perforation was analyzed by multivariable logistic regression analysis, while the impact of the lead characteristics on early and late infection and late heart perforation over a three-year period were analyzed using Cox regression. This study included 36,104 patients with a mean age of 73.4±12.5 years. In terms of both early and late heart perforations, there were no significant differences between groups across the different types of fixation and insulations. In the multivariable Cox regression analysis, the pacemaker-related infection rate was significantly lower in the active fixation only group compared to either the both fixation (OR, 0.23; 95% CI, 0.07-0.80; P = 0.020 or the passive fixation group (OR, 0.26; 95% CI, 0.08-0.83; P = 0.023.There was no difference in heart perforation between active and passive fixation leads. Active fixation leads were associated with reduced risk of pacemaker-related infection.

  11. The Envy of Scholars: Applying the Lessons of the Framingham Heart Study to the Prevention of Chronic Kidney Disease

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    Walter G. Wasser

    2015-07-01

    Full Text Available During the past 50 years, a dramatic reduction in the mortality rate associated with cardiovascular disease has occurred in the US and other countries. Statistical modeling has revealed that approximately half of this reduction is the result of risk factor mitigation. The successful identification of such risk factors was pioneered and has continued with the Framingham Heart Study, which began in 1949 as a project of the US National Heart Institute (now part of the National Heart, Lung, and Blood Institute. Decreases in total cholesterol, blood pressure, smoking, and physical inactivity account for 24%, 20%, 12%, and 5% reductions in the mortality rate, respectively. Nephrology was designated as a recognized medical professional specialty a few years later. Hemodialysis was first performed in 1943. The US Medicare End-Stage Renal Disease (ESRD Program was established in 1972. The number of patients in the program increased from 5,000 in the first year to more than 500,000 in recent years. Only recently have efforts for risk factor identification, early diagnosis, and prevention of chronic kidney disease (CKD been undertaken. By applying the approach of the Framingham Heart Study to address CKD risk factors, we hope to mirror the success of cardiology; we aim to prevent progression to ESRD and to avoid the cardiovascular complications associated with CKD. In this paper, we present conceptual examples of risk factor modification for CKD, in the setting of this historical framework.

  12. The Envy of Scholars: Applying the Lessons of the Framingham Heart Study to the Prevention of Chronic Kidney Disease.

    Science.gov (United States)

    Wasser, Walter G; Gil, Amnon; Skorecki, Karl L

    2015-07-30

    During the past 50 years, a dramatic reduction in the mortality rate associated with cardiovascular disease has occurred in the US and other countries. Statistical modeling has revealed that approximately half of this reduction is the result of risk factor mitigation. The successful identification of such risk factors was pioneered and has continued with the Framingham Heart Study, which began in 1949 as a project of the US National Heart Institute (now part of the National Heart, Lung, and Blood Institute). Decreases in total cholesterol, blood pressure, smoking, and physical inactivity account for 24%, 20%, 12%, and 5% reductions in the mortality rate, respectively. Nephrology was designated as a recognized medical professional specialty a few years later. Hemodialysis was first performed in 1943. The US Medicare End-Stage Renal Disease (ESRD) Program was established in 1972. The number of patients in the program increased from 5,000 in the first year to more than 500,000 in recent years. Only recently have efforts for risk factor identification, early diagnosis, and prevention of chronic kidney disease (CKD) been undertaken. By applying the approach of the Framingham Heart Study to address CKD risk factors, we hope to mirror the success of cardiology; we aim to prevent progression to ESRD and to avoid the cardiovascular complications associated with CKD. In this paper, we present conceptual examples of risk factor modification for CKD, in the setting of this historical framework.

  13. Modified Right Heart Contrast Echocardiography Versus Traditional Method in Diagnosis of Right-to-Left Shunt: A Comparative Study

    Science.gov (United States)

    Wang, Yi; Zeng, Jie; Yin, Lixue; Zhang, Mei; Hou, Dailun

    2016-01-01

    Summary Background The purpose of this study was to evaluate the reliability, effectiveness, and safety of modified right heart contrast transthoracic echocardiography (cTTE) in comparison with the traditional method. Material/Methods We performed a modified right heart cTTE using saline mixed with a small sample of patient’s own blood. Samples were agitated with varying intensity. This study protocol involved microscopic analysis and patient evaluation. 1. Microscopic analysis: After two contrast samples had been agitated 10 or 20 times, they underwent a comparison of bubble size, bubble number, and red blood cell morphology. 2. Patient analysis: 40 patients with suspected RLS (right- to-left shunt) were enrolled. All patients underwent right heart contrast echocardiography. Oxygen saturation, transit time and duration, presence of RLS, change in indirect bilirubin and urobilinogen concentrations were compared afterward. Results Modified method generated more bubbles (Pbubble size were not significant (P>0.05). Twenty-four patients were diagnosed with RLS (60%) using the modified method compared to 16 patients (40%) with the traditional method. The transit time of ASb20 group was the shortest (P<0.05). However, the duration time in this group was much longer (P<0.05). Also, in semi-quantitative analysis mean rank of RLS was higher after injecting the modified contrast agent agitated 20 times (P<0.05). Conclusions Modified right heart contrast echocardiography is a reliable, effective and safe method of detecting cardiovascular RLS. PMID:27668027

  14. β blockers and mortality after myocardial infarction in patients without heart failure: multicentre prospective cohort study

    Science.gov (United States)

    Riant, Elisabeth; Aissoui, Nadia; Soria, Angèle; Ducrocq, Gregory; Coste, Pierre; Cottin, Yves; Aupetit, Jean François; Bonnefoy, Eric; Blanchard, Didier; Cattan, Simon; Steg, Gabriel; Schiele, François; Ferrières, Jean; Juillière, Yves; Simon, Tabassome; Danchin, Nicolas

    2016-01-01

    Objective To assess the association between early and prolonged β blocker treatment and mortality after acute myocardial infarction. Design Multicentre prospective cohort study. Setting Nationwide French registry of Acute ST- and non-ST-elevation Myocardial Infarction (FAST-MI) (at 223 centres) at the end of 2005. Participants 2679 consecutive patients with acute myocardial infarction and without heart failure or left ventricular dysfunction. Main outcome measures Mortality was assessed at 30 days in relation to early use of β blockers (≤48 hours of admission), at one year in relation to discharge prescription, and at five years in relation to one year use. Results β blockers were used early in 77% (2050/2679) of patients, were prescribed at discharge in 80% (1783/2217), and were still being used in 89% (1230/1383) of those alive at one year. Thirty day mortality was lower in patients taking early β blockers (adjusted hazard ratio 0.46, 95% confidence interval 0.26 to 0.82), whereas the hazard ratio for one year mortality associated with β blockers at discharge was 0.77 (0.46 to 1.30). Persistence of β blockers at one year was not associated with lower five year mortality (hazard ratio 1.19, 0.65 to 2.18). In contrast, five year mortality was lower in patients continuing statins at one year (hazard ratio 0.42, 0.25 to 0.72) compared with those discontinuing statins. Propensity score and sensitivity analyses showed consistent results. Conclusions Early β blocker use was associated with reduced 30 day mortality in patients with acute myocardial infarction, and discontinuation of β blockers at one year was not associated with higher five year mortality. These findings question the utility of prolonged β blocker treatment after acute myocardial infarction in patients without heart failure or left ventricular dysfunction. Trial registration Clinical trials NCT00673036. PMID:27650822

  15. Acupuncture Effects on Heart Failure: How to Create Objective Study Designs

    Institute of Scientific and Technical Information of China (English)

    HJ Greten; M Goncalves; O Karrer; A Remppis; A Kick; E Scholz; J Fischer; T Greten; F Brazkiewicz; F Schr(o)der; S Sertel; Wendt

    2008-01-01

    According to a modem understanding of acupuncture mechanisms, acupuncture may elicit vegetative reflexes, presumably influencing the systemwide vegetative dysregulation associated with the heart failure syndrome, a feature of which is low performance in the 6 min walk test. The author performed a preliminary prospective, randomized, single-blinded clinical trial (n=21) in a cross-over design comparing acupuncture treatment, which was either compatible with individual Chinese diagnosis according to the Heidelberg Model of TCM (i-ACU) or a standardized treatment on acupoints with no specific relation to TCM diagnosis (u-ACU). The repeated measures analysis revealed a significant effect for i-ACU vs. u-ACU (F=7.2, df=1.37, P=0.011). The study revealed first evidence that acupuncture may prolong 6 min walk distance as a key parameter of heart failure.%根据对针刺机制的现代理解,针刺可以引起植物神经反射,可能是影响与心力衰竭(其特征之一是6分钟步行实验得分较低)症状有关的系统植物神经调节异常.笔者进行了一个初步的前瞻性随机、单盲、交叉临床试验,比较符合海德尔堡中医模型诊断(i-ACU)和不符合这一模型(u-ACU)的两种针刺治疗.重复测量分析提示:与不符合海德尔堡中医模型的针灸治疗相比,符合这一模型的针灸治疗更有效(F=7.2,df=1.37,P=0.011).这一研究结果表明针刺可延长6分钟行走距离这一心力衰竭的重要指标.

  16. Clinical application of radionuclide cardiac study to the right heart diseases

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    Shimizu, Tatsuro; Ozaki, Masaharu; Ikezono, Tohru (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1984-12-01

    We experienced the four cases of rare right heart diseases: those are two-chambered right ventricle, ball thrombus in right ventricle, right ventricular hypertrophy and tricuspid valve regurgitation due to multiple pulmonary infarction, and right ventricular and right atrial infarction. The preoperative or ante mortem diagnosis of these diseases is difficult, especially by use of a noninvasive technique. This report shows the usefulness of radionuclide cardiac study for diagnosis of these cases. In the two-chambered right ventricle, abnormal muscle bundle was visualized by /sup 201/TlCl and was observed as the filling defect by sup(99m)Tc-HSA radionuclide angiography. The ball thrombus showed the filling defect of sup(99m)Tc-HSA in the right ventricle but was not extracted by /sup 201/TlCl in the site of the defect area. In the multiple pulmonary infarction, the right ventricular free wall was visualized by /sup 201/TlCl, and during right ventricular systole, regurgitation from right atrium to inferior vena cava was noticed by means of sup(99m)Tc-HSA radionuclide angiography. These findings suggested right ventricular hypertrophy and tricuspid valve regurgitation. In the right ventricular and right atrial infarction, right ventricular ejection fraction and right atrial fractional emptying were lower than those of normal controls.

  17. Review of novel therapeutic targets for improving heart failure treatment based on experimental and clinical studies

    Science.gov (United States)

    Bonsu, Kwadwo Osei; Owusu, Isaac Kofi; Buabeng, Kwame Ohene; Reidpath, Daniel Diamond; Kadirvelu, Amudha

    2016-01-01

    Heart failure (HF) is a major public health priority due to its epidemiological transition and the world’s aging population. HF is typified by continuous loss of contractile function with reduced, normal, or preserved ejection fraction, elevated vascular resistance, fluid and autonomic imbalance, and ventricular dilatation. Despite considerable advances in the treatment of HF over the past few decades, mortality remains substantial. Pharmacological treatments including β-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and aldosterone antagonists have been proven to prolong the survival of patients with HF. However, there are still instances where patients remain symptomatic, despite optimal use of existing therapeutic agents. This understanding that patients with chronic HF progress into advanced stages despite receiving optimal treatment has increased the quest for alternatives, exploring the roles of additional pathways that contribute to the development and progression of HF. Several pharmacological targets associated with pathogenesis of HF have been identified and novel therapies have emerged. In this work, we review recent evidence from proposed mechanisms to the outcomes of experimental and clinical studies of the novel pharmacological agents that have emerged for the treatment of HF. PMID:27350750

  18. Longitudinal variance-components analysis of the Framingham Heart Study data.

    Science.gov (United States)

    Macgregor, Stuart; Knott, Sara A; White, Ian; Visscher, Peter M

    2003-12-31

    The Framingham Heart Study offspring cohort, a complex data set with irregularly spaced longitudinal phenotype data, was made available as part of Genetic Analysis Workshop 13. To allow an analysis of all of the data simultaneously, a mixed-model- based random-regression (RR) approach was used. The RR accounted for the variation in genetic effects (including marker-specific quantitative trait locus (QTL) effects) across time by fitting polynomials of age. The use of a mixed model allowed both fixed (such as sex) and random (such as familial environment) effects to be accounted for appropriately. Using this method we performed a QTL analysis of all of the available adult phenotype data (26,106 phenotypic records). In addition to RR, conventional univariate variance component techniques were applied. The traits of interest were BMI, HDLC, total cholesterol, and height. The longitudinal method allowed the characterization of the change in QTL effects with aging. A QTL affecting BMI was shown to act mainly at early ages.

  19. Antidepressants and Valvular Heart Disease: A Nested Case-Control Study in Taiwan.

    Science.gov (United States)

    Lin, Chia-Hui; Hsiao, Fei-Yuan; Liu, Yen-Bin; Gau, Susan Shur-Fen; Wang, Chi-Chuan; Shen, Li-Jiuan

    2016-04-01

    Empirical evidence regarding the association between antidepressants and valvular heart disease (VHD) is scarce.Using Taiwan's National Health Insurance Research database, this nested case-control study assessed the association between antidepressants and VHD in a Chinese population.Among a cohort of patients who used at least 3 prescription antidepressants, 874 cases with VHD and 3496 matched controls (1:4 ratio) were identified. Conditional logistic regression models were used to examine the timing, duration, dose and type of antidepressants use, and the risk of VHD.Current use of antidepressants was associated with a 1.4-fold increase in the risk of VHD (adjusted odds ratio [aOR] 1.44; 95% confidence interval [CI] 1.17-1.77). Among current users, a dose-response association was observed in terms of the cumulative duration and the cumulative antidepressant dose. Significantly higher risks of VHD were observed among the current users of tricyclic antidepressants (aOR 1.40 [1.05-1.87]).We found that the use of antidepressants was associated with a greater risk of VHD and that the risks varied according to different antidepressants.

  20. Benfluorex and unexplained valvular heart disease: a case-control study.

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    Irène Frachon

    Full Text Available BACKGROUND: Recent case reports suggest that benfluorex, a fenfluramine derivative used in the management of overweight diabetic patients and dyslipidemia, is associated with cardiac valve regurgitation. METHODS: We conducted a case-control study. Eligible patients were those admitted in the cardiology or the cardiac surgery units of our hospital between January, 1(st 2003 and June 30(th 2009, with mitral insufficiency diagnostic codes (ICD-10 I340 and I051. Patients with either a primary cause (degenerative, known rheumatic heart disease, infectious endocarditis, congenital, radiation-induced valvular disease, associated connective and/or vasculitis disease, trauma, tumor or a secondary (functional cause were considered as having an "explained" mitral regurgitation. Other patients were considered as having an "unexplained" mitral regurgitation and were included as cases. For each case, two controls were matched for gender and for the closest date of birth, among a list of patients with an "explained" mitral regurgitation. Drug exposures were assessed blindly regarding the case or control status, through contacts with patients, their family and/or their physicians. RESULTS: Out of the 682 eligible patients, 27 cases and 54 matched controls were identified. The use of benfluorex was reported in 22 patients: 19 of the 27 cases, versus 3 of the 54 controls, odds-ratio 17.1 (3.5 to 83, adjusted for body mass index, diabetes and dexfenfluramine use. CONCLUSION: The use of benfluorex is associated with unexplained mitral regurgitation.

  1. Histological and physiological studies on rat heart following irradiation with single doses of X-rays

    Energy Technology Data Exchange (ETDEWEB)

    Yeung, T.K.; Hopewell, J.W.

    1986-01-01

    In the first 6 months after x-irradiation, most rats appeared normal, gaining weight after initial growth delay. Their general condition then declined, death occurring from about 230 days post-irradiation. Mean survival was dose-dependent, ranging from 550 +-12 days to 260 +- 13 days after 20 Gy and 50 Gy respectively. At post-mortem, 70% of irradiated animals had slight pleural effusions and 38% ascites. Early myocardial injury, indicated by T-wave abnormalities, were observed 2 months post-irradiation, consistent with observed degenerative changes seen in the myocardium, but the difference between cardiac output values measured in irradiated and control animals was very small. About 7 months after irradiation, ECG studies showed onset of arrhythmia. Histologically, in addition to chronic myocardial changes, lesions were observed in the larger vessel walls. Measurements of 'equivalent heart muscle wall thickness' showed a dose-dependent decline in irradiated animals after this. Histological and physiological changes were reflected by substantial reduction in cardiac output values in irradiated animals.

  2. The contribution of chromosomal abnormalities to congenital heart defects: a population-based study.

    Science.gov (United States)

    Hartman, Robert J; Rasmussen, Sonja A; Botto, Lorenzo D; Riehle-Colarusso, Tiffany; Martin, Christa L; Cragan, Janet D; Shin, Mikyong; Correa, Adolfo

    2011-12-01

    We aimed to assess the frequency of chromosomal abnormalities among infants with congenital heart defects (CHDs) in an analysis of population-based surveillance data. We reviewed data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth-defects surveillance system, to assess the frequency of chromosomal abnormalities among live-born infants and fetal deaths with CHDs delivered from January 1, 1994, to December 31, 2005. Among 4430 infants with CHDs, 547 (12.3%) had a chromosomal abnormality. CHDs most likely to be associated with a chromosomal abnormality were interrupted aortic arch (type B and not otherwise specified; 69.2%), atrioventricular septal defect (67.2%), and double-outlet right ventricle (33.3%). The most common chromosomal abnormalities observed were trisomy 21 (52.8%), trisomy 18 (12.8%), 22q11.2 deletion (12.2%), and trisomy 13 (5.7%). In conclusion, in our study, approximately 1 in 8 infants with a CHD had a chromosomal abnormality. Clinicians should have a low threshold at which to obtain testing for chromosomal abnormalities in infants with CHDs, especially those with certain types of CHDs. Use of new technologies that have become recently available (e.g., chromosomal microarray) may increase the identified contribution of chromosomal abnormalities even further.

  3. THE STUDY OF PRODUCTION AND MECHANISM OF ANTIPHOSPHOLIPID ANTIBODIES IN PATIENTS WITH CORONARY HEART DISEASE

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To assess whether there was strong association between antiphospholipid antibodies(APA) and coronary heart disease(CHD), to study the environmental factors of APA production and APA pathogenic mechanism in patients with CHD.Methods Blood samples from 76 patients with CHD and 30 controls were tested for anticardiolipin antibodies IgG(ACA-IgG),human cytomegalovirus IgG,IgM(HCMV-IgG,IgM) by enzyme-link immunosorbant assay(ELISA) and 6-keto-PGF1a,endothelin(ET) by radioimmunoassay(RIA).Results A total of 27 patients(35.53%) were ACA positive in 76, as compared to 2 of 30(6.67%) healthy individuals, P<0.05. There was no difference in ACA among acute myocardial infarction(AMI,39.13%), old myocardial infarction(OMI,26.53%), unstable angina pectoris(UA,38.40%), P>0.05. The number of ACA positive subjects was higher in HCMV infection patients with CHD than no HCMV infectious patients with CHD. There was no PGI2 and ET level difference between ACA-IgG positive and negative CHD.Conclusion There are strong association between APA and CHD. The HCMV infection may be an environmental factor of APA production in CHD patients with raised ACA. The alteration of PGI2 and ET are not the pathogenic mechanism of ACA in patients with CHD.

  4. Epidemiological Study Of Coronary Heart Disease (CHD In Rural Population Of Gurgaon District (Haryana State

    Directory of Open Access Journals (Sweden)

    Chadha S.L

    1989-01-01

    Full Text Available A community based survey of coronary heart disease (CHD was carried out on a random rural sample of 3375 adults in the age group 25-64 years in gurgaon district (Haryana about 50-70 Km. Away from Delhi. CHD was diagnosed either (a on the basis of clinical history supported by documentary evidence of treatment in a hospital or at home of (b on ECG evidence in accordance with minnesta code. The overall prevalence rate of CHD on clinical history basis was 5.9 (7.4 in males and 5.1 in females per 1000 adults in the age group 25-64 years. Increased number of cases were found in the age group 55-64 years both in males and females. The prevalence rate based both on clinical history and ECG criteria is estimated at 27.1/1000. Risk factors for CHD such as hypertension, smoking, family history, obesity and physical activity were studied.

  5. Diagnostic discrepancies in clinical practice: An autopsy study in patients with heart failure.

    Science.gov (United States)

    Issa, Victor Sarli; Dinardi, Layara Fernanda Lipari; Pereira, Thiago Vicente; de Almeida, Lyna Kyria Rodrigues; Barbosa, Thaisa Silveira; Benvenutti, Luiz Alberto; Ayub-Ferreira, Silvia Moreira; Bocchi, Edimar Alcides

    2017-01-01

    Autopsies are the gold standard for diagnostic accuracy; however, no recent study has analyzed autopsies in heart failure (HF).We reviewed 1241 autopsies (January 2000-May 2005) and selected 232 patients with HF. Clinical and autopsy diagnoses were analyzed and discrepancies categorized according to their importance regarding therapy and prognosis.Mean age was 63.3 ± 15.9 years; 154 (66.4%) patients were male. The causes of death at autopsy were end-stage HF (40.9%), acute myocardial infarction (17.2%), infection (15.9), and pulmonary embolism 36 (15.5). Diagnostic discrepancies occurred in 191 (82.3%) cases; in 56 (24.1%), discrepancies were related to major diagnoses with potential influence on survival or treatment; pulmonary embolism was the cause of death for 24 (42.9%) of these patients. In 35 (15.1%), discrepancies were related to a major diagnosis with equivocal influence on survival or treatment; in 100 (43.1%), discrepancies did not influence survival or treatment. In multivariate analysis, age (OR: 1.03, 95% CI: 1.008-1.052, P = 0.007) and presence of diabetes mellitus (OR: 0.359, 95% CI: 0.168-0.767, P = 0.008) influenced the occurrence discrepancies.Diagnostic discrepancies with a potential impact on prognosis are frequent in HF. These findings warrant reconsideration in diagnostic and therapeutic practices with HF patients.

  6. Vital exhaustion as a risk factor for ischaemic heart disease and all-cause mortality in a community sample. A prospective study of 4084 men and 5479 women in the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Prescott, Eva; Holst, Claus; Grønbaek, Morten

    2003-01-01

    for biological, behavioural, and socioeconomic risk factors did not substantially affect the association for IHD but attenuated the association with all-cause mortality. CONCLUSIONS: Measures of fatigue and depression were common symptoms in this population sample and convey increased risk of IHD and of all-cause......BACKGROUND: Vital exhaustion, a psychological measure characterized by fatigue and depressive symptoms, has been suggested to be an independent risk factor for ischaemic heart disease (IHD) but the generality of the phenomenon remains in question. The aim of this study is to describe prevalence...... of these symptoms in a community sample and determine whether they prospectively predict increased risk of IHD and all-cause mortality in men and women. METHODS: The study base was 4084 men and 5479 women aged 20-98 free of IHD examined in 1991-1993 in the Copenhagen City Heart Study. Events were ascertained...

  7. Awareness, treatment and control of hypertension in Nepal: findings from the Dhulikhel Heart Study

    Science.gov (United States)

    Karmacharya, Biraj M; Koju, Rajendra P; LoGerfo, James P; Chan, Kwun Chuen Gary; Mokdad, Ali H; Shrestha, Archana; Sotoodehnia, Nona; Fitzpatrick, Annette L

    2017-01-01

    Objectives Although previous studies have suggested alarming rise in the prevalence of hypertension in Nepal, there is dearth of information on its awareness, treatment and control. In this cross-sectional study, we assessed awareness, treatment and control of hypertension among 298 hypertensive adults from the suburban town of Dhulikhel, Nepal. Methods This cross-sectional study is based on Dhulikhel Heart Study, which included 1073 adults, aged ≥18 years, recruited from randomly selected households. Comprehensive health interviews and blood pressure measurements were completed during home interviews. Hypertensives (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or receiving antihypertensive medication) were further evaluated for awareness, treatment and control of hypertension. Multivariate regression model quantified the association of the sociodemographic characteristics and the cardiovascular disease (CVD) risk factors with hypertension awareness. Differences between sociodemographic characteristics and CVD risk factors with treatment and control of hypertension were tested using χ2 tests. Results A total of 43.6% of all hypertensives (n=298) were aware of their hypertension status. In multivariate analyses, hypertension awareness was associated with increasing age (p<0.001). More than three-fourth (76.1%) of those who were aware of their hypertension status (n=130) were currently on treatment. There were significant differences in treatment status by sex, occupation, age, income quartiles and body mass index. Only 35.3% of those on treatment (n=99) had blood pressure control. Conclusions The levels of awareness, treatment and control of hypertension in this sample of Nepalese adults were low. PMID:28123454

  8. Trends in dietary carbohydrate consumption from 1991 to 2008 in the Framingham Heart Study Offspring Cohort.

    Science.gov (United States)

    Makarem, Nour; Scott, Marc; Quatromoni, Paula; Jacques, Paul; Parekh, Niyati

    2014-06-14

    The intake of carbohydrates has been evaluated cross-sectionally, but not longitudinally in an ageing American adult population. The aim of the present study was to examine trends in the intake of dietary carbohydrates and their major food sources among the Framingham Heart Study Offspring (FOS) cohort, which had been uniquely tracked for 17 years in the study. The FOS cohort was recruited in 1971-1975. Follow-up examinations were conducted, on average, every 4 years. Dietary data collection began in 1991 (examination 5) using a validated semi-quantitative FFQ. The study included 2894 adults aged ≥ 25 years with complete dietary data in at least three examinations from 1991 to 2008. Descriptive statistics were generated using SAS version 9.3, and a repeated-measures model was used to examine trends in the intake of carbohydrates and their food sources in the whole sample, and by sex and BMI category. Over 17 years of follow-up, the percentage of energy from total carbohydrates (51·0-46·8 %; P for trend soda, cakes/cookies/quick breads/doughnuts, potatoes, milk, pasta, rice and cooked grains, fruit juice/drinks, potato chips/maize chips/popcorn, and lunch foods (e.g. pizzas and burgers) decreased significantly (P for trend ice cream/sherbet/frozen yogurt increased significantly (P for trend<0·04). Similar trends were observed when the analyses were stratified by sex and BMI. The present results suggest favourable trends in dietary carbohydrate consumption, but dietary guidelines for fruits, vegetables and fibre were not met in this cohort.

  9. Altered renal sodium handling and risk of incident hypertension: Results of the Olivetti Heart Study

    Science.gov (United States)

    D’Elia, Lanfranco; Cappuccio, Francesco P.; Iacone, Roberto; Russo, Ornella; Galletti, Ferruccio; Strazzullo, Pasquale

    2017-01-01

    Renal tubular sodium (Na) handling plays a key role in blood pressure (BP) regulation. Several cross-sectional studies reported a positive association between higher proximal tubule fractional reabsorption of Na and BP, but no prospective investigation has been reported of this possible association. Hence, the purpose of this study was to estimate the predictive role of renal Na handling on the risk of incident hypertension and the changes in BP occurring in the 8-year follow-up observation of a sample of initially normotensive men (The Olivetti Heart Study). The study included 294 untreated normotensive non-diabetic men with normal renal function examined twice (1994–95 and 2002–04). Renal tubular Na handling was estimated by exogenous lithium clearance. Fractional reabsorption of Na in proximal and distal tubules was calculated and included in the analysis. At baseline, there was no association between BP and either proximal or distal fractional reabsorption of Na. At the end of the 8-year follow-up, direct associations were observed between baseline proximal (but not distal) Na fractional reabsorption and the changes occurred in systolic and diastolic BP over time (+2.79 and +1.53 mmHg, respectively, per 1SD difference in proximal Na-FR; phypertension, independently of potential confounders (OR: 1.34, 95%CI:1.06–1.70). The results of this prospective investigation strongly suggest a causal relationship between an enhanced rate of Na reabsorption in the proximal tubule and the risk of incident hypertension in initially normotensive men. PMID:28196131

  10. Long-term physical activity in leisure time and mortality from coronary heart disease, stroke, respiratory diseases, and cancer. The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Schnohr, Peter; Lange, Peter; Scharling, Henrik

    2006-01-01

    BACKGROUND: The purpose of this study was to describe the associations between different levels of long-term physical activity in leisure time and subsequent causes of deaths. DESIGN: The Copenhagen City Heart Study is a prospective cardiovascular population study of 19 329 men and women aged 20......-93 in 1976. Physical activity in leisure time was estimated at the examinations in 1976-78 and 1981-83. This analysis consists of 2136 healthy men and 2758 women aged 20-79 years, with unchanged physical activity at the two examinations, and with all covariates included in the multivariate analyses: smoking......, for moderate physical activity 0.71 (0.51, 0.99) and for high 0.56 (0.38, 0.82). For cancer, moderate activity 0.77 (0.61, 0.97) and high activity 0.73 (0.56, 0.95) and for all-cause mortality, moderate 0.78 (0.68, 0.89) and high 0.75 (0.64, 0.87) for both sexes combined. Using Kaplan-Meier plots we calculated...

  11. Long-term physical activity in leisure time and mortality from coronary heart disease, stroke, respiratory diseases, and cancer. The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Schnohr, Peter; Lange, Peter; Scharling, Henrik

    2006-01-01

    , for moderate physical activity 0.71 (0.51, 0.99) and for high 0.56 (0.38, 0.82). For cancer, moderate activity 0.77 (0.61, 0.97) and high activity 0.73 (0.56, 0.95) and for all-cause mortality, moderate 0.78 (0.68, 0.89) and high 0.75 (0.64, 0.87) for both sexes combined. Using Kaplan-Meier plots we calculated......BACKGROUND: The purpose of this study was to describe the associations between different levels of long-term physical activity in leisure time and subsequent causes of deaths. DESIGN: The Copenhagen City Heart Study is a prospective cardiovascular population study of 19 329 men and women aged 20......-93 in 1976. Physical activity in leisure time was estimated at the examinations in 1976-78 and 1981-83. This analysis consists of 2136 healthy men and 2758 women aged 20-79 years, with unchanged physical activity at the two examinations, and with all covariates included in the multivariate analyses: smoking...

  12. Analysis of heart rate variability in pre-eclamptic pregnancy: a study employing frequency domain analysis

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    Gul Ar Navi Khan

    2014-08-01

    Full Text Available Background: Preeclampsia is a disorder characterized by development of hypertension to the extent of 140/90 mmHg or more with proteinuria after 20th weeks of pregnancy in a previously normotensive and non proteinuric woman. Physiologically blood pressure is controlled by Autonomic Nervous System (ANS so study of ANS during pregnancy plays a significant role to extract some vital information which may be helpful to deal with Pregnancy Induced Hypertension (PIH or preeclampsia. The autonomic nervous system and changes in ANS during different pathophysiological conditions could be evaluated with heart rate variability analysis test. The modification in the autonomic control occurs during pregnancy and its evaluation through Heart Rate Variability (HRV analysis is very informative technique now a day but studied little thus the main objective of our project is to compare the maternal HRV changes between normal pregnancy and pre-eclamptic pregnancy. Methods: 48 subjects (33 of normotensive pregnant women i.e., control group and 15 pre-eclamptic pregnant women i.e, study group of more than 20 weeks pregnancy were recruited from the outpatients, antenatal unit and wards of obstetrics and gynaecology department of JNMC, AMU, Aligarh. Physical examination was done and anthropometric measurement like height and weight were taken. BMI was calculated as per Quetlet's index. Urine test was conducted to every pregnant woman for urine albumin and we designated the pregnant women as pre-eclamptic women on the basis of definition. The subject was advised to take complete bed rest in supine position for 15 minutes in a cool and calm environment. The recording of short term HRV was done according to recommendation of the task force on HRV. The data was transferred from Medicaid machine to window based computer with HRV analysis software. Frequency domain analysis of HRV was taken for further statistical analysis. Results: There was no significant difference of

  13. Home-based exercise rehabilitation in addition to specialist heart failure nurse care: design, rationale and recruitment to the Birmingham Rehabilitation Uptake Maximisation study for patients with congestive heart failure (BRUM-CHF: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Ingram Jackie T

    2007-03-01

    for home-exercise less than half of patients treated by specialist heart failure services were eligible for the study. Many patients had co-morbidities preventing exercise and others had concerns about undertaking an exercise programme.

  14. Association between resting heart rate and N-terminal pro-brain natriuretic peptide in a community-based population study in Beijing

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    Cao R

    2014-12-01

    Full Text Available Ruihua Cao, Yongyi Bai, Ruyi Xu, Ping Ye Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China Background: N-terminal pro-brain natriuretic peptide (NT-proBNP is associated with an increased risk of cardiac insufficiency, which possibly leads to heart failure. However, the relationship between resting heart rate and NT-proBNP is unclear.Objective: This study focuses on this relativity between resting heart rate and plasma NT-proBNP levels in a surveyed community-based population.Methods: We evaluated the relativity between resting heart rate and plasma levels of NT-proBNP in 1,567 participants (mean age 61.0 years, range 21–96 years from a community-based population in Beijing, People’s Republic of China.Results: In patients with high resting heart rate (≥75 beats/min, NT-proBNP was higher than in those having low resting heart rate (<75 beats/min. In multiple linear stepwise regression analysis, plasma NT-proBNP was associated with resting heart rate (partial correlation coefficient, 0.82; 95% confidence interval, 0.18–1.51; P=0.011. A subsequent subgroup analysis revealed that the association between resting heart rate and plasma NT-proBNP was strengthened in subjects over 60 years old (partial correlation coefficient 1.28; 95% confidence interval, 0.49–2.36; P=0.031; while the relativity between resting heart rate and plasma NT-proBNP was not emerged in the younger subgroup (<60 years old.Conclusions: Resting heart rate was associated with plasma NT-proBNP in the elderly, which indicated a relationship between resting heart rate and cardiac function damage. Keywords: resting heart rate, N-terminal pro-brain natriuretic peptide, epidemiology, cardiac function, relationship

  15. Prevalence of cardiovascular disease risk factors in migrants participating in the PEP family heart study, Nuremberg

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    Gerda-Maria Haas

    2010-01-01

    Full Text Available Objectives: The aim of this study was to assess the prevalence of cardiovascular risk factors in adults and their children from the 3 major groups of migrants participating in the PEP Family Heart Study [11] and to compare the cardio-metabolic risk profiles between migrants and German participants. Methods: In this community-based cross-sectional study, anthropometric data, blood pressure and lipid profiles of migrants (480 children, 363 adults from Turkey (TUR, Eastern Europe (EEU and German immigrants from the former Soviet Union (GFSU were compared with age and gender adjusted German (GER resi-dents (3253 children, 2491 adults. Results: The profile of risk factors differed considerably regarding specificity and frequency. The prevalence of ≥3 risk factors was as follows: in GFSU men 62%, women 36%, boys 19% and girls 17%; in TUR men 57%, women 30%, 15% boys and 6% girls; in GER men 48%, women 19%, boys 4% and girls 6%; for EEU men 38%, women 25% and 0% in children. No risk factor was present in GFSU men 13%, women 25%, boys 38% and girls 42%; TUR men 13%, women 28%, boys 27% and girls 22 %; GER men16%, women 45%, boys 46% and girls 41%; EEU men 17%, women 42 %, boys 29% and girls 27%. About 50% of the adults from Turkey and Eastern Europe were current smokers and one third of women and half of men from these two countries were over-weight. Conclusions: The implementation of primary care measures for the prevention of cardiovascular disease in migrants is necessary, and it should consider the ethnic differences and the heterogene-ous risk profiles.

  16. Prevalence of Cardiovascular Disease Risk Factors in Migrants Participating in the PEP Family Heart Study, Nuremberg

    Directory of Open Access Journals (Sweden)

    Gerda-Maria Haas

    2010-01-01

    Full Text Available Objectives: The aim of this study was to assess the prevalence of cardiovascularrisk factors in adults and their children from the 3 majorgroups of migrants participating in the PEP Family Heart Study 11 andto compare the cardio-metabolic risk profiles between migrants andGerman participants.Methods: In this community-based cross-sectional study, anthropometricdata, blood pressure and lipid profiles of migrants (480 children,363 adults from Turkey (TUR, Eastern Europe (EEU and Germanimmigrants from the former Soviet Union (GFSU were comparedwith age- and gender adjusted German (GER residents (3253 children,2491 adults.Results: The profile of risk factors differed considerably regardingspecificity and frequency. The prevalence of ≥3 risk factors was asfollows: in GFSU men 62%, women 36%, boys 19% and girls 17%; inTUR men 57%, women 30%, 15% boys and 6% girls; in GER men48%, women 19%, boys 4% and girls 6%; for EEU men 38%, women25% and 0% in children. No risk factor was present in GFSU men13%, women 25%, boys 38% and girls 42%; TUR men 13%, women28%, boys 27% and girls 22 %; GER men16%, women 45%, boys 46%and girls 41%; EEU men 17%, women 42 %, boys 29% and girls 27%.About 50% of the adults from Turkey and Eastern Europe were currentsmokers and one third of women and half of men from these twocountries were overweight.Conclusions: The implementation of primary care measures for theprevention of cardiovascular disease in migrants is necessary, and itshould consider the ethnic differences and the heterogeneous risk profiles

  17. Thigh circumference and risk of heart disease and premature death: prospective cohort study

    DEFF Research Database (Denmark)

    Heitmann, Berit; Frederiksen, Peder

    2009-01-01

    in Denmark. PARTICIPANTS: 1436 men and 1380 women participating in the Danish MONICA project, examined in 1987-8 for height, weight, and thigh, hip, and waist circumference, and body composition by impedance. MAIN OUTCOME MEASURES: 10 year incidence of cardiovascular and coronary heart disease and 12.5 years...... of follow-up for total death. RESULTS: A small thigh circumference was associated with an increased risk of cardiovascular and coronary heart diseases and total mortality in both men and women. A threshold effect for thigh circumference was evident, with greatly increased risk of premature death below...... circumference seems to be associated with an increased risk of developing heart disease or premature death. The adverse effects of small thighs might be related to too little muscle mass in the region. The measure of thigh circumference might be a relevant anthropometric measure to help general practitioners...

  18. Different effects of bisoprolol on heart rate in patients with ischemic or idiopathic dilated cardiomyopathy (A 24-hour Holter substudy of the Cardiac Insufficiency Bisoprolol Study [CIBIS])

    NARCIS (Netherlands)

    Anthonio, RL; Brouwer, J; Lechat, P; Haaksma, J; van der Ven, L; van Veldhuisen, DJ; Crijns, HJGM; van Gilst, WH

    1999-01-01

    The effect of beta blockade on heart rate in patients with either idiopathic or ischemic cardiomyopathy was studied. It was found that beta blockade reduced the early morning increase in heart rate to a greater extent in patients with idiopathic dilated cardiomyopathy than in those with ischemic dil

  19. A STUDY OF PROFILE AND PATTERNS OF “JOINT INVOLVEMENT” IN UNDER 15 YEARS AGE GROUP CHILDREN WITH ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE

    OpenAIRE

    2015-01-01

    CONTEXT (BACKGROUND): Acute Rheumatic fever / Rheumatic Heart disease is the most common acquired childhood heart disease diagnosis made in India. Poly Arthritis is one of the common manifestations of the disease and making it one among many differential diagnoses for sub - acute arthritis. AIMS & OBJECTIVES: To study the profile and patterns ...

  20. Congenital heart defects and medical imaging.

    Science.gov (United States)

    Gehin, Connie; Ragsdale, Lisa

    2013-01-01

    Radiologic technologists perform imaging studies that are useful in the diagnosis of congenital heart defects in infants and adults. These studies also help to monitor congenital heart defect repairs in adults. This article describes the development and functional anatomy of the heart, along with the epidemiology and anatomy of congenital heart defects. It also discusses the increasing population of adults who have congenital heart defects and the most effective modalities for diagnosing, evaluating, and monitoring congenital heart defects.

  1. A simulation study of the reaction of human heart to biphasic electrical shocks

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    Seemann Gunnar

    2004-06-01

    Full Text Available Abstract Background This article presents a study, which examines the effects of biphasic electrical shocks on human ventricular tissue. The effects of this type of shock are not yet fully understood. Animal experiments showed the superiority of biphasic shocks over monophasic ones in defibrillation. A mathematical computer simulation can increase the knowledge of human heart behavior. Methods The research presented in this article was done with different models representing a three-dimensional wedge of ventricular myocardium. The electrophysiology was described with Priebe-Beuckelmann model. The realistic fiber twist, which is specific to human myocardium was included. Planar electrodes were placed at the ends of the longest side of the virtual cardiac wedge, in a bath medium. They were sources of electrical shocks, which varied in magnitude from 0.1 to 5 V. In a second arrangement ring electrodes were placed directly on myocardium for getting a better view on secondary electrical sources. The electrical reaction of the tissue was generated with a bidomain model. Results The reaction of the tissue to the electrical shock was specific to the initial imposed characteristics. Depolarization appeared in the first 5 ms in different locations. A further study of the cardiac tissue behavior revealed, which features influence the response of the considered muscle. It was shown that the time needed by the tissue to be totally depolarized is much shorter when a biphasic shock is applied. Each simulation ended only after complete repolarization was achieved. This created the possibility of gathering information from all states corresponding to one cycle of the cardiac rhythm. Conclusions The differences between the reaction of the homogeneous tissue and a tissue, which contains cleavage planes, reveals important aspects of superiority of biphasic pulses. ...

  2. Chocolate consumption and risk of heart failure in the Physicians’ Health Study

    Science.gov (United States)

    Petrone, Andrew B; Gaziano, J. Michael; Djoussé, Luc

    2015-01-01

    Aims To test the hypothesis that chocolate consumption is associated with a lower risk of heart failure (HF). Methods and Results We prospectively studied 20,278 men from the Physicians’ Health Study. Chocolate consumption was assessed between 1999 and 2002 via a self-administered food frequency questionnaire and HF was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted relative risk of HF. During a mean follow-up of 9.3 years, there were 876 new cases of HF. The mean age at baseline was 66.4 ± 9.2 years. Hazard ratios (95% CI) for HF were 1.0 (ref), 0.86 (0.72–1.03), 0.80 (0.66–0.98), 0.92 (0.74–1.13), and 0.82 (0.63–1.07), for chocolate consumption of less than 1/month, 1–3/week, 2–4/week, and 5+/week, respectively, after adjusting for age, body mass index (BMI), smoking, alcohol, exercise, energy intake, and history of atrial fibrillation (p for quadratic trend = 0.62). In a secondary analysis, chocolate consumption was inversely associated with risk of HF in men whose BMI was <25 kg/m2 (HR (95% CI) = 0.59 (0.37–0.94) for consumption of 5+ servings/week, p for linear trend = 0.03) but not in those with BMI of 25+ kg/m2 (HR (95% CI) = 1.01 (0.73–1.39), p for linear trend = 0.42, p for interaction=0.17). Conclusions Our data suggest that moderate consumption of chocolate might be associated with a lower risk of HF in male physicians.. PMID:25311633

  3. A procedure for wall detection in [{sup 18}F]FDG positron emission tomography heart studies

    Energy Technology Data Exchange (ETDEWEB)

    Landoni, C. [INB CNR, Dept. of Nuclear Medicine, Milan Univ., Inst. H San Raffaele (Italy); Bettinardi, V. [INB CNR, Dept. of Nuclear Medicine, Milan Univ., Inst. H San Raffaele (Italy); Lucignani, G. [INB CNR, Dept. of Nuclear Medicine, Milan Univ., Inst. H San Raffaele (Italy); Gilardi, M.C. [INB CNR, Dept. of Nuclear Medicine, Milan Univ., Inst. H San Raffaele (Italy); Striano, G. [INB CNR, Dept. of Nuclear Medicine, Milan Univ., Inst. H San Raffaele (Italy); Fazio, F. [INB CNR, Dept. of Nuclear Medicine, Milan Univ., Inst. H San Raffaele (Italy)

    1996-01-01

    We implemented a data processing technique to improve the accuracy of the localization of ROIs on the MW and LV in fluorine-18 labelled deoxyglucose ([{sup 18}F]FDG) PET heart studies. This technique combines transmission data, acquired before tracer administration and used for attenuation correction, and dynamic emission data (DY), acquired to obtain myocardial time-activity curves and used to calculate regional myocardial glucose utilization, to generate a new set of `transmission` images (TRDY) with enhanced contrast between MW and LV. These new transmission images identify the extravascular myocardial tissue and can be used for ROI placement. Validation of the method was performed in 25 patients, studied after an oral glucose load, by drawing irregular ROIs on three transaxial slices outlining the septum and anteriorapical and lateral was on the last frame of the DY images (steady state) and then on the TRDY images. Two kinds of analysis were performed on a total of 225 myocardial segments: (1) Mean counts per pixel in the DY images from ROIs independently drawn on DY and TRDY images were compared; (2) TRDY ROIs were copied onto DY images and repositioned in the event of mismatch between ROIs and myocardial tissue edge. Mean counts per pixel in the DY images from the original and the repositioned TRDY ROIs were compared. An excellent correlation was found in both cases. This technique can be used for clinical applications in physiological and pathological conditions in which the myocardial [{sup 18}F]FDG uptake is reduced or minimal, including diabetes and myocardial infraction. (orig./MG)

  4. Exposure assessment and heart rate variability monitoring in workers handling titanium dioxide particles: a pilot study

    Science.gov (United States)

    Ichihara, Sahoko; Li, Weihua; Omura, Seiichi; Fujitani, Yuji; Liu, Ying; Wang, Qiangyi; Hiraku, Yusuke; Hisanaga, Naomi; Wakai, Kenji; Ding, Xuncheng; Kobayashi, Takahiro; Ichihara, Gaku

    2016-03-01

    Titanium dioxide (TiO2) particles are used for surface coating and in a variety of products such as inks, fibers, food, and cosmetics. The present study investigated possible respiratory and cardiovascular effects of TiO2 particles in workers exposed to this particle at high concentration in a factory in China. The diameter of particles collected on filters was measured by scanning electron microscopy. Real-time size-dependent particle number concentration was monitored in the nostrils of four workers using condensation particle counter and optical particle counter. Electrocardiogram was recorded using Holter monitors for the same four workers to record heart rate variability. Sixteen workers underwent assessment of the respiratory and cardiovascular systems. Mass-based individual exposure levels were also measured with personal cascade impactors. The primary particle diameter ranged from 46 to 562 nm. Analysis of covariance of the pooled data of the four workers showed that number of particles with a diameter <300 nm was associated positively with total number of N-N and negatively with total number of increase or decrease in successive RR intervals greater than 50 ms (RR50+/-) or percentage of RR 50+/- that were parameters of parasympathetic function. The total mass concentration was 9.58-30.8 mg/m3 during work, but significantly less before work (0.36 mg/m3). The clear abnormality in respiratory function was not observed in sixteen workers who had worked for 10 months to 13 years in the factory. The study showed that exposure to particles with a diameter <300 nm might affect HRV in workers handling TiO2 particles. The results highlight the need to investigate the possible impact of exposure to nano-scaled particles on the autonomic nervous system.

  5. Heart rate variability during treatment of breakthrough pain in patients with advanced cancer: a pilot study

    Science.gov (United States)

    Masel, Eva Katharina; Huber, Patrick; Engler, Tobias; Watzke, Herbert Hans

    2016-01-01

    Background Decisions on the intensity of analgesic therapy and judgments regarding its efficacy are difficult at the end of life, when many patients are not fully conscious and pain is a very common symptom. In healthy individuals and in postoperative settings, nociception and subsequent pain relief have been shown to induce changes in the autonomic nervous system (ANS), which can be detected by measuring heart rate variability (HRV). Objectives The changes in the ANS were studied by measuring HRV during opioid therapy for cancer breakthrough pain (CBTP) in palliative-care patients with cancer and compared these changes with patient-reported pain levels on a numeric rating scale (NRS). Patients and methods The study included ten patients with advanced cancer and baseline opioid therapy. In each patient, a 24-hour peak-to-peak HRV measurement with a sampling rate of 4,000 Hz was performed. High frequency (HF), low frequency (LF), total power, pNN50 (indicating parasympathetic activity), and log LF/HF were obtained in two intervals prior to therapy and in four intervals thereafter. Intensity of CBTP was recorded using a patient-reported NRS prior to therapy and 30 minutes afterward. Results CBTP occurred in seven patients (three males and four females; mean age: 62 ± 5.2 years) and was treated with opioids. A highly significant positive correlation was found between opioid-induced reduction in patient-reported pain intensity based on NRS and changes in log LF/HF (r > 0.700; p 2 points on the NRS but remained unchanged in the other patients. Conclusion Our data suggest that log LF/HF may be a useful surrogate marker for alleviation of CBTP in patients with advanced cancer and might allow detection of pain without active contribution from patients. PMID:28003771

  6. Pneumoconiosis increases the risk of congestive heart failure: A nationwide population-based cohort study.

    Science.gov (United States)

    Yen, Chia-Ming; Lin, Cheng-Li; Lin, Ming-Chia; Chen, Huei-Yong; Lu, Nan-Han; Kao, Chia-Hung

    2016-06-01

    The purpose of the study was to determine the relationship between pneumoconiosis and congestive heart failure (CHF).We collected data from the National Health Insurance Research Database in Taiwan. The study sample comprised 8923 patients with pneumoconiosis and 35,692 nonpneumoconiosis controls enrolled from 2000 to 2011. Patients were followed up until the end of 2011 to evaluate the incidence of CHF. The risk of CHF was analyzed using Cox proportional hazard regression models, and the analysis accounted for factors such as sex, age, comorbidities, and air pollutants (μg/m).The overall incidence of CHF was higher in the pneumoconiosis cohort (15.7 per 1000 person-y) than in the nonpneumoconiosis cohort (11.2 per 1000 person-y), with a crude hazard ratio (HR) of 1.40 (P < 0.001). The HR for CHF was 1.38-fold greater in the pneumoconiosis cohort than in the nonpneumoconiosis cohort (P < 0.001) after the model was adjusted for age, sex, various comorbidities, and air pollutants (μg/m). The relative risk for CHF in the sex-specific pneumoconiosis cohort compared with the nonpneumoconiosis cohort was significant for men (adjusted HR = 1.40, 95% confidence interval = 1.21-1.62, P < 0.001). The incidence density rates of CHF increased with age; pneumoconiosis patients had a higher relative risk of CHF for all age group.Patients with pneumoconiosis were at higher risk for developing CHF than patients in the nonpneumoconiosis cohort, particularly in cases with coexisting coronary artery disease, hypertension, and chronic obstructive pulmonary disease.

  7. Pathological study on right atrium myocardium in rheumatic heart disease patients with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    DUAN Xiang-ying; ZHANG Bao-ren; LI Li

    2002-01-01

    Objective:To study the pathological basis of right atrial fibrillation in rheumatic heart disease (RHD) patients with atrial fibrillation (AF). Methods: Twenty-nine patients with mitral valve replacement of RHD were divided into AF group (n= 13) and sinus rhythm group (SN group) (n= 16). There was no significant statistical difference in clinical factors between the 2 groups. During the operation of valve replacement, the samples of right atrial appendages were taken and the qualitative and quantitative study were made by light microscopy and electron microscopy. Results: (1) Light microscope: The interstitial fibrosis and the arrangement of myocardium was more disordered in AF group than that in SN group. However, no statistic difference was found in interstitial fibrosis and cellar hypertrophy degree between the 2 groups. (2) Electron microscope: Mitochondrial crosta broke and dissolved obviously in AF group. The mitochondrial volume in AF group was smaller than that in SN group. Volume density, average area and average perimeter in AF group were less than that in SN group; specific surface in AF group was bigger than that in SN group. There was significant difference of above factors between the 2 groups; but there was no significant difference of surface density and numerical density on area in the 2 groups. Volume density of myofibril in AF group and SN group were less than that in SN group. (3)Split of Intercalated disc(ID) gap was found in AF group, and there was marrowing and floccular substance in ID gap. Conclusion: There were significant differences in the pathological changes of right atrial myocardium between AF and SN with RHD, these changes may be the important pathological basis for RA fibrillation of AF patients with RHD.

  8. Fish consumption and incidence of heart failure: a meta-analysis of prospective cohort studies

    Institute of Scientific and Technical Information of China (English)

    LI Yue-hua; ZHOU Cheng-hui; PEI Han-jun; ZHOU Xian-liang; LI Li-huan; WU Yong-jian; HUI Ru-tai

    2013-01-01

    Background The association between fish consumption and heart failure (HF) incidence is inconsistent.Methods We performed a systematic search of Pubmed and Embase (from 1953 to June 2012) using key words related to fish and HF.Studies with at least three categories of fish consumption reporting both relative risk (RR) and corresponding 95% confidence interval (CI) for HF incidence were included.The pooled RR and 95%C/were calculated using a fixed or random-effects model.The generalized least squares regression model was used to quantify the dose-response relationship between fish consumption and HF incidence.Results Five prospective cohort studies including 4750 HF events of 170 231 participants with an average of 9.7-year follow-up were selected and identified.Compared with those who never ate fish,individuals with higher fish consumption had a lower HF incidence.The pooled RRs for HF incidence was 0.99 (95%CI,0.91 to 1.08) for fish consumption 1 to 3 times per month,0.91 (95%C/,0.84 to 0.99) for once a week,0.87 (95%C/,0.81 to 0.95) for 2 to 4 times per week,and 0.86 (95%C/,0.84 to 0.99) for 5 or more times per week.An increment of 20 g of daily fish intake was related to a 6% lower risk of HF (RR:0.94,95% CI,0.90 to 0.97; P for trend =0.001).Conclusions This meta-analysis suggests that there is a dose-dependent inverse relationship between fish consumotion and HF incidence.Fish intake once or more times a week could reduce HF incidence.

  9. Bayesian analysis of recurrent event with dependent termination: an application to a heart transplant study.

    Science.gov (United States)

    Ouyang, Bichun; Sinha, Debajyoti; Slate, Elizabeth H; Van Bakel, Adrian B

    2013-07-10

    For a heart transplant patient, the risk of graft rejection and risk of death are likely to be associated. Two fully specified Bayesian models for recurrent events with dependent termination are applied to investigate the potential relationships between these two types of risk as well as association with risk factors. We particularly focus on the choice of priors, selection of the appropriate prediction model, and prediction methods for these two types of risk for an individual patient. Our prediction tools can be easily implemented and helpful to physicians for setting heart transplant patients' biopsy schedule.

  10. ASSOCIATION OF CORONARY HEART DISEASE AND OBESITY: A CROSS SECTIONAL STUDY FROM DARBHANGA DISTRICT OF BIHAR

    Directory of Open Access Journals (Sweden)

    Vijay Kumar

    2015-08-01

    Full Text Available INTRODUCTION: Overweight and Obesity has been found to be strongly associated with some cardiovascular risk factors like adverse lipid profiles, hypertension and glucose intolerance. Although, the contribution of obesity to coronary heart disease (CHD incidence may be largely mediated through effect on major cardiovascular risk factors, obesity must be considered to be an important modifiable risk factor for the disease. MATERIALS AND METHODS: This was a cross - sectional study conducted from Jan . 2015 to March 2015 (3 mo nths, involving staffs and doctors of Darbhanga Medical College & Hospital. They were selected by simple random sampling. Variables measured in the study were weight ( I n kilograms, height ( I n metres, and waist & hip circumference (I n centimetres. OBSER VATION: The percentage of male members enrolled for the study was 98.58% and females were 1.22%. Majority of the responden ts were in the age group of 30 - <40 yrs. 3.25% of the males were found to be obese. 41.70% of the males were found to be overweight. Th e association of obesity with CHD in the present study was found to be statistically significant (for overwe ight p<0.05 and for obese p< 0.001. 12.50% of the females were found to be obese. 37.50% of the female were found to be overweight. Truncal obesity among the males was found to be 20.27%. Truncal obesity among the females was found to be 50%. The association of truncal obesity with CHD in the present study was found to be statistically significant (p<0.01. CONCLUSION : It was concluded that the overall prevalence of CHD in our present study was 5.16% and the maximum prevalence of CHD was found in the age group of 50 - 59 years. Obesity was present in 3.25% of the study subjects and 41.70% were overweight. The association of obesity with the prevalence of CHD was found to be statistically significant (p<0.001. Truncal obesity was present in 20.27% of male and 50% of the female subjects. RECOMMENDATIONS: Proper

  11. Genome-wide association study for subclinical atherosclerosis in major arterial territories in the NHLBI's Framingham Heart Study

    Directory of Open Access Journals (Sweden)

    Hwang Shih-Jen

    2007-09-01

    Full Text Available Abstract Introduction Subclinical atherosclerosis (SCA measures in multiple arterial beds are heritable phenotypes that are associated with increased incidence of cardiovascular disease. We conducted a genome-wide association study (GWAS for SCA measurements in the community-based Framingham Heart Study. Methods Over 100,000 single nucleotide polymorphisms (SNPs were genotyped (Human 100K GeneChip, Affymetrix in 1345 subjects from 310 families. We calculated sex-specific age-adjusted and multivariable-adjusted residuals in subjects tested for quantitative SCA phenotypes, including ankle-brachial index, coronary artery calcification and abdominal aortic calcification using multi-detector computed tomography, and carotid intimal medial thickness (IMT using carotid ultrasonography. We evaluated associations of these phenotypes with 70,987 autosomal SNPs with minor allele frequency ≥ 0.10, call rate ≥ 80%, and Hardy-Weinberg p-value ≥ 0.001 in samples ranging from 673 to 984 subjects, using linear regression with generalized estimating equations (GEE methodology and family-based association testing (FBAT. Variance components LOD scores were also calculated. Results There was no association result meeting criteria for genome-wide significance, but our methods identified 11 SNPs with p -5 by GEE and five SNPs with p -5 by FBAT for multivariable-adjusted phenotypes. Among the associated variants were SNPs in or near genes that may be considered candidates for further study, such as rs1376877 (GEE p ABI2 for maximum internal carotid artery IMT and rs4814615 (FBAT p = 0.000003, located in PCSK2 for maximum common carotid artery IMT. Modest significant associations were noted with various SCA phenotypes for variants in previously reported atherosclerosis candidate genes, including NOS3 and ESR1. Associations were also noted of a region on chromosome 9p21 with CAC phenotypes that confirm associations with coronary heart disease and CAC in two

  12. Utility of biomarkers in the differential diagnosis of heart failure in older people: findings from the heart failure in care homes (HFinCH diagnostic accuracy study.

    Directory of Open Access Journals (Sweden)

    James M Mason

    Full Text Available BACKGROUND: The performance of biomarkers for heart failure (HF in older residents in long-term care is poorly understood and has not differentiated between left ventricular systolic dysfunction (LVSD and HF with preserved ejection fraction (HFpEF. METHODS: This is the first diagnostic accuracy study in this population to assess the differential diagnostic performance and acceptability of a range of biomarkers against a clinical diagnosis using portable echocardiography. A total of 405 residents, aged 65-100 years (mean 84.2, in 33 UK long-term care facilities were enrolled between April 2009 and June 2010. RESULTS: For undifferentiated HF, BNP or NT-proBNP were adequate rule-out tests but would miss one in three cases (BNP: sensitivity 67%, NPV 86%, cut-off 115 pg/ml; NT-proBNP: sensitivity 62%, NPV 87%, cut-off 760 pg/ml. Using higher test cut-offs, both biomarkers were more adequate tests of LVSD, but would still miss one in four cases (BNP: sensitivity 76%, NPV 97%, cut-off 145 pg/ml; NT-proBNP: sensitivity 73%, NPV 97%, cut-off 1000 pg/ml. At these thresholds one third of subjects would test positive and require an echocardiogram. Applying a stricter 'rule out' threshold (sensitivity 90%, only one in 10 cases would be missed, but two thirds of subjects would require further investigation. Biomarkers were less useful for HFpEF (BNP: sensitivity 63%, specificity 61%, cut-off 110 pg/ml; NT-proBNP: sensitivity 68%, specificity 56%, cut-off 477 pg/ml. Novel biomarkers (Copeptin, MR-proADM, and MR-proANP and common signs and symptoms had little diagnostic utility. CONCLUSIONS: No test, individually or in combination, adequately balanced case finding and rule-out for heart failure in this population; currently, in-situ echocardiography provides the only adequate diagnostic assessment. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN19781227.

  13. Music and the heart.

    Science.gov (United States)

    Koelsch, Stefan; Jäncke, Lutz

    2015-11-21

    Music can powerfully evoke and modulate emotions and moods, along with changes in heart activity, blood pressure (BP), and breathing. Although there is great heterogeneity in methods and quality among previous studies on effects of music on the heart, the following findings emerge from the literature: Heart rate (HR) and respiratory rate (RR) are higher in response to exciting music compared with tranquilizing music. During musical frissons (involving shivers and piloerection), both HR and RR increase. Moreover, HR and RR tend to increase in response to music compared with silence, and HR appears to decrease in response to unpleasant music compared with pleasant music. We found no studies that would provide evidence for entrainment of HR to musical beats. Corresponding to the increase in HR, listening to exciting music (compared with tranquilizing music) is associated with a reduction of heart rate variability (HRV), including reductions of both low-frequency and high-frequency power of the HRV. Recent findings also suggest effects of music-evoked emotions on regional activity of the heart, as reflected in electrocardiogram amplitude patterns. In patients with heart disease (similar to other patient groups), music can reduce pain and anxiety, associated with lower HR and lower BP. In general, effects of music on the heart are small, and there is great inhomogeneity among studies with regard to methods, findings, and quality. Therefore, there is urgent need for systematic high-quality research on the effects of music on the heart, and on the beneficial effects of music in clinical settings.

  14. Blood pressure in young adults with and without a paternal history of premature coronary heart disease in Europe: the EARS study. [European arteriosclerosis study

    NARCIS (Netherlands)

    Masana, L.; Farinaro, E.; Henauw, S. de; Nicaud, V.

    1996-01-01

    Objective : The European Arteriosclerosis Study (EARS) was designed to identify variables which discriminate subjects with a paternal history of premature coronary heart disease (CHD) from controls and to study the distribution of these variables across Europe. In this article we report on the blood

  15. Food Choices and Coronary Heart Disease: A Population Based Cohort Study of Rural Swedish Men with 12 Years of Follow-up

    Directory of Open Access Journals (Sweden)

    Sara Holmberg

    2009-10-01

    Full Text Available Coronary heart disease is associated with diet. Nutritional recommendations are frequently provided, but few long term studies on the effect of food choices on heart disease are available. We followed coronary heart disease morbidity and mortality in a cohort of rural men (N = 1,752 participating in a prospective observational study. Dietary choices were assessed at baseline with a 15-item food questionnaire. 138 men were hospitalized or deceased owing to coronary heart disease during the 12 year follow-up. Daily intake of fruit and vegetables was associated with a lower risk of coronary heart disease when combined with a high dairy fat consumption (odds ratio 0.39, 95% CI 0.21-0.73, but not when combined with a low dairy fat consumption (odds ratio 1.70, 95% CI 0.97-2.98. Choosing wholemeal bread or eating fish at least twice a week showed no association with the outcome.

  16. Long-Term Survival after Stroke: 30 Years of Follow-Up in a Cohort, the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Boysen, G.; Marott, J.L.; Gronbaek, M.

    2009-01-01

    died before the end of 2007. The National Register of Causes of Death provided cause of death. Survival in stroke patients was compared with survival in participants in the Copenhagen City Heart Study who did not suffer a stroke, and with survival in the general Danish population. Cox regression...... in the Copenhagen City Heart Study who experienced a first-ever stroke from 1978 to the end of 2001 were followed to the end of 2007. Stroke events were validated using the World Health Organization's definition of stroke. Linkage to the Danish Civil Registration System enabled identification of participants who......-stroke controls. Long-term survival improved steadily over time. Life expectancy after stroke increased up to 4 years from 1978 to the end of 2001, exceeding the increase of life expectancy in the general population. Slightly longer survival was found in women than in men when adjusted for age at stroke onset...

  17. Simulated sudden increase in geomagnetic activity and its effect on heart rate variability: Experimental verification of correlation studies

    Science.gov (United States)

    Caswell, Joseph M.; Singh, Manraj; Persinger, Michael A.

    2016-08-01

    Previous research investigating the potential influence of geomagnetic factors on human cardiovascular state has tended to converge upon similar inferences although the results remain relatively controversial. Furthermore, previous findings have remained essentially correlational without accompanying experimental verification. An exception to this was noted for human brain activity in a previous study employing experimental simulation of sudden geomagnetic impulses in order to assess correlational results that had demonstrated a relationship between geomagnetic perturbations and neuroelectrical parameters. The present study employed the same equipment in a similar procedure in order to validate previous findings of a geomagnetic-cardiovascular dynamic with electrocardiography and heart rate variability measures. Results indicated that potential magnetic field effects on frequency components of heart rate variability tended to overlap with previous correlational studies where low frequency power and the ratio between low and high frequency components of heart rate variability appeared affected. In the present study, a significant increase in these particular parameters was noted during geomagnetic simulation compared to baseline recordings.

  18. One year follow-up of the multi-centre European PARTNER transcatheter heart valve study

    Science.gov (United States)

    Lefèvre, Thierry; Kappetein, Ari Pieter; Wolner, Ernst; Nataf, Patrick; Thomas, Martyn; Schächinger, Volker; De Bruyne, Bernard; Eltchaninoff, Hélène; Thielmann, Matthias; Himbert, Dominique; Romano, Mauro; Serruys, Patrick; Wimmer-Greinecker, Gerhard

    2011-01-01

    Background Transcatheter aortic valve implantation (TAVI) has emerged as a new therapeutic option in high-risk patients with severe aortic stenosis. Aims PARTNER EU is the first study to evaluate prospectively the procedural and mid-term outcomes of transfemoral (TF) or transapical (TA) implantation of the Edwards SAPIEN® valve involving a multi-disciplinary approach. Methods and results Primary safety endpoints were 30 days and 6 months mortality. Primary efficacy endpoints were haemodynamic and functional improvement at 12 months. One hundred and thirty patients (61 TF, 69 TA), aged 82.1 ± 5.5 years were included. TA patients had higher logistic EuroSCORE (33.8 vs. 25.7%, P = 0.0005) and more peripheral disease (49.3 vs. 16.4%, P< 0.0001). Procedures were aborted in four TA (5.8%) and six TF cases (9.8%). Valve implantation was successful in the remaining patients in 95.4 and 96.4%, respectively. Thirty days and 6 months survival were 81.2 and 58.0% (TA) and 91.8 and 90.2% (TF). In both groups, mean aortic gradient decreased from 46.9 ± 18.1 to 10.9 ± 5.4 mmHg 6 months post-TAVI. In total, 78.1 and 84.8% of patients experienced significant improvement in New York Heart Association (NYHA) class, whereas 73.9 and 72.7% had improved Kansas City Cardiomyopathy Questionnaire (KCCQ) scores in TA and TF cohorts, respectively. Conclusion This first team-based multi-centre European TAVI registry shows promising results in high-risk patients treated by TF or TA delivery. Survival rates differ significantly between TF and TA groups and probably reflect the higher risk profile of the TA cohort. Optimal patient screening, approach selection, and device refinement may improve outcomes. PMID:21075775

  19. Firefighters and on-duty deaths from coronary heart disease: a case control study

    Directory of Open Access Journals (Sweden)

    Soteriades Elpidoforos S

    2003-11-01

    Full Text Available Abstract Background Coronary heart disease (CHD is responsible for 45% of on-duty deaths among United States firefighters. We sought to identify occupational and personal risk factors associated with on-duty CHD death. Methods We performed a case-control study, selecting 52 male firefighters whose CHD deaths were investigated by the National Institute for Occupational Safety and Health. We selected two control populations: 51 male firefighters who died of on-duty trauma; and 310 male firefighters examined in 1996/1997, whose vital status and continued professional activity were re-documented in 1998. Results The circadian pattern of CHD deaths was associated with emergency response calls: 77% of CHD deaths and 61% of emergency dispatches occurred between noon and midnight. Compared to non-emergency duties, fire suppression (OR = 64.1, 95% CI 7.4–556; training (OR = 7.6, 95% CI 1.8–31.3 and alarm response (OR = 5.6, 95% CI 1.1–28.8 carried significantly higher relative risks of CHD death. Compared to the active firefighters, the CHD victims had a significantly higher prevalence of cardiovascular risk factors in multivariate regression models: age ≥ 45 years (OR 6.5, 95% CI 2.6–15.9, current smoking (OR 7.0, 95% CI 2.8–17.4, hypertension (OR 4.7, 95% CI 2.0–11.1, and a prior diagnosis of arterial-occlusive disease (OR 15.6, 95% CI 3.5–68.6. Conclusions Our findings strongly support that most on-duty CHD fatalities are work-precipitated and occur in firefighters with underlying CHD. Improved fitness promotion, medical screening and medical management could prevent many of these premature deaths.

  20. Relationship between Medication Use and Cardiovascular Disease Health Outcomes in the Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Monique S. White

    2011-06-01

    Full Text Available Even though some medications have the potential to slow the progress of atherosclerosis and development of CVD, there are many at-risk individuals who continue to resist the benefits that are available by not following the advice of medical professionals. Non-adherence to prescribed drug regimens is a pervasive medical problem that negatively affects treatment outcomes. Information from standardized interviews of 5301 African Americans participating in the Jackson Heart Study was examined to determine the association between demographic parameters, behavior including adherence to prescribed medical regimens, and health outcomes. Data were also collected at Annual Follow-Up and Surveillance visits. During the two weeks prior to the examination visit, almost 52% of the participants reported taking blood pressure medication, 14% took cholesterol medication, 16% took medication for diabetes, and 19% took blood thinning medication. Of those who did not take the prescribed medications, the reasons given were the following: 47% were in a hurry, too busy, or forgot to take medications; 23% were trying to do without medications; 18% had no money to purchase medications; 19% indicated that the medications made them feel bad; 17% felt that they could not carry out daily functions when taking medications. The African American population can benefit from heightened awareness of the risk factors that are associated with CVD and the benefits of following a prescribed treatment regimen. Unacceptable secondary effects of prescribed medication comprised an important cause of non-compliance. Encouragement of this population to communicate with their healthcare providers to ensure that medication regimens are better tolerated could increase compliance and improve health outcomes.

  1. Relationship between medication use and cardiovascular disease health outcomes in the Jackson Heart Study.

    Science.gov (United States)

    Addison, Clifton C; Jenkins, Brenda W; Sarpong, Daniel; Wilson, Gregory; Champion, Cora; Sims, Jeraline; White, Monique S

    2011-06-01

    Even though some medications have the potential to slow the progress of atherosclerosis and development of CVD, there are many at-risk individuals who continue to resist the benefits that are available by not following the advice of medical professionals. Non-adherence to prescribed drug regimens is a pervasive medical problem that negatively affects treatment outcomes. Information from standardized interviews of 5301 African Americans participating in the Jackson Heart Study was examined to determine the association between demographic parameters, behavior including adherence to prescribed medical regimens, and health outcomes. Data were also collected at Annual Follow-Up and Surveillance visits. During the two weeks prior to the examination visit, almost 52% of the participants reported taking blood pressure medication, 14% took cholesterol medication, 16% took medication for diabetes, and 19% took blood thinning medication. Of those who did not take the prescribed medications, the reasons given were the following: 47% were in a hurry, too busy, or forgot to take medications; 23% were trying to do without medications; 18% had no money to purchase medications; 19% indicated that the medications made them feel bad; 17% felt that they could not carry out daily functions when taking medications. The African American population can benefit from heightened awareness of the risk factors that are associated with CVD and the benefits of following a prescribed treatment regimen. Unacceptable secondary effects of prescribed medication comprised an important cause of non-compliance. Encouragement of this population to communicate with their healthcare providers to ensure that medication regimens are better tolerated could increase compliance and improve health outcomes.

  2. Heart Rate Variability in Children with Attention-Deficit/Hyperactivity Disorder: A Pilot Study

    Science.gov (United States)

    Rukmani, Malligurki Raghurama; Seshadri, Shekhar P.; Thennarasu, Kandavel; Raju, Trichur R.; Sathyaprabha, Talakad N.

    2016-01-01

    Background Attention deficit/hyperactivity disorder (ADHD) is a common childhood neuropsychiatric disorder. Autonomic nervous system plays a vital role in attention, self-regulation, emotional stability and social affiliation, which are affected in ADHD. The prefrontal cortex, which is vital for attention, motor control, emotional regulation and higher order autonomic control, is hypofunctional in ADHD. In addition, catecholamine dysregulation is there. Purpose We hypothesized that there is autonomic dysfunction: reduction in overall heart rate variability (HRV) and sympathovagal imbalance in children with ADHD. Methods Study criteria were drug-naïve ADHD children who were 7-12 years of age of either gender who fulfilled DSM-IV criteria for ADHD and did not have any associated comorbid psychiatric/neurological/medical disorders. Two hundred and seventy ADHD children were screened out of which only 12 were found eligible and 10 participated. Sample size was 20 (cases = 10, age- and gender-matched healthy controls = 10). Short-term HRV of both time and frequency domains were assessed by recording lead II electrocardiogram after using Tell-Show-Do, a behavior shaping technique. Comparison between groups was done using Mann-Whitney and Wilcoxon test. Demographic variables like age, height, weight and body mass index were similar between groups. Results Among time domain parameters, SD of all NN intervals, square root of the mean of the sum of squares of differences between adjacent NN intervals and percentage of count of number of pairs of adjacent NN intervals differing by more than 50 ms were reduced in ADHD group with p < 0.05. Among frequency domain parameters, total power was reduced in ADHD group with p < 0.05, high frequency power (HF) was reduced in ADHD group with p < 0.01 and low frequency power to HF ratio was higher in ADHD group with p < 0.01. Conclusion There is autonomic dysfunction in children with ADHD - reduction in overall HRV with sympathovagal

  3. Heart Rate Variability, Insulin Resistance, and Insulin Sensitivity in Japanese Adults: The Toon Health Study

    Directory of Open Access Journals (Sweden)

    Isao Saito

    2015-09-01

    Full Text Available Background: Although impaired cardiac autonomic function is associated with an increased risk of type 2 diabetes in Caucasians, evidence in Asian populations with a lower body mass index is limited. Methods: Between 2009–2012, the Toon Health Study recruited 1899 individuals aged 30–79 years who were not taking medication for diabetes. A 75-g oral glucose tolerance test was used to diagnose type 2 diabetes, and fasting and 2-h-postload glucose and insulin concentrations were measured. We assessed the homeostasis model assessment index for insulin resistance (HOMA-IR and Gutt’s insulin sensitivity index (ISI. Pulse was recorded for 5 min, and time-domain heart rate variability (HRV indices were calculated: the standard deviation of normal-to-normal intervals (SDNN and the root mean square of successive difference (RMSSD. Power spectral analysis provided frequency domain measures of HRV: high frequency (HF power, low frequency (LF power, and the LF:HF ratio. Results: Multivariate-adjusted logistic regression models showed decreased SDNN, RMSSD, and HF, and increased LF:HF ratio were associated significantly with increased HOMA-IR and decreased ISI. When stratified by overweight status, the association of RMSSD, HF, and LF:HF ratio with decreased ISI was also apparent in non-overweight individuals. The interaction between LF:HF ratio and decreased ISI in overweight individuals was significant, with the odds ratio for decreased ISI in the highest quartile of LF:HF ratio in non-overweight individuals being 2.09 (95% confidence interval, 1.41–3.10. Conclusions: Reduced HRV was associated with insulin resistance and lower insulin sensitivity. Decreased ISI was linked with parasympathetic dysfunction, primarily in non-overweight individuals.

  4. Combining GPS with heart rate monitoring to measure physical activity in children: A feasibility study.

    Science.gov (United States)

    Duncan, J Scott; Badland, Hannah M; Schofield, Grant

    2009-09-01

    The recent development of global positioning system (GPS) receivers with integrated heart rate (HR) monitoring has provided a new method for estimating the energy expenditure associated with children's movement. The purpose of this feasibility study was to trial a combination of GPS surveillance and HR monitoring in 39 primary-aged children from New Zealand. Spatial location and HR data were recorded during a school lunch break using an integrated GPS/HR receiver (1Hz). Children averaged a total distance of 1.10+/-0.56km at speeds ranging from 0 to 18.6kmh(-1). Activity patterns were characterised by short bursts of moderate to high speeds followed by longer periods of slow speeds. In addition, boys averaged higher speeds than girls (1.77+/-0.62kmh(-1) and 1.36+/-0.50kmh(-1), respectively; p=0.003). The percentage of time spent at 0kmh(-1) (stationary) ranged from 0.1% to 21.3% with a mean of 6.4+/-4.6%. These data suggest that while children were relatively active during the lunch period, they spent a substantial portion of time engaged in slow or stationary physical activities. Furthermore, associations between HR, average speed, and stationary time demonstrated that children who moved at faster speeds expended more energy than those who moved at slower speeds. We conclude that the combined approach of GPS and HR monitoring is a promising new method for investigating children's play-related energy expenditure. There is also scope to integrate GPS data with geographic information systems to examine where children play and accumulate physical activity.

  5. Regional Fat Distribution and Blood Pressure Level and Variability: The Dallas Heart Study.

    Science.gov (United States)

    Yano, Yuichiro; Vongpatanasin, Wanpen; Ayers, Colby; Turer, Aslan; Chandra, Alvin; Carnethon, Mercedes R; Greenland, Philip; de Lemos, James A; Neeland, Ian J

    2016-09-01

    Our aim was to investigate the associations of regional fat distribution with home and office blood pressure (BP) levels and variability. Participants in the Dallas Heart Study, a multiethnic cohort, underwent 5 BP measurements on 3 occasions during 5 months (2 in home and 1 in office) and quantification of visceral adipose tissue, abdominal subcutaneous adipose tissue, and liver fat by magnetic resonance imaging, and lower body subcutaneous fat by dual x-ray absorptiometry. The relation of regional adiposity with short-term (within-visit) and long-term (overall visits) mean BP and average real variability was assessed with multivariable linear regression. We have included 2595 participants with a mean age of 44 years (54% women; 48% black), and mean body mass index was 29 kg/m(2) Mean systolic BP/diastolic BP was 127/79 mm Hg and average real variability systolic BP was 9.8 mm Hg during 3 visits. In multivariable-adjusted models, higher amount of visceral adipose tissue was associated with higher short-term (both home and office) and long-term mean systolic BP (β[SE]: 1.9[0.5], 2.7[0.5], and 2.1[0.5], respectively; all Pfat was associated with lower short-term home and long-term mean BP (β[SE]: -0.30[0.13] and -0.24[0.1], respectively; both Pfat was associated with BP levels or variability. In conclusion, excess visceral fat was associated with persistently higher short- and long-term mean BP levels and with lower long-term BP variability, whereas lower body fat was associated with lower short- and long-term mean BP. Persistently elevated BP, coupled with lower variability, may partially explain increased risk for cardiac hypertrophy and failure related to visceral adiposity.

  6. Markers of endogenous desaturase activity and risk of coronary heart disease in the CAREMA cohort study.

    Directory of Open Access Journals (Sweden)

    Yingchang Lu

    Full Text Available BACKGROUND: Intakes of n-3 polyunsaturated fatty acids (PUFAs, especially EPA (C20:5n-3 and DHA (C22:6n-3, are known to prevent fatal coronary heart disease (CHD. The effects of n-6 PUFAs including arachidonic acid (C20:4n-6, however, remain unclear. δ-5 and δ-6 desaturases are rate-limiting enzymes for synthesizing long-chain n-3 and n-6 PUFAs. C20:4n-6 to C20:3n-6 and C18:3n-6 to C18:2n-6 ratios are markers of endogenous δ-5 and δ-6 desaturase activities, but have never been studied in relation to incident CHD. Therefore, the aim of this study was to investigate the relation between these ratios as well as genotypes of FADS1 rs174547 and CHD incidence. METHODS: We applied a case-cohort design within the CAREMA cohort, a large prospective study among the general Dutch population followed up for a median of 12.1 years. Fatty acid profile in plasma cholesteryl esters and FADS1 genotype at baseline were measured in a random subcohort (n = 1323 and incident CHD cases (n = 537. Main outcome measures were hazard ratios (HRs of incident CHD adjusted for major CHD risk factors. RESULTS: The AA genotype of rs174547 was associated with increased plasma levels of C204n-6, C20:5n-3 and C22:6n-3 and increased δ-5 and δ-6 desaturase activities, but not with CHD risk. In multivariable adjusted models, high baseline δ-5 desaturase activity was associated with reduced CHD risk (P for trend = 0.02, especially among those carrying the high desaturase activity genotype (AA: HR (95% CI = 0.35 (0.15-0.81 for comparing the extreme quintiles. High plasma DHA levels were also associated with reduced CHD risk. CONCLUSION: In this prospective cohort study, we observed a reduced CHD risk with an increased C20:4n-6 to C20:3n-6 ratio, suggesting that δ-5 desaturase activity plays a role in CHD etiology. This should be investigated further in other independent studies.

  7. Studies in Early Infant Learning: Classical Conditioning of the Neonatal Heart Rate

    Science.gov (United States)

    Crowell, David H.; And Others

    1976-01-01

    In three experiments, it was demonstrated that human newborn heart rate level can be reliably modified through classical conditioning procedures. Findings support the idea that early learning may occur under a variety of conditions and different theories may account for the results. (Author/SB)

  8. Progenitor cells from the heart : in vitro study of CMPC and EPDC behavior

    NARCIS (Netherlands)

    van Oorschot, A.A.M.

    2011-01-01

    Cardiovascular disorders are currently the leading cause of death in the Western world. Myocardial infarction (MI) is one of the main contributors to ischemic heart disease. After ischemia, cardiomyocytes die and are replaced by fibrous scar tissue while in the remaining cardiomyocytes hypertrophy i

  9. Dietary fatty acids and risk factors for coronary heart disease: controlled studies in healthy volunteers.

    NARCIS (Netherlands)

    Zock, P.L.

    1995-01-01

    High levels of LDL cholesterol, blood pressure and Lp(a), and low levels of HDL cholesterol increase the risk for coronary heart disease (CHD). This thesis describes the effects of dietary fatty acids on these risk factors. In each of three trials we fed diets with tailored fatty acid composition to

  10. A study of Conrad's Assault on Colonialism in Heart of Darkness

    Institute of Scientific and Technical Information of China (English)

    陈贻祥

    2010-01-01

    "Conrad's Heart of Darkness is a rich,vivid,layered,para-doxical,and problematic novella or long tale.It has proved to be a-head of its time."(Stape 45) how did it come to be ahead of itstime? The answer lies in its satiric verve and skeptical boldness,thelayered narration,

  11. Risk of Coronary Heart Disease in Men With Poor Emotional Control : A Prospective Study

    NARCIS (Netherlands)

    Potijk, Marieke R.; Janszky, Imre; Reijneveld, Sijmen A.; Falkstedt, Daniel

    2016-01-01

    Objective Many psychosocial factors have been associated with coronary heart disease (CHD), including hostility, anger, and depression. We tested the hypothesis that these factors may have their basis in emotion regulation abilities. Our aim was to determine whether poor emotional control predicted

  12. Heart rate variability and skin conductance biofeedback: A triple-blind randomized controlled study

    NARCIS (Netherlands)

    Raaijmakers, S.F.; Steel,F.W.; Goede, M. de; Wouwe, N.C. van; Erp, J.B.F. van; Brouwer, A.M.

    2013-01-01

    High heart rate variability (HRV) and low skin conductance level (SCL) have been associated with low levels of stress. Biofeedback - providing an individual with online information about his or her own physiological state – may help to change these signals in the desired direction and therewith impr

  13. Outcome of implantable cardioverter defibrillators in adults with congenital heart disease : a multi-centre study

    NARCIS (Netherlands)

    Yap, Sing-Chien; Roos-Hesselink, Jolien W.; Hoendermis, Elke S.; Budts, Werner; Vliegen, Hubert W.; Mulder, Barbara J. M.; van Dijk, Arie P. J.; Schalij, Martin J.; Drenthen, Willem

    2007-01-01

    Aims To investigate outcome and complications of implantable cardioverter defibrillators (ICDs) in adults with congenital heart disease (CHD) and to identify predictors of (in-) appropriate shocks. Methods and results Sixty-four CHD patients >= 18 years at first ICD implantation [63% tetralogy of Fa

  14. Educational Level and the Quality of Life of Heart Failure Patients : A Longitudinal Study

    NARCIS (Netherlands)

    Barbareschi, Giorgio; Sanderman, Robbert; Lesman-Leegte, Ivonne; Van Veldhuisen, Dirk J.; Jaarsma, Tiny

    2011-01-01

    Background: Lower education in heart failure (HF) patients is associated with high levels of anxiety, limited physical functioning, and an increased risk of hospitalization. We examined whether educational level is related to longitudinal differences in quality of life (QoL) in HF patients. Methods

  15. Sex differences and heritability of two indices of heart rate dynamics : A twin study

    NARCIS (Netherlands)

    Snieder, Harold; van Doornen, Lorenz J. P.; Boomsma, Dorret I.; Thayer, Julian F.

    2007-01-01

    We investigated whether women show larger heart rate variability (HRV) than men after controlling for a large number of health-related covariates, using two indices of HRV, namely respiratory sinus arrhythmia (RSA) and approximate entropy (ApEn). In a twin design, the heritability of both indices wa

  16. Survival in Mediterranean Ambulatory Patients With Chronic Heart Failure. A Population-based Study

    NARCIS (Netherlands)

    Frigola Capell, E.; Comin-Colet, J.; Davins-Miralles, J.; Gich-Saladich, I.J.; Wensing, M.; Verdu-Rotellar, J.M.

    2013-01-01

    INTRODUCTION AND OBJECTIVES: Scarce research has been performed in ambulatory patients with chronic heart failure in the Mediterranean area. Our aim was to describe survival trends in our target population and the impact of prognostic factors. METHODS: We carried out a population-based retrospective

  17. A comparative study of pulse rate variability and heart rate variability in healthy subjects.

    Science.gov (United States)

    Wong, Jih-Sen; Lu, Wan-An; Wu, Kung-Tai; Liu, Margaret; Chen, Gau-Yang; Kuo, Cheng-Deng

    2012-04-01

    Both heart rate variability (HRV) and pulse rate variability (PRV) are noninvasive means for the assessment of autonomic nervous control of the heart. However, it is not settled whether or not the PRV obtained from either hand can be the surrogate of HRV. The HRV measures obtained from electrocardiographic signals and the PRV measures obtained from the pulse waves recorded from the index fingers of both hands were compared in normal subjects by using linear regression analysis and Bland and Altman method. Highly significant correlations (P < 0.001, 0.89 < r < 1.0) were found between all HRV measures and the corresponding PRV measures of both hands. However, there were insufficient agreements in some measures between pairwise comparisons among HRV, right PRV and left PRV except heart rate and ultra-low frequency power (ULFP). The PRV of either hand is close to, but not the same as the HRV in healthy subjects. The HRV, right PRV and left PRV are not surrogates of one another in normal subjects except heart rate and ULFP. Since HRV is generally accepted as the standard method for the assessment of the autonomic nervous modulation of a subject, the PRV of either hand may not be suitable for the assessment of the cardiac autonomic nervous modulation of the subject.

  18. Small dense low density lipoprotein cholesterol and coronary heart disease: results from the Framingham Offspring Study

    Science.gov (United States)

    We sought to establish reference values for a new direct assay for small dense LDL cholesterol (sdLDL-C) and to measure sdLDL-C concentrations in patients with established coronary heart disease (CHD) vs controls. Direct LDL-C and sdLDL-C were measured in samples from 3188 male and female participan...

  19. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... outside the heart. Some heart defects may need surgery right after the baby is born. For others, ...

  20. Hypoplastic left heart syndrome

    Science.gov (United States)

    HLHS; Congenital heart - hypoplastic left heart; Cyanotic heart disease - hypoplastic left heart ... Hypoplastic left heart is a rare type of congenital heart disease. It is more common in males than in ...

  1. Hip dysplasia and osteoarthrosis: a survey of 4151 subjects from the Osteoarthrosis Substudy of the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Søballe, K

    2005-01-01

    Acta Orthop. 2005 Apr;76(2):149-58. Related Articles, Links Hip dysplasia and osteoarthrosis: a survey of 4151 subjects from the Osteoarthrosis Substudy of the Copenhagen City Heart Study. Jacobsen S, Sonne-Holm S, Soballe K, Gebuhr P, Lund B. Department of Orthopaedic Surgery, Copenhagen...... in the general population. The assumption that HD is an etiological factor in the development of hip OA was confirmed. PMID: 16097538 [PubMed - indexed for MEDLINE]...

  2. Lifetime Risk of Cardiovascular Disease Among Individuals With and Without Diabetes Stratified by Obesity Status in the Framingham Heart Study

    OpenAIRE

    Pencina, Michael J.; Wilson, Peter W. F.; Vasan, Ramachandran S; D’Agostino, Ralph B.; Fox, Caroline; Paynter, Nina Palanza

    2008-01-01

    Objective: We assessed the lifetime risk of cardiovascular disease (CVD) among individuals with and without obesity and diabetes. Research Design and Methods: Participants were drawn from the original and offspring cohorts of the Framingham Heart Study. Lifetime (30-year) risk of CVD was assessed using a modified Kaplan-Meier approach adjusting for the competing risk of death, beginning from age 50 years. Results: Over 30 years, the lifetime risk of CVD among women with diabetes was 54.8% amo...

  3. Prevalence and Characteristics of Central Compared to Obstructive Sleep Apnea: Analyses from the Sleep Heart Health Study Cohort

    Science.gov (United States)

    Donovan, Lucas M.; Kapur, Vishesh K.

    2016-01-01

    Study Objectives: Determine the prevalence of central sleep apnea (CSA) in a large community-based cohort using current definitions and contrast the clinical characteristics of subjects with CSA to those with obstructive sleep apnea (OSA) and no sleep apnea. Methods: A cross sectional analysis of baseline data from 5,804 participants of the Sleep Heart Health study was performed. Subjects meeting contemporary diagnostic criteria for CSA and Cheyne Stokes respiration (CSR) were compared to those without sleep apnea and those with OSA. Demographic data, medical comorbidities, medication use, and sleep related symptoms were compared between the groups Results: The prevalences of CSA and Cheyne Stokes respiration (CSR) in this sample were 0.9 (95% confidence intervals [CI]: 0.7–1.2)% and 0.4 (95% CI: 0.3–0.6)%, respectively. Individuals with CSA were older, had lower body mass indexes (BMI), lower Epworth Sleepiness Scale scores, and were more likely to be male than individuals with obstructive sleep apnea OSA. Among those with self-reported heart failure (HF), OSA was much more common at 55.1% (95% CI: 45.6–64.6) than CSA 4.1% (95% CI: 0.3–7.9). Conclusions: This is the largest community-based study of the prevalence and characteristics of CSA to date and demonstrates a prevalence of CSA that is intermediate to those previously noted. Contrary to prior data from clinic based samples, individuals with heart failure were much more likely to have OSA than CSA. Citation: Donovan LM, Kapur VK. Prevalence and characteristics of central compared to obstructive sleep apnea: analyses from the sleep heart health study cohort. SLEEP 2016;39(7):1353–1359. PMID:27166235

  4. Heart attack

    Science.gov (United States)

    ... Saunders; 2014:chap 51. Read More Arrhythmias Cardiogenic shock Diabetes Hardening of the arteries Heart failure - overview High blood pressure Implantable cardioverter-defibrillator Lipoprotein- ...

  5. Resting heart rate, heart rate variability and functional decline in old age

    DEFF Research Database (Denmark)

    Ogliari, Giulia; Mahinrad, Simin; Stott, David J;

    2015-01-01

    BACKGROUND: Heart rate and heart rate variability, markers of cardiac autonomic function, have been linked with cardiovascular disease. We investigated whether heart rate and heart rate variability are associated with functional status in older adults, independent of cardiovascular disease. METHODS......: We obtained data from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). A total of 5042 participants were included in the present study, and mean followup was 3.2 years. Heart rate and heart rate variability were derived from baseline 10-second electrocardiograms. Heart rate...... heart rate and lower heart rate variability were associated with worse functional status and with higher risk of future functional decline in older adults...

  6. Gene-environment interaction effects on lung function- a genome-wide association study within the Framingham heart study

    Science.gov (United States)

    2013-01-01

    Background Previous studies in occupational exposure and lung function have focused only on the main effect of occupational exposure or genetics on lung function. Some disease-susceptible genes may be missed due to their low marginal effects, despite potential involvement in the disease process through interactions with the environment. Through comprehensive genome-wide gene-environment interaction studies, we can uncover these susceptibility genes. Our objective in this study was to explore gene by occupational exposure interaction effects on lung function using both the individual SNPs approach and the genetic network approach. Methods The study population comprised the Offspring Cohort and the Third Generation from the Framingham Heart Study. We used forced expiratory volume in one second (FEV1) and ratio of FEV1 to forced vital capacity (FVC) as outcomes. Occupational exposures were classified using a population-specific job exposure matrix. We performed genome-wide gene-environment interaction analysis, using the Affymetrix 550 K mapping array for genotyping. A linear regression-based generalized estimating equation was applied to account for within-family relatedness. Network analysis was conducted using results from single-nucleotide polymorphism (SNP)-level analyses and from gene expression study results. Results There were 4,785 participants in total. SNP-level analysis and network analysis identified SNP rs9931086 (Pinteraction =1.16 × 10-7) in gene SLC38A8, which may significantly modify the effects of occupational exposure on FEV1. Genes identified from the network analysis included CTLA-4, HDAC, and PPAR-alpha. Conclusions Our study implies that SNP rs9931086 in SLC38A8 and genes CTLA-4, HDAC, and PPAR-alpha, which are related to inflammatory processes, may modify the effect of occupational exposure on lung function. PMID:24289273

  7. Relationships betveen pain intensity and heart rate variability in patients after abdominal surgery: a pilot study

    Institute of Scientific and Technical Information of China (English)

    CHANG Ling-hua; MA Tso-chiang; TSAY Shiow-luan; JONG Gwo-ping

    2012-01-01

    Background A link between postoperative pain intensity and heart rate variability (HRV) had not been well established.This study aimed to investigate the correlation between post-operative pain intensity and HRV.Methods The subjects in this cross-sectional correlation study comprised of patients who had undergone abdominal surgery in a regional teaching hospital in central Taiwan during the period July 2009-November 2009.The visual analogue scale (VAS) and the short-form McGill pain questionnaire (SF-MPQ) were used to measure post-operative pain.HRV was measured as the standard deviation of normal RR interval,and by power spectral analysis that included high frequency (HF),low frequency (LF),very low frequency power,and LF/HF ratio.Results Atotal of 34 subjects were included in this study.We found that the day after the surgery,the mean VAS score was 47.50±20.98 and the mean SF-MPQ score was 18.06±8.90,indicating a moderate degree of pain.Moderate to severe degrees of tenderness were reported by 70.6% of the patients,moderate to severe degrees of gnawing pain were experienced by 67.7% of the patients,moderate to severe degrees of tiring-exhaustion pain were reported by 64.7% of the patients,and 41.2% of the patients who experienced moderate to severe pain believed that the pain was punishing-cruel.The standard deviation of normal RR interval and high frequency values obtained from male patients or married patients were higher than female patients or unmarried (P <0.05).The correlation of the standard deviation of normal RR interval,high frequency,very low frequency value and patient's age were negative (p <0.05).The total SF-MPQ pain scores positively correlated with the LF/HF ratio (P <0.05).Conclusions The multidimensional pain assessment tool (SF-MPQ) reflects better the patients' post-operative pain than the single-dimensional assessment tool (VAS).HRV positively correlated with SF-MPQ scores in patients after abdominal surgery.

  8. Associations of Adiponectin with Individual European Ancestry in African Americans: the Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Aurelian eBidulescu

    2014-02-01

    Full Text Available Background: Compared with European Americans, African Americans (AA exhibit lower levels of the cardio-metabolically protective adiponectin even after accounting for adiposity measures. Because few studies have examined in AA the association between adiponectin and genetic admixture, a dense panel of ancestry informative markers (AIMs was used to estimate the individual proportions of European ancestry (PEA for the African Americans enrolled in a large community-based cohort, the Jackson Heart Study (JHS. We tested the hypothesis that plasma adiponectin and PEA are directly associated and assessed the interaction with a series of cardio-metabolic risk factors.Methods: Plasma specimens from 1,439 JHS participants were analyzed by ELISA for adiponectin levels. Using pseudo-ancestral population genotype data from the HapMap Consortium, PEA was estimated with a panel of up to 1,447 genome-wide preselected AIMs by a maximum likelihood approach. Interaction assessment, stepwise linear and cubic multivariable-adjusted regression models were used to analyze the cross-sectional association between adiponectin and PEA.Results: Among the study participants (62% women; mean age 48 ± 12 years, the median (interquartile range of PEA was 15.8 (9.3%. Body mass index (p = 0.04 and insulin resistance (p = 0.0001 modified the association between adiponectin and PEA. Adiponectin was directly and linearly associated with PEA (β = 0.62 ± 0.28, p = 0.03 among non-obese (n = 673 and insulin sensitive participants (n = 1,141; β = 0.74 ± 0.23, p = 0.001, but not among those obese or with insulin resistance. No threshold effect was detected for non-obese participants.Conclusions: In a large African American population, the individual proportion of European ancestry was linearly and directly associated with plasma adiponectin among non-obese and non insulin-resistant participants, pointing to the interaction of genetic and metabolic factors influencing adiponectin

  9. Missing data in the exposure of interest and marginal structural models: a simulation study based on the Framingham Heart Study.

    Science.gov (United States)

    Shortreed, Susan M; Forbes, Andrew B

    2010-02-20

    Missing data are common in longitudinal studies and can occur in the exposure interest. There has been little work assessing the impact of missing data in marginal structural models (MSMs), which are used to estimate the effect of an exposure history on an outcome when time-dependent confounding is present. We design a series of simulations based on the Framingham Heart Study data set to investigate the impact of missing data in the primary exposure of interest in a complex, realistic setting. We use a standard application of MSMs to estimate the causal odds ratio of a specific activity history on outcome. We report and discuss the results of four missing data methods, under seven possible missing data structures, including scenarios in which an unmeasured variable predicts missing information. In all missing data structures, we found that a complete case analysis, where all subjects with missing exposure data are removed from the analysis, provided the least bias. An analysis that censored individuals at the first occasion of missing exposure and includes a censorship model as well as a propensity model when creating the inverse probability weights also performed well. The presence of an unmeasured predictor of missing data only slightly increased bias, except in the situation such that the exposure had a large impact on missing data and the unmeasured variable had a large impact on missing data and outcome. A discussion of the results is provided using causal diagrams, showing the usefulness of drawing such diagrams before conducting an analysis.

  10. Prevalence, prognostic significance, and treatment of atrial fibrillation in congestive heart failure with particular reference to the DIAMOND-CHF study

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Brendorp, Bente; Køber, Lars;

    2003-01-01

    failure and the prevalence increases with the severity of the disease. These two conditions seem to be linked together, and congestive heart failure may either be the cause or the consequence of atrial fibrillation. The prognosis of atrial fibrillation is controversial, but studies indicate that atrial...... fibrillation is a risk factor in congestive heart failure patients. In the last 10-15 years, significant advances in the treatment of heart failure have improved survival, whereas effective management of atrial fibrillation in heart failure patients still awaits similar progress. Empirically, two strategies......Atrial fibrillation is a growing health problem and the most common cardiac arrhythmia, affecting 5% of persons above the age of 65 years. The number of hospital discharges for atrial fibrillation has more than doubled in the past decade. It occurs very often in patients with congestive heart...

  11. Residential Proximity to Major Roadways Is Not Associated with Cardiac Function in African Americans: Results from the Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Anne M. Weaver

    2016-06-01

    Full Text Available Cardiovascular disease (CVD, including heart failure, is a major cause of morbidity and mortality, particularly among African Americans. Exposure to ambient air pollution, such as that produced by vehicular traffic, is believed to be associated with heart failure, possibly by impairing cardiac function. We evaluated the cross-sectional association between residential proximity to major roads, a marker of long-term exposure to traffic-related pollution, and echocardiographic indicators of left and pulmonary vascular function in African Americans enrolled in the Jackson Heart Study (JHS: left ventricular ejection fraction, E-wave velocity, isovolumic relaxation time, left atrial diameter index, and pulmonary artery systolic pressure. We examined these associations using multivariable linear or logistic regression, adjusting for potential confounders. Of 4866 participants at study enrollment, 106 lived <150 m, 159 lived 150–299 m, 1161 lived 300–999 m, and 3440 lived ≥1000 m from a major roadway. We did not observe any associations between residential distance to major roads and these markers of cardiac function. Results were similar with additional adjustment for diabetes and hypertension, when considering varying definitions of major roadways, or when limiting analyses to those free from cardiovascular disease at baseline. Overall, we observed little evidence that residential proximity to major roads was associated with cardiac function among African Americans.

  12. Fibrinogen and albumin levels and risk of atrial fibrillation in men and women (the Copenhagen City Heart Study)

    DEFF Research Database (Denmark)

    Mukamal, KJ; Tolstrup, JS; Friberg, J

    2006-01-01

    .47, 95% CI 0.28 to 0.77) but not among men (hazard ratio 1.01, 95% CI 0.56 to 1.84). Additional adjustment for cases of coronary heart disease, congestive heart failure, and stroke that occurred during follow-up did not attenuate these associations. In conclusion, higher levels of fibrinogen and lower...... Heart Study. We measured plasma fibrinogen and serum albumin levels at a study visit from 1991 to 1994. We identified 286 subsequent cases of AF during a mean of 7.5 years of follow-up by a validated nationwide registry of all hospitalizations. The fibrinogen levels at baseline were associated...... with a higher risk of AF, with a multivariate-adjusted hazard ratio for the highest versus lowest quartiles of 1.98 (95% confidence interval [CI] 0.94 to 4.17) among men and 2.14 (95% CI 1.15 to 3.96) among women. The albumin levels were inversely associated with the risk of AF among women (hazard ratio 0...

  13. Endotracheal tube tip culture in post-operative respiratory infections in open heart surgery patients: a one year prospective study

    Directory of Open Access Journals (Sweden)

    Chandra Mouli HC

    2016-10-01

    Full Text Available Background: Respiratory tract infections are a common occurrence after open heart surgery, leading to prolonged hospital stay, morbidity and costing the hospital exchequer. This study was conducted to study the utility of postextubation endotracheal tube [ET] tip culture in providing an early-basis for starting evidence-based antibiotic therapy. Methods: We retrospectively reviewed the case records of 172 patients who had undergone heart surgery at our tertiary care teaching hospital for occurrence of post-operative infections from clinical and microbiological data. Results: Bacterial culture was positive in 67(39% patients. Endotracheal tube patients, grew organisms that were sensitive to empirical antibiotic therapy, in 39 (58% patients. In 28 (42% patients organisms resistant to empirical therapy were grown; only 14 of the 28 patients (50% were symptomatic. Staphylococcus was the most common organism isolated followed by Acinetobacter and Enterobacter. Pseudomonas aeruginosa isolates were sensitive to all the antibiotics tested. Resistance was high among Acinetobacter sp. All the Gram-negative bacteria were sensitive to tigecycline. Resistance for beta-lactam antibiotics ranged from 35%-66% with imipenem being the most effective antibiotic. Conclusion: Our observations provide useful information regarding the microbiology of respiratory infection occurring in post-operative patients who had undergone open-heart surgery. Post-extubation endotracheal tip culture appears to be a useful tool for reliable and accurate diagnosis and treatment of these infections.

  14. Theory of heart

    Energy Technology Data Exchange (ETDEWEB)

    Glass, L. (ed.) (McGill Univ., Montreal (Canada). Dept. of Physiology); Hunter, P. (ed.) (Auckland Univ., Auckland (New Zealand). Dept. of Engineering Science); McCulloch, A. (ed.) (California Univ., San Diego (United States))

    1991-01-01

    In recent years there has been a growth in interest in studying the heart from the perspective of the physical sciences: mechanics, fluid flow, electromechanics. This volume is the result of a workshop held in July 1989 at the Institute for Nonlinear Sciences at the University of California at San Diego that brought together scientists and clinicians with graduate students and postdoctoral fellows who share an interest in the heart. The chapters were prepared by the invited speakers as didactic reviews of their subjects but also include up-to-date results in their fields. Topics covered include the structure, mechanical properties, and function of the heart and the myocardium, electrical activity of the heart and myocardium, and mathematical models of heart function. Individual chapters are abstracted separately.

  15. Resting heart rate is associated with cardiovascular and all-cause mortality after adjusting for inflammatory markers: The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Jensen, Magnus Thorsten; Marott, Jacob L; Allin, Kristine H

    2012-01-01

    Aims: To investigate the association between resting heart rate (RHR) and markers of chronic low-grade inflammation. Also, to examine whether elevated resting heart rate is independently associated with cardiovascular and all-cause mortality in the general population, or whether elevated RHR...... is merely a marker of chronic low-grade inflammation. Methods and results: A group of 6518 healthy subjects from the the Danish general population were followed for 18 years during which 1924 deaths occurred. Subjects underwent assessment of baseline RHR, conventional cardiovascular risk factors, high...

  16. Secular trends in the etiology and comorbidity of hospitalized patients with congestive heart failure: A single-center retrospective study

    Institute of Scientific and Technical Information of China (English)

    Zhi-Yong Pei; Yu-Sheng Zhao; Jia-Yue Li; Qiao Xue; Lei Gao; Shi-Wen Wang

    2012-01-01

    Objective To assess the secular trends in the etiology and comorbidity of patients hospitalized with congestive heart failure (CHF). Methods Data of 7,319 patients (mean age 59.6 years, 62.1% male) with a primary discharge diagnosis of CHF, hospitalized from January 1, 1993 to December 31, 2007 at the Chinese People's Liberation Army (PLA) General Hospital were extracted and analyzed. These patients were divided into three groups according to hospitalization period: 1993-1997 (n = 1623), 1998-2002 (n = 2444), and 2003-2007 (n = 3252). The etiological characteristics and comorbidities were assessed. Results Over the study period, the proportion of patients with ischemic heart disease (IHD) increased from 37.2% during the period 1993-1997 to 46.8% during the period 2003-2007, while that with valvular heart disease (VHD) decreased from 35.2% during the period 1993-1997 to 16.6% during the period 2003-2007 (both P < 0.05). Atrial fibrillation (AF) was the most common comorbidity of heart failure (23.2%, 23.0% and 20.6%, respectively, in the three periods). Compared to that of the period of 1993-1997 with that of, the proportion of patients with myocardial infarction, pneumonia, renal function impairment and hepatic cirrhosis of the period of 2003-2007 increased significantly (P < 0.05) and the proportion of patients with chronic obstructive pulmonary disease and atrial fibrillation decreased significantly (P < 0.05). Conclusions This study implies that IHD has became a more common etiology of CHF, while VHD has deceased as an etiology of CHF in Chinese patients during the last two decades.

  17. Novel ECG-Synchronized Pulsatile ECLS System With Various Heart Rates and Cardiac Arrhythmias: An In Vitro Study.

    Science.gov (United States)

    Wang, Shigang; Spencer, Shannon B; Kunselman, Allen R; Ündar, Akif

    2017-01-01

    The objective of this study is to evaluate electrocardiography (ECG)-synchronized pulsatile flow under varying heart rates and different atrial and ventricular arrhythmias in a simulated extracorporeal life support (ECLS) system. The ECLS circuit consisted of an i-cor diagonal pump and console, an iLA membrane ventilator, and an 18 Fr arterial cannula. The circuit was primed with lactated Ringer's solution and packed red blood cells (hematocrit 35%). An ECG simulator was used to trigger pulsatile flow and to generate selected cardiac rhythms. All trials were conducted at a flow rate of 2.5 L/min at room temperature for normal sinus rhythm at 45-180 bpm under non-pulsatile and pulsatile modes. Various atrial and ventricular arrhythmias were also tested. Real-time pressure and flow data were recorded using a custom-based data acquisition system. The energy equivalent pressure (EEP) generated by pulsatile flow was always higher than the mean pressure. No surplus hemodynamic energy (SHE) was recorded under non-pulsatile mode. Under pulsatile mode, SHE levels increased with increasing heart rates (45-120 bpm). SHE levels under a 1:2 assist ratio were higher than the 1:1 and 1:3 assist ratios with a heart rate of 180 bpm. A similar trend was recorded for total hemodynamic energy levels. There was no statistical difference between the two perfusion modes with regards to pressure drops across the ECLS circuit. The main resistance and energy loss came from the arterial cannula. The i-cor console successfully tracked electrocardiographic signals of 12 atrial and ventricular arrhythmias. Our results demonstrated that the i-cor pulsatile ECLS system can be synchronized with a normal heart rate or with various atrial/ventricular arrhythmias. Further in vivo studies are warranted to confirm our findings.

  18. A case for consideration of cultural diversity in heart failure management--Part 1: Rationale for the DISCOVER Study.

    Science.gov (United States)

    Davidson, Patricia M; Macdonald, Peter; Ang, Esther; Paull, Glenn; Choucair, Sam; Daly, John; Moser, Debra K; Dracup, Kathleen

    2004-10-01

    Heart failure is a condition increasing in prevalence and responsible for high health care utilization, morbidity and mortality. Randomised controlled trials of nurse-coordinated interventions have determined self-care and the incorporation of the patient and their family in care planning as critical elements of service delivery. Coping with a chronic illness, such as heart failure, forces the individual to adjust to changed physical, social and emotional functioning and to modify their lifestyle accordingly. Clinicians increasingly use models of care that focus care delivery on the community setting. In order to develop strategies to assist patients and their families with self-care it is important that clinicians understand the health-care seeking behaviours of all individuals targeted in the community. Australia is a culturally diverse nation, yet evaluations of models of care have been undertaken largely in individuals from predominately Anglo-Celtic origins. The end result of this approach is failure to understand the full range of diverse perspectives that individuals hold that can have an impact on self-care behaviours. Consideration of cultural diversity should extend beyond language to a broader appreciation of cultural values, health seeking beliefs and engagement of culturally unique communities. The 'Understanding the cultural experiences of individuals with chronic heart failure (CHF) in South East Health (DISCOVER) Study' seeks to uncover information on the health patterns, information needs and the adjustment process for overseas-born individuals with heart failure. Such information will assist clinicians to tailor health care service delivery and ensure the delivery of appropriate, quality care. This manuscript provides the background, rationale and methods for this study.

  19. Introducing the Tehran Heart Center's Premature Coronary Atherosclerosis Cohort: THC-PAC Study

    Directory of Open Access Journals (Sweden)

    SeyedHesameddin Abbasi

    2015-10-01

    Full Text Available Background: Data on premature coronary artery disease (CAD are scarce. The Tehran Heart Center's Premature Coronary Atherosclerosis Cohort Study (THC-PAC is the first study of its kind in the Middle East to assess major adverse cardiac events (MACE in young CAD patients.Methods: The cohort consists of CAD patients, males ≤ 45 years old and females ≤ 55 years old. The participants are residents of Tehran or its suburbs and underwent coronary angiography between June 2004 and July 2011. A 10-year follow-up, via either clinical visits or telephone calls at least once a year, was commenced in August 2012. The end point is considered MACE, encompassing death, myocardial infarction, stroke, new coronary involvement, percutaneous coronary intervention, and coronary artery bypass grafting.Results: The cohort comprises 1232 eligible patients (613 [49.8%] males at a mean age of 45.1 years (SD = 5.8. High frequencies of conventional risk factors, including hyperlipidemia (884 [71.8%], hypertension (575 [46.7%], positive family history (539 [43.8%], cigarette smoking (479 [38.8%], and diabetes mellitus (390 [31.7%], were seen in the participants. The mean body mass index (BMI of the enrolled patients was high (29.2 ± 4.8 kg/m2, and 532 (43.3% and 440 (35.8% of them were overweight and obese, respectively. The females’ BMI was higher (30.4 ± 5.3 vs. 28.0 ± 3.9 kg/m2; P < 0.001 and they had a greater mean abdominal circumference (99.9 ± 13.5 vs. 98.1 ± 9.3 cm; P = 0.035. Between August 2012 and August 2013, follow-up was successful in 1173 (95.2% patients (median follow-up duration = 55.3 months, 95%CI: 53.5-57.0 months.Conclusion: Our younger patients with CAD had a high frequency of risk factors compared to the same-age general population and all-age CAD patients, which may predispose them to higher incidence of recurrent MACE.

  20. A couples’ based self-management program for heart failure: Results of a feasibility study

    Directory of Open Access Journals (Sweden)

    Ranak Trivedi

    2016-08-01

    Full Text Available Background: Heart failure (HF is associated with frequent exacerbations and shortened lifespan. Informal caregivers such as significant others often support self-management in patients with HF. However, existing programs that aim to enhance self-management seldom engage informal caregivers or provide tools that can help alleviate caregiver burden or improve collaboration between patients and their informal caregivers. Objective: To develop and pilot test a program targeting the needs of self-management support among HF patients as well as their significant others. Methods: We developed the Dyadic Health Behavior Change model and conducted semi-structured interviews to determine barriers to self-management from various perspectives. Participants’ feedback was used to develop a family-centered self-management program called SUCCEED: Self-management Using Couples’ Coping EnhancEment in Diseases. The goals of this program are to improve HF self-management, quality of life, communication within couples, relationship quality, and stress and caregiver burden. We conducted a pilot study with 17 Veterans with HF and their significant others to determine acceptability of the program. We piloted psychosocial surveys at baseline and after participants’ program completion to evaluate change in depressive symptoms, caregiver burden, self-management of HF, communication, quality of relationship, relationship mutuality, and quality of life. Results: Of the 17 couples, 14 completed at least 1 SUCCEED session. Results showed high acceptability for each of SUCCEED’s sessions. At baseline, patients reported poor quality of life, clinically significant depressive symptoms, and inadequate self-management of HF. After participating in SUCCEED, patients showed improvements in self-management of HF, communication, and relationship quality, while caregivers reported improvements in depressive symptoms and caregiver burden. Quality of life of both patients and

  1. Association between trans fatty acid intake and 10-year risk of coronary heart disease in the Zutphen Elderly Study : a prospective population-based study

    NARCIS (Netherlands)

    Oomen, C.M.; Ocké, M.C.; Feskens, E.J.M.; Erp-Baart, M.A. J. van; Kok, F.J.; Kromhout, D.

    2001-01-01

    Background: Evidence on the relation between trans fatty acid intake and coronary heart disease is limited. We investigated this relation in a Dutch population with a fairly high trans fatty acid intake, including trans fatty acids from partly hydrogenated fish oils. Methods: We prospectively studie

  2. Role of ischemia in postinfarction heart failure: hypothetical considerations based on use of verapamil in the DAVIT II Study. Danish Study Group on Verapamil in Myocardial Infarction

    DEFF Research Database (Denmark)

    Jespersen, C M

    1994-01-01

    significant, we propose, in accordance with other studies, that in postinfarction patients with both heart failure and residual myocardial ischemia, the harmful negative inotropic effects of antiischemic drugs might be outweighed by their antiischemic effects, by means of which the prognosis might be improved...

  3. Heart failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970284 Effects of enalapril on heart rate variabilityin patients with congestive heart failure. ZHANGYouhua(章友华), et a1. Dept Cardiol, Cardiovasc Instit& Fuwai Hosp, CAMS & PUMC, Beijing, 100037. ChinCir J 1996; 11(2): 729-732.

  4. Heart transplant

    Science.gov (United States)

    ... factors include the type and severity of your heart disease, and how sick you are at the time you are listed. The amount of time you spend on a waiting list is usually NOT a factor for how soon you get a heart, except in the case of children. Most, but ...

  5. Heart Anatomy

    Science.gov (United States)

    ... from the left ventricle into the aorta, your body's largest artery. See also on this site: The Heartbeat The Conduction System (illustration) Electrical impulses from your heart muscle (the myocardium) cause your heart to contract. This electrical signal begins in the sinoatrial (SA) node, located at ...

  6. [The Study of the Measurement of Heart Rate Variability Using ECG and Photoplethysmographic Signal].

    Science.gov (United States)

    Wang, Buqing; Chai, Xiaoke; Zhang Zhengbo; Wang, Weidong

    2015-07-01

    In comparison with the measurement of heart rate variability from ECG and from photoplethysmographic signal from 46 healthy adults in their spontaneous breathing state. The beat-to-beat intervals in ECG and pulse-to-pulse intervals in photoplethysmographic signal are extracted, and then the parameters of heart rate variability are calculated. Three kinds of algorithms are chosen to get the pulse-to-pulse intervals, which are the intervals of maximum of second derivative, the maximum of PPG signal and the tangent intersection. The results show that the correlation coefficients of the HRV parameters in the two calculation methods are highly correlated. The Bland-Altman scattered plots show the relative bias results from the algorithm of the maximum of PPG signal are smallest and singular points that deviate from the consistent limits are the least compared with the other two algorithms.

  7. 慢性肺源性心脏病患者24小时心率变异性的研究%The study of heart rate variability in patients w ith chronic pulmonary heart disease

    Institute of Scientific and Technical Information of China (English)

    何九龙; 王永东; 等

    2001-01-01

    目的:研究男性慢性肺源性心脏病患者的心率变异 性。方法:46例健康男性,34例男性慢性肺源性心脏病患者,行24 h动态心电图记录,作时域和频域分析。结果:慢性肺源性心脏病病人的高频(HF)、低频(LF)、NN50计数占 总R-R间期的百分比(pNN50)、每5 min正常R-R间期标准差的平均值(SDANN)均下降,其中严 重的慢性肺源性心脏病患者下降更为显著。结论:男性慢性肺源性心脏病患者存在植物神经功能紊乱,病情严 重程度也与植物神经功能相关。%Objective:To study variability of heart rate in pat ients with chronic pulmonary heart disease.Method:Twenty-four hour Holter monitoring were perf ormed in 46 male healthy volunteers and 34 cases of chronic pulmonary heart dis ease who were divided into groups according to the severity of their heart failure.Results:The HF,LF,pNN50 and SDANN were decreased in the chronic pulmonary heart disease cases in comparing to the normal group.T hese values were the lowest in the severe chronic pulmonary heart disease g roup.Conclusion:The autonomic nervous function of the chronic pulmonary heart diseasemale sufferers differs from that of normal people .It is possible that the changes of autonomic nervous function of chronic pulmonary heart disease sufferers are related to the severity of chronic pulmonary heart d isease.

  8. Pilot study employing heart rate variability biofeedback training to decrease anxiety in patients with eating disorders.

    Science.gov (United States)

    Scolnick, Barbara; Mostofsky, David I; Keane, Robert J

    2014-01-01

    Heart rate variability (HRV) biofeedback, a technique which encourages slow meditative breathing, was offered to 25 in-patients with various eating disorder diagnoses-anorexia nervosa, bulimia nervosa and binge eating disorder. We found that this modality had no serious side effects, and was subjectively useful to most participants. An enhanced ability to generate highly coherent HRV patterns in patients with recent onset anorexia nervosa was observed.

  9. Reference gene alternatives to Gapdh in rodent and human heart failure gene expression studies

    Directory of Open Access Journals (Sweden)

    Levy Finn Olav

    2010-03-01

    Full Text Available Abstract Background Quantitative real-time RT-PCR (RT-qPCR is a highly sensitive method for mRNA quantification, but requires invariant expression of the chosen reference gene(s. In pathological myocardium, there is limited information on suitable reference genes other than the commonly used Gapdh mRNA and 18S ribosomal RNA. Our aim was to evaluate and identify suitable reference genes in human failing myocardium, in rat and mouse post-myocardial infarction (post-MI heart failure and across developmental stages in fetal and neonatal rat myocardium. Results The abundance of Arbp, Rpl32, Rpl4, Tbp, Polr2a, Hprt1, Pgk1, Ppia and Gapdh mRNA and 18S ribosomal RNA in myocardial samples was quantified by RT-qPCR. The expression variability of these transcripts was evaluated by the geNorm and Normfinder algorithms and by a variance component analysis method. Biological variability was a greater contributor to sample variability than either repeated reverse transcription or PCR reactions. Conclusions The most stable reference genes were Rpl32, Gapdh and Polr2a in mouse post-infarction heart failure, Polr2a, Rpl32 and Tbp in rat post-infarction heart failure and Rpl32 and Pgk1 in human heart failure (ischemic disease and cardiomyopathy. The overall most stable reference genes across all three species was Rpl32 and Polr2a. In rat myocardium, all reference genes tested showed substantial variation with developmental stage, with Rpl4 as was most stable among the tested genes.

  10. Mechanisms of the Frank-Starling phenomena studied in intact hearts.

    Science.gov (United States)

    Burkhoff, D; Stennett, R A; Ogino, K

    1995-01-01

    The impact of ventricular volume on the relationship between intracellular calcium and ventricular pressure under steady-state conditions was determined in intact ferret hearts. The results reveal major quantitative differences and minor qualitative differences between these relations and those previously measured in isolated intact and skinned cardiac muscle. The importance of these differences is discussed within the context of developing a comprehensive mechanistic theory to describe load-dependence of the intact ventricle.

  11. Ularitide for the treatment of acute decompensated heart failure: from preclinical to clinical studies

    OpenAIRE

    Anker, Stefan D.; Ponikowski, Piotr; Mitrovic, Veselin; Peacock, W. Frank; Filippatos, Gerasimos

    2015-01-01

    The short- and long-term morbidity and mortality in acute heart failure is still unacceptably high. There is an unmet need for new therapy options with new drugs with a new mode of action. One of the drugs currently in clinical testing in Phase III is ularitide, which is the chemically synthesized form of the human natriuretic peptide urodilatin. Urodilatin is produced in humans by differential processing of pro-atrial natriuretic peptide in distal renal tubule cells. Physiologically, urodila...

  12. Effect of repeated intracoronary injection of bone marrow cells in patients with ischaemic heart failure the Danish stem cell study--congestive heart failure trial (DanCell-CHF)

    DEFF Research Database (Denmark)

    Diederichsen, Axel Cosmus Pyndt; Møller, Jacob E; Thayssen, Per;

    2008-01-01

    BACKGROUND: It has been suggested that myocardial regeneration may be achieved by a single intracoronary bone marrow derived stem cell infusion in selected patients with ischaemic heart disease. The effect is uncertain in patients with chronic ischaemic heart failure and it is not known whether...... repeated infusions would have additional positive effects. AIMS: To assess whether two treatments of intracoronary infusion of bone marrow stem cells, administered 4 months apart, could improve left ventricular (LV) systolic function in patients with chronic ischaemic heart failure. METHODS: The study...... was prospective and non-randomised, comprising an observational baseline period of 4 months followed by an interventional period of 12 months. Intracoronary bone marrow cell infusion was performed at the end of the baseline period and repeated 4 months later. RESULTS: 32 patients were included. LV ejection...

  13. Clinical Study on Acupoint Injection plus Acupuncture for Insomnia Due to Heart-kidney Disharmony

    Institute of Scientific and Technical Information of China (English)

    Zheng Qiao-ping; Zhang Bi-meng; Zhou Jun-mei; Hu Qi-long

    2014-01-01

    Objective: To observe the clinical efficacy of acupoint injection at Neiguan (PC 6) plus acupuncture in treating insomnia due to heart-kidney disharmony. Methods: A hundred patients with insomnia due to heart-kidney disharmony were randomized into an observation group and a control group. Fifty-three cases in the observation group were intervened by acupoint injection at Neiguan (PC 6) plus acupuncture; while 54 cases in the control group were intervened by acupuncture alone. The Pittsburgh sleep quality index (PSQI) was evaluated before and after intervention, and the therapeutic efficacies of the two groups were compared. Results: Acupoint injection at Neiguan (PC 6) plus acupuncture produced significantly higher efficacies in improving sleep quality, shortening sleep latency, and enhancing sleep efficiency than acupuncture alone (P Conclusion: The two groups both can improve the condition of insomnia; acupoint injection at Neiguan (PC 6) has significant advantages, manifested by a higher therapeutic efficacy for insomnia due to heart-kidney disharmony, higher safety evaluation, efficiency, and less adverse events, thus proper for clinical application.

  14. Prevalence and Risk Factors of Heart Failure with Preserved Ejection Fraction: A Population-Based Study in Northeast China

    Directory of Open Access Journals (Sweden)

    Liang Guo

    2016-07-01

    Full Text Available Background: Heart failure with preserved ejection fraction (HFpEF has attracted increasing attention worldwide. We aimed to estimate the prevalence of HFpEF and analyze its correlates in a sample of residents of northeast China; Methods: A population-based study of 2230 participants ≥35 years old was conducted in rural areas of Liaoning Province from January 2012 through August 2013. Information about lifestyle and other potential risk factors was obtained. HFpEF was diagnosed according to the recommendations of European Society of Cardiology; Results: The overall prevalence of HFpEF was 3.5% (1.8% in men and 4.9% in women. The prevalence of HFpEF increased with age in both genders and was greater in women than in men for every age group. Multivariable logistic regression analysis found that female gender (OR, 3.575; 95% CI, 1.761–7.256, hypertension (OR, 3.711; 95% CI, 2.064–6.674, and history of heart disease (2.086; 95% CI, 1.243–3.498 were associated factors for prevalent HFpEF; Conclusions: In a general population from rural northeast China, we found that female gender, hypertension, and history of heart disease were risk factors for prevalent HFpEF.

  15. Molecular System Bioenergics of the Heart: Experimental Studies of Metabolic Compartmentation and Energy Fluxes versus Computer Modeling

    Directory of Open Access Journals (Sweden)

    Valdur Saks

    2011-12-01

    Full Text Available In this review we analyze the recent important and remarkable advancements in studies of compartmentation of adenine nucleotides in muscle cells due to their binding to macromolecular complexes and cellular structures, which results in non-equilibrium steady state of the creatine kinase reaction. We discuss the problems of measuring the energy fluxes between different cellular compartments and their simulation by using different computer models. Energy flux determinations by 18O transfer method have shown that in heart about 80% of energy is carried out of mitochondrial intermembrane space into cytoplasm by phosphocreatine fluxes generated by mitochondrial creatine kinase from adenosine triphosphate (ATP, produced by ATP Synthasome. We have applied the mathematical model of compartmentalized energy transfer for analysis of experimental data on the dependence of oxygen consumption rate on heart workload in isolated working heart reported by Williamson et al. The analysis of these data show that even at the maximal workloads and respiration rates, equal to 174 µmol O2 per min per g dry weight, phosphocreatine flux, and not ATP, carries about 80–85% percent of energy needed out of mitochondria into the cytosol. We analyze also the reasons of failures of several computer models published in the literature to correctly describe the experimental data.

  16. The prevalence and management of heart failure in Dutch nursing homes; design of a multi-centre cross-sectional study

    Directory of Open Access Journals (Sweden)

    Daamen Mariëlle AMJ

    2012-06-01

    Full Text Available Abstract Background Heart failure is likely to be particularly prevalent in the nursing home population, but reliable data about the prevalence of heart failure in nursing homes are lacking. Therefore the aims of this study are to investigate (a the prevalence and management of heart failure in nursing home residents and (b the relation between heart failure and care dependency as well as heart failure and quality of life in nursing home residents. Methods/design Nursing home residents in the southern part of the Netherlands, aged over 65 years and receiving long-term somatic or psychogeriatric care will be included in the study. A panel of two cardiologists and a geriatrician will diagnose heart failure based on data collected from actual clinical examinations (including history, physical examination, ECG, cardiac markers and echocardiography, patient records and questionnaires. Care dependency will be measured using the Care Dependency Scale. To measure the quality of life of the participating residents, the Qualidem will be used for psychogeriatric residents and the SF-12 and VAS for somatic residents. Conclusion The study will provide an insight into the actual prevalence and management of heart failure in nursing home residents as well as their quality of life and care dependency. Trial registration Dutch trial register NTR2663

  17. Micro-economic impact of congenital heart surgery: results of a prospective study from a limited-resource setting.

    Directory of Open Access Journals (Sweden)

    Manu Raj

    Full Text Available The microeconomic impact of surgery for congenital heart disease is unexplored, particularly in resource limited environments. We sought to understand the direct and indirect costs related to congenital heart surgery and its impact on Indian households from a family perspective.Baseline and first follow-up data of 644 consecutive children admitted for surgery for congenital heart disease (March 2013 - July 2014 in a tertiary referral hospital in Central Kerala, South India was collected prospectivelyfrom parents through questionnaires using a semi-structured interview schedule.The median age was 8.2 months (IQR: 3.0- 36.0 months. Most families belonged to upper middle (43.0% and lower middle (35.7% socioeconomic class. Only 3.9% of families had some form of health insurance. The median expense for the admission and surgery was INR 201898 (IQR: 163287-266139 [I$ 11989 (IQR: 9696-15804], which was 0.93 (IQR: 0.52-1.49 times the annual family income of affected patients. Median loss of man-days was 35 (IQR: 24-50 and job-days was 15 (IQR: 11-24. Surgical risk category and hospital stay duration significantly predicted higher costs. One in two families reported overwhelming to high financial stress during admission period for surgery. Approximately half of the families borrowed money during the follow up period after surgery.Surgery for congenital heart disease results in significant financial burden for majority of families studied. Efforts should be directed at further reductions in treatment costs without compromising the quality of care together with generating financial support for affected families.

  18. A comparative analysis of preprocessing techniques of cardiac event series for the study of heart rhythm variability using simulated signals

    Directory of Open Access Journals (Sweden)

    Guimarães H.N.

    1998-01-01

    Full Text Available In the present study, using noise-free simulated signals, we performed a comparative examination of several preprocessing techniques that are used to transform the cardiac event series in a regularly sampled time series, appropriate for spectral analysis of heart rhythm variability (HRV. First, a group of noise-free simulated point event series, which represents a time series of heartbeats, was generated by an integral pulse frequency modulation model. In order to evaluate the performance of the preprocessing methods, the differences between the spectra of the preprocessed simulated signals and the true spectrum (spectrum of the model input modulating signals were surveyed by visual analysis and by contrasting merit indices. It is desired that estimated spectra match the true spectrum as close as possible, showing a minimum of harmonic components and other artifacts. The merit indices proposed to quantify these mismatches were the leakage rate, defined as a measure of leakage components (located outside some narrow windows centered at frequencies of model input modulating signals with respect to the whole spectral components, and the numbers of leakage components with amplitudes greater than 1%, 5% and 10% of the total spectral components. Our data, obtained from a noise-free simulation, indicate that the utilization of heart rate values instead of heart period values in the derivation of signals representative of heart rhythm results in more accurate spectra. Furthermore, our data support the efficiency of the widely used preprocessing technique based on the convolution of inverse interval function values with a rectangular window, and suggest the preprocessing technique based on a cubic polynomial interpolation of inverse interval function values and succeeding spectral analysis as another efficient and fast method for the analysis of HRV signals

  19. Eplerenone survival benefits in heart failure patients post-myocardial infarction are independent from its diuretic and potassium-sparing effects. Insights from an EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) substudy

    DEFF Research Database (Denmark)

    Rossignol, Patrick; Ménard, Joël; Fay, Renaud

    2011-01-01

    The purpose of this study was to determine whether a diuretic effect may be detectable in patients treated with eplerenone, a mineralocorticoid receptor antagonist, as compared with placebo during the first month of EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and S...

  20. Eplerenone survival benefits in heart failure patients post-myocardial infarction are independent from its diuretic and potassium-sparing effects. Insights from an EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) substudy

    DEFF Research Database (Denmark)

    Rossignol, Patrick; Ménard, Joël; Fay, Renaud;

    2011-01-01

    The purpose of this study was to determine whether a diuretic effect may be detectable in patients treated with eplerenone, a mineralocorticoid receptor antagonist, as compared with placebo during the first month of EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy...

  1. Influence of Diabetes Mellitus and Hyperglycemia on Prognosis in Patients >= 70 Years Old With Heart Failure and Effects of Nebivolol (Data from the Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors With Heart Failure [SENIORS])

    NARCIS (Netherlands)

    de Boer, Rudolf A.; Doehner, Wolfram; van der Horst, Iwan C. C.; Anker, Stefan D.; Babalis, Daphne; Roughton, Michael; Coats, Andrew J.; Flather, Marcus D.; van Veldhuisen, Dirk J.

    2010-01-01

    The beneficial effects of beta blockers in younger patients with heart failure (HF) due to systolic dysfunction are well established. However, data from patients >= 70 years old with diabetes mellitus and HF are lacking. The Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalizatio

  2. Benzathine Penicillin Prophylaxis in Children with Rheumatic Fever (RF/ Rheumatic Heart Disease (RHD: A Study of Compliance

    Directory of Open Access Journals (Sweden)

    Radha G. Ghildiyal

    2010-04-01

    Full Text Available Aims and Objectives: To study the compliance of patients of Rheumatic fever (RF/ Rheumatic heart disease (RHD regarding secondary prophylaxis with injection benzathine penicillin. Materials and Methods: The study was conducted in the Pediatric Rheumatology Outpatients’ Department (OPD of a tertiary care teaching university affiliated hospital. Patients below 18 years of age diagnosed as Rheumatic fever/ Rheumatic heart disease following up in Pediatric Rheumatology OPD for at least 1 year for benzathine pencillin prophylaxis were included in the study. The patients diagnosed to have RF/ RHD were advised injection benzathine penicillin prophylaxis every 3 weeks. A proforma was devised for recording the clinical details of the patient- including demographic information, clinical details regarding RF/ RHD and rheumatic fever recurrences. The details of the benzathine penicillin prophylaxis taken by the patient were also recorded in the proforma. The reasons for non-compliance were noted and enlisted as per their frequency. Results: The study included 10 patients following up at the specialty clinic for rheumatic heart disease patients. We had 7 males and 3 females in the study. The average age was 9.7 yrs (6 years to 12 years. The average number of months of follow up for assessing the compliance was 20.7 months (12.6 months to 44 months. The average compliance (% of the 10 patients was 89.60% (63.69% to 100%. Out of the 10 subjects, four had a recurrence of rheumatic fever manifesting in the form of congestive cardiac failure & carditis. Though most of the times the patients were not able to recall the reason for missing the dose, trip to one’s native place was an important reason for missed doses besides forgetting the dates of the prophylaxis and doubts about need for the prophylaxis. Conclusions: Compliance of secondary prophylaxis with benzathine penicillin was about 90% in the present study. Frequent travel by patients to their native

  3. Clinical characteristics of very old patients hospitalized in internal medicine wards for heart failure: a sub-analysis of the FADOI-CONFINE Study Group

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    Paolo Biagi

    2014-03-01

    Full Text Available The incidence and prevalence of chronic heart failure are increasing worldwide, as is the number of very old patients (>85 years affected by this disease. The aim of this sub-analysis of the multicenter, observational CONFINE study was to detect clinical and therapeutic peculiarities in patients with chronic heart failure aged >85 years. We recruited patients admitted with a diagnosis of chronic heart failure and present in the hospital in five index days, in 91 Units of Internal Medicine. The patients’ clinical characteristics, functional and cognitive status, and the management of the heart failure were analyzed. A total of 1444 subjects were evaluated, of whom 329 (23.1% were over 85 years old. Signs and symptoms of chronic heart failure were more common in very old patients, as were severe renal insufficiency, anemia, disability and cognitive impairment. The present survey found important age-related differences (concomitant diseases, cognitive status among patients with chronic heart failure, as well as different therapeutic strategies and clinical outcome for patients over 85 years old. Since these patients are usually excluded from clinical trials and their management remains empirical, specific studies focused on the treatment of very old patients with chronic heart failure are needed.

  4. Genome-Wide Association Study of Lp-PLA2 Activity and Mass in the Framingham Heart Study

    Science.gov (United States)

    Suchindran, Sunil; Rivedal, David; Guyton, John R.; Milledge, Tom; Gao, Xiaoyi; Benjamin, Ashlee; Rowell, Jennifer; Ginsburg, Geoffrey S.; McCarthy, Jeanette J.

    2010-01-01

    Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an emerging risk factor and therapeutic target for cardiovascular disease. The activity and mass of this enzyme are heritable traits, but major genetic determinants have not been explored in a systematic, genome-wide fashion. We carried out a genome-wide association study of Lp-PLA2 activity and mass in 6,668 Caucasian subjects from the population-based Framingham Heart Study. Clinical data and genotypes from the Affymetrix 550K SNP array were obtained from the open-access Framingham SHARe project. Each polymorphism that passed quality control was tested for associations with Lp-PLA2 activity and mass using linear mixed models implemented in the R statistical package, accounting for familial correlations, and controlling for age, sex, smoking, lipid-lowering-medication use, and cohort. For Lp-PLA2 activity, polymorphisms at four independent loci reached genome-wide significance, including the APOE/APOC1 region on chromosome 19 (p = 6×10−24); CELSR2/PSRC1 on chromosome 1 (p = 3×10−15); SCARB1 on chromosome 12 (p = 1×10−8) and ZNF259/BUD13 in the APOA5/APOA1 gene region on chromosome 11 (p = 4×10−8). All of these remained significant after accounting for associations with LDL cholesterol, HDL cholesterol, or triglycerides. For Lp-PLA2 mass, 12 SNPs achieved genome-wide significance, all clustering in a region on chromosome 6p12.3 near the PLA2G7 gene. Our analyses demonstrate that genetic polymorphisms may contribute to inter-individual variation in Lp-PLA2 activity and mass. PMID:20442857

  5. Genome-wide association study of Lp-PLA(2 activity and mass in the Framingham Heart Study.

    Directory of Open Access Journals (Sweden)

    Sunil Suchindran

    2010-04-01

    Full Text Available Lipoprotein-associated phospholipase A(2 (Lp-PLA(2 is an emerging risk factor and therapeutic target for cardiovascular disease. The activity and mass of this enzyme are heritable traits, but major genetic determinants have not been explored in a systematic, genome-wide fashion. We carried out a genome-wide association study of Lp-PLA(2 activity and mass in 6,668 Caucasian subjects from the population-based Framingham Heart Study. Clinical data and genotypes from the Affymetrix 550K SNP array were obtained from the open-access Framingham SHARe project. Each polymorphism that passed quality control was tested for associations with Lp-PLA(2 activity and mass using linear mixed models implemented in the R statistical package, accounting for familial correlations, and controlling for age, sex, smoking, lipid-lowering-medication use, and cohort. For Lp-PLA(2 activity, polymorphisms at four independent loci reached genome-wide significance, including the APOE/APOC1 region on chromosome 19 (p = 6 x 10(-24; CELSR2/PSRC1 on chromosome 1 (p = 3 x 10(-15; SCARB1 on chromosome 12 (p = 1x10(-8 and ZNF259/BUD13 in the APOA5/APOA1 gene region on chromosome 11 (p = 4 x 10(-8. All of these remained significant after accounting for associations with LDL cholesterol, HDL cholesterol, or triglycerides. For Lp-PLA(2 mass, 12 SNPs achieved genome-wide significance, all clustering in a region on chromosome 6p12.3 near the PLA2G7 gene. Our analyses demonstrate that genetic polymorphisms may contribute to inter-individual variation in Lp-PLA(2 activity and mass.

  6. The Influence of Exercise Training on Quality of Life and Psychosocial Functioning in Children with Congenital Heart Disease:A Review of Intervention Studies

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    Karolijn Dulfer

    2017-02-01

    Full Text Available Children and adolescents operated upon for congenital heart disease may show reduced exercise capacity and physical activity, associated with lowered quality of life. This review presents intervention studies on the influence of an exercise program on quality of life and psychosocial functioning in children with severe congenital heart disease. Participation in an exercise program among young people with complex congenital heart disease seemed to have positive effects on quality of life and passive leisure time spent. However, more effects of the exercise programs may have been expected. For future research it is important to critically evaluate the content of the exercise programs.

  7. Heart and Stroke Foundation of Ontario (HSFO high blood pressure strategy's hypertension management initiative study protocol

    Directory of Open Access Journals (Sweden)

    Von Sychowski Shirley

    2008-12-01

    Full Text Available Abstract Background Achieving control of hypertension prevents target organ damage at both the micro and macrovascular level and is a highly cost effective means of lowering the risk for heart attack and stroke particularly in people with diabetes. Clinical trials demonstrate that blood pressure control can be achieved in a large proportion of people. Translating this knowledge into widespread practice is the focus of the Hypertension Management Initiative, which began in 2004 with the goal of improving the management of this chronic health condition by primary care providers and patients in the community. Methods This study will test the effect of a systems change on the management of high blood pressure in real world practice in primary care in Ontario, Canada. The systems change intervention involves an interprofessional educational program bringing together physicians, nurses and pharmacists with tools for both providers and patients to facilitate blood pressure management. Each of two waves of subjects were enrolled over a 6 month period with the initial enrollment between waves separated by 9 months. Blood pressure will be measured with the BpTru ® automated blood pressure device. To determine the effectiveness of the intervention, a before and after analysis within all subjects will compare blood pressure at baseline to annual measurements for the three year study. To assess whether the intervention has an impact on blood pressure control independent of community trends, a betwen group comparison of baseline blood pressures in the delayed wave will be made with the immediate wave during the same time period, so that the immediate wave has experienced the intervention for at least 9 months. The total enrollment goal is 5,000 subjects. The practice locations include 10 Family Health Teams (FHTs and 1 Community Health Centre (CHC and approximately 49 primary care physicians, 15 nurse practitioners, 37 registered nurses and over 150

  8. Heart rate variability biofeedback in patients with alcohol dependence: a randomized controlled study

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    Penzlin AI

    2015-10-01

    Full Text Available Ana Isabel Penzlin,1 Timo Siepmann,2 Ben Min-Woo Illigens,3 Kerstin Weidner,4 Martin Siepmann4 1Institute of Clinical Pharmacology, 2Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony, Germany; 3Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 4Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony, Germany Background and objective: In patients with alcohol dependence, ethyl-toxic damage of vasomotor and cardiac autonomic nerve fibers leads to autonomic imbalance with neurovascular and cardiac dysfunction, the latter resulting in reduced heart rate variability (HRV. Autonomic imbalance is linked to increased craving and cardiovascular mortality. In this study, we sought to assess the effects of HRV biofeedback training on HRV, vasomotor function, craving, and anxiety. Methods: We conducted a randomized controlled study in 48 patients (14 females, ages 25–59 years undergoing inpatient rehabilitation treatment. In the treatment group, patients (n=24 attended six sessions of HRV biofeedback over 2 weeks in addition to standard rehabilitative care, whereas, in the control group, subjects received standard care only. Psychometric testing for craving (Obsessive Compulsive Drinking Scale, anxiety (Symptom Checklist-90-Revised, HRV assessment using coefficient of variation of R-R intervals (CVNN analysis, and vasomotor function assessment using laser Doppler flowmetry were performed at baseline, immediately after completion of treatment or control period, and 3 and 6 weeks afterward (follow-ups 1 and 2. Results: Psychometric testing showed decreased craving in the biofeedback group immediately postintervention (OCDS scores: 8.6±7.9 post-biofeedback versus 13.7±11.0 baseline [mean ± standard deviation], P<0.05, whereas craving was unchanged at

  9. Randomized and comparative study between two intra-hospital exercise programs for heart transplant patients

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    Tatiana Satie Kawauchi

    2013-09-01

    Full Text Available OBJECTIVE: To compare the effects of two physical therapy exercise in-hospital programs in pulmonary function and functional capacity of patients in the postoperative period of heart transplantation. METHODS: Twenty-two heart transplanted patients were randomized to the control group (CG, n=11 and training group (TG, n=11. The control group conducted the exercise program adopted as routine in the institution and the training group has had a protocol consisting of 10 stages, with incremental exercises: breathing exercises, resistance training, stretching and walking. The programs began on the first day after extubation and stretched until hospital discharge. Assessed pulmonary function, distance walked in six minutes walk test (6MWT and peripheral muscle strength by one repetition maximum test (1RM. RESULTS: Similar behavior was observed between the two groups treated, with statistically significant increases between the first and second test of the following variables: FVC (59% in CG and 35.2% in TG; MIP (8.6% in CG and 53.5% in TG, MEP (28.8% in CG and 40.7% in TG and 6MWT (44.5% in CG and 31.4% in TG. There was an increase of peripheral strength by 1RM test, over time, to the muscle groups of the elbow flexors, shoulder flexors, hip abductors and knee flexors. CONCLUSION: Heart transplant patients benefit from exercise programs in hospital, regardless of the program type applied. A new training proposal did not result in superiority compared to routine programme applied. Exercise protocols provided improves in ventilatory variables and functional capacity of this population.

  10. Ischemic heart disease,factor predisposing to Barrett’s adenocarcinoma: A case control study

    Institute of Scientific and Technical Information of China (English)

    Panagiotis; Tsibouris; Mark; T; Hendrickse; Panagiota; Mavrogianni; Peter; ET; Isaacs

    2014-01-01

    AIM:To define the significance of ischemic heart disease(IHD)(stable angina to infarction) co-existance in Barrett esophagus(BE) patients and patients with esophageal adenocarcinoma(AdE).METHODS: All BE/AdE patients in Blackpool-Wyre-Fylde area and Trikala prefecture identified from medical records. Patient clinical details were obtained from hospital and General Practitioner records. Additional information was gathered from validated questionnaire.RESULTS: Forty(33%) AdE and 83(19%) BE patients had IHD(P = 0.002). Eighteen(15%) AdE and 34(8%) BE patients had suffered a myocardial infarction(P = 0.03). Three(3%) AdE and 7(2%) BE patients had severe heart failure(P = 0.82). Thirty-nine(47%) BE with IHD and 8(20%) AdE patients with IHD consumed aspirin daily(P = 0.004). Seventh-seven(93%) BE patients with IHD and 36(90%) AdE patients with IHD were on statins(P = 0.86). Logistic regression analysis: AdE was more frequent in the elderly,with long termreflux,long BE and concurrent IHD(odds ratio: 2.086,P = 0.001) not consuming statins. Eighteen(22%) BE patients with IHD [16(84%) with myocardial infarction] vs 33(10%) without IHD died from non-neoplastic causes within 24 mo from BE diagnosis(P = 0.005). CONCLUSION: IHD is more prevalent in AdE than BE patients. Increased prevalence of AdE is related with the presence of myocardial infarction but not severe heart failure,possibly because patients with BE and se-vere IHD have low life expectancy.

  11. ASSOCIATION OF HYPERTENSION AND CORONARY HEART DISEASE WITH STROKE: A HOSPITAL BASED CASE CONTROL STUDY FROM KISHANGANJ, BIHAR

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    Anuj Kumar

    2016-06-01

    Full Text Available Stroke is a major cause of mortality and morbidity worldwide and commonly occurs amongst elderly. Every year, 15 million people worldwide suffer from stroke. Hypertension is the most powerful and important modifiable risk factor for all stroke subtypes. Approximately 30-40% stroke risk reduction can be achieved with lowering of blood pressure only. Heart disease is also a strong risk factor for stroke, although only for one type of stroke, ischemic strokes. MATERIALS AND METHODS This was a retrospective, cross-sectional, case-control study conducted from Jan-2015 to March-2015 (3 months. Study was done among stroke patients aged 20 years and above, hospitalized in M.G.M Medical College and L.S.K Hospital, Kishanganj. Age and gender matched control subjects were selected among neurologically healthy people who were admitted for other ailments in this hospital. Sample size was 312 people, containing 156 cases and 156 controls. Statistical analysis was done using Med Calc Version 12.7.5.0 software. Chi-square test was used as test of significance and p value less than 0.05 was considered as significant. OBSERVATION Male:Female ratio among the cases and control was 1.51:1. Mean age of cases and controls were 51.30±11.13 and 51.93±14.60. Out of 156 cases, 97 (62.18 % cases were having history of hypertension, while only 33 (21.15% controls had hypertension. P value was 0.0001, which is significant. Coronary heart disease was present in 21 (13.46% of cases and 6 (3.85% of controls. P value was significant. CONCLUSION To conclude in the present hospital-based case control study, systemic hypertension (p<0.001 and coronary heart diseases were significant risk factors in patients with stroke. Thus, our present study is a step towards determination of risk factors of stroke.

  12. Heart shaking transitions - A phenomenological-hermeneutic study of patients´ experiences in cardiac rehabilitation

    DEFF Research Database (Denmark)

    Simonÿ, Charlotte; Dreyer, Pia; Pedersen, Birthe D.

    enrolled in the cardiac rehabilitation programme. The data underwent interpretation consisting of three phases: naïve reading, structural analysis and comprehensive interpretation. Results. The preliminary findings are that the patients go through a Heart Shaking Journey in Cardiac Rehabilitation. Three......-patient cardiac rehabilitation during 1-2 months is offered after the acute treatment. Knowledge of the patients’ experiences of cardiac problems when receiving the current standards of treatment is needed in order to develop sufficient care. Hence the aim was to investigate how patients with new onset unstable...

  13. Pathology of the heart in AIDS. A study of 60 consecutive autopsies

    DEFF Research Database (Denmark)

    Hansen, B F

    1992-01-01

    single samples of ventricular myocardium (the first 21 cases) or by an examination of the whole heart (the last 39 cases). Myocarditis according to the Dallas criteria was seen in 25 of 60 cases (42%), and in seven of these cases a probable pathogen (Toxoplasma gondii, cytomegalovirus, fungi......) was demonstrated. Diffuse myocardial fibrosis was seen in 40 of 60 cases (67%) and is considered to be partly due to repair after myocyte necrosis/myocarditis. A myocardium thus weakened might not be able to meet an increase in functional demand, and in 15 of the 39 cases (38%) where an examination of the whole...

  14. [Radiotelemetric study of heart rate and electroencephalogram during parachute jumping (author's transl)].

    Science.gov (United States)

    Gauthier, P; Jouffray, L; Rodi, M; Gottesmann, C

    1977-01-01

    Twelve subjects, experienced parachutists, have been recorded by telemetry before, during and after free-fall parachute jumps. The heart rate showed a statistically significant tachycardia during the different events of the jump (exit, free-fall, opening, open parachute and landing) compared to the baseline before boarding the aircraft. This tachycardia indicates a stress reaction confirmed by a significant increase of adrenalin and noradrenalin in urine. The electroencephalographic invesitgation does not show any adnormalities. Alpha rhythms have been recorded from alpha reactive subjects during free-fall stabilization.

  15. Effects of carvedilol in heart failure due to dilated cardiomyopathy. Results of a double-blind randomized placebo-controlled study (CARIBE study

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Chizzola

    2000-03-01

    Full Text Available OBJECTIVE: To assess the effects of carvedilol in patients with idiopathic dilated cardiomyopathy. METHODS: In a double-blind randomized placebo-controlled study, 30 patients (7 women with functional class II and III heart failure were assessed. Their ages ranged from 28 to 66 years (mean of 43±9 years, and their left ventricular ejection fraction varied from 8% to 35%. Carvedilol was added to the usual therapy of 20 patients; placebo was added to the usual therapy of 10 patients. The initial dose of carvedilol was 12.5 mg, which was increased weekly until it reached 75 mg/day, according to the patient's tolerance. Clinical assessment, electrocardiogram, echocardiogram, and radionuclide ventriculography were performed in the pretreatment phase, being repeated after 2 and 6 months of medication use. RESULTS: A reduction in heart rate (p=0.016 as well as an increase in left ventricular shortening fraction (p=0.02 and in left ventricular ejection fraction (p=0.017 occurred in the group using carvedilol as compared with that using placebo. CONCLUSION: Carvedilol added to the usual therapy for heart failure resulted in better heart function.

  16. A STUDY OF PROFILE AND PATTERNS OF “JOINT INVOLVEMENT” IN UNDER 15 YEARS AGE GROUP CHILDREN WITH ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE

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    Bhavani Shankar

    2015-03-01

    Full Text Available CONTEXT (BACKGROUND: Acute Rheumatic fever / Rheumatic Heart disease is the most common acquired childhood heart disease diagnosis made in India. Poly Arthritis is one of the common manifestations of the disease and making it one among many differential diagnoses for sub - acute arthritis. AIMS & OBJECTIVES: To study the profile and patterns of joint involvement in children with Acute Rheumatic fever / Rheumatic Heart dise ase. MATERIALS & METHODS: The Study was conducted in a tertiary care hospital for 2 years period on less than 15 years children diagnosed as Acute Rheumatic fever / Rheumatic Heart disease as per Jones criteria (U pdated 1992. RESULTS: Joint involvement is one of the common manifestations of Acute Rheumatic fever / Rheumatic Heart disease. In our study Joint involvement is found in 50% cases (18 out of 36 cases i.e., 87.5% (7 out of 8cases of first attack cases and 39.28 %( 11 out 28 cases of reactivation cases. Further we found Polyarthritis is the predominant pattern of joint involvement. CONCLUSION: Basing on the results of our study we conclude that Joint involvement was observed in majority of cases, more so in first attack cases of Acute Rheumatic fever. Further Polyarthritis is the predominant pattern in our study. We found Knee Joint involvement as most common joint to be involved in children with Acute Rheumatic fever / Rheumatic Heart disease.

  17. Lungs in Heart Failure

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    Anna Apostolo

    2012-01-01

    Full Text Available Lung function abnormalities both at rest and during exercise are frequently observed in patients with chronic heart failure, also in the absence of respiratory disease. Alterations of respiratory mechanics and of gas exchange capacity are strictly related to heart failure. Severe heart failure patients often show a restrictive respiratory pattern, secondary to heart enlargement and increased lung fluids, and impairment of alveolar-capillary gas diffusion, mainly due to an increased resistance to molecular diffusion across the alveolar capillary membrane. Reduced gas diffusion contributes to exercise intolerance and to a worse prognosis. Cardiopulmonary exercise test is considered the “gold standard” when studying the cardiovascular, pulmonary, and metabolic adaptations to exercise in cardiac patients. During exercise, hyperventilation and consequent reduction of ventilation efficiency are often observed in heart failure patients, resulting in an increased slope of ventilation/carbon dioxide (VE/VCO2 relationship. Ventilatory efficiency is as strong prognostic and an important stratification marker. This paper describes the pulmonary abnormalities at rest and during exercise in the patients with heart failure, highlighting the principal diagnostic tools for evaluation of lungs function, the possible pharmacological interventions, and the parameters that could be useful in prognostic assessment of heart failure patients.

  18. Men and Heart Disease

    Science.gov (United States)

    ... Pressure Salt Cholesterol Million Hearts® WISEWOMAN Men and Heart Disease Fact Sheet Recommend on Facebook Tweet Share Compartir ... Source: Interactive Atlas of Heart Disease and Stroke Heart Disease Facts in Men Heart disease is the leading ...

  19. How the Heart Works

    Science.gov (United States)

    ... Works Explore How the Heart Works What Is... Anatomy Contraction Circulation Electrical System Heart Disease Related Topics Arrhythmia Congenital Heart Defects Coronary Heart Disease Heart Valve Disease How the Lungs Work Send a link to NHLBI to someone ...

  20. About Heart Failure

    Science.gov (United States)

    ... talk about your health and the medicines About Heart Failure Heart failure is a disease where the heart cannot do ... very important for your health. common causes of heart failure are diseases or conditions that damage the heart. ...

  1. What Is Heart Failure?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Is Heart Failure? Heart failure is a condition in which the heart can' ... force. Some people have both problems. The term "heart failure" doesn't mean that your heart has stopped ...

  2. Wine and heart health

    Science.gov (United States)

    Health and wine; Wine and heart disease; Preventing heart disease - wine; Preventing heart disease - alcohol ... more often just to lower your risk of heart disease. Heavier drinking can harm the heart and ...

  3. High sensitive troponin T and heart fatty acid binding protein: Novel biomarker in heart failure with normal ejection fraction?: A cross-sectional study

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    Barroso Michael

    2011-07-01

    Full Text Available Abstract Background High sensitive troponin T (hsTnT and heart fatty acid binding protein (hFABP are both markers of myocardial injury and predict adverse outcome in patients with systolic heart failure (SHF. We tested whether hsTnT and hFABP plasma levels are elevated in patients with heart failure with normal ejection fraction (HFnEF. Methods We analyzed hsTnT, hFABP and N-terminal brain natriuretic peptide in 130 patients comprising 49 HFnEF patients, 51 patients with asymptomatic left ventricular diastolic dysfunction (LVDD, and 30 controls with normal diastolic function. Patients were classified to have HFnEF when the diagnostic criteria as recommended by the European Society of Cardiology were met. Results Levels of hs TnT and hFABP were significantly higher in patients with asymptomatic LVDD and HFnEF (both p Conclusion In HFnEF patients, hsTnT and hFABP are elevated independent of coronary artery disease, suggesting that ongoing myocardial damage plays a critical role in the pathophysiology. A combination of biomarkers and echocardiographic parameters might improve diagnostic accuracy and risk stratification of patients with HFnEF.

  4. Heart Disease

    Science.gov (United States)

    ... Atherosclerosis is also the most common cause of cardiovascular disease. It can be caused by correctable problems, such as an unhealthy diet, lack of exercise, being overweight and smoking. Causes of heart arrhythmia ...

  5. Heart Attack

    Science.gov (United States)

    ... tear in the heart artery (spontaneous coronary artery dissection). Certain factors contribute to the unwanted buildup of ... logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2017 Mayo Foundation for Medical ...

  6. Reproducibility of creatine kinase reaction kinetics in human heart: a (31) P time-dependent saturation transfer spectroscopy study.

    Science.gov (United States)

    Bashir, Adil; Gropler, Robert

    2014-06-01

    Creatine kinase (CK) is essential for the buffering and rapid regeneration of adenosine triphosphate (ATP) in heart tissue. Herein, we demonstrate a (31) P MRS protocol to quantify CK reaction kinetics in human myocardium at 3 T. Furthermore, we sought to quantify the test-retest reliability of the measured metabolic parameters. The method localizes the (31) P signal from the heart using modified one-dimensional image-selected in vivo spectroscopy (ISIS), and a time-dependent saturation transfer (TDST) approach was used to measure CK reaction parameters. Fifteen healthy volunteers (22 measurements in total) were tested. The CK reaction rate constant (kf ) was 0.32 ± 0.05 s(-1) and the coefficient of variation (CV) was 15.62%. The intrinsic T1 for phosphocreatine (PCr) was 7.36 ± 1.79 s with CV = 24.32%. These values are consistent with those reported previously. The PCr/ATP ratio was equal to 1.94 ± 0.15 with CV = 7.73%, which is within the range of healthy subjects. The reproducibility of the technique was tested in seven subjects and inferred parameters, such as kf and T1 , exhibited good reliability [intraclass correlation coefficient (ICC) of 0.90 and 0.79 for kf and T1 , respectively). The reproducibility data provided in this study will enable the calculation of the power and sample sizes required for clinical and research studies. The technique will allow for the examination of cardiac energy metabolism in clinical and research studies, providing insight into the relationship between energy deficit and functional deficiency in the heart.

  7. Examining the relationship between heart rate and problem behavior: a case study of severe skin picking in Prader-Willi syndrome.

    Science.gov (United States)

    Hall, Scott S; Hammond, Jennifer L; Hustyi, Kristin M

    2013-11-01

    Few studies have examined the relationship between heart rate and self-injurious behavior (SIB) shown by individuals with IDD (intellectual and developmental disabilities). In this single-case study, we simultaneously monitored heart rate and activity levels during a functional analysis of severe skin picking behavior exhibited by a young man with Prader-Willi syndrome (PWS). Results of the functional analysis indicated that the participant's skin picking was maintained by automatic reinforcement. A within-session analysis of the data indicated that skin picking bouts resulted in an increase in heart rate, suggesting a positive- automatic reinforcement function. These data indicate that inclusion of heart rate and activity-level monitoring during a functional analysis may provide important additional information concerning the determinants of SIB.

  8. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008037 Factors associated with efficacy of cardiac resynchronization therapy for patients with congestive heart failure. SHI Haoying(史浩颖), et al. Dept Cardiol, Zhongshan Hosp Fudan Univ, Shanghai 200032. Chin J Cardiol 2007;35(12):1099-1163. Objective The efficacy of cardiac resynchronization therapy (CRT) in patients with congestive heart failure and the potential factors associated with responder or nonresponder were investigated. Methods Fifty

  9. Association Between Heart Rate at Rest and Incident Atrial Fibrillation (from the Copenhagen Electrocardiographic Study)

    DEFF Research Database (Denmark)

    Skov, Morten W.; Bachmann, Troels N.; Rasmussen, Peter V.

    2016-01-01

    Heart rate (HR) at rest is a well-known marker of cardiovascular morbidity and mortality. Results on the association between HR and incident atrial fibrillation (AF) have, however, been conflicting. Using digital electrocardiograms from 281,451 primary care patients, we aimed to describe the asso......Heart rate (HR) at rest is a well-known marker of cardiovascular morbidity and mortality. Results on the association between HR and incident atrial fibrillation (AF) have, however, been conflicting. Using digital electrocardiograms from 281,451 primary care patients, we aimed to describe...... the association between HR at rest and the hazards of incident AF. Secondary end points were death from all causes and pacemaker implantation. Data on drug use, co-morbidity, and outcomes were collected from nationwide administrative health care registries. During a median follow-up time of 8.4 years, 15......,666 subjects were observed to develop AF, of which 1,631 were lone AF. A HR at rest from 30 to 51 beats/min was associated with an adjusted hazard ratio of 1.16 (95% CI 1.06 to 1.27) for AF compared with the reference group (66 to 72 beats/min). From 72 beats/min and upward, the hazard ratio of AF increased...

  10. Pomegranate Supplementation Protects against Memory Dysfunction after Heart Surgery: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Susan A. Ropacki

    2013-01-01

    Full Text Available Memory dysfunction is a common complaint following heart surgery and may be related to a diffuse ischemic state induced by microemboli dislodged during the procedure. Ischemia can induce damage by a number of mechanisms, including oxidative stress. Because pomegranates contain a variety of polyphenols with antioxidant and other potentially beneficial effects, we tested whether supplementation with a pomegranate extract before and after heart surgery could protect against postoperative cognitive dysfunction. Patients undergoing elective coronary artery bypass graft and/or valve surgery were given either 2 g of pomegranate extract (in 2 POMx pills or placebo (pills containing no pomegranate ingredients per day from one week before surgery to 6 weeks after surgery. The patients were also administered a battery of neuropsychological tests to assess memory function at 1 week before surgery (baseline, 2 weeks after surgery, and 6 weeks after surgery. The placebo group had significant deficits in postsurgery memory retention, and the pomegranate treatment not only protected against this effect, but also actually improved memory retention performance for up to 6 weeks after surgery as compared to presurgery baseline performance.

  11. Advances in the Study of Heart Development and Disease Using Zebrafish

    Science.gov (United States)

    Brown, Daniel R.; Samsa, Leigh Ann; Qian, Li; Liu, Jiandong

    2016-01-01

    Animal models of cardiovascular disease are key players in the translational medicine pipeline used to define the conserved genetic and molecular basis of disease. Congenital heart diseases (CHDs) are the most common type of human birth defect and feature structural abnormalities that arise during cardiac development and maturation. The zebrafish, Danio rerio, is a valuable vertebrate model organism, offering advantages over traditional mammalian models. These advantages include the rapid, stereotyped and external development of transparent embryos produced in large numbers from inexpensively housed adults, vast capacity for genetic manipulation, and amenability to high-throughput screening. With the help of modern genetics and a sequenced genome, zebrafish have led to insights in cardiovascular diseases ranging from CHDs to arrhythmia and cardiomyopathy. Here, we discuss the utility of zebrafish as a model system and summarize zebrafish cardiac morphogenesis with emphasis on parallels to human heart diseases. Additionally, we discuss the specific tools and experimental platforms utilized in the zebrafish model including forward screens, functional characterization of candidate genes, and high throughput applications. PMID:27335817

  12. Automated Texture Analysis and Determination of Fibre Orientation of Heart Tissue: A Morphometric Study

    Science.gov (United States)

    Hofer, Ernst; Asslaber, Martin; Ahammer, Helmut

    2016-01-01

    The human heart has a heterogeneous structure, which is characterized by different cell types and their spatial configurations. The physical structure, especially the fibre orientation and the interstitial fibrosis, determines the electrical excitation and in further consequence the contractility in macroscopic as well as in microscopic areas. Modern image processing methods and parameters could be used to describe the image content and image texture. In most cases the description of the texture is not satisfying because the fibre orientation, detected with common algorithms, is biased by elements such as fibrocytes or endothelial nuclei. The goal of this work is to figure out if cardiac tissue can be analysed and classified on a microscopic level by automated image processing methods with a focus on an accurate detection of the fibre orientation. Quantitative parameters for identification of textures of different complexity or pathological attributes inside the heart were determined. The focus was set on the detection of the fibre orientation, which was calculated on the basis of the cardiomyocytes’ nuclei. It turned out that the orientation of these nuclei corresponded with a high precision to the fibre orientation in the image plane. Additionally, these nuclei also indicated very well the inclination of the fibre. PMID:27505420

  13. Social gradient in the metabolic syndrome not explained by psychosocial and behavioural factors: evidence from the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Prescott, Eva; Godtfredsen, Nina; Osler, Merete

    2007-01-01

    BACKGROUND: Psychosocial stressors may mediate the effect of social status on the metabolic syndrome (MS). The paper explores this hypothesis in a random sample of the general population. DESIGN: A total of 3462 women and 2576 men aged 20-97 years from the Copenhagen City Heart Study. METHODS......: An MS index was defined from the seven components: waist-hip ratio, high-density lipoprotein (HDL)-cholesterol, triglycerides, systolic blood pressure (SBP), blood glucose, C-reactive protein (CRP) and fibrinogen. Social status was measured by educational level. Psychosocial factors included fatigue...

  14. Monoamine Oxidases as Potential Contributors to Oxidative Stress in Diabetes: Time for a Study in Patients Undergoing Heart Surgery

    Directory of Open Access Journals (Sweden)

    Oana M. Duicu

    2015-01-01

    Full Text Available Oxidative stress is a pathomechanism causally linked to the progression of chronic cardiovascular diseases and diabetes. Mitochondria have emerged as the most relevant source of reactive oxygen species, the major culprit being classically considered the respiratory chain at the inner mitochondrial membrane. In the past decade, several experimental studies unequivocally demonstrated the contribution of monoamine oxidases (MAOs at the outer mitochondrial membrane to the maladaptative ventricular hypertrophy and endothelial dysfunction. This paper addresses the contribution of mitochondrial dysfunction to the pathogenesis of heart failure and diabetes together with the mounting evidence for an emerging role of MAO inhibition as putative cardioprotective strategy in both conditions.

  15. Family lifestyle factors related to children s congenital heart defects in China:a case-control study

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Objective To explore the multiple risk factors for family lifestyle of children with congenital heart defects(CHDs)in Shaanxi Province,China.Methods A 1∶1 case-control study was carried out to investigate 60 pairs of children and their parents.The univariate and multivariable logistic regression models were used to analyze the influence of risk factors related to parents' lifestyle on CHDs.Results Several possible risk factors were found for CHDs,including fever(OR=4.465,P=0.017),pesticides contact(OR=2.234...

  16. [Application of the immunohistochemical detection of PGP 9.5 protein for the study of rat and human heart innervation].

    Science.gov (United States)

    Korzhevskiy, D E; Sukhorukova, Ye G; Petrova, Ye S; Tzukanova, A F; Chumasov, Ye I

    2013-01-01

    In this paper we describe the modern immunohistochemical method detecting the neuronal marker PGP 9.5. The application of this method for the study of the innervation of rat and human heart, the detailed examination of the topography of the cardiac nervous apparatus, as well as their changes in pathological states, is demonstrated. Structural organization and the nature of the terminal branches of nerve apparatus suggest that they have afferent function. Protocol of the reaction demonstrating PGP 9.5 on paraffin sections is presented.

  17. Genome-Wide Association Study for Incident Myocardial Infarction and Coronary Heart Disease in Prospective Cohort Studies: The CHARGE Consortium.

    Directory of Open Access Journals (Sweden)

    Abbas Dehghan

    Full Text Available Data are limited on genome-wide association studies (GWAS for incident coronary heart disease (CHD. Moreover, it is not known whether genetic variants identified to date also associate with risk of CHD in a prospective setting.We performed a two-stage GWAS analysis of incident myocardial infarction (MI and CHD in a total of 64,297 individuals (including 3898 MI cases, 5465 CHD cases. SNPs that passed an arbitrary threshold of 5×10-6 in Stage I were taken to Stage II for further discovery. Furthermore, in an analysis of prognosis, we studied whether known SNPs from former GWAS were associated with total mortality in individuals who experienced MI during follow-up.In Stage I 15 loci passed the threshold of 5×10-6; 8 loci for MI and 8 loci for CHD, for which one locus overlapped and none were reported in previous GWAS meta-analyses. We took 60 SNPs representing these 15 loci to Stage II of discovery. Four SNPs near QKI showed nominally significant association with MI (p-value<8.8×10-3 and three exceeded the genome-wide significance threshold when Stage I and Stage II results were combined (top SNP rs6941513: p = 6.2×10-9. Despite excellent power, the 9p21 locus SNP (rs1333049 was only modestly associated with MI (HR = 1.09, p-value = 0.02 and marginally with CHD (HR = 1.06, p-value = 0.08. Among an inception cohort of those who experienced MI during follow-up, the risk allele of rs1333049 was associated with a decreased risk of subsequent mortality (HR = 0.90, p-value = 3.2×10-3.QKI represents a novel locus that may serve as a predictor of incident CHD in prospective studies. The association of the 9p21 locus both with increased risk of first myocardial infarction and longer survival after MI highlights the importance of study design in investigating genetic determinants of complex disorders.

  18. Randomly and Non-Randomly Missing Renal Function Data in the Strong Heart Study: A Comparison of Imputation Methods.

    Science.gov (United States)

    Shara, Nawar; Yassin, Sayf A; Valaitis, Eduardas; Wang, Hong; Howard, Barbara V; Wang, Wenyu; Lee, Elisa T; Umans, Jason G

    2015-01-01

    Kidney and cardiovascular disease are widespread among populations with high prevalence of diabetes, such as American Indians participating in the Strong Heart Study (SHS). Studying these conditions simultaneously in longitudinal studies is challenging, because the morbidity and mortality associated with these diseases result in missing data, and these data are likely not missing at random. When such data are merely excluded, study findings may be compromised. In this article, a subset of 2264 participants with complete renal function data from Strong Heart Exams 1 (1989-1991), 2 (1993-1995), and 3 (1998-1999) was used to examine the performance of five methods used to impute missing data: listwise deletion, mean of serial measures, adjacent value, multiple imputation, and pattern-mixture. Three missing at random models and one non-missing at random model were used to compare the performance of the imputation techniques on randomly and non-randomly missing data. The pattern-mixture method was found to perform best for imputing renal function data that were not missing at random. Determining whether data are missing at random or not can help in choosing the imputation method that will provide the most accurate results.

  19. Randomly and Non-Randomly Missing Renal Function Data in the Strong Heart Study: A Comparison of Imputation Methods.

    Directory of Open Access Journals (Sweden)

    Nawar Shara

    Full Text Available Kidney and cardiovascular disease are widespread among populations with high prevalence of diabetes, such as American Indians participating in the Strong Heart Study (SHS. Studying these conditions simultaneously in longitudinal studies is challenging, because the morbidity and mortality associated with these diseases result in missing data, and these data are likely not missing at random. When such data are merely excluded, study findings may be compromised. In this article, a subset of 2264 participants with complete renal function data from Strong Heart Exams 1 (1989-1991, 2 (1993-1995, and 3 (1998-1999 was used to examine the performance of five methods used to impute missing data: listwise deletion, mean of serial measures, adjacent value, multiple imputation, and pattern-mixture. Three missing at random models and one non-missing at random model were used to compare the performance of the imputation techniques on randomly and non-randomly missing data. The pattern-mixture method was found to perform best for imputing renal function data that were not missing at random. Determining whether data are missing at random or not can help in choosing the imputation method that will provide the most accurate results.

  20. Validation of a new simple scale to measure symptoms in heart failure from traditional Chinese medicine view: a cross-sectional questionnaire study

    OpenAIRE

    Fu, Tieh-Cheng; Lin, Yi-Chung; Chang, Ching-Mao; Chou, Wei-Ling; Yuan, Pei-Hsun; Liu, Min-Hui; Wang, Chao-Hung; Chen, Juei-Chao; Chang, Hen-Hong; Pan, Tai-Long

    2016-01-01

    Background Current clinical practices used to functionally classify heart failure (HF) are time-consuming, expensive, or require complex calculations. This study aimed to design an inquiry list from the perspective of traditional Chinese medicine (TCM) that could be used in routine clinical practice to resolve these problems. Methods The severity of documented HF in 115 patients was classified according to their performance in maximal exercise tests into New York Heart Association (NYHA) func...

  1. Heart mitochondrial proteome study elucidates changes in cardiac energy metabolism and antioxidant PRDX3 in human dilated cardiomyopathy.

    Directory of Open Access Journals (Sweden)

    Esther Roselló-Lletí

    Full Text Available Dilated cardiomyopathy (DCM is a public health problem with no available curative treatment, and mitochondrial dysfunction plays a critical role in its development. The present study is the first to analyze the mitochondrial proteome in cardiac tissue of patients with DCM to identify potential molecular targets for its therapeutic intervention.16 left ventricular (LV samples obtained from explanted human hearts with DCM (n = 8 and control donors (n = 8 were extracted to perform a proteomic approach to investigate the variations in mitochondrial protein expression. The proteome of the samples was analyzed by quantitative differential electrophoresis and Mass Spectrometry. These changes were validated by classical techniques and by novel and precise selected reaction monitoring analysis and RNA sequencing approach increasing the total heart samples up to 25. We found significant alterations in energy metabolism, especially in molecules involved in substrate utilization (ODPA, ETFD, DLDH, energy production (ATPA, other metabolic pathways (AL4A1 and protein synthesis (EFTU, obtaining considerable and specific relationships between the alterations detected in these processes. Importantly, we observed that the antioxidant PRDX3 overexpression is associated with impaired ventricular function. PRDX3 is significantly related to LV end systolic and diastolic diameter (r = 0.73, p value<0.01; r = 0.71, p value<0.01, fractional shortening, and ejection fraction (r = -0.61, p value<0.05; and r = -0.62, p value<0.05, respectively.This work could be a pivotal study to gain more knowledge on the cellular mechanisms related to the pathophysiology of this disease and may lead to the development of etiology-specific heart failure therapies. We suggest new molecular targets for therapeutic interventions, something that up to now has been lacking.

  2. The specific features of the diagnosis and treatment of coronary heart disease in rheumatoid arthritis (Results of the authors’ studies

    Directory of Open Access Journals (Sweden)

    Natalya Anatolyevna Khramtsova

    2012-01-01

    Full Text Available Coronary heart disease (CHD and its complications occupy the leading place in the pattern of the causes of untimely death in rheumatoid arthritis (RA. Objective: to study the incidence, pattern, and specific features of CHD in patients with RA. Patients and methods. An analytical cross-sectional study was conducted in 257 patients with RA (ARA, 1987. The patients’ mean age was 55.4±11.6 years; RA duration was 14.7years (range 2—20 years. Results. The incidence of CHD in RA was as much as 45.9% (n = 118, including 52.5% (n = 62 for typical angina pectoris on exertion; 25.4% (n = 30 and 22.1% (n = 26 for silent ischemia and arrhythmias, respectively. A high proportion of vertebrogenic cardialgias (48.8%; n = 100 were noted in those who complained of heart pain. The authors identified traditional risk factors, such as hypertension (OR = 12.1, smoking (OR = 10.2, early menopause (OR = 3.6, decreased glomerular filtration rate (OR = 3.5, cardiovascular heredity (OR = 3.1, overweight (OR = 2.5, a heart rate of more than 70 beats/min (OR = 2.3, atherogenic dyslipidemia (OR = 2.3, hyperglycemia (OR = 2.1, and age (OR = 1.7. Along with those, the authors also ascertained CHD predictors associating with chronic inflammation consequences: use of glucocorticoids (OR = 5.0, concomitant anemia as a common complication of RA (OR = 4.7, high DAS 28 scores (OR = 3.7, visual analog scale pain scores of > 50 mm (OR = 2.6, and RA duration of >10 years (OR = 2.2. Conclusion. The specific features of CHD in RA include the frequent detection of arrhythmias and silent ischemia. The importance of the degree of inflammatory activity along with the traditional risk factors of CHD is apparent.

  3. Heart rate reduction for 36 months with ivabradine reduces left ventricular mass in cardiac allograft recipients: a long-term follow-up study

    Directory of Open Access Journals (Sweden)

    Doesch AO

    2013-11-01

    Full Text Available Andreas O Doesch,1 Susanne Mueller,1 Christian Erbel,1 Christian A Gleissner,1 Lutz Frankenstein,1 Stefan Hardt,1 Arjang Ruhparwar,2 Philipp Ehlermann,1 Thomas Dengler,3 Hugo A Katus1 1Department of Cardiology, 2Department of Cardiovascular Surgery, University of Heidelberg, Heidelberg, 3SLK Plattenwald Hospital, Bad Friedrichshall, Germany Background: Due to graft denervation, sinus tachycardia is a common problem after heart transplantation, underlining the importance of heart rate control without peripheral effects. However, long-term data regarding the effects of ivabradine, a novel If channel antagonist, are limited in patients after heart transplantation. Methods: In this follow-up analysis, the resting heart rate, left ventricular mass indexed to body surface area (LVMI, tolerability, and safety of ivabradine therapy were evaluated at baseline and after 36 months in 30 heart transplant recipients with symptomatic sinus tachycardia versus a matched control group. Results: During the study period, ivabradine medication was stopped in three patients (10% of total. Further analysis was based on 27 patients with 36 months of drug intake. The mean patient age was 53.3±11.3 years and mean time after heart transplantation was 5.0±4.8 years. After 36 months, the mean ivabradine dose was 12.0±3.4 mg/day. Resting heart rate was reduced from 91.0±10.7 beats per minute before initiation of ivabradine therapy (ie, baseline to 81.2±9.8 beats per minute at follow-up (P=0.0006. After 36 months of ivabradine therapy, a statistically significant reduction of LVMI was observed (104.3±22.7 g at baseline versus 93.4±18.4 g at follow-up, P=0.002. Hematologic, renal, and liver function parameters remained stable during ivabradine therapy. Except for a lower mycophenolate mofetil dose at follow-up (P=0.02, no statistically significant changes in immunosuppressive drug dosage or blood levels were detected. No phosphenes were observed during 36 months of

  4. Nonlinear Heart Rate Variability features for real-life stress detection. Case study: students under stress due to university examination

    Directory of Open Access Journals (Sweden)

    Melillo Paolo

    2011-11-01

    Full Text Available Abstract Background This study investigates the variations of Heart Rate Variability (HRV due to a real-life stressor and proposes a classifier based on nonlinear features of HRV for automatic stress detection. Methods 42 students volunteered to participate to the study about HRV and stress. For each student, two recordings were performed: one during an on-going university examination, assumed as a real-life stressor, and one after holidays. Nonlinear analysis of HRV was performed by using Poincaré Plot, Approximate Entropy, Correlation dimension, Detrended Fluctuation Analysis, Recurrence Plot. For statistical comparison, we adopted the Wilcoxon Signed Rank test and for development of a classifier we adopted the Linear Discriminant Analysis (LDA. Results Almost all HRV features measuring heart rate complexity were significantly decreased in the stress session. LDA generated a simple classifier based on the two Poincaré Plot parameters and Approximate Entropy, which enables stress detection with a total classification accuracy, a sensitivity and a specificity rate of 90%, 86%, and 95% respectively. Conclusions The results of the current study suggest that nonlinear HRV analysis using short term ECG recording could be effective in automatically detecting real-life stress condition, such as a university examination.

  5. Quantitative Mitochondrial Proteomics Study on Protective Mechanism of Grape Seed Proanthocyanidin Extracts Against Ischemia/Reperfusion Heart Injury in Rat

    Institute of Scientific and Technical Information of China (English)

    LU Wei-da; QIU Jie; ZHAO Gai-xia; QIE Liang-yi; WEI Xin-bing; GAO Hai-qing

    2012-01-01

    Cardiac ischemia/reperfusion(I/R) injury is a critical condition,often associated with high morbidity and mortality.The cardioprotective effect of grape seed proanthocyanidin extracts(GSPE) against oxidant injury during I/R has been described in previous studies.However,the underlying molecular mechanisms have not been fully elucidated.This study investigated the effect of GSPE on reperfusion arrhythmias especially ventricular tachycardia(VT)and ventricular fibrillation(VF),the lactic acid accumulation and the ultrastructure of ischemic cardiomyocytes as well as the global changes of mitochondria proteins in in vivo rat heart model against I/R injury.GSPE significantly reduced the incidence of VF and VT,lessened the lactic acid accumulation and attenuated the ultrastructure damage.Twenty differential proteins related to cardiac protection were revealed by isobaric tag for relative and absolute quantitation(iTRAQ) profiling.These proteins were mainly involved in energy metabolism.Besides,monoamine oxidase A(MAOA) was also identified.The differential expression of several proteins was validated by Western blot.Our study offered important information on the mechanism of GSPE treatment in ischemic heart disease.

  6. Impact of valvular heart disease on oral anticoagulant therapy in non-valvular atrial fibrillation: results from the RAMSES study.

    Science.gov (United States)

    Başaran, Özcan; Dogan, Volkan; Beton, Osman; Tekinalp, Mehmet; Aykan, Ahmet Çağrı; Kalaycıoğlu, Ezgi; Bolat, Ismail; Taşar, Onur; Şafak, Özgen; Kalçık, Macit; Yaman, Mehmet; İnci, Sinan; Altıntaş, Bernas; Kalkan, Sedat; Kırma, Cevat; Biteker, Murat

    2017-02-01

    The definition of non-valvular atrial fibrillation (NVAF) is controversial. We aimed to assess the impact of valvular heart disease on stroke prevention strategies in NVAF patients. The RAMSES study was a multicenter and cross-sectional study conducted on NVAF patients (ClinicalTrials.gov identifier NCT02344901). The study population was divided into patients with significant valvular disease (SVD) and non-significant valvular disease (NSVD), whether they had at least one moderate valvular disease or not. Patients with a mechanical prosthetic valve and mitral stenosis were excluded. Baseline characteristics and oral anticoagulant (OAC) therapies were compared. In 5987 patients with NVAF, there were 3929 (66%) NSVD and 2058 (34%) SVD patients. The predominant valvular disease was mitral regurgitation (58.1%), followed by aortic regurgitation (24.1%) and aortic stenosis (17.8%). Patients with SVD had higher CHA2DS2VASc [3.0 (2.0; 4.0) vs. 4.0 (2.0; 5.0), p valvular heart disease with the predominance of mitral regurgitation. Patients with SVD were at greater risk of stroke and bleeding compared to patients with NSVD. Although patients with mitral regurgitation should be given more aggressive anticoagulant therapy due to their higher risk of stroke, they are undertreated compared to patients with aortic valve diseases.

  7. Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies.

    Science.gov (United States)

    Dauchet, Luc; Amouyel, Philippe; Hercberg, Serge; Dallongeville, Jean

    2006-10-01

    The consumption of fruit and vegetables is associated with a reduced rate of coronary heart disease (CHD) in observational cohorts. The purpose of this study was to assess the strength of this association in a meta-analysis. Cohort studies were selected if they reported relative risks (RRs) and 95% CI for coronary heart disease or mortality and if they presented a quantitative assessment of fruit and vegetable intake. The pooled RRs were calculated for each additional portion of fruit and/or vegetables consumed per day, and the linearity of the associations were examined. Nine studies were eligible for inclusion in the meta-analysis that consisted of 91,379 men, 129,701 women, and 5,007 CHD events. The risk of CHD was decreased by 4% [RR (95% CI): 0.96 (0.93-0.99), P = 0.0027] for each additional portion per day of fruit and vegetable intake and by 7% [0.93 (0.89-0.96), P fruit intake. The association between vegetable intake and CHD risk was heterogeneous (P = 0.0043), more marked for cardiovascular mortality [0.74 (0.75-0.84), P fruit and vegetable consumption is inversely associated with the risk of CHD. The causal mechanism of this association, however, remains to be demonstrated.

  8. Signs of deterioration in infants discharged home following congenital heart surgery in the first year of life: a qualitative study

    Science.gov (United States)

    Tregay, Jenifer; Brown, Katherine L; Crowe, Sonya; Bull, Catherine; Knowles, Rachel L; Smith, Liz; Wray, Jo

    2016-01-01

    Aims To describe the ways in which parents recognise and make decisions about their child's symptoms following discharge home after congenital heart interventions in the first year of life and their experiences of seeking help. Methods This was a qualitative study involving semistructured interviews with parents. Twenty-one parents were recruited to the study. Parents all had a child who had congenital heart surgery in their first year of life between September 2009 and October 2013 at one of three UK cardiac centres; the children had either died or were readmitted as an emergency following initial discharge. Results Some parents were unable to identify any early warning signs. Others described symptoms of deterioration including changes in feeding and appearance, respiratory distress and subtle behavioural changes that may not be routinely highlighted to parents at discharge. Several barriers to accessing prompt medical assistance were identified including parents feeling that their concerns were not taken seriously, long wait times and lack of protocols at A&E. Conclusions Our study highlights behavioural symptoms as being a potentially underemphasised sign of deterioration and identifies a number of barriers to parents accessing support when they are concerned. It is important that parents are encouraged to seek advice at the earliest opportunity and that those health professionals at the front line have access to the information they need in order to respond in an appropriate and timely way. A role for home monitoring was also noted as potentially useful in identifying at risk children who appear clinically well. PMID:26823534

  9. Genetic and other factors determining mannose-binding lectin levels in American Indians: the Strong Heart Study

    DEFF Research Database (Denmark)

    Best, Lyle G; Ferrell, Robert E; Decroo, Susan

    2009-01-01

    in Caucasian and other populations, result in markedly reduced expression of functional protein. Prospective epidemiologic studies, including a nested, case-control study from the present population, have demonstrated the ability of MBL2 genotypes to predict complications of atherosclerosis,. The genetic...... control of MBL2 expression is complex and genetic background effects in specific populations are largely unknown. METHODS: The Strong Heart Study is a longitudinal, cohort study of cardiovascular disease among American Indians. A subset of individuals genotyped for the above mentioned case-control study...... were selected for analysis of circulating MBL levels by double sandwich ELISA method. Mean MBL levels were compared between genotypic groups and multivariate regression was used to determine other independent factors influencing MBL2 expression. RESULTS: Our results confirm the effects of variant...

  10. The impact of heart failure on prognosis of diabetic and non-diabetic patients with myocardial infarction: a 15-year follow-up study

    DEFF Research Database (Denmark)

    Melchior, T; Rask-Madsen, C; Torp-Pedersen, C;

    2001-01-01

    BACKGROUND: Information about the occurrence of heart failure in the acute phase of myocardial infarction (MI) in diabetic patients and its impact on prognosis are sparse. AIM: The purpose of the present study was to describe how MI patients with diabetes mellitus (DM) differed from MI patients...... to the development of heart failure. In acute myocardial infarction diabetic patients with heart failure have a worse prognosis than non-diabetic patients with heart failure....... admitted to one coronary care unit (CCU) between 1979 and 1983. DM was diagnosed in 10% (n=194), with 17% (n=33) on insulin therapy. Patients with DM comprised of a higher proportion of women (DM 36% vs. no DM 26%, P

  11. Murine atrial HL-1 cell line is a reliable model to study drug metabolizing enzymes in the heart.

    Science.gov (United States)

    Elshenawy, Osama H; Anwar-Mohamed, Anwar; Abdelhamid, Ghada; El-Kadi, Ayman O S

    2013-04-01

    HL-1 cells are currently the only cells that spontaneously contract while maintaining a differentiated cardiac phenotype. Thus, our objective was to examine murine HL-1 cells as a new in vitro model to study drug metabolizing enzymes. We examined the expression of cytochrome P450s (Cyps), phase II enzymes, and nuclear receptors and compared their levels to mice hearts. Our results demonstrated that except for Cyp4a12 and Cyp4a14 all Cyps, phase II enzymes: glutathione-S-transferases (Gsts), heme oxygenase-1 (HO-1), and NAD(P)H: quinone oxidoreductase (Nqo1), nuclear receptors: aryl hydrocarbon receptor (AhR), constitutive androstane receptor (CAR), pregnane X receptor (PXR), and peroxisome proliferator activated receptor (PPAR-alpha) were all constitutively expressed in HL-1 cells. Cyp2b19, Cyp2c29, Cyp2c38, Cyp2c40, and Cyp4f16 mRNA levels were higher in HL-1 cells compared to mice hearts. Cyp2b9, Cyp2c44, Cyp2j9, Cyp2j11, Cyp2j13, Cyp4f13, Cyp4f15 mRNA levels were expressed to the same extent to that of mice hearts. Cyp1a1, Cyp1a2, Cyp1b1, Cyp2b10, Cyp2d10, Cyp2d22, Cyp2e1, Cyp2j5, Cyp2j6, Cyp3a11, Cyp4a10, and Cyp4f18 mRNA levels were lower in HL-1 cells compared to mice hearts. Moreover, 3-methylcholanthrene induced Cyp1a1 while fenofibrate induced Cyp2j9 and Cyp4f13 mRNA levels in HL-1 cells. Examining the metabolism of arachidonic acid (AA) by HL-1 cells, our results demonstrated that HL-1 cells metabolize AA to epoxyeicosatrienoic acids, dihydroxyeicosatrienoic acids, and 20-hydroxyeicosatetraenoic acids. In conclusion, HL-1 cells provide a valuable in vitro model to study the role of Cyps and their associated AA metabolites in addition to phase II enzymes in cardiovascular disease states.

  12. 1st and 2nd Trimester Headsize in Fetuses with Congenital Heart Disease: A Cohort Study

    DEFF Research Database (Denmark)

    Lauridsen, Mette Høj; Petersen, Olav Bjørn; Vestergaard, Else Marie;

    2014-01-01

    and screening for fetal malformations is carried out. Our cohort includes all fetuses in Western Denmark (2.9 million inhabitants) screened in between January 1st 2012 and December 31st 2013, diagnosed with any structural, non-syndromic congenital heart disease either during pregnancy or up to 6 months after...... birth. Results 276 fetuses with CHD were identified. 114 (41%) were genetically screened primarily by chromosomal microarray analysis (n=82). Fetuses with identified chromosomal abnormalities were excluded as were multiple gestation fetuses and fetuses with major extra cardiac malformations. Data from...... 208 fetuses (75%) with presumed non-syndromic CHD were included, 85 (41%) with minor and 123 (59%) with major CHD. Z-scores for head size were analysed. Conclusions: Our preliminary results suggest that Bi-parietal-diameter in children with CHD is within the normal range in the 1st trimester...

  13. [Heart rate variability study based on a novel RdR RR Intervals Scatter Plot].

    Science.gov (United States)

    Lu, Hongwei; Lu, Xiuyun; Wang, Chunfang; Hua, Youyuan; Tian, Jiajia; Liu, Shihai

    2014-08-01

    On the basis of Poincare scatter plot and first order difference scatter plot, a novel heart rate variability (HRV) analysis method based on scatter plots of RR intervals and first order difference of RR intervals (namely, RdR) was proposed. The abscissa of the RdR scatter plot, the x-axis, is RR intervals and the ordinate, y-axis, is the difference between successive RR intervals. The RdR scatter plot includes the information of RR intervals and the difference between successive RR intervals, which captures more HRV information. By RdR scatter plot analysis of some records of MIT-BIH arrhythmias database, we found that the scatter plot of uncoupled premature ventricular contraction (PVC), coupled ventricular bigeminy and ventricular trigeminy PVC had specific graphic characteristics. The RdR scatter plot method has higher detecting performance than the Poincare scatter plot method, and simpler and more intuitive than the first order difference method.

  14. Study on Large Power Tractor Driver's Heart Rate and Fatigue in Sowing Work

    Institute of Scientific and Technical Information of China (English)

    KONG Degang; ZHAO Yongchao; ZHU Zhenying; ZHANG Shuai; ZHU Lei

    2008-01-01

    In order to reduce the driving fatigue in sowing work, this paper based on heart rate (HR) as the main indicator to survey, tested and analyzed the fatigue condition of the drivers of three imported tractors and one domestic tractor in sowing work. The results showed that when driving the imported tractors in sowing work, the HR increasing rate was 10.4%-14.3%, labor intensity belonged to the light level;when driving domestic tractor in sowing work, the HR increasing rate was 23.4%-33.0%, it was remarkably bigger than that of driving imported tractors (P<0.05), labor intensity belonged to the middle level. The main effects on driving fatigue included the control methods, tractors' cab environment, processing time, operating content, and so on. Finally, we proposed the concrete measures and suggestions to reduce driving fatigue and improve drivers' work condition.

  15. Urinary Proteomics Pilot Study for Biomarker Discovery and Diagnosis in Heart Failure with Reduced Ejection Fraction

    DEFF Research Database (Denmark)

    Rossing, Kasper; Bosselmann, Helle Skovmand; Gustafsson, Finn

    2016-01-01

    BACKGROUND: Biomarker discovery and new insights into the pathophysiology of heart failure with reduced ejection fraction (HFrEF) may emerge from recent advances in high-throughput urinary proteomics. This could lead to improved diagnosis, risk stratification and management of HFrEF. METHODS...... AND RESULTS: Urine samples were analyzed by on-line capillary electrophoresis coupled to electrospray ionization micro time-of-flight mass spectrometry (CE-MS) to generate individual urinary proteome profiles. In an initial biomarker discovery cohort, analysis of urinary proteome profiles from 33 HFr.......6%) in individuals with diastolic left ventricular dysfunction (N = 176). The HFrEF-related peptide biomarkers mainly included fragments of fibrillar type I and III collagen but also, e.g., of fibrinogen beta and alpha-1-antitrypsin. CONCLUSION: CE-MS based urine proteome analysis served as a sensitive tool...

  16. Ensembles of engineered cardiac tissues for physiological and pharmacological study: heart on a chip.

    Science.gov (United States)

    Grosberg, Anna; Alford, Patrick W; McCain, Megan L; Parker, Kevin Kit

    2011-12-21

    Traditionally, muscle physiology experiments require multiple tissue samples to obtain morphometric, electrophysiological, and contractility data. Furthermore, these experiments are commonly completed one at a time on cover slips of single cells, isotropic monolayers, or in isolated muscle strips. In all of these cases, variability of the samples hinders quantitative comparisons among experimental groups. Here, we report the design of a "heart on a chip" that exploits muscular thin film technology--biohybrid constructs of an engineered, anisotropic ventricular myocardium on an elastomeric thin film--to measure contractility, combined with a quantification of action potential propagation, and cytoskeletal architecture in multiple tissues in the same experiment. We report techniques for real-time data collection and analysis during pharmacological intervention. The chip is an efficient means of measuring structure-function relationships in constructs that replicate the hierarchical tissue architectures of laminar cardiac muscle.

  17. Left Ventricular Wall Stress-Mass-Heart Rate Product and Cardiovascular Events in Treated Hypertensive Patients: LIFE Study.

    Science.gov (United States)

    Devereux, Richard B; Bang, Casper N; Roman, Mary J; Palmieri, Vittorio; Boman, Kurt; Gerdts, Eva; Nieminen, Markku S; Papademetriou, Vasilios; Wachtell, Kristian; Hille, Darcy A; Dahlöf, Björn

    2015-11-01

    In the Losartan Intervention for End Point Reduction in Hypertension (LIFE) study, 4.8 years' losartan- versus atenolol-based antihypertensive treatment reduced left ventricular hypertrophy and cardiovascular end points, including cardiovascular death and stroke. However, there was no difference in myocardial infarction (MI), possibly related to greater reduction in myocardial oxygen demand by atenolol-based treatment. Myocardial oxygen demand was assessed indirectly by the left ventricular mass×wall stress×heart rate (triple product) in 905 LIFE participants. The triple product was included as time-varying covariate in Cox models assessing predictors of the LIFE primary composite end point (cardiovascular death, MI, or stroke), its individual components, and all-cause mortality. At baseline, the triple product in both treatment groups was, compared with normal adults, elevated in 70% of patients. During randomized treatment, the triple product was reduced more by atenolol, with prevalences of elevated triple product of 39% versus 51% on losartan (both P≤0.001). In Cox regression analyses adjusting for age, smoking, diabetes mellitus, and prior stroke, MI, and heart failure, 1 SD lower triple product was associated with 23% (95% confidence interval 13%-32%) fewer composite end points, 31% (18%-41%) less cardiovascular mortality, 30% (15%-41%) lower MI, and 22% (11%-33%) lower all-cause mortality (all P≤0.001), without association with stroke (P=0.34). Although losartan-based therapy reduced ventricular mass more, greater heart rate reduction with atenolol resulted in larger reduction of the triple product. Lower triple product during antihypertensive treatment was strongly, independently associated with lower rates of the LIFE primary composite end point, cardiovascular death, and MI, but not stroke.

  18. [Morphological and electrophysiological changes of the heart atria in necropsy patients with atrial fibrillation - a pilot study].

    Science.gov (United States)

    Matějková, Adéla; Steiner, Ivo

    2014-01-01

    Atrial fibrillation (AF), the most common supraventricular tachycardia, has a morphological base, so called remodelation of atrial myocardium, with its abnormal conduction pattern as a consequence. The remodelation regards electrical, contractile, and structural properties. In this pilot study we attempted to find relations between the myocardial morphological (scarring, amyloidosis, left atrial enlargement) and electrophysiological (ECG characteristics of the P-wave) changes in patients with AF. We examined 40 hearts of necropsy patients - 20 with a history of AF and 20 with no history of AF. Grossly, the heart weight and the size of the left atrium (LA) were evaluated. Histologically, 7 standard sites from the atria were examined. In each specimen, the degree of myocardial scarring and of deposition of isolated atrial amyloid (IAA) were assessed. We failed to show any significant difference in the P-wave pattern between patients with and without AF. Morphologically, however, there were several differences - the patients with AF had significantly heavier hearts, larger left atria, more severely scarred myocardium of the LA and the atrial septum, and more severe deposition of IAA in both atria in comparison to the control group of patients with sinus rhythm. The left atrial distribution of both fibrosis and amyloidosis was irregular. In patients with AF the former was most pronounced in the LA ceiling while the latter in the LA anterior wall. The entire series showed more marked amyloidosis in the left than in the right atrium. An interesting finding was the universal absence of IAA in the sinoatrial node. The knowledge of distribution of atrial myocardial structural changes could be utilized by pathologists in taking specimens for histology and also by cardiologists in targeting the radiofrequency ablation therapy.

  19. Urinary Proteomics Pilot Study for Biomarker Discovery and Diagnosis in Heart Failure with Reduced Ejection Fraction.

    Directory of Open Access Journals (Sweden)

    Kasper Rossing

    Full Text Available Biomarker discovery and new insights into the pathophysiology of heart failure with reduced ejection fraction (HFrEF may emerge from recent advances in high-throughput urinary proteomics. This could lead to improved diagnosis, risk stratification and management of HFrEF.Urine samples were analyzed by on-line capillary electrophoresis coupled to electrospray ionization micro time-of-flight mass spectrometry (CE-MS to generate individual urinary proteome profiles. In an initial biomarker discovery cohort, analysis of urinary proteome profiles from 33 HFrEF patients and 29 age- and sex-matched individuals without HFrEF resulted in identification of 103 peptides that were significantly differentially excreted in HFrEF. These 103 peptides were used to establish the support vector machine-based HFrEF classifier HFrEF103. In a subsequent validation cohort, HFrEF103 very accurately (area under the curve, AUC = 0.972 discriminated between HFrEF patients (N = 94, sensitivity = 93.6% and control individuals with and without impaired renal function and hypertension (N = 552, specificity = 92.9%. Interestingly, HFrEF103 showed low sensitivity (12.6% in individuals with diastolic left ventricular dysfunction (N = 176. The HFrEF-related peptide biomarkers mainly included fragments of fibrillar type I and III collagen but also, e.g., of fibrinogen beta and alpha-1-antitrypsin.CE-MS based urine proteome analysis served as a sensitive tool to determine a vast array of HFrEF-related urinary peptide biomarkers which might help improving our understanding and diagnosis of heart failure.

  20. Outcome of left heart mechanical valve replacement in West African children - A 15-year retrospective study

    Directory of Open Access Journals (Sweden)

    Tamatey Martin

    2011-04-01

    Full Text Available Abstract Background The West African sub-region has poor health infrastructure. Mechanical valve replacement in children from such regions raises important postoperative concerns; among these, valve-related morbidity and complications of lifelong anticoagulation are foremost. Little is known about the long-term outcome of mechanical valve replacement in West Africa. We sought to determine the outcome of mechanical valve replacement of the left heart in children from this sub-region. Method We conducted a retrospective review of all consecutive left heart valve replacements in children ( Results One hundred and fourteen patients underwent mitral valve replacement (MVR, aortic valve replacement (AVR or mitral and aortic valve replacements (MAVR. Their ages ranged from 6-18 years (13.3 ± 3.1 years. All patients were in NYHA class III or IV. Median follow up was 9.1 years. MVR was performed in 91 (79.8% patients, AVR in 13 (11.4% and MAVR in 10 (8.8% patients. Tricuspid valve repair was performed concomitantly in 45 (39.5% patients. There were 6 (5.3% early deaths and 6 (5.3% late deaths. Preoperative left ventricular dysfunction (ejection fraction Conclusion Mechanical valve replacement in West African children has excellent outcomes in terms of mortality, valve-related events, and reoperation rate. Preoperative left ventricular dysfunction is the primary determinant of mortality within the first 2 years of valve replacement. The risk of valve-related complications is acceptably low. Anticoagulation is well tolerated with a very low risk of bleeding even in this socioeconomic setting.

  1. Multicentre, prospective, randomised, open-label, blinded end point trial of the efficacy of allopurinol therapy in improving cardiovascular outcomes in patients with ischaemic heart disease: protocol of the ALL-HEART study

    Science.gov (United States)

    Ford, Ian; Walker, Andrew; Hawkey, Chris; Begg, Alan; Avery, Anthony; Taggar, Jaspal; Wei, Li; Struthers, Allan D; MacDonald, Thomas M

    2016-01-01

    Introduction Ischaemic heart disease (IHD) is one of the most common causes of death in the UK and treatment of patients with IHD costs the National Health System (NHS) billions of pounds each year. Allopurinol is a xanthine oxidase inhibitor used to prevent gout that also has several positive effects on the cardiovascular system. The ALL-HEART study aims to determine whether allopurinol improves cardiovascular outcomes in patients with IHD. Methods and analysis The ALL-HEART study is a multicentre, controlled, prospective, randomised, open-label blinded end point (PROBE) trial of allopurinol (up to 600 mg daily) versus no treatment in a 1:1 ratio, added to usual care, in 5215 patients aged 60 years and over with IHD. Patients are followed up by electronic record linkage and annual questionnaires for an average of 4 years. The primary outcome is the composite of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Secondary outcomes include all-cause mortality, quality of life and cost-effectiveness of allopurinol. The study will end when 631 adjudicated primary outcomes have occurred. The study is powered at 80% to detect a 20% reduction in the primary end point for the intervention. Patient recruitment to the ALL-HEART study started in February 2014. Ethics and dissemination The study received ethical approval from the East of Scotland Research Ethics Service (EoSRES) REC 2 (13/ES/0104). The study is event-driven and results are expected after 2019. Results will be reported in peer-reviewed journals and at scientific meetings. Results will also be disseminated to guideline committees, NHS organisations and patient groups. Trial registration number 32017426, pre-results. PMID:27609859

  2. Association between Vitamin D Status and Coronary Heart Disease among Adults in Saudi Arabia: A Case-Control Study.

    Science.gov (United States)

    Aljefree, Najlaa M; Lee, Patricia; Alsaqqaf, Jamal M; Ahmed, Faruk

    2016-10-17

    Recent evidence has pointed out an association between vitamin D deficiency and coronary heart disease (CHD). Due to the growing epidemic of CHD and vitamin D deficiency in Saudi Arabia, exploring the role of vitamin D in the prevention of CHD is crucial. The aim of this study was to examine the association between vitamin D status and CHD in Saudi Arabian adults. This case-control study included 130 CHD cases and 195 age-sex matched controls. Study subjects were recruited from three hospitals in the western region of Saudi Arabia. Study participants were interviewed face-to-face to collect data on their socio-demographic characteristics and family history of CHD. Fasting blood samples were collected, and serum levels of vitamin D, glucose, and total cholesterol were measured. Body weight, height, and blood pressure measurements were also recorded. Severe vitamin D deficiency (25(OH)D Saudi adults.

  3. Morphology characterization and biocompatibility study of PLLA (Poly-L-Llactid-Acid) coating chitosan as stent for coronary heart disease

    Science.gov (United States)

    Widiyanti, Prihartini; Paramadini, Adanti W.; Jabbar, Hajria; Fatimah, Inas; Nisak, Fadila N. K.; Puspitasari, Rahma A.

    2016-03-01

    Cardiovascular disease is a global disease with high urgency. In the severe case of coronary heart disease while a blockage in the coronary arteries reach 75% or more, the patient required stent implantation. Stents are made of metal which has many limitations that can lead to blood clots and stent incompatibility toward the size of the blood vessels. There is a metal stent replacement solution that made from polymer material which is biocompatible. PLLA also has biocompatibility and good mechanical strength. PLLA stent will be coated with chitosan as a candidate for drug-coated stents which is able to work as a drug carrier. The aim of this study is to know the morphology information and biocompability status of PLLA coating chitosan as candidate of heart stent. Morphological results using SEM showed a smooth surface structure which reinforced clinical standard of stent material. Results of cytotoxicity test by MTT Assay method showed that the result of four samples in this experiment living cells is reached 90% which is non toxic and safe to use in the human body. %). The conclusion of this study is PLLA is polymer has potency to be used as stent material.

  4. A pilot study on the effects of heart rate variability biofeedback in patients with depression and in healthy subjects.

    Science.gov (United States)

    Siepmann, Martin; Aykac, Volkan; Unterdörfer, Jana; Petrowski, Katja; Mueck-Weymann, Michael

    2008-12-01

    Decreased vagal activity and increased sympathetic arousal have been proposed as major contributors to the increased risk of cardiovascular mortality in patients with depression. It was aim of the present study to assess the feasibility of using heart rate variability (HRV) biofeedback to treat moderate to severe depression. This was an open-label study in which 14 patients with different degrees of depression (13 f, 1 m) aged 30 years (18-47; median; range) and 12 healthy volunteers attended 6 sessions of HRV biofeedback over two weeks. Another 12 healthy subjects were observed under an active control condition. At follow up BDI was found significantly decreased (BDI 6; 2-20; median 25%-75% quartile) as compared to baseline conditions (BDI 22;15-29) in patients with depression. In addition, depressed patients had reduced anxiety, decreased heart rate and increased HRV after conduction of biofeedback (p biofeedback nor in normal controls. In conclusion, HRV biofeedback appears to be a useful adjunct for the treatment of depression, associated with increases in HRV.

  5. EFFECT OF ERYTHROPOIETIN ON THE CLINICAL COURSE OF CHRONIC HEART FAILURE IN PATIENTS WITH ANEMIA: RESULTS OF NOT COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    V. M. Provotorov

    2011-01-01

    Full Text Available Aim. To study the clinical efficacy of corrective therapy of anemia in patients with chronic heart failure (CHF and ischemic heart disease (IHD. Material and methods. Patients (n=58; 32 female, 26 male; aged 47-85 years with IHD and CHF with left ventricular ejection fraction (LVEF <45% were included into the study. They received basic CHF therapy. Patients (n=12 with iron deficiency anemia also received erythropoietin and iron containing drugs during 12 weeks. Clinic and instrumental examination was performed before and after the treatment. Exercise tolerance was evaluated by 6-minute walk test. Results. The anemia was revealed in 14 (24.8% patients, including 12 patients with iron deficiency anemia. By the end of 12 week therapy with erythropoietin and iron containing drugs significant increase (+36% in 6-minute walk distance and LVEF (+32.5%, improvement of CHF NYHA functional class were observed. Besides increase in hemoglobin (+12.5%; p<0.001 and hematocrit (+5.8%; p<0.001 levels, as well as increase in red blood cells number (+8%; p<0.001 were found. Conclusion. In patients with CHF and IHD correction of anemia with erythropoietin and iron containing drugs additionally to the basic CHF/IHD therapy leads to a significant clinical and functional improvement.

  6. Association between ABO Blood Group and Risk of Congenital Heart Disease: A 6-year large cohort study

    Science.gov (United States)

    Zu, Bailing; You, Guoling; Fu, Qihua; Wang, Jing

    2017-01-01

    ABO blood group, except its direct clinical implications for transfusion and organ transplantation, is generally accepted as an effect factor for coronary heart disease, but the associations between ABO blood group and congenital heart disease (CHD) are not coherent by previous reports. In this study, we evaluated the the potential relationship between ABO blood group and CHD risk. In 39,042 consecutive inpatients (19,795 CHD VS 19,247 controls), we used multivariable logistic regression to evaluate the roles of ABO blood group, gender, and RH for CHD. The associations between ABO blood group and CHD subgroups, were further evaluated using stratification analysis, adjusted by gender. A blood group demonstrated decreased risk for isolated CHD (OR 0.82; 95% CI, 0.78–0.87) in individuals with A blood group in the overall cohort analysis, and the finding was consistently replicated in independent subgroup analysis. ABO blood group may have a role for CHD, and this novel finding provides ABO blood group as a possible marker for CHD, but more studies need to be done. PMID:28211529

  7. Real-time Assessment of Heart Rate Variability and Loss of Control Eating in Adolescent Girls: A pilot study

    Science.gov (United States)

    Ranzenhofer, Lisa M.; Engel, Scott G.; Crosby, Ross D.; Haigney, Mark; Anderson, Micheline; McCaffery, Jeanne M.; Tanofsky-Kraff, Marian

    2015-01-01

    Objective Studying physiologic underpinnings of loss-of-control (LOC) eating may inform its etiology and contribute to intervention efforts. We therefore examined temporal relationships between autonomic indices (heart rate (HR), heart rate variability (HRV)) and LOC-eating in the natural environment. Method For two days, adolescents (n=17, 14.77±1.55 years, BMI-Z 2.17±0.48) with LOC-eating reported on LOC using an electronic device while HR and HRV were assessed continuously using Holter monitoring. Results Higher HR and lower HRV in the 30-minutes before eating were significantly associated with LOC-eating overall (p’s 0.44). Examined categorically, HR was significantly higher, and HRV significantly lower, prior to high-LOC compared to low-LOC episodes (p’s < 0.001). Discussion This pilot study suggests that LOC-eating may involve physiologic underpinnings. Additional research with larger samples is needed to further investigate this phenomenon. PMID:26401652

  8. Effects of Heart Rate Variability Biofeedback on EEG Alpha Asymmetry and Anxiety Symptoms in Male Athletes: A Pilot Study.

    Science.gov (United States)

    Dziembowska, Inga; Izdebski, Paweł; Rasmus, Anna; Brudny, Janina; Grzelczak, Marta; Cysewski, Piotr

    2016-06-01

    Heart rate variability biofeedback (HRV-BFB) has been shown as useful tool to manage stress in various populations. The present study was designed to investigate whether the biofeedback-based stress management tool consisting of rhythmic breathing, actively self-generated positive emotions and a portable biofeedback device induce changes in athletes' HRV, EEG patterns, and self-reported anxiety and self-esteem. The study involved 41 healthy male athletes, aged 16-21 (mean 18.34 ± 1.36) years. Participants were randomly divided into two groups: biofeedback and control. Athletes in the biofeedback group received HRV biofeedback training, athletes in the control group didn't receive any intervention. During the randomized controlled trial (days 0-21), the mean anxiety score declined significantly for the intervention group (change-4 p biofeedback group showed substantial and statistically significant improvement in heart rate variability indices and changes in power spectra of both theta and alpha brain waves, and alpha asymmetry. These changes suggest better self-control in the central nervous system and better flexibility of the autonomic nervous system in the group that received biofeedback training. A HRV biofeedback-based stress management tool may be beneficial for stress reduction for young male athletes.

  9. ASSOCIATION OF HYPERTENSION AND AGE WITH CORONARY HEART DISEASE: A CROSS - SECTIONAL STUDY FROM DARBHANGA DISTRICT OF BIHAR

    Directory of Open Access Journals (Sweden)

    Sheela

    2015-07-01

    Full Text Available INTRODUCTION: The epidemic of cardiovascular diseases ( C oronary heart disease & stroke is advancing rapidly in India. Elevation of blood pressure for both men and women increases the risk of coronary heart disease (CHD. OBJECTIVES: to study the association between age and hypertension (HTN with CHD. MATERIALS & METHODS: This was a cross - sectional study done among all the fourth grade staffs of Darbhanga Medical College, aged between 20 to 50 years, from Jan . 2015 to Mar . 2015. Study subjects were selected by simple random sampling. Sample size was estimated to be 642. Observation: It was observed that 39.68% of the total study population was found to be hypertensive, among which 39.89% of the population were males and 25% were females. The association between HTN and CHD in the present study was found to be statistically very highly significant (p<0.001. It was also observed in that maximum prevalence of HTN (70.59% among the study subject was in the age group of 50 - 59 years and the overall prevalence of HTN among the study population was found to be 39.67%. The association of the prevalence of CHD with the increase in age was found to be statistically significant (p<0.001. CONCLUSION: It was concluded from our study that the overall prevalence of CHD was 5.16% and the maximum prevalence of CHD was found in the age group of 50 - 59 years. A positive association was observed between advancement of age and increased prevalence of CHD. Also, a significant association between HTN and the prevalence of CHD was observed. RECOMMENDATIONS: Periodic screening of diseases like HTN, diabetes mellitus, obesity, dyslipidemia, etc. should be done with age. Persons having sedentary life - styles should be encouraged to undergo regular physical exercises.

  10. Joint statement of the European Association for the Study of Obesity and the European Society of Hypertension: obesity and heart failure.

    Science.gov (United States)

    Jordan, Jens; Toplak, Hermann; Grassi, Guido; Yumuk, Volkan; Kotsis, Vasilios; Engeli, Stefan; Cuspidi, Cesare; Nilsson, Peter M; Finer, Nick; Doehner, Wolfram

    2016-09-01

    Obese individuals are more likely to develop heart failure. Yet, once heart failure is established, the impact of overweight and obesity on prognosis and survival is unclear. The purpose of this joint scientific statement of the European Association for the Study of Obesity and the European Society of Hypertension is to provide an overview on the current scientific literature on obesity and heart failure in terms of prognosis, mechanisms, and clinical management implications. Moreover, the document identifies open questions that ought to be addressed. The need for more tailored weight management recommendations in heart failure will be emphasized and, in line with the emerging evidence, aims to distinguish between primary disease and secondary outcome prevention. In the primary prevention of heart failure, it appears prudent advising obese individuals to lose or achieve a healthy body weight, especially in those with risk factors such as hypertension or type 2 diabetes. However, there is no evidence from clinical trials to guide weight management in overweight or obese patients with established heart failure. Prospective clinical trials are strongly encouraged.

  11. Design and methodology of the NorthStar Study: NT-proBNP stratified follow-up in outpatient heart failure clinics -- a randomized Danish multicenter study

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars;

    2008-01-01

    BACKGROUND: Randomized clinical trials have shown that newly discharged and symptomatic patients with chronic heart failure (CHF) benefit from follow-up in a specialized heart failure clinic (HFC). Clinical stable and educated patients are usually discharged from the HFC when on optimal therapy....... It is unknown if risk stratification using natriuretic peptides could identify patients who would benefit from longer-term follow-up. Furthermore, data on the use of natriuretic peptides for monitoring of stable patients with CHF are sparse. AIMS: The aims of this study are to test the hypothesis that clinical...... stable, educated, and medical optimized patients with CHF with N-terminal pro-brain natriuretic peptide (NT-proBNP) levels > or = 1,000 pg/mL benefit from long-term follow-up in an HFC and to assess the efficacy of NT-proBNP monitoring. METHODS: A total of 1,250 clinically stable, medically optimized...

  12. Lack of circadian variation and reduction of heart rate variability in women with breast cancer undergoing lumpectomy: a descriptive study.

    Science.gov (United States)

    Hansen, Melissa V; Rosenberg, Jacob; Gögenur, Ismail

    2013-07-01

    Changes in the autonomic nervous system with increased sympathetic tone may be a cause of postoperative short-, and long-term cardiovascular complications. Heart rate variability (HRV) is assessed by Holter monitoring as a measure of autonomic tone and has not been investigated in patients with breast cancer undergoing surgery. We aimed to investigate evening- and night-time HRV after lumpectomy. Twelve patients were included in this descriptive study. HRV was measured the night before surgery (PREOP), the night after surgery (PO1) and 14 days after surgery (PO14) from 1900 to 0700 h. For calculation of HRV, time domain parameters (SDNN-standard deviation of all normal-to-normal (NN) intervals around the mean NN for the period of measurement, pNN50-percentage of beats where the change from one beat to the next is more than 50 ms, rMSSD-root mean square of successive differences) were used. We analyzed the variation of the overall time period and the circadian variation between evening and night (sympathetic vs. parasympathetic tonus). Mean heart rate increased from PREOP to PO1 (p parasympathetic activity and lack of circadian variation 14 days after lumpectomy.

  13. Prevalence of memory disorders in ambulatory patients aged ≥70 years with chronic heart failure (from the EFICARE study).

    Science.gov (United States)

    Hanon, Olivier; Vidal, Jean-Sébastien; de Groote, Pascal; Galinier, Michel; Isnard, Richard; Logeart, Damien; Komajda, Michel

    2014-04-01

    The aim of this multicenter observational study conducted in France was to determine the prevalence of memory impairment in ambulatory patients aged≥70 years with chronic heart failure (HF). Two hundred ninety-one cardiologists recruited 912 ambulatory patients with HF (mean age 79.2±5.8 years) from January to November 2009. Memory was evaluated by the delayed-recall Memory Impairment Screen (MIS-D). Memory impairment was defined as MIS-D score≤6 and severe memory impairment as MIS-D score≤4. HF was diagnosed 4.4±4.8 years earlier and mean left ventricular ejection fraction was 43.6±12.0%. Memory impairment was found in 416 subjects (45.6%, 95% confidence interval 42.4 to 48.8) and severe memory impairment in 213 subjects (23.4%, 95% confidence interval 20.6 to 26.1), whereas cardiologists only suspected memory impairment in 109 patients (12%; before evaluation by MIS). Determinants of memory disorders included older age, lower education level, depression, history of stroke, renal failure, and less regular physical activity. The severity of memory impairment increased with increasing severity of HF (New York Heart Association classification; p<0.00001). In conclusion, memory impairment in older patients with HF is common. The use of a simple-to-use tool such as the MIS-D may identify patients at risk and enable implementation of management strategies to improve therapeutic compliance.

  14. Plasma levels of the anti-coagulation protein C and the risk of ischaemic heart disease. A Mendelian randomisation study.

    Science.gov (United States)

    Schooling, C Mary; Zhong, Yi

    2017-01-26

    Protein C is an environmentally modifiable anticoagulant, which protects against venous thrombosis, whether it also protects against ischaemic heart disease is unclear, based on observational studies and relatively small genetic studies. It was our study aim to clarify the role of protein C in ischaemic heart disease. The risk of coronary artery disease/myocardial infarction (CAD/MI) was assessed according to genetically predicted protein C in very large studies. Associations with lipids and diabetes were similarly assessed to rule out effects via traditional cardiovascular disease risk factors. Separate sample instrumental variable analysis with genetic instruments (Mendelian randomisation) was used to obtain an unconfounded estimate of the association of protein C (based on (rs867186 (PROCR), rs3746429 (EDEM2), rs7580658 (inter/PROC)) with CAD/MI in an extensively genotyped case (n=64374)-control (n=130681) study, CARDIoGRAMplusC4D. Associations with lipids and diabetes were similarly assessed using the Global Lipids Genetics Consortium Results (n=196,475) and the DIAbetes Genetics Replication And Meta-analysis case (n=34,380)-control (n=114,981) study. Genetically predicted protein C was negatively associated with CAD/MI, odds ratio (OR) 0.85 µg/ml, 95 % confidence interval 0.80 to 0.90, but had no such negative association with lipids or diabetes. Results were similar for the SNP rs867186 functionally relevant to protein C, and including additional potentially pleiotropic SNPs (rs1260326 (GCKR), rs17145713 (BAZ1B) and rs4321325 (CYP27C1)). In conclusion, protein C may protect against CAD/MI. Whether environmental or dietary items that raise protein C protect against ischaemic cardiovascular disease by that mechanism should be investigated.

  15. Heart failure - tests

    Science.gov (United States)

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... the best test to: Identify which type of heart failure (systolic versus diastolic, valvular) Monitor your heart failure ...

  16. Problem: Heart Valve Stenosis

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  17. Healthy Heart Quizzes

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  18. Problem: Heart Valve Regurgitation

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  19. Travel and Heart Disease

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  20. Does a variation in self-reported physical activity reflect variation in objectively measured physical activity, resting heart rate, and physical fitness? Results from the Tromso study

    DEFF Research Database (Denmark)

    Emaus, Aina; Degerstrøm, Jorid; Wilsgaard, Tom

    2010-01-01

    -time and work were assessed and resting heart rate was measured. In a sub-study, the activity study, PA (Actigraph LLC) and physical fitness (VO₂(max)) were objectively measured among 313 healthy men and women aged 40-44 years. RESULTS: Self-reported leisure PA was significantly correlated with VO₂(max) (ml......AIMS: To study the association between self-reported physical activity (PA) and objectively measured PA, resting heart rate, and physical fitness. METHODS: During 2007-08, 5017 men and 5607 women aged 30-69 years attended the sixth survey of the Tromsø study. Self-reported PA during leisure...

  1. Control of whole heart geometry by intramyocardial mechano-feedback: a model study.

    Directory of Open Access Journals (Sweden)

    Theo Arts

    2012-02-01

    Full Text Available Geometry of the heart adapts to mechanical load, imposed by pressures and volumes of the cavities. We regarded preservation of cardiac geometry as a homeostatic control system. The control loop was simulated by a chain of models, starting with geometry of the cardiac walls, sequentially simulating circulation hemodynamics, myofiber stress and strain in the walls, transfer of mechano-sensed signals to structural changes of the myocardium, and finalized by calculation of resulting changes in cardiac wall geometry. Instead of modeling detailed mechano-transductive pathways and their interconnections, we used principles of control theory to find optimal transfer functions, representing the overall biological responses to mechanical signals. As biological responses we regarded tissue mass, extent of contractile myocyte structure and extent of the extra-cellular matrix. Mechano-structural stimulus-response characteristics were considered to be the same for atrial and ventricular tissue. Simulation of adaptation to self-generated hemodynamic load rendered physiologic geometry of all cardiac cavities automatically. Adaptation of geometry to chronic hypertension and volume load appeared also physiologic. Different combinations of mechano-sensors satisfied the condition that control of geometry is stable. Thus, we expect that for various species, evolution may have selected different solutions for mechano-adaptation.

  2. Study of Heart Rate Variability in bipolar disorder: linear and nonlinear parameters during sleep

    Directory of Open Access Journals (Sweden)

    Matteo eMigliorini

    2012-01-01

    Full Text Available In the present paper we propose a methodology for the assessment of the autonomic nervous system (ANS in patients affected by bipolar disorder. ANS was explored by means heart rate variability (HRV analysis carried out during night recordings through the evaluation of many different parameters in the time and in the frequency domain, linear and non-linear. The recording of the signals was performed by a wearable sensorized T-shirt. HRV with movement analysis allowed also sleep staging and the estimation of REM sleep percentage over the total sleep time. A group of 8 normal female constituted the control group, on which normality ranges were estimated. One pathologic subject was recorded during four different nights, at time intervals of at least one week, and during different phases of the disturbance. Some of the calculated parameters (MEANNN, SDNN, RMSSD confirmed reduced HRV in depression and bipolar disorder. REM sleep percentage was found to be increased. LZC (Lempel Ziv complexity and SampEn (Sample Entropy, on the other hand, seem to correlate with the depression level. Even if the number of examined subjects is small, and the results need further validation, the proposed methodology and the calculated parameters seem promising tools for the monitoring of mood changes in psychiatric disorders.

  3. A Study on Apolipoprotein E Polymorphism in Early Onset of Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    朱铁兵; 杨志健; 钱卫冲; 王连生; 马根山; 马文珠

    2003-01-01

    Objective:To assess the relationship between apolipoprotein E( apoE) polymorphism and early anset of Coronary heart disease(CHD) and the effect of apoE on lipids and lipoproteins in Chinese healthy subjects.Methods:Sixty-eight cases(CHD1) aged less than 55y,136 cases(CHD2) aged more than 65y with CHD and 136 healthy subjects were enrolled and their plamsma levels of triglyceride(TG),total cholesterol(TC) and high density lipoprotein cholesterol(HDL-C) were determined.The apoE genotypes were identified by polymerase chain reaction-restriction fragment lengths polymorphism.Results:apoE3/4 genotype and E4 allele frequency in CHD1 were higher than those in CHD2 and healthy subjects and no difference was found between CHD2 and healthy subjects.Meanwhile the plasma levels of TC and low density lipoprotein cholesterol(LDL-C) were higher in CHD2 than in either CHD1 or healthy subjects.Each apoE isoprotein has variable TC and LDL-C levels characterized by E2(E2/2+E2/3)

  4. [Study on application of SVM in prediction of coronary heart disease].

    Science.gov (United States)

    Zhu, Yue; Wu, Jianghua; Fang, Ying

    2013-12-01

    Base on the data of blood pressure, plasma lipid, Glu and UA by physical test, Support Vector Machine (SVM) was applied to identify coronary heart disease (CHD) in patients and non-CHD individuals in south China population for guide of further prevention and treatment of the disease. Firstly, the SVM classifier was built using radial basis kernel function, liner kernel function and polynomial kernel function, respectively. Secondly, the SVM penalty factor C and kernel parameter sigma were optimized by particle swarm optimization (PSO) and then employed to diagnose and predict the CHD. By comparison with those from artificial neural network with the back propagation (BP) model, linear discriminant analysis, logistic regression method and non-optimized SVM, the overall results of our calculation demonstrated that the classification performance of optimized RBF-SVM model could be superior to other classifier algorithm with higher accuracy rate, sensitivity and specificity, which were 94.51%, 92.31% and 96.67%, respectively. So, it is well concluded that SVM could be used as a valid method for assisting diagnosis of CHD.

  5. Sex differences in risk factors for coronary heart disease: a study in a Brazilian population

    Directory of Open Access Journals (Sweden)

    Oliveira Helena CF

    2001-04-01

    Full Text Available Abstract Background In Brazil coronary heart disease (CHD constitutes the most important cause of death in both sexes in all the regions of the country and interestingly, the difference between the sexes in the CHD mortality rates is one of the smallest in the world because of high rates among women. Since a question has been raised about whether or how the incidence of several CHD risk factors differs between the sexes in Brazil the prevalence of various risk factors for CHD such as high blood cholesterol, diabetes mellitus, hypertension, obesity, sedentary lifestyle and cigarette smoking was compared between the sexes in a Brazilian population; also the relationships between blood cholesterol and the other risk factors were evaluated. Results The population presented high frequencies of all the risk factors evaluated. High blood cholesterol (CHOL and hypertension were more prevalent among women as compared to men. Hypertension, diabetes and smoking showed equal or higher prevalence in women in pre-menopausal ages as compared to men. Obesity and physical inactivity were equally prevalent in both sexes respectively in the postmenopausal age group and at all ages. CHOL was associated with BMI, sex, age, hypertension and physical inactivity. Conclusions In this population the high prevalence of the CHD risk factors indicated that there is an urgent need for its control; the higher or equal prevalences of several risk factors in women could in part explain the high rates of mortality from CHD in females as compared to males.

  6. The effects of respiratory sinus arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: a pilot study.

    Science.gov (United States)

    Zucker, Terri L; Samuelson, Kristin W; Muench, Frederick; Greenberg, Melanie A; Gevirtz, Richard N

    2009-06-01

    Recent studies have found a significant association between PTSD and low heart rate variability (HRV), a biomarker of autonomic dysregulation. Research indicates that respiratory sinus arrhythmia (RSA) biofeedback increases HRV while reducing related pathological symptoms. This controlled pilot study compared RSA biofeedback to progressive muscle relaxation (PMR) as adjunctive interventions for 38 persons with PTSD symptoms in a residential treatment facility for a substance use disorder. Both groups were assessed at pre-intervention and 4-week post-intervention. Group x time interactions revealed significantly greater reductions in depressive symptoms and increases in HRV indices for the RSA group. Both groups significantly reduced PTSD and insomnia symptoms and a statistical trend was observed for reduced substance craving for the RSA group. Increases in HRV were significantly associated with PTSD symptom reduction. Overall, these results provide preliminary support for the efficacy of RSA biofeedback in improving physiological and psychological health for individuals with PTSD.

  7. Acute postoperative digitalization of patients with arteriosclerotic heart disease after major surgery. A randomized haemodynamic study and proposal for therapy.

    Science.gov (United States)

    Bille-Brahe, N E; Engell, H C; Sørensen, M B

    1980-12-01

    Twenty patients with impaired left ventricular function during exercise, who underwent major vascular surgery for arteriosclerotic disease, were randomly digitalized in the immediate postoperative period. All patients had a smooth postoperative course. Haemodynamic measurements showed improved left ventricular function in those who received digitalis, since 60 min after full digitalization the digitalized patients had a highly significant decrease in pulmonary capillary wedge pressure (PCWP) with unchanged stroke volume index (SVI) and left ventricular stroke work index (LVSWI). The same improvement in cardiac function was present the next morning. The present study provides haemodynamic data in support of clinical studies showing a beneficial effect of prophylactic digitalization in surgical patients with clinical signs of arteriosclerotic heart disease, though not in overt failure.

  8. Controlled study of myocardial recovery after interval training in heart failure: SMARTEX-HF - rationale and design

    DEFF Research Database (Denmark)

    Støylen, Asbjørn; Conraads, Viviane; Halle, Martin;

    2011-01-01

    Background: The large randomized controlled multicentre clinical trial, HF-ACTION, recently demonstrated that a programme of recommendation of regular exercise training at moderate intensity is safe, improves quality of life, and reduces the combined endpoint of all-cause death and hospitalization...... interval training at high relative intensity would yield significantly larger effects in terms of left ventricular remodelling compared to moderate continuous exercise training. Study design: In a three-armed randomized multicentre study of stable heart failure patients with left ventricular ejection...... of regular exercise (RE) of the individual patients' own preference based on clinical practice at the local centre. The primary endpoint is reverse remodelling, defined as change in left ventricular end-diastolic diameter assessed by echocardiography. Secondary endpoints include peak oxygen uptake (VO(2peak...

  9. Absence of association between the INSIG2 gene polymorphism (rs7566605) and obesity in the European Youth Heart Study (EYHS)

    DEFF Research Database (Denmark)

    Vimaleswaran, Karani S; Franks, Paul W; Brage, Soren

    2009-01-01

    (930 boys and 1,073 girls) from the European Youth Heart Study (EYHS), a school-based, cross-sectional study of pre- and early pubertal children. The association between the polymorphism and obesity traits was tested using additive and recessive models adjusted for age, age-group, gender, maturity...... of this polymorphism with obesity traits. This polymorphism has been hypothesized to alter INSIG2 expression leading to inhibition of fatty acid and cholesterol synthesis. Hence, we investigated the association of the INSIG2 rs7566605 polymorphism with obesity- and lipid-related traits in Danish and Estonian children......, the polymorphism was not associated with overweight (P = 0.87) or obesity (P = 0.34). We also did not find association with waist circumference (WC), sum of four skinfolds, or with total cholesterol, triglycerides, low-density lipoprotein, or high-density lipoprotein. There were no gender-specific (P = 0.55), age...

  10. The Land Management Pattern in " Green Heart" Area——A Case Study of Changsha-Zhuzhou-Xiangtan Urban Agglomeration

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    By analyzing the status quo of land resources in " green heart" area of Changsha-Zhuzhou-Xiangtan urban agglomeration,and problems existing in land management,this article puts forward some countermeasures and proposals as follows:establish new land management mechanism in " green heart" area;based on land planning," green heart" overall planning and policies and regulations,manage land and promote the protection of urban ecological environment.

  11. Aldosterone status associates with insulin resistance in patients with heart failure-data from the ALOFT study

    OpenAIRE

    Freel, E M; Tsorlalis, I.K.; Lewsey, J D; Latini, R; Maggioni, A.P.; Solomon, S.; Pitt, B; Connell, J M C; McMurray, J.J.V.

    2009-01-01

    Background: Aldosterone plays a key role in the pathophysiology of heart failure. In around 50% of such patients, aldosterone 'escapes' from inhibition by drugs that interrupt the renin-angiotensin axis; such patients have a worse clinical outcome. Insulin resistance is a risk factor in heart failure and cardiovascular disease. The relationship between aldosterone status and insulin sensitivity was investigated in a cohort of heart failure patients.\\ud \\ud Methods: 302 patients with New York ...

  12. Tag-based Heart Rate Measurements of Harbor Porpoises During Normal and Noise-exposed Dives to Study Stress Responses

    Science.gov (United States)

    2014-09-30

    1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Tag-based Heart Rate Measurements of Harbor Porpoises...The typical mammalian startle or stress response to an acoustic stressor is increased heart rate, cardiac output and ventilation rate (Graham 1979...routinely experience. Here we propose to examine the dive heart rate, ventilation rate and activity in both captive and wild porpoise to better understand

  13. Coronary heart disease mortality among young adults in Scotland in relation to social inequalities:time trend study

    OpenAIRE

    O'Flaherty, Martin; Bishop, Jennifer; Redpath, Adam; McLaughlin, Terry; Murphy, David; Chalmers, James; Capewell, Simon

    2009-01-01

    Objective To examine recent trends and social inequalities in age specific coronary heart disease mortality.Design Time trend analysis using joinpoint regression.Setting Scotland, 1986-2006.Participants Men and women aged 35 years and over.Main outcome measures Age adjusted and age, sex, and deprivation specific coronary heart disease mortality.Results Persistent sixfold social differentials in coronary heart disease mortality were seen between the most deprived and the most affluent groups a...

  14. STUDY OF RISK FACTORS AND LABORATORY PROFILE IN UNDER 15 YEARS AGE GROUP CHILDREN WITH ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    Ramu

    2015-03-01

    Full Text Available CONTEXT : BACKGROUND : Acute Rheumatic fever / Rheumatic Heart disease is the most common acquired child hood heart disease diagnosis made in India and is consistently associated with poverty and overcrowding. There is no single symptom , sign or laboratory test that is diagnostic of Acute Rheumatic fever and carditis . Revised , edited and updated Jones criteria are guidelines to assist practitioners and are not a substitute for clinical judgment . The main concern in liberalizing these criteria in developed countries may be over diagnosis of Acute Rheumatic fever. AIMS & OBJECTIVES: To study the risk factors and laboratory profile in children with Acute Rheumatic fever / Rheumatic Heart d isease. MATERIALS & METHODS: The Study was conducted for 2 years period in a tertiary care hospital on less than 15 years children diagnosed as Acute Rheumatic fever / Rheumatic Heart disease. RESULTS: In our study all the cases (100% , 36 cases belongs to Lower socio economic status. Overcrowding is noted in all 36 cases (100% and we noticed rural predilection in 91.7% (33 cases cases. CONCLUSION: Basing on the results of our study we conclude that lower socio economic status , overcrowding (100% cases a nd rural predilection (91.7% are frequent associate risk factors of Acute Rheumatic fever / Rheumatic Heart disease. Further we found Anemia (88.89% , positive C.R.P (86.11% , and A.S.O titer more than 400 I.U/ml in (69.44% as common laboratory abnormali ties.

  15. Paradoxical dissociation between heart rate and heart rate variability following different modalities of exercise in individuals with metabolic syndrome: The RESOLVE study.

    Science.gov (United States)

    Boudet, Gil; Walther, Guillaume; Courteix, Daniel; Obert, Philippe; Lesourd, Bruno; Pereira, Bruno; Chapier, Robert; Vinet, Agnès; Chamoux, Alain; Naughton, Geraldine; Poirier, Paul; Dutheil, Frédéric

    2017-02-01

    Aims To analyse the effects of different modalities of exercise training on heart rate variability (HRV) in individuals with metabolic syndrome (MetS). Methods and results Eighty MetS participants (aged 50-70 years) were housed and managed in an inpatient medical centre for 21 days, including weekends. Physical activity and food intake/diet were intensively monitored. Participants were randomly assigned into three training groups, differing only by intensity of exercise: moderate-endurance-moderate-resistance ( re), high-resistance-moderate-endurance ( Re), and moderate-resistance-high-endurance ( rE). HRV was recorded before and after the intervention by 24-hour Holter electrocardiogram. Although mean 24-hour heart rate decreased more in Re than re (-11.6 ± 1.6 vs. -4.8 ± 2.1%; P = 0.010), low frequency/high frequency decreased more in re than Re (-20.4 ± 5.5% vs. + 20.4 ± 9.1%; P = 0.002) and rE (-20.4 ± 5.5% vs. -0.3 ± 11.1%; P = 0.003). Very low frequency increased more in Re than re (+121.2 ± 35.7 vs. 42.9 ± 11.3%; P = 0.004). For all HRV parameters, rE ranged between re and Re values. Low frequency/high frequency changes were linked with visceral fat loss only in re (coefficient 5.9, 95% CI 1.9-10.0; P = 0.004). By day 21, HRV parameters of MetS groups (heart rate -8.6 ± 1.0%, standard deviation of R-R intervals + 34.0 ± 6.6%, total power + 63.3 ± 11.1%; P < 0.001) became closer to values of 50 aged-matched healthy controls. Conclusions A 3-week residential programme with intensive volumes of physical activity (15-20 hours per week) enhanced HRV in individuals with MetS. Participants with moderate intensity of training had greater improvements in sympathovagal balance, whereas those with high intensity in resistance training had greater decreases in heart rate and greater increases in very low frequency. Modality-specific relationships were observed between enhanced HRV

  16. Women's Heart Disease: Heart Disease Risk Factors

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table of ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk factors. ...

  17. Women's Heart Disease: Heart Attack Symptoms

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter 2014 Table ... NHLBI has uncovered some of the causes of heart diseases and conditions, as well as ways to prevent ...

  18. Heart Health: The Heart Truth Campaign 2009

    Science.gov (United States)

    ... Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table of ... of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) and ...

  19. Heart failure in patients treated with bisphosphonates

    DEFF Research Database (Denmark)

    Grove, Erik; Abrahamsen, B; Vestergaard, P

    2013-01-01

    The aim of this study was to investigate the occurrence of heart failure in patients treated with bisphosphonates.......The aim of this study was to investigate the occurrence of heart failure in patients treated with bisphosphonates....

  20. Gallstones Linked to Higher Heart Disease Risk

    Science.gov (United States)

    ... news/fullstory_160497.html Gallstones Linked to Higher Heart Disease Risk Researcher says study highlights a connection between ... may have a slightly increased risk of developing heart disease down the road, a large new study suggests. ...

  1. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    2009170 Curcumin attenuates left ventricular dysfunction and remodeling in rabbits with chronic heart failure. TANG Yanhong(唐艳红),et al.Dept Cardiol,Renmin Hosp,Wuhan Univ,Wuhan 430060.Chin J Cardiol,2009;37(3):262-267.

  2. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008411 Expression of S100B during heart failure in rats. JIANG Zhenni(蒋珍妮), et al. Dept Cardiol, 2nd Affili Hosp, Zhejiang Univ, Coll Med Hangzhou 310009. Chin J Emerg Med 2008;17(5):475-478. Objective To evaluate the value of S100B gene on cardiovascular remodeling in rats with abdominal aorta coarctation.

  3. Health locus of control and the sense of self-efficacy in patients with systolic heart failure: a pilot study

    Directory of Open Access Journals (Sweden)

    Rydlewska A

    2013-04-01

    Full Text Available Agnieszka Rydlewska,1,2 Justyna Krzysztofik,3 Julia Libergal,3 Agata Rybak,3 Waldemar Banasiak,1 Piotr Ponikowski,1,2 Ewa A Jankowska1,21Centre for Heart Diseases, Department of Cardiology, Military Hospital, Wroclaw, Poland; 2Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; 3Student’s Scientific Organization, Laboratory for Applied Research on Cardiovascular System, Wroclaw Medical University, Wroclaw, PolandBackground: Treatment of heart failure (HF requires the lifelong adherence to medical self-care regimes. The objective of this study was to examine health-control beliefs and the sense of self-efficacy (psychological features particularly important for efficient compliance among patients suffering from chronic diseases in patients with systolic HF in relation to clinical status and depressive symptoms.Subjects and methods: Sixty-six consecutive patients with chronic systolic HF, hospitalized in the Centre for Heart Diseases, Military Hospital (94% men, age: 61 ± 11 years, ischemic etiology: 63%, left ventricular ejection fraction: 32% ± 12%, filled in (during their hospital stay: (1 the Multidimensional Health Locus of Control Scale measuring three possible localizations of health control: “internality” (ie, the belief that health status depends only on personal decisions and behaviors; “powerful others externality” ([PHLC subscale] ie, the conviction that health depends on “powerful people” such as doctors, family members, close friends, and “chance externality” (ie, belief that health status is determined by chance, fate, or luck, and (2 the Generalized Self-Efficacy Scale. The results obtained by HF patients were compared to those reported by patients with other chronic diseases and healthy subjects.Results: In patients with HF, internality was similar to values obtained by patients with diabetes, men after myocardial infarction, and women after mastectomy; and was lower than in healthy

  4. Heart rates during competitive orienteering.

    OpenAIRE

    Bird, S R; Bailey, R.; Lewis, J.

    1993-01-01

    This study investigated the heart rate profiles of 16 experienced, competitive orienteers (aged 15-62 years) during three competitive events. Each competitor was assessed over three different types of course which were classified as: fast run (FR), slow run (SR) and highly physical (HP). The results showed that all subjects recorded heart rates that were between 140 and 180 beats min-1 for the majority of each event (irrespective of age or course type). The heart rate data indicated that the ...

  5. Long-term prognosis of asthma, chronic obstructive pulmonary disease, and asthma-chronic obstructive pulmonary disease overlap in the Copenhagen City Heart study

    DEFF Research Database (Denmark)

    Lange, Peter; Çolak, Yunus; Ingebrigtsen, Truls Sylvan

    2016-01-01

    focus on individuals with asthma-COPD overlap. METHODS: We assigned participants from the Copenhagen City Heart Study into six subgroups: healthy never-smokers, ever-smokers without asthma and COPD, those with asthma with low cumulated smoking exposure and no airflow limitation, those with COPD, those...... mixed-effects model. FINDINGS: We included 8382 participants from the Copenhagen City Heart Study in our study: 2199 never-smokers, 5435 ever-smokers, 158 with asthma, 320 with COPD, 68 with asthma-COPD overlap with early-onset asthma, and 202 with asthma-COPD overlap with late-onset asthma...

  6. Linkage of the cholesterol 7α-hydroxylase gene and low-density lipoprotein cholesterol conditional on apolipoprotein E association: the National Heart, Lung, and Blood Institute Family Heart Study

    Institute of Scientific and Technical Information of China (English)

    Jing-Ping Lin; Richard H. Myers; Laura Almasy; Hilary H. Coon; Donna K. Arnett; Yuling Hong; Steven C. Hunt

    2005-01-01

    Background Genetic factors account for approximately 50% of the individual variation in plasma low-density lipoprotein cholesterol (LDL-C) concentrations in the general population. Several candidate genes have been proposed but their relative contributions to the variance in LDL-C are not known, except for apolipoprotein E (apoE). We report here an investigation of the relationship between LDL-C and cholesterol 7α-hydroxylase (CYP7), as well as apoE and low-density lipoprotein receptor (LDLR), three pivotal genes in LDL metabolism. Methods Our study population included more than 200 nuclear families with increased coronary heart disease (CHD) risk from the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Variance-component linkage methods, a measured genotype approach, and a variance-component linkage analysis conditional on a measured genotype association were used. Results The results showed significant linkage between a genetic determinant of plasma LDL-C concentrations and a polymorphism near CYP7 with its allelic variation accounting for 27% of the total LDL-C variation. There is significant association between plasma LDL-C concentrations and apoE genotypes. Conditional on the apoE association, the total LDL-C variation accounted by allelic variation of a polymorphism near CYP7 was increased significantly.Conclusion Our results suggest the apoE and CYP7 may be two important genes accounting for the genetic variation of plasma LDL-C concentrations in a population with cardiovascular diseases.

  7. Tissue-type plasminogen activator and C-reactive protein in acute coronary heart disease. A nested case-control study

    DEFF Research Database (Denmark)

    Gram, J; Bladbjerg, E-M; Møller, L

    2000-01-01

    OBJECTIVES: To study the importance of inflammation and fibrinolysis for evolution of ischaemic heart disease in a cohort of initially healthy subjects. DESIGN: Nested case-control study. Follow-up periods 7-15 years. SUBJECTS: Included in the study were 133 cases with coronary heart disease...... and 258 controls. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Subjects with ischaemic heart disease identified in 1991 by the Danish National Hospital Register. Protein concentration of C-reactive protein (CRP) and tissue-type plasminogen activator (t-PA) were measured with ELISA methods in stored serum...... samples. RESULTS: CRP and t-PA concentrations were both significantly higher in cases than in controls (P difference between cases and controls for CRP and t-PA was present in both men (CRP: P = 0.022; t-PA: P = 0.001) and women (CRP: P = 0.013; t-PA: P = 0...

  8. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... slow down or stop. A risk factor for heart disease is something that increases your chance of getting ...

  9. Diabetic Heart Disease

    Science.gov (United States)

    ... be coronary heart disease (CHD), heart failure, and diabetic cardiomyopathy. Diabetes by itself puts you at risk for heart disease. Other risk factors include Family history of heart disease Carrying extra ...

  10. Classes of Heart Failure

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Classes of Heart Failure Updated:Sep 28,2016 Doctors usually classify patients' ... Blood Pressure Tracker Find additional helpful resources here Heart Failure • Home • About Heart Failure Introduction Types of Heart ...

  11. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  12. The Effect of Resting Heart Rate on the New Onset of Microalbuminuria in Patients With Type 2 Diabetes: A Subanalysis of the ROADMAP Study.

    Science.gov (United States)

    Schmieder, Roland E; Bramlage, Peter; Haller, Hermann; Ruilope, Luis M; Böhm, Michael

    2016-04-01

    The association between resting heart rate and new-onset microalbuminuria in patients with type 2 diabetes is not clear. The objective of the current analysis was to assess the relationship between heart rate and incidence of microalbuminuria in patients with type 2 diabetes. Data from the Randomised Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) study were retrospectively analyzed. New-onset microalbuminuria was documented and related to heart rate as recorded at baseline and last assessment, and the mean of the measurements taken during the double-blind part of the ROADMAP trial. Patients (n = 4299) had a mean age of 57.8 ± 8.7 years and 46.3% were male. Characteristics were not different between the olmesartan and the placebo groups, except for a higher systolic blood pressure (136.7 vs 135.7 mm Hg; P = 0.04) and albumin creatinine ratio (5.9 vs 5.5; P = 0.03). Increased risk of microalbuminuria was found with increasing heart rate, independent of whether baseline [highest vs lowest quartile odds ratio (OR) 1.39; 95% confidence interval (95% CI) 1.03-1.87; P = 0.032], last assessment (OR 1.71; 95% CI 1.26-2.31; P = 0.001), or mean heart rate was considered (OR: 1.77; 95% CI: 1.30-2.41; P = 0.0003). The greater risk of new-onset microalbuminuria with a high baseline heart rate was also found when data were adjusted for mean systolic blood pressure (OR: 1.35; 95% CI: 1.00-1.82; P = 0.0496; interaction P microalbuminuria was less frequent in patients receiving olmesartan in the low heart rate quartiles (P = 0.002 for trend). A low heart rate reduces the risk of patients with type 2 diabetes developing microalbuminuria, independent of blood pressure. The data demonstrate potential benefits of reducing the heart rate of type 2 diabetes patients, and indicate that olmesartan could, in particular, reduce the risk of microalbuminuria in patients with low heart rate.

  13. [Efficacy and safety analysis of ivabradine hydrochloride treatment of Chinese patients with chronic heart failure: subgroup analysis of Chinese patients in the SHIFT study].

    Science.gov (United States)

    Hu, D Y; Huang, D J; Yuan, Z Y; Zhao, R P; Yan, X W; Wang, M H

    2017-03-24

    Objective: To evaluate the efficacy and safety of ivabradine for the treatment of Chinese patients with chronic heart failure based on the Chinese subgroup data of the systolic heart failure treatment with the I(f) inhibitor ivabradine trial (SHIFT). Method: A total of 6 558 stable outpatients who presented symptoms of heart failure, with a left ventricular ejection fraction (LVEF) ≤35%, sinus rhythms with a heart rate ≥70 bpm participated in the randomized, double-blind, placebo-controlled, international multicenter clinical study.The subset of Chinese patients with heart rate ≥75 bpm was enrolled in the post-hoc subgroup analyses.Patients were randomly allocated by computer-generated assignment through a telephone interactive voice response system to ivabradine group (starting dose 5 mg bid, which was then uptitrated to the maximum 7.5 mg bid) or matched placebo group.The clinical baseline characteristics of participants were obtained and analyzed.The primary outcome endpoint was a composite endpoint of cardiovascular death or hospitalization resulting from worsening HF.The primary safety endpoint included total incidence of adverse events during the study, bradycardia, and adverse visual reaction (phosphenes). Results: A total of 49 Chinese centers enrolled a total of 225 patients with chronic heart failure, of whom, 106 patients were randomized to the ivabradine group and the other 119 patients to the placebo group, and the mean follow-up time was (15.6±5.1) months.By the end of the study, mean heart rate (71.0 bpm vs. 80.3 bpm, Pivabradine group than in the placebo group.The total number of adverse events (129 events, 49.6% PY) in the ivabradine group was lower than that in the placebo group (203 events, 50.8% PY). In the ivabradine group and the placebo group, there were respectively 2 patients (1.9%) and 0 patients experienced bradycardia, 3 patients (2.9%) and 1 patient (0.8%) experienced adverse visual reaction (phosphenes). Conclusions: Ivabradine

  14. The effect of a single session of short duration heart rate variability biofeedback on EEG: a pilot study.

    Science.gov (United States)

    Prinsloo, Gabriell E; Rauch, H G Laurie; Karpul, David; Derman, Wayne E

    2013-03-01

    This pilot study examines the effect of heart rate variability (HRV) biofeedback on measures of electroencephalogram (EEG) during and immediately after biofeedback. Eighteen healthy males exposed to work-related stress, were randomised into an HRV biofeedback (BIO) or a comparative group (COM). EEG was recorded during the intervention and during rest periods before and after the intervention. Power spectral density in theta, alpha and beta frequency bands and theta/beta ratios were calculated. During the intervention, the BIO group had higher relative theta power [Fz and Pz (p biofeedback after a single training session was associated with changes in EEG suggestive of increased internal attention and relaxation both during and after the intervention. However, the comparative intervention was associated with changes suggestive of increased mental effort and possible anxiety during and after the intervention.

  15. Extreme lipoprotein(a) levels and risk of myocardial infarction in the general population: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Kamstrup, P.R.; Benn, M.; Tybjaerg-Hansen, A.

    2008-01-01

    estimates. METHODS AND RESULTS: We examined 9330 men and women from the general population in the Copenhagen City Heart Study. During 10 years of follow-up, 498 participants developed MI. In women, multifactorially adjusted hazard ratios for MI for elevated lipoprotein(a) levels were 1.1 (95% CI, 0.6 to 1...... bias, and lack of absolute risk estimates in the general population. We tested the hypothesis that extreme lipoprotein(a) levels predict MI in the general population, measuring levels shortly after sampling, correcting for regression dilution bias, and calculating hazard ratios and absolute risk...... observed a stepwise increase in risk of MI with increasing levels of lipoprotein(a), with no evidence of a threshold effect. Extreme lipoprotein(a) levels predict a 3- to 4-fold increase in risk of MI in the general population and absolute 10-year risks of 20% and 35% in high-risk women and men...

  16. Could vitamin D supplements be a new therapy for heart failure? Possible pathogenic mechanisms from data of intervention studies.

    Science.gov (United States)

    Dalbeni, Andrea; Delva, Pietro; Minuz, Pietro

    2014-10-01

    Vitamin D deficiency may play a role in the pathogenesis of chronic heart failure (HF), but whether giving patients supplements to raise vitamin D into the normal range improves their survival is not clear. It has been demonstrated that vitamin D deficiency is common in patients with HF, especially the elderly, in obese and in dark skinned people, and that low vitamin D levels are associated with adverse outcome. The epidemiological data have been confirmed by experimental data, which show that knockout mice for the vitamin D receptor developed myocardial hypertrophy and dysfunction. Data from interventional studies are scarce and discordant, and more research is urgently needed to confirm whether add-on supplementation therapy with vitamin D has a role in the management of patients with chronic HF.

  17. Progress in the study of the pulmonary embolism in congestive heart failure%心力衰竭并发肺动脉栓塞研究进展

    Institute of Scientific and Technical Information of China (English)

    陈远刚

    2014-01-01

    Many clinical manifestations of congestive heart failure are similar to that of pulmonary embolism. Pulmonary embolism is a common complication of heart failure. The prognosis will be worse when a heart failure patient was complicated with pulmonary embolism. Here we briefly review the progress in the study of the pulmonary embolism in congestive heart failure from the aspects of etiopathogenisis,risk factor,clinical manifestation,diagnosis and prognosis,precaution and treatment. We hope that it may provide some informa-tion and study strategies for the diagnosis and precaution of the pulmonary embolism in congestive heart failure.%充血性心力衰竭(CHF)在许多临床表现上与肺动脉栓塞相似,而前者易并发后者,两者一旦合并存在,即提示患者预后更为恶劣。该文从发病原因、危险因素、临床表现、诊断与预后、预防及治疗等方面复习近年心力衰竭并发肺动脉栓塞研究进展,以期能在诊断及预防CHF并发肺动脉栓塞等方面提供相关的信息和思路。

  18. Early recognition of heart failure in patients with diabetes type 2 in primary care. A prospective diagnostic efficiency study. (UHFO-DM2

    Directory of Open Access Journals (Sweden)

    de Wit G Ardine

    2009-12-01

    Full Text Available Abstract Background We hypothesize that the prevalence of unknown heart failure in diabetic patients aged 60 years and over is relatively high (15% or more and that a cost-effective strategy can be developed to detect heart failure in these patients. The strategy is expected to include some signs and symptoms (such as dyspnoea, orthopnoea, pulmonary crepitations and laterally displaced apical beat, natriuretic peptide measurements (Amino-terminal B-type natriuretic peptide and possibly electrocardiography. In a subset of patients straightforward echocardiography may show to be cost-effective. With information from our study the detection of previously unknown heart failure in diabetic patients could be improved and enable the physician to initiate beneficial morbidity and mortality reducing heart failure treatment more timely. Primary objectives - To assess the prevalence of (previously unrecognised heart failure in primary care patients with diabetes type 2. - To establish the most cost-effective diagnostic strategy to detect unrecognised heart failure in these patients. Secondary objectives - To assess the impact of heart failure, and the combination of a new diagnosis with accordingly treatment in patients with diabetes type 2 on health status. Methods/Design Design: A prospective diagnostic efficiency study. Patient population: Patients aged 60 years and older with diabetes type 2 from primary care, enlisted with the diabetes service of the Diagnostic Center in Etten-Leur (SHL All participants will be investigated at the cardiology out-patient department of the regional hospital (Oosterschelde Hospital in Goes, Zeeland, the Netherlands during a single 1.5 hour standardised diagnostic assessment, including history taking, physical examination, electrocardiography, echocardiography, blood tests, and Health status questionnaires. Patients will be asked if we can contact them afterwards for follow-up and for repeating the questionnaires after

  19. Effects of a 14-month low-cost maintenance training program in patients with chronic systolic heart failure: a randomized study

    DEFF Research Database (Denmark)

    Prescott, Eva; Hjardem-Hansen, Rasmus; Dela, Flemming;

    2009-01-01

    BACKGROUND: Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning. METHODS: Study base consisted of all patients diagnosed with CHF...... in a 3-year period. Sixty-six patients with systolic CHF (ejection fraction Heart Association II-III) were randomized to 12 months of either usual care orhome-based maintenance exercise with group training sessions every 2 weeks after an initial 8-week training program. The primary endpoint...

  20. Study of some risk factors and accelerating factors of heart attack and the delay reasons in referring to theMazandaran Cardiac Center in 2009

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    Hedayat Jafari

    2009-01-01

    Full Text Available 12 3 4 (Received 21 October, 2009 ; Accepted 13 January, 2010AbstractBackground and purpose: Coronary artery disease (CAD particularly of the acute myocardial infraction (MI is one of the main causes of mortality in the developing countries. Considering the complication of the disease, the aim of this study was to investigate risk and accelerating factors of heart attack and the reason of the patients' delay in referring to Mazandaran Cardiac Center in 2009.Materials and methods: This cross-sectional study was preformed on 200 acute myocardial infarction (AMI patients. The criteria of diagnosis for AMI in this study was ST elevation of ECG, increase of CKMB above 25 in three phases and increase of Troponin-1 above 1nd/ml and also LDH increase: The demographic information, history of having specific and related disease and the heart attack accelerating factors and the reason of delay in referring to cardiac center was recorded in questionnaire. The collected data were coded, then analyzed by X2 test and ANOVA test using u. SPSS soft wave.Results: Of 200 patients under study, 57% were male. With mean age and BMI of 62.02 years and of 26.66 respectively. The major risk factor in incidence of heart attack in this study first was high blood pressure (24.7 % and the second one was diabetes mellitus 15.5 %. The accelerating factors of heart attack were heavy physical activity (25.3 %, sudden wake ups (25.2 %, and mental work along with tension (12.6 % respectively.Conclusion: Considering the risk factors and heart attack accelerating factors, providing proper education to the public, it is possible it reduce the number of heart attack cases and implement proper strategy to reduce the delay in referring of such patients to a cardiac center. J Mazand Univ Med Sci 2009; 19(73: 69-74 (Persian.