Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Heart Diseases; Myocardial Infarction; Infection; Chlamydia Infections; Cytomegalovirus Infections; Helicobacter Infections; Atherosclerosis
Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Myocardial Infarction; Venous Thromboembolism; Heart Diseases; Infection; Chlamydia Infections; Cytomegalovirus Infections; Helicobacter Infections; Herpesviridae Infections; Inflammation
Petoumenos, Kathy; Worm, Signe W
, including cardiovascular disease (CVD). It is suggested that CVD occurs earlier among HIV-positive patients compared with HIV-negative patients, and at a higher rate. Several factors have been proposed to contribute to this. First, the traditional CVD risk factors are highly prevalent in this population...
Full Text Available Atherosclerosis is a multifactorial vascular inflammatory process; however, the inciting cause for inflammation remains unclear. Two decades ago, Chlamydophila pneumoniae (formerly Chlamydia pneumoniae infection was proposed as a putative etiologic agent. We performed a PubMed search using the keywords Chlamydia and atherosclerosis in a Boolean query to identify published studies on C. pneumoniae and its role in atherogenesis, and to understand research interest in this topic. We found 1,652 published articles on this topic between 1991 and 2011. We analyzed relevant published studies and found various serological, molecular, and animal modeling studies in the early period. Encouraged by positive results from these studies, more than a dozen antibiotic clinical-trials were subsequently conducted, which did not find clinical benefits of anti-Chlamydophila drug therapy. While many researchers believe that the organism is still important, negative clinical trials had a similar impact on overall research interest. With many novel mechanisms identified for atherogenesis, there is a need for newer paradigms in Chlamydophila-atherosclerosis research.
Baker, Jason V; Lundgren, Jens D
particle changes (e.g. high-density lipoprotein particles). Some of these mechanisms are attenuated, though incompletely, with antiretroviral therapy (ART)-related suppression of HIV replication. Exposure to ART is also associated with variable toxicity that may simultaneously decrease (via viral......Atherosclerotic cardiovascular disease (CVD) has become an important cause of morbidity and mortality among individuals with human immunodeficiency virus (HIV) infection with access to antiretroviral medications, as the risk for AIDS has fallen and life expectancy improved. Traditional CVD risk...... factors are often more common among individuals with HIV infection, and traditional prevention strategies remain important. Recent data have revealed that untreated HIV infection itself amplifies additional pro-atherogenic mechanisms related to immune activation, inflammation, coagulation, and lipoprotein...
Petoumenos, K; Worm, S; Reiss, P;
The aim of the study was to estimate the rates of cardiovascular disease (CVD) events after stopping smoking in patients with HIV infection.......The aim of the study was to estimate the rates of cardiovascular disease (CVD) events after stopping smoking in patients with HIV infection....
Duprez, Daniel A; Neuhaus, Jacqueline; Kuller, Lewis H;
The SMART study was a trial of intermittent use of antiretroviral therapy (ART) (drug conservation [DC]) versus continuous use of ART (viral suppression [VS]) as a strategy to reduce toxicities, including cardiovascular disease (CVD) risk. We studied the predictive value of high sensitivity C-rea...
Sabin, Caroline A.; Nielsen, Lene Ryom; De Wit, Stephane; Mocroft, Amanda; Phillips, Andrew N; Worm, Signe W; Weber, Rainer; D'Arminio Monforte, Antonella; Reiss, Peter; Kamara, David; El-Sadr, Wafaa; Pradier, Christian; Dabis, Francois; Law, Matthew; Lundgren, Jens
To consider associations between the latest/nadir CD4 cell count, and time spent with CD4 cell count less than 200 cells/μl (duration of immune depression), and myocardial infarction (MI), coronary heart disease (CHD), stroke, or cardiovascular disease (CVD) (CHD or stroke) in 33 301 HIV...
Aydin, Mesut; Yildiz, Abdulkadir; Kaya, Zeynettin; Kaya, Zekeriya; Basarir, Ahmet Ozgur; Cakmak, Nazmiye; Donmez, Ibrahim; Morrad, Baktash; Avci, Ahmet; Demir, Kenan; Cagliyan, Emre Caglar; Yuksel, Murat; Elbey, Mehmet Ali; Kayan, Fethullah; Ozaydogdu, Necdet; Islamoglu, Yahya; Cayli, Murat; Alan, Said; Ulgen, Mehmet Siddik; Ozhan, Hakan
Infection is one of the most devastating outcomes of cardiovascular implantable electronic device (CIED) implantation and is related to significant morbidity and mortality. In our country, there is no evaluation about CIED infection. Therefore, our aim was to investigate clinical characteristics and outcome of patients who had infection related to CIED implantation or replacement. The study included 144 consecutive patients with CIED infection treated at 11 major hospitals in Turkey from 2005 to 2014 retrospectively. We analyzed the medical files of all patients hospitalized with the diagnosis of CIED infection. Inclusion criteria were definite infection related to CIED implantation, replacement, or revision. Generator pocket infection, with or without bacteremia, was the most common clinical presentation, followed by CIED-related endocarditis. Coagulase-negative staphylococci and Staphylococcus aureus were the leading causative agents of CIED infection. Multivariate analysis showed that infective endocarditis and ejection fraction were the strongest predictors of in-hospital mortality. PMID:25589093
Full Text Available Background:HIV infected patients, especially those treated with antiretroviral (ARV drugs, show an increased risk and incidence of cardiovascular disease.Objectives:The aim of this study was to evaluate the progression of subclinical atherosclerosis in the carotid arteries, expressed as the value of carotid intima-media thickness (cIMT and the amount of atherosclerotic plaques, and to analyze the correlation between cIMT and risk factors for cardiovascular diseases in a cohort of HIV infected patients.Methods:The analysis included 72 HIV infected patients, mean age 39.4 years, and 27 healthy HIV negative individuals, matched for age and sex. The data collected included evaluation of the infection, ARV treatment, past cardiovascular events, assessment of traditional and nontraditional risk factors for cardiovascular diseases, cIMT measurements and amount of atherosclerotic plaques in the carotid arteries.Results:HIV infected patients show more advanced subclinical atherosclerosis in the carotid arteries (cIMT and plaques incidence. The cardiovascular risk profile of the HIV infected patients is significantly different from HIV negative people. Among the HIV positive group lower body mass index (BMI and higher waist/hip ratio (WHR are observed. The concentration of all cholesterol fractions is lower, whereas the concentration of triglycerides is higher. Cigarette smoking is more common among HIV-infected individuals. A strong statistical correlation between cIMT and age, hypertension, non-high-density lipoprotein (non-HDL cholesterol and ARV time were found. Total and LDL cholesterol, and lifetime smoking exposure also affect the cIMT. The relationship between cIMT and current HIV RNA may indicate the impact of the current infection status on the cIMT dynamics in this subpopulation.
Murray, L J; Bamford, K B; O'Reilly, D P; McCrum, E E; Evans, A. E.
OBJECTIVE--To determine whether Helicobacter pylori infection is associated with the development of ischaemic heart disease and whether such infection can explain the social class inequality in ischaemic heart disease. DESIGN--Cardiovascular risk factor levels, prevalence of ischaemic heart disease (Rose questionnaire angina, and/or a history of myocardial infarction), and serum antibodies to H pylori (enzyme linked immunosorbent assay) were assessed in a cross sectional population based surv...
Mansueto Gomes Neto
Full Text Available INTRODUCTION: In recent years, there has been growing concern about an increasing rate of cardiovascular diseases in human immunodeficiency virus-infected patients, which could be associated with side effects of highly active antiretroviral therapy. It is likely that the metabolic disorders related to anti-human immunodeficiency virus treatment will eventually translate into a increased cardiovascular risk in patients submitted to such regimens. OBJECTIVE: To evaluate if human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy are at higher risk of cardiovascular diseases than human immunodeficiency virus infected patients not receiving highly active antiretroviral therapy, or the general population. RESEARCH DESIGN AND METHODS: We conducted a computer-based search in representative databases, and also performed manual tracking of citations in selected articles. RESULT: The available evidence suggests an excess risk of cardiovascular events in human immunodeficiency virus-infected persons compared to non-human immunodeficiency virus infected individuals. The use of highly active antiretroviral therapy is associated with increased levels of total cholesterol, triglycerides, low-density lipoprotein and morphological signs of cardiovascular diseases. Some evidence suggested that human immunodeficiency virus-infected individuals on highly active antiretroviral therapy regimens are at increased risk of dyslipidemia, ischemic heart disease, and myocardial infarction, particularly if the highly active antiretroviral therapy regimen contains a protease inhibitor. CONCLUSION: Physicians must weigh the cardiovascular risk against potential benefits when prescribing highly active antiretroviral therapy. Careful cardiac screening is warranted for patients who are being evaluated for, or who are receiving highly active antiretroviral therapy regimens, particularly for those with known underlying cardiovascular risk
Patel, P.; Mendall, M A; Carrington, D; Strachan, D. P.; Leatham, E; Molineaux, N; Levy, J.; Blakeston, C.; Seymour, C. A.; Camm, A J
OBJECTIVE--To investigate the relation between seropositivity to chronic infections with Helicobacter pylori and Chlamydia pneumoniae and both coronary heart disease and cardiovascular risk factors. DESIGN--Cross sectional study of a population based random sample of men. Coronary heart disease was assessed by electrocardiography, Rose angina questionnaire, and a history of myocardial infarction; serum antibody levels to H pylori and C pneumoniae were measured, risk factor levels determined, ...
Yaghfoori, Saeed; Razmi, Gholam Reza; Mohri, Mehrdad; Razavizadeh, Ali Reza Taghavi; Movassaghi, Ahmad Reza
The malignant ovine theileriosis is caused by Theileria lestoquardi, which is highly pathogenic in sheep. Theileriosis involves different organs in ruminants, but the effect of the disease on the cardiovascular system is unclear. To understand the pathogenesis of T. lestoquardi on the cardiovascular system, Baluchi breed sheep were infected with the mentioned parasite by releasing unfed adults of Hyalomma anatolicum anatolicum, which were infected with T. lestoquardi. The infected sheep were clinically examined on days 0, 2, 5, 7, 10, 12, 14, 17, and 21, and the blood samples were collected for biochemical parameters measurement. At termination of the experiment, the infected sheep were euthanized and pathological examinations of heart tissue were conducted. During experimental infection of sheep with T. lestoquardi, activities of cardiac troponin I (cTnI), lactate dehydrogenase, and aspartate aminotransferase, were significantly increased (P˂0.05), while a conspicuous decrease (P˂0.05) was observed in creatine phosphokinase activities. Alterations made in biochemical factors almost coincided with the presence of piroplasm in the blood and schizont in lymph nodes. Maximum and minimum of parasitemia in the sheep stood between 3.3% and 0.28%, respectively. In addition, electrocardiography revealed sinus tachycardia, sinus arrhythmia, sino-atrial block and ST-elevation, atrial premature beat, and alteration in QRS and in T waves' amplitude. Heart histopathological examination showed hyperemia, infiltration of mononuclear inflammatory cells into interstitial tissue, endocarditis, and focal necrosis of cardiac muscle cells. In addition, in one of the sheep, definite occurrence of infarction was observed. The results indicate that T. lestoquardi infection has devastating pathological impacts on the cardiovascular system of sheep. Furthermore, measurement of the cTnI amount is a useful biochemical factor for diagnosis and for better understanding of the severity and
Chastain, Daniel B.; King, Travis S.; Stover, Kayla R.
Background: Increasing rates of HIV have been observed in women, African Americans, and Hispanics, particularly those residing in rural areas of the United States. Although cardiovascular (CV) complications in patients infected with human immunodeficiency virus (HIV) have significantly decreased following the introduction of antiretroviral therapy on a global scale, in many rural areas, residents face geographic, social, and cultural barriers that result in decreased access to care. Despite the advancements to combat the disease, many patients in these medically underserved areas are not linked to care, and fewer than half achieve viral suppression. Methods: Databases were systematically searched for peer-reviewed publications reporting infectious and non-infectious etiologies of cardiovascular disease in HIV-infected patients. Relevant articles cited in the retrieved publications were also reviewed for inclusion. Results: A variety of outcomes studies and literature reviews were included in the analysis. Relevant literature discussed the manifestations, diagnosis, treatment, and outcomes of infectious and non-infectious etiologies of cardiovascular disease in HIV-infected patients. Conclusion: In these medically underserved areas, it is vital that clinicians are knowledgeable in the manifestations, diagnosis, and treatment of CV complications in patients with untreated HIV. This review summarizes the epidemiology and causes of CV complications associated with untreated HIV and provide recommendations for management of these complications.
Full Text Available One of the consistent findings among various studies on HIV has been simultaneous multiorgan dysfunction. Cardiovascular disorders are now most common cause of mortality worldwide. With more effective and widespread treatment of HIV in resource-rich settings, morbidity and mortality from non-AIDS-related events have surpassed those from AIDS-related events with cardiovascular diseases emerging as an important cause of death in HIV-infected patients relative to the decreasing incidence of opportunistic disease. Various studies have reported a 1.5-fold increase in the rate of cardiovascular events in HIV-infected individuals compared to control populations. MATERIAL AND METHODS The aim of the study was to the find the prevalence and types of different cardiovascular abnormalities in HIV positive patients and assess their association with CD4 counts. Consecutive 82 patients, HIV positive patients fulfilling the inclusion criteria and giving informed consent were included in the study. All patients were subjected to history taking and a detailed physical examination. Blood counts, renal function tests, lipid profile and CD4 counts were estimated and patients were subjected to 12-lead ECG, chest X-ray and 2D/Colour Doppler Echocardiogram. RESULTS Of the 82 patients studied 47.46% had evidence of cardiovascular involvement, out of which 12% had clinical features of heart failure while electrocardiographic changes were seen in 35% of patients in the form of sinus tachycardia (27%, QTc prolongation (10% and left sided chamber enlargements (6%. Echocardiographic abnormalities were noted in 39 patients (47.56% including fractional shortening associated with systolic dysfunction (26.8%. The mean CD4 count in patients with echocardiographic abnormalities was found to be 58.87±29.80, whereas in patients without echocardiographic abnormalities it was 136.53±38.80 (p<0.0001. CONCLUSION High frequencies of cardiac abnormalities, both symptomatic and
Kristoffersen, U S; Kofoed, K; Kronborg, G;
OBJECTIVES: To investigate, using a longitudinal design, whether biomarkers of cardiovascular risk change after a switch to an abacavir (ABC)-containing regimen in HIV-1-infected individuals already receiving combination antiretroviral therapy (ART). METHODS: Thirty-five HIV-1-infected individuals...
Langdahl Bente L; Nielsen Ulla S; Frederiksen Christian A; Melchjorsen Jesper; Tolstrup Martin; Rasmussen Thomas A; Østergaard Lars; Laursen Alex L
Abstract Background Our objective was to evaluate and compare the effect of abacavir on levels of biomarkers associated with cardiovascular risk. Methods In an open-label randomized trial, HIV-infected patients were randomized 1:1 to switch from zidovudine/lamivudine to abacavir/lamivudine or tenofovir/emtricitabine. In the present analysis, we measured levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), soluble intercellular adhesion molecule-1 (sICAM-1), soluble va...
Shima; Shahbaz; Marcella; Manicardi; Giovanni; Guaraldi; Paolo; Raggi
After the successful introduction of highly active antiretroviral agents the survival of patients infected with the human immunodeficiency virus(HIV) in developed countries has increased substantially. This has allowed the surfacing of several chronic diseases among which cardiovascular disease(CVD) is prominent. The pathogenesis of CVD in HIV is complex and involves a combination of traditional and HIV related factors. An accurate assessment of risk of CVD in these patients is still elusive and as a consequence the most appropriate preventive and therapeutic interventions remain controversial.
Leclercq, Pascale; Blanc, Myriam
Life expectancy of HIV-infected patients has improved considerably with HAART. However long term use of HAART is linked with lipodystrophy syndrom (subcutaneous lipoatrophy and central fat accumulation) associated with dyslipemia (hypoHDL, hyperLDL and hypertriglyceridemia) and insulin resistance. It is also linked with mitochondrial toxicity clinically expressed by chronic fatigue syndrom and premature aging. The induced metabolic syndrom has cardiovascular consequences and myocardial infarction is the cause of 7% of the HIV-infected deaths in 2000. Assessment of these complications should be done at least every year. Treatment options concern antiretroviral therapy with the search for the least toxic drug (but with equal antiviral efficacy), symptomatic treatment (statin, fibrates, thiazolidinediones, metformin) and lifestyle modifications (first of all, stopping cigarette smoking!) PMID:16775979
Salmeri, Mario; Sorbello, Maria Grazia; Mastrojeni, Silvana; Santanocita, Angela; Milazzo, Marina; Di Stefano, Giuseppe; Scalia, Marina; Addamo, Alessandro; Toscano, Maria Antonietta; Stefani, Stefania; Mezzatesta, Maria Lina
The aim of the study was to describe the microbial aetiology of infections from cardiovascular implantable electronic devices (CIEDs) between 2001 and 2014 at The Centro Cuore Morgagni Hospital (Catania, Italy). In this 14-year retrospective study on pacemaker isolates 1,366 patients were evaluated and clinical data were collected. CIEDs were analyzed and isolates tested by routine microbiological techniques. The presence of bacterial biofilm was assessed by means of scanning electron microscopy. Of the patients, fifty-three had catheter-related infections (3.9%), mainly resulting from Staphylococci (4 S. aureus, 32 S. epidermidis, 15 S. hominis, 3 S. haemolyticus, 1 S. warnerii, 1 S. schleiferi, 1 S. lentus and 1 S. capitis) that covered the cardiac catheter with biofilm. Overall, oxacillin-resistance was 55.1%, especially among S. epidermidis, while all isolates were susceptible to vancomycin, teicoplanin, tigecyclin, rifampin, trimethoprim/sulfamethoxazole, linezolid, moxifloxacin, tobramycin and gentamicin. Coagulase-negative staphylococci were the most frequently isolated and S. epidermidis was largely the main single agent. Only four Gram negatives caused polymicrobial infections with Staphylococci. Despite improvements in CIED design and implantation techniques, infection of cardiac devices remains a serious problem. PMID:27367323
Full Text Available HIV-1-infected patients are thought to be at higher risk of cardiovascular events. Measures of arterial stiffness are independently associated with cardiovascular risk . The aim of our study was to determine if higher Framingham risk is associated with higher carotid femoral pulse wave velocity (cfPWV in HIV-infected volunteers (HIV cohort and to establish whether there is a difference in cfPWV between the HIV cohort and age- and gender-matched controls. We recruited 47 males (HIV cohort on antiretroviral treatment, from a UK HIV clinic between October 2010 and March 2012 (31 low Framingham risk <10% and 16 high risk >20%. This group was matched with 46 healthy subjects from a contemporaneous study performed by our group. The inclusion criteria were: age 35–75 years with Framingham risk >20% or <10%, on antiretroviral treatment with undetectable viral load, no previous coronary heart disease, stroke or insulin therapy. Subjects underwent cfPWV measurement using Complior® (Artech, France. Student's t-test was used to evaluate differences between high- and low-risk groups and also between cases and controls. The mean age of the HIV cohort was 49.43±9.35 years (mean±SD and in the control group 52.20±8.80 years (p=0.15. Mean duration of HIV infection was 13.83±7.25 years, mean CD4 count was 728.81±312.62×106/L and all viral loads were undetectable. In the HIV cohort, cfPWV was 8.39±1.09 m/s in the low-risk group and 10.43±2.93 m/s in the high-risk group (p=0.02. Multivariate analysis with cfPWV as dependent variable, and age, systolic blood pressure, cholesterol, smoking history, duration of HIV infection and antiretroviral therapy, zenith viral loads and nadir CD4 counts as independent variables was performed in the high- and low-risk groups. This showed age alone to be a significant predictive factor (p=0.002. With Framingham risk as dependent variable and using the above factors as independent variables, no HIV-related factors were
Full Text Available Benjamin Longo-Mbenza,1 Jacqueline Nkondi Nsenga,2 Etienne Mokondjimobe,3 Thierry Gombet,3 Itoua Ngaporo Assori,3 Jean Rosaire Ibara,3 Bertrand Ellenga-Mbolla,3 Dieudonné Ngoma Vangu,4 Simon Mbungu Fuele41Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa; 2Division of Gastroenterology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo; 3Faculty of Health Sciences, University of Marien Ngouabi, Brazzaville, Democratic Republic of the Congo; 4Biostatistics Unit, Lomo Medical Center, Limete, Kinshasa, Democratic Republic of the CongoBackground: Helicobacter pylori is now incriminated in the pathogenesis of atherosclerosis.Objective: To examine the importance of H. pylori infection as a cardiovascular disease (CVD risk factor.Methods: Two hundred five patients (128 with H. pylori infection [HP-seropositive] and 77 without had a baseline assessment for other potential CVD risk factors and were followed prospectively for 10 years (1999–2008. They were assessed on a monthly basis for the outcomes of carotid plaque, angina pectoris, myocardial infarction, and stroke. In the HP-seropositive group, male sex and quartile 4 for IgG anti-H. pylori antibodies (anti-HP Ab were correlated with traditional CVD risk factors, stroke, myocardial infarction, and angina pectoris.Results: At the baseline assessment, the levels of carotid intima-media thickness, blood fibrinogen, total cholesterol, fasting plasma glucose, and uric acid were higher in H. pylori-infected patients than in the uninfected group. Serum HDL-cholesterol was significantly lower in the HP-seropositive group. Men had higher levels of IgG anti-HP Ab, waist circumference, blood pressure, uric acid, and total cholesterol than women. Within the HP-seropositive group, individuals in quartile 4 for IgG anti-HP Ab had higher rates of elevated fibrinogen, diabetes mellitus, low high-density lipoprotein cholesterol, arterial hypertension, and high total
G Emerens Wensink
Full Text Available As life expectancy improves among Human Immunodeficiency Virus (HIV patients, renal and cardiovascular diseases are increasingly prevalent in this population. Renal and cardiovascular disease are mutual risk factors and are characterized by albuminuria. Understanding the interactions between HIV, cardiovascular risk factors and renal disease is the first step in tackling this new therapeutic frontier in HIV.In a rural primary health care centre, 903 HIV-infected adult patients were randomly selected and data on HIV-infection and cardiovascular risk factors were collected. Glomerular filtration rate (eGFR was estimated. Albuminuria was defined as an Albumin-Creatinine-Ratio above 30 mg/g. Multivariate logistic regression analysis was used to analyse albuminuria and demographic, clinical and HIV-associated variables.The study population consisted of 903 HIV-infected patients, with a median age of 40 years (Inter-Quartile Range (IQR 34-48 years, and included 625 (69% women. The median duration since HIV diagnosis was 26 months (IQR 12-58 months and 787 (87% received antiretroviral therapy. Thirty-six (4% of the subjects were shown to have diabetes and 205 (23% hypertension. In the cohort, 21% had albuminuria and 2% an eGFR <60 mL/min/1.73m2. Albuminuria was associated with hypertension (adjusted odds ratio (aOR 1.59; 95% confidence interval (CI 1.05-2.41; p<0.05, total cholesterol (aOR 1.31; 95% CI 1.11-1.54; p<0.05, eGFR (aOR 0.98; 95% CI 0.97-0.99; p<0.001 and detectable viral load (aOR 2.74; 95% CI 1.56-4.79; p<0.001. Hypertension was undertreated: 78% were not receiving treatment, while another 11% were inadequately treated. No patients were receiving lipid-lowering medication.Glomerular filtration rate was well conserved, while albuminuria was common amongst HIV-infected patients in rural South Africa. Both cardiovascular and HIV-specific variables were associated with albuminuria. Improved cardiovascular risk prevention as well as adequate
van Wijk, Jeroen P. H.; Manuel Castro Cabezas
The use of combination antiretroviral therapy (CART) in HIV-infected patients has resulted in a dramatic decline in AIDS-related mortality. However, mortality due to non-AIDS conditions, particularly cardiovascular disease (CVD) seems to increase in this population. CART has been associated with several metabolic risk factors, including insulin resistance, low HDL-cholesterol, hypertriglyceridemia and postprandial hyperlipidemia. In addition, HIV itself, as well as specific antiretroviral age...
Langdahl Bente L
Full Text Available Abstract Background Our objective was to evaluate and compare the effect of abacavir on levels of biomarkers associated with cardiovascular risk. Methods In an open-label randomized trial, HIV-infected patients were randomized 1:1 to switch from zidovudine/lamivudine to abacavir/lamivudine or tenofovir/emtricitabine. In the present analysis, we measured levels of interleukin-6 (IL-6, high-sensitivity C-reactive protein (hs-CRP, soluble intercellular adhesion molecule-1 (sICAM-1, soluble vascular adhesion molecule-1 (sVCAM-1, E-selectin, and myeloperoxidase (MPO at baseline and 4, 12, and 48 weeks after randomization. D-dimer and fasting lipids were measured at baseline and weeks 12 and 48. Levels of biomarkers at all time points and changes from baseline were compared across study arms using Wilcoxon rank sum test. Results Of 40 included patients, 35 completed 48 weeks of randomized therapy and follow up. Levels of E-selectin (P = 0.004 and sVCAM-1 (P = 0.041 increased transiently from baseline to week 4 in the abacavir arm compared with the tenofovir arm, but no long-term increases were detected. We found no significant differences between study arms in the levels or changes in the levels of sICAM-1, MPO, d-dimer, IL-6, or hs-CRP. Levels of total cholesterol and high density lipoprotein (HDL increased in the abacavir arm relative to the tenofovir arm, but no difference was found in total cholesterol/HDL ratio. Conclusion In patients randomized to abacavir-based HIV-treatment transient increases were seen in the plasma levels of E-selectin and sVCAM-1 compared with treatment with tenofovir, but no difference between study arms was found in other biomarkers associated with endothelial dysfunction, inflammation, or coagulation. The clinical significance of these findings is uncertain. Trial Regestration Clinicaltrials.gov identifier: NCT00647244.
Full Text Available Introduction: Successfully treated HIV-infected patients may still have an increased risk for cardiovascular morbidity and mortality, which might be related not only to traditional risks, but also to inflammation and dyslipidemia induced by HIV and/or antiretroviral therapy [1, 2]. We examined the relationship of serum lipid levels with plasma biomarkers of inflammation using a composite inflammatory burden score (IBS from the following seven markers of inflammation: CD40L, tPA, MCP-1, IL-8, IL-6, hCRP and P-selectin. Materials and Methods: Subjects were selected among consecutive HIV-infected males ≥18 years of age with an undetectable viral load (75th percentile were considered elevated and an IBS was constructed as the presence of zero, one, two, or three or more elevated biomarkers. Correlations between the IBS and lipid parameters were examined using Spearman's Rho and by ordered logistic regression proportional odds model to estimate the odds of more elevated (>75th percentile biomarkers. Results: 181 male patients were included into the study, the median age was 46.7 (Q1–Q3, 39.9–55.0 years and the median current CD4 cell count was 553.0 (Q1–Q3, 389–729 per microliter. The patients were mainly treated with two nucleoside reverse transcriptase inhibitor (NRTI plus one non-NRTI (NNRTI (N=100, 60.8% or two NRTI plus lopinavir (N=50, 27.6%. There was a significant correlation between the IBS and serum cholesterol (Rho=0.23, 95% CI, 0.09–0.37, triglycerides (Rho=0.30, 95% CI, 0.16–0.42 and cholesterol/HDL-cholesterol ratio (Rho=0.25, 95% CI 0.11–0.38. In the multivariable model a one unit increase in cholesterol/HDL-cholesterol ratio was associated with a 1.72-fold (95% CI, 1.27–2.33 increased odds of having a greater IBS. One unit increase (mmol/L of cholesterol and triglycerides was associated with a 1.41-fold (95% CI, 1.13–1.76 and 1.37-fold (95% CI, 1.18–1.60 increased odds of having a greater IBS, respectively
Full Text Available Neutrophil to lymphocyte ratio (NLR has been shown to predict occurrence of cardiovascular events in the general population. The aim of our study was to evaluate the role of NLR to predict major cardiovascular disease (CVD events in HIV-infected subjects. We performed a retrospective cohort study of HIV-infected patients residing in the Local Health Authority (LHA of Brescia, northern Italy, from 2000 to 2012. The incidence of CVD events in HIV-positive patients was compared with that expected in the general population living in the same area, computing standardized incidence ratios (SIRs. To evaluate the predictive role of NLR, univariate and multivariate Cox regression models were applied, computing hazard ratios (HRs. A total of 3766 HIV-infected patients (mean age 38.1 years, 71.3% males were included (person-years 28768.6. A total of 134 CVD events occurred in 119 HIV-infected patients. A 2-fold increased risk (SIR 2.02 of CVD was found in HIV-infected patients compared to the general population. NLR levels measured at baseline and during follow-up were independently associated with CVD incidence, when also adjusting for both traditional CVD risk factors and HIV-related factors (HR 3.05 for NLR≥ 1.2. The area under the receiver operating characteristics (ROC curve showed a modest, not statistically significant, increase, from 0.81 to 0.83, with addition of NLR to Framingham risk score model covariates. In conclusion an elevated NLR is a predictor of risk CVD in HIV-infected patients, independently from the traditional CVD risk factors.
Cotti, Elisabetta; Dessì, Cristina; Piras, Alessandra; Mercuro, Giuseppe
Cardiovascular diseases (CVD) have a complex etiology determined by risk factors, which are in turn associated to a strong genetic component and to environmental factors. In the biological background for the development of CVD, low-grade chronic inflammation plays a role as a pathogenetic determinant of atherosclerosis. Dental infections have been associated with CVD. Periodontal disease is a chronic infection of the supporting tissues of the tooth that can lead to teeth loss. In recent years, a number of reports have demonstrated the possible relationship between periodontal disease and CVD. Apical periodontitis, on the other hand, is the late consequence of an endodontic infection, which is caused by the persistence of coronal caries and involves the root canal system of the tooth. Most of the time, it is a chronic infection. Some studies have found a correlation between a "composite status" of oral health (eg. caries, tooth loss, periodontal disease) and CVD, but only a few of them have addressed the association between apical periodontitis and CVD. This "state of the art" paper represents the first stage of an incoming study on the relationship between chronic endodontic infection and CVD. PMID:20851474
Conclusions:The positive correlation observed suggests this pathway as one of the mechanisms that may lead to increasing severity of periodontal disease and its systemic effects. Further research efforts should be made in designing appropriate clinical trials, starting at an early stage and monitoring the potential benefits of maintenance of oral hygiene on cardiovascular health.
Full Text Available Arterial aging is well characterized in industrial populations, but scantly described in populations with little access to modern medicine. Here we characterize health and aging among the Tsimane, Amazonian forager-horticulturalists with short life expectancy, high infectious loads and inflammation, but low adiposity and robust physical fitness. Inflammation has been implicated in all stages of arterial aging, atherogenesis and hypertension, and so we test whether greater inflammation associates with atherosclerosis and CVD risk. In contrast, moderate to vigorous daily activity, minimal obesity, and low fat intake predict minimal CVD risk among older Tsimane.Peripheral arterial disease (PAD, based on the Ankle-Brachial Index (ABI, and hypertension were measured in Tsimane adults, and compared with rates from industrialized populations. No cases of PAD were found among Tsimane and hypertension was comparatively low (prevalence: 3.5%, 40+; 23%, 70+. Markers of infection and inflammation were much higher among Tsimane than among U.S. adults, whereas HDL was substantially lower. Regression models examine associations of ABI and BP with biomarkers of energy balance and metabolism and of inflammation and infection. Among Tsimane, obesity, blood lipids, and disease history were not significantly associated with ABI. Unlike the Tsimane case, higher cholesterol, C-reactive protein, leukocytes, cigarette smoking and systolic pressure among North Americans are all significantly associated with lower ABI.Inflammation may not always be a risk factor for arterial degeneration and CVD, but instead may be offset by other factors: healthy metabolism, active lifestyle, favorable body mass, lean diet, low blood lipids and cardiorespiratory health. Other possibilities, including genetic susceptibility and the role of helminth infections, are discussed. The absence of PAD and CVD among Tsimane parallels anecdotal reports from other small-scale subsistence
Full Text Available BACKGROUND: Psychological factors are known predictors of cardiovascular disease in many clinical settings, but data are lacking for HIV infection. We carried out a prospective cohort study to evaluate potential psychological predictors of preclinical and clinical vascular disease in HIV patients. METHODOLOGY/PRINCIPAL FINDINGS: HIV patients were consecutively enrolled. Demographics, viral and immune parameters and traditional cardiovascular predictors were considered; Intima-Media Thickness (c-IMT, continuous measure and Carotid Plaques (CPs, focal thickening ≥1.5 mm were investigated by B-mode ultrasonography; depressive symptoms by the Beck Depression Inventory (BDI-II, Type D personality (Distressed Personality or Type D by the DS14, alexithymia by the Toronto Alexithymia Scale (TAS-20. Vascular outcomes included transient ischemic attacks or stroke, acute coronary syndrome, myocardial or other organ infarction. We enrolled 232 HIV subjects, 73.9% males, aged 44.5±9.9 y, 38.2% with AIDS diagnosis, 18.3% untreated. Mean Nadir CD4 T-cell counts were 237.5±186.2/mmc. Of them, 224 (96.5% attended IMT measurements; 201 (86.6% attended both IMT assessment and psychological profiling. Mean follow-up was 782±308 days. Fifty-nine patients (29.4% had CPs at baseline. Nineteen patients (9.5% had ≥1 vascular event; 12 (6.0% died due to such events (n = 4 or any cause. At baseline cross-sectional multivariate analysis, increasing age, total cholesterol, current smoking and Alexithymia score≥50 were significantly associated with both increased cIMT (linear regression and CPs (logistic regression. At follow-up analysis, log-rank tests and Cox's regression revealed that only older age (p = 0.001, current smoking (p = 0.019 and alexithymia score≥50 (p = 0.013 were independently associated with vascular events. CONCLUSIONS/SIGNIFICANCE: In HIV-infected subjects, the Alexithymic trait emerges as a strong predictor of increased IMT, presence of CPs
Tristan J Barber
Full Text Available Introduction: Use of some protease inhibitors (PI is associated with unconjugated hyperbilirubinaemia (HBR, due to inhibition of UGT1A1. As observed in Gilbert's syndrome, HBR may have antioxidant and anti-inflammatory effects. Inflammation may be relevant to neurocognitive (NC impairment, cardiovascular, renal and bone co-morbidities in HIV infection. This study aimed to analyse correlations between antiretroviral associated HBR and NC impairment as well as renal, bone and cardiovascular parameters. Material and Methods: This cross-sectional study included 101 HIV-1-infected individuals stable (>6 months on antiretroviral regimens including tenofovir/emtricitabine or abacavir/lamivudine plus a ritonavir-boosted PI. Patients with >grade 2 HBR were compared to patients with normal bilirubin on NC data collected using CogState. An overall composite score was calculated for each subject. Two-tail P-values were calculated using the Mann-Whitney U test. We measured the following parameters in all participants: Bone – Calcaneal Stiffness Index (CSI, blood bone markers, calculated FRAX score; CV – vascular endothelial function markers (iCAM, vCAM, lipid fractions and sub fractions (Total, HDL and LDL cholesterol, triglycerides, ApoB, Carotid Intimal Thickness (CIT, Pulse Wave Velocity (PWV, glucose and insulin for calculation of HOMA-IR, IL-6, d-dimer, uric acid, and hsCRP; Renal – urea and electrolytes (U&E, urinary protein/creatinine ratio (uPCR, urinary retinal binding protein (RBP/creatinine ratio. Results: Forty-three participants had normal bilirubin (NBR levels and 35 had high bilirubin (HBR; >2.5 times upper limit; the remaining 23 patients had intermediate bilirubin levels or violated the protocol. The mean age of participants was 48 years; 93% were male and 84% Caucasian. Mostly no significant differences were seen in any of the markers when comparing the NBR and HBR groups. Two component tests of the CogState were seen to be different
Eholié, Serge Paul; Lacombe, Karine; Krain, Alysa; Diallo, Zelica; Ouiminga, Mariama; Campa, Pauline; Bouchaud, Olivier; Bissagnene, Emmanuel; Girard, Pierre-Marie
In a cohort of HIV-infected patients of sub-Saharan origin we describe the incidence of metabolic syndrome, insulin resistance, and lipodystrophy after 3 years of combined antiretroviral therapy, and model the 10-year risk of cardiovascular diseases, while taking into account environmental factors. This is a multinational, prospective cohort study conducted in HIV outpatient clinics from four tertiary care centers set in France and Côte d'Ivoire. The participants were HIV-infected, treatment-naive patients eligible to start antiretroviral treatment and were of sub-Saharan African origin. The main outcome measures were the incidence of metabolic syndrome, insulin resistance, and lipodystrophy, and the assessment of the 10-year risk of cardiovascular diseases using Framingham risk prediction, D.A.D. Cardiovascular Disease Risk, and WHO/ISH prediction charts. Of 245 patients followed for up to 3 years, the incidence of metabolic syndrome, insulin resistance, and lipodystrophy was 5.5, 8.5, and 6.8 per 100 person-years of follow-up (cumulative incidence: 14.4%, 19.2%, and 18.1%, respectively). Living in France as well as female gender and being overweight were risk factors for metabolic disorders as whole and only first generation protease inhibitors were marginally associated with metabolic syndrome. Cardiovascular risk as modeled through the three equations was high in all patients with the synergistic and deleterious effect of living in France compared to Côte d'Ivoire. This cohort study shows how the synergy between HIV, antiretroviral (ARV) exposure, and westernization of life style in a cohort of HIV-infected patients of sub-Saharan origin leads to a progressive increase in the risk of lipodystrophy, as well as metabolic syndrome and insulin resistance, all associated with increased cardiovascular risk. PMID:25707418
Full Text Available Introduction: The increasing age, higher modifiable and inherent cardiovascular disease (CVD risk of HIV-infected patients  necessitates improved approaches to reducing co-morbidities. We aimed to assess the effectiveness of a team intervention in reducing modifiable CVD risk. Materials and Methods: HIV-infected patients ≥50 years attending a large HIV caseload primary-care practice, who were virologically suppressed on antiretroviral therapy (ART, with moderate or severe 10-year CVD Framingham risk (≥10% were recruited for this prospective case-control study. Intervention participants were provided a team approach to care, which involved treatment by study doctors for lipid, hypertension and ART management, and monthly review by a team of research nurses and dieticians for smoking cessation, exercise and dietary advice over 12 months. Controls were matched on age and smoking status, and were given standard of care (SOC by non-study doctors. Outcomes included CVD risk factors, body composition and CVD risk assessment, including Framingham 10-yr risk  and D:A:D 5-year estimated risk of coronary heart disease (CHD . Repeated measures analysis of variance was used to examine pre- and post-intervention differences, with p-values used to assess time and main effects of approach to care (Intervention, SOC. Results: A total of 33 patients completed the intervention, with 33 controls (58.0±6.8 and 59.1±6.9 years, respectively. Smoking cessation occurred in 25% cases versus nil controls. There was a significant change in CVD risk between intervention and control groups, in both Framingham scores (time and group×time interaction and D:A:D scores (group×time interaction only (Table 1. There was also a significant difference in change in total cholesterol over the study period (time and group×time interaction. Body composition was only measured in intervention patients, with a significant loss in % body fat observed in pre- and post
Full Text Available Introduction: We have previously shown in the SSAT 044 study that unconjugated hyperbilirubinaemia in subjects receiving a boosted protease inhibitor (PI/r has limited impact on renal, cardiovascular (CV and bone biomarkers, as well as on neurocognitive performance, relative to those receiving PI/r with a normal bilirubin. We present here a secondary analysis comparing markers in those receiving abacavir- vs tenofovir- based antiretroviral therapy (ART. Materials and Methods: This cross-sectional study included 101 HIV-1 infected individuals stable (HIV RNA6 months on antiretroviral regimens including tenofovir (TDF/emtricitabine or abacavir/lamivudine plus a ritonavir boosted PI. Results: Forty-three subjects had normal bilirubin (NBR levels and 35 had high bilirubin (>2.5 times upper limit; the remaining 23 patients had intermediate bilirubin levels or violated the protocol. The mean age of participants was 48 years; 93% were male and 84% Caucasian; 22 received ABC-based therapy and 78 TDF. No differences were seen in cardiovascular markers: Framingham (10-year risk % median, IQR: ABC 8.1, 5.6–15.3; TDF 9.5, 4.8–13.4 (p=ns; pulse wave velocity and carotid intimal thickness also showed no significant differences. No differences were seen in bone parameters: Calcaneal Stiffness Index (median score, IQR: ABC −0.5, −0.8 to 0.8; TDF −0.5, 1.4–0.4 (p=ns; 10 year FRAX score (% median, IQR: ABC 5.0, 2.4–6.2; TDF 3.6, 2.5–5.8 (p=ns. There were differences in renal parameters as shown in Table 1. We show statistically significant differences in urine protein/creatinine ratio (uPCR (10 vs 7; p=0.004 and urine albumin/creatinine ratio (uACR (15 vs 8; p=0.002, with both being higher in the TDF group. Conclusions: Tenofovir use is associated with excess loss of proteins including those typically resorbed in the renal tubule. Abacavir use was not associated with an increase in biomarkers of CV risk or vascular dysfunction.
Full Text Available Background: Cardiovascular disease in the context of human immunodeﬁciency virus infection has become a major clinical concern in recent years. In the current report we assess hospitalizations due to cardiovascular disease in human immunodeﬁciency virus patients in a Social Security reference hospital in Peru.Methods:A retrospective study was carried out between January 1996 and December 2012 in a General Hospital in Lima, Peru.Results: We included 26 patients hospitalized due to cardiovascular disease. Mean age was 46.3 years (SD 12.5, predominantly male (57.7%. Ten patients (38.4% were in Acquired Immunodeﬁciency Syndrome stages. Seventeen (65.4% received high-active-antiretroviral therapy. Eleven (42.3% had cardiac involvement and 15 (57.7% had non-cardiac vascular involvement. The most frequent causes of cardiac involvement were pericardial effusion and myocardial infarction. On the other hand, deep vein thrombosis and stroke were the most frequent for non-cardiac vascular involvement.Conclusions: Cardiovascular disease is an important cause of hospitalization in Peruvian human immunodeﬁciency virus patients, with differences between immunosuppression stages. Further studies analyzing associated factors are warranted.
Knudsen, Andreas; Mathiasen, Anders B; Worck, R.H.;
A matched cohort study was conducted comparing patients with first-time acute coronary syndromes infected with human immunodeficiency virus (HIV) to non-HIV-infected patients with and without diabetes matched for smoking, gender, and type of acute coronary syndrome who underwent first-time corona...... angiography. A total of 48 HIV-infected patients were identified from a national database. Coronary angiography showed that the HIV-infected patients had significantly fewer lesions with classification B2/C than the 2 control groups (p...
目的 分析心血管病患者住院期间并发肺部感染原因,提出防治对策,以期为降低心血管病住院患者医院感染的发生提供参考依据.方法 对432例心血管病患者临床资料进行回顾性分析,分析患者肺部感染发生情况.结果 432例患者住院期间发生肺部感染者64例,感染率为14.81％；患者高龄、合并有多种基础疾病、抗菌药物应用种类较多、抗菌药物应用时间较长、有侵入性操作、住院时间较长等是引起心血管病住院患者肺部感染发生的主要危险因素(P＜0.01);64例肺部感染患者痰培养共检出病原菌68株,其中革兰阳性菌45株占66.18％,革兰阴性菌21株占30.88％,真菌2株占2.94％,革兰阴性菌主要为肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌,分别占25.00％、17.65％、11.76％,革兰阳性菌主要为金黄色葡萄球菌、表皮葡萄球菌、溶血性链球菌,分别占11.76％、7.35％、4.41％,真菌主要为白色假丝酵母菌,占2.94％.结论 心血管病住院患者并发肺部感染的原因主要与高龄、合并有多种基础疾病、抗菌药物应用种类较多、抗菌药物应用时间较长、有侵入性操作、住院时间较长等原因有关,感染病原菌主要为革兰阴性菌,应针对以上高危因素进行干预,以降低医院感染发生率.%OBJECTIVE To analyze the causes of the pulmonary infections in the patients with cardiovascular diseases during the hospital stay and propose prevention countermeasures so as to reduce the incidence of nosocomial infections in the hospitalized patients with cardiovascular diseases.METHODS The medical records of 432 cases of patients with cardiovascular diseases were retrospectively analyzed,and the incidence of pulmonary infections was analyzed.RESULTS Of totally 432 hospitalized patients,the pulmonary infections occurred in 64 cases with the infection rate of 14.81％.The advanced age,complication of multiple
Risco cardiovascular: marcadores antropométricos, clínicos e dietéticos em indivíduos infectados pelo vírus HIV Cardiovascular risk: anthropometric, clinical and dietary markers in HIV-infected persons
Luísa Helena Maia Leite
Full Text Available OBJETIVO: Descrever marcadores antropométricos, clínicos e dietéticos associados ao risco cardiovascular em indivíduos infectados pelo vírus HIV. MÉTODOS: Realizou-se um estudo transversal com 100 indivíduos, adultos, com HIV/Aids, da cidade do Rio de Janeiro. O risco cardiovascular foi estimado pelo escore de risco de Framingham. O consumo alimentar foi avaliado por meio de um recordatório de 24 horas e de uma lista de frequência de consumo de alimentos. Para comparar variáveis, foram utilizados o teste t de Student e o teste Qui-quadrado. RESULTADOS: Dentre os indivíduos avaliados, 63% eram homens, com idade média de 41,8, DP=9,6 anos, 77% faziam uso de antirretrovirais. Escore de risco de Framingham >10% foi identificado em 53% dos indivíduos. Os principais fatores de risco cardiovascular potencialmente modificáveis identificados foram: lipoproteína de alta densidade baixo (70%, hipercolesterolemia (35%, hipertensão arterial (35%, seguidos de tabagismo (23% e glicose alta (21%. Indivíduos com escore de risco de Framingham >10% apresentavam uma tendência para consumir dietas mais ricas em colesterol (p=0,720, em sódio (p=0,898, em açúcares/doces (p=0,032 e pobres em fibras (p=0,273, associadas a um maior consumo de bebidas alcoólicas (p=0,053. A avaliação dos hábitos de vida revelou maior prevalência de tabagismo e maior nível de sedentarismo no grupo com escore de risco de Framingham >10, porém não significativos. CONCLUSÃO: Os resultados deste estudo mostram que pacientes com HIV/Aids sob terapia Highly Active Antiretroviral Therapy e com mais altos escore de risco de Framingham não seguem as medidas preventivas contra doenças cardiovasculares e devem ser permanentemente encorajados a fazer escolhas alimentares saudáveis, parar de fumar e aumentar a atividade física.OBJECTIVE: This study described the anthropometric, clinical and dietary markers associated with cardiovascular risk in HIV-infected persons
Hasse, Barbara; Tarr, Philip E; Marques-Vidal, Pedro; Waeber, Gerard; Preisig, Martin; Mooser, Vincent; Valeri, Fabio; Djalali, Sima; Andri, Rauch; Bernasconi, Enos; Calmy, Alexandra; Cavassini, Matthias; Vernazza, Pietro; Battegay, Manuel; Weber, Rainer; Senn, Oliver; Vollenweider, Peter; Ledergerber, Bruno; Aubert, V; Barth, J; Battegay, M; Bernasconi, E; Böni, J; Bucher, H C; Burton-Jeangros, C; Calmy, A; Cavassini, M; Egger, M; Elzi, L; Fehr, J; Fellay, J; Furrer, H; Fux, C A; Gorgievski, M; Günthard, H; Haerry, D; Hasse, B; Hirsch, H H; Hösli, I; Kahlert, C; Kaiser, L; Keiser, O; Klimkait, T; Kouyos, R; Kovari, H; Ledergerber, B; Martinetti, G; Martinez de Tejada, B; Metzner, K; Müller, N; Nadal, D; Pantaleo, G; Rauch, A; Regenass, S; Rickenbach, M; Rudin, C; Schöni-Affolter, F; Schmid, P; Schultze, D; Schüpbach, J; Speck, R; Staehelin, C; Tarr, P; Telenti, A; Trkola, A; Vernazza, P; Weber, R; Yerly, S; Jean-Michel, Aubry; Murielle, Bochud; Jean Michel, Gaspoz; Christoph, Hock; Thomas, Lüscher; Pedro, Marques Vidal; Vincent, Mooser; Fred, Paccaud; Martin, Preisig; Peter, Vollenweider; Roland, Von Känel; Aidacic, Vladeta; Gerard, Waeber; Jürg, Beriger; Markus, Bertschi; Heinz, Bhend; Martin, Büchi; Hans-Ulrich, Bürke; Ivo, Bugmann; Reto, Cadisch; Isabelle, Charles; Corinne, Chmiel; Sima, Djalali; Peter, Duner; Simone, Erni; Andrea, Forster; Markus, Frei; Claudius, Frey; Jakob, Frey; Ali, Gibreil Musa; Matthias, Günthard; Denis, Haller; Marcel, Hanselmann; Walter, Häuptli; Simon, Heininger; Felix, Huber; Paul, Hufschmid; Eva, Kaiser; Vladimir, Kaplan; Daniel, Klaus; Stephan, Koch; Beat, Köstner; Benedict, Kuster; Heidi, Kuster; Vesna, Ladan; Giovanni, Lauffer; Werner, Leibundgut Hans; Phillippe, Luchsinger; Severin, Lüscher; Christoph, Maier; Jürgen, Martin; Damian, Meli; Werner, Messerli; Titus, Morger; Valentina, Navarro; Jakob, Rizzi; Thomas, Rosemann; Hana, Sajdl; Frank, Schindelek; Georg, Schlatter; Oliver, Senn; Pietro, Somaini; Jacques, Staeger; Alfred, Staehelin; Alois, Steinegger; Claudia, Steurer; Othmar, Suter; Phuoc, Truong The; Marco, Vecellio; Alessandro, Violi; René, Von Allmen; Hans, Waeckerlin; Fritz, Weber; Johanna, Weber-Schär; Joseph, Widler; Marco, Zoller
Background. Although acquired immune deficiency syndrome-associated morbidity has diminished due to excellent viral control, multimorbidity may be increasing among human immunodeficiency virus (HIV)-infected persons compared with the general population. Methods. We assessed the prevalence of comorbidities and multimorbidity in participants of the Swiss HIV Cohort Study (SHCS) compared with the population-based CoLaus study and the primary care-based FIRE (Family Medicine ICPC-Research using Electronic Medical Records) records. The incidence of the respective endpoints were assessed among SHCS and CoLaus participants. Poisson regression models were adjusted for age, sex, body mass index, and smoking. Results. Overall, 74 291 participants contributed data to prevalence analyses (3230 HIV-infected; 71 061 controls). In CoLaus, FIRE, and SHCS, multimorbidity was present among 26%, 13%, and 27% of participants. Compared with nonsmoking individuals from CoLaus, the incidence of cardiovascular disease was elevated among smoking individuals but independent of HIV status (HIV-negative smoking: incidence rate ratio [IRR] = 1.7, 95% confidence interval [CI] = 1.2-2.5; HIV-positive smoking: IRR = 1.7, 95% CI = 1.1-2.6; HIV-positive nonsmoking: IRR = 0.79, 95% CI = 0.44-1.4). Compared with nonsmoking HIV-negative persons, multivariable Poisson regression identified associations of HIV infection with hypertension (nonsmoking: IRR = 1.9, 95% CI = 1.5-2.4; smoking: IRR = 2.0, 95% CI = 1.6-2.4), kidney (nonsmoking: IRR = 2.7, 95% CI = 1.9-3.8; smoking: IRR = 2.6, 95% CI = 1.9-3.6), and liver disease (nonsmoking: IRR = 1.8, 95% CI = 1.4-2.4; smoking: IRR = 1.7, 95% CI = 1.4-2.2). No evidence was found for an association of HIV-infection or smoking with diabetes mellitus. Conclusions. Multimorbidity is more prevalent and incident in HIV-positive compared with HIV-negative individuals. Smoking, but not HIV status, has a strong impact on cardiovascular risk and
Full Text Available Introduction: Epidemiological studies suggest that some antiretroviral drugs may contribute to increase cardiovascular risk in HIV-infected patients. However, data from Latin American countries are limited, as impact of HAART on cardiovascular risk remains understudied. In this context, we aimed to evaluate if 10-year Framingham Cardiovascular Risk Score (FCRS increases in patients following exposure to EFV- and LPV/r-based HAART in a Latin American cohort. Materials and Methods: Retrospective 48-week cohort study. We reviewed clinical charts of randomly selected samples of patients initiating (according to national guidelines EFV first-line HAART and LPV/r first- or second-line (but first PI-based HAART assisted at a reference HIV centre in Buenos Aires, Argentina (period 2004–2012. Each patient could only be included in one arm. FCRS was calculated according to National Institutes of Health risk assessment tool (http://cvdrisk.nhlbi.nih.gov/. Results: A total of 357 patients were included: 249 in EFV arm and 108 in LPV/r arm (80 as first line and 28 as second line, but first PI-based HAART. Baseline characteristics (median, interquartile range: age, 38 (33–45 years; male, 247 (69%; viral load, 98200 (20550–306000 copies/mL; CD4 T-cell count, 115 (60–175 cel/µL; total cholesterol, 159 (135–194 mg/dL; HDL: 39 (31–41 mg/dL; LDL: 94 (72–123 mg/dL; current smoker, 29%; on antihypertensive drugs: 14 (4%, diabetic: 4 (1%. Most frequent accompanying nucleoside reverse transcriptase inhibitors (NRTIs were 3TC (92% and zidovudine (AZT; 76%. Baseline FCRS was low, moderate and high for 93%, 7% and 0% of patients on EFV arm and 96.7%, 1.7% and 1.7% on LPV/r arm. On EFV arm, an increase in FCRS category (low to moderate or moderate to high was observed in 1 patient (0.9% at 24 weeks and 6 (5,6% at 48 weeks; 5 (4.7% decreased category. On LPV/r arm no one varied FCRS category at 24 weeks and 2 (3.4% increased from low to moderate at 48 weeks
Adelzon A Paula
Full Text Available INTRODUCTION: After antiretroviral therapy (ART became available, there was a decline in the number of deaths in persons infected with HIV. Thereafter, there was a decrease in the proportion of deaths attributed to opportunistic infections and an increase in the proportion of deaths attributed to chronic comorbidities. Herein we extend previous observations from a nationwide survey on temporal trends in causes of death in HIV-infected patients in Brazil. METHODS: We describe temporal trends in causes of death among adults who had HIV/AIDS listed in the death certificate to those who did not. All death certificates issued in Brazil from 1999 to 2011 and listed in the national mortality database were included. Generalized linear mixed-effects logistic models were used to study temporal trends in proportions. RESULTS: In the HIV-infected population, there was an annual adjusted average increase of 6.0%, 12.0%, 4.0% and 4.1% for cancer, external causes, cardiovascular diseases (CVD and diabetes mellitus (DM, respectively, compared to 3.0%, 4.0%, 1.0% and 3.9%, in the non-HIV group. For tuberculosis (TB, there was an adjusted average increase of 0.3%/year and a decrease of 3.0%/year in the HIV and the non-HIV groups, respectively. Compared to 1999, the odds ratio (OR for cancer, external causes, CVD, DM, or TB in the HIV group were, respectively, 2.31, 4.17, 1.76, 2.27 and 1.02, while for the non-HIV group, the corresponding OR were 1.31, 1.63, 1.14, 1.62 and 0.67. Interactions between year as a continuous or categorical variable and HIV were significant (p<0.001 for all conditions, except for DM when year was considered as a continuous variable (p = 0.76. CONCLUSIONS: Non HIV-related co-morbidities continue to increase more rapidly as causes of death among HIV-infected individuals than in those without HIV infection, highlighting the need for targeting prevention measures and surveillance for chronic diseases among those patients.
Full Text Available Shenghan Lai,1–4 Elliot K Fishman,2 Gary Gerstenblith,3 Jeffrey Brinker,3 Hong Tai,1 Shaoguang Chen,1 Ji Li,4 Wenjing Tong,1 Barbara Detrick,1 Hong Lai2 1Department of Pathology, 2Department of Radiology, 3Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA; 4Department of Epidemiology, John Hopkins University, Johns Hopkins Bloomberg School of Public Heath, Baltimore, MD, USA Objective: Patients with HIV infection are at increased risk for coronary artery disease (CAD, and growing evidence suggests a possible link between vitamin D deficiency and clinical/subclinical CAD. However, the relationship between vitamin D deficiency and coronary artery calcification (CAC, a sensitive marker for subclinical CAD, in those with HIV infection is not well investigated. Methods: CAC was quantified using a Siemens Cardiac 64 scanner, and vitamin D levels and the presence of traditional and novel risk factors for CAD were obtained in 846 HIV-infected African American (AA participants aged 25 years or older in Baltimore, MD, USA without symptoms or clinical evidence of CAD. Results: The prevalence of vitamin D deficiency (25-hydroxy vitamin D <10 ng/mL was 18.7%. CAC was present in 238 (28.1% of the 846 participants. Logistic regression analysis revealed that the following factors were independently associated with CAC: age (adjusted odds ratio [OR]: 1.11; 95% confidence interval [CI]: 1.08–1.14; male sex (adjusted OR: 1.71; 95% CI: 1.18–2.49; family history of CAD (adjusted OR: 1.53; 95% CI: 1.05–2.23; total cholesterol (adjusted OR: 1.006; 95% CI: 1.002–1.010; high-density lipoprotein cholesterol (adjusted OR: 0.989; 95% CI: 0.979–0.999; years of cocaine use (adjusted OR: 1.02; 95% CI: 1.001–1.04; duration of exposure to protease inhibitors (adjusted OR: 1.004; 95% CI: 1.001–1.007; and vitamin D deficiency (adjusted OR: 1.98; 95% CI: 1.31–3.00. Conclusion: Both vitamin D deficiency and CAC are prevalent in AAs with
... Potential Hazards Exposure of employees to community and nosocomial infections, e.g., Methicillin-resistant Staphylococcus aureus (MRSA) . Nosocomial infections are infections that occur from exposure to infectious ...
Cardiovascular risk in patients infected by the human immunodeficiency virus compared with that of uninfected patients and general population = Estudio del riesgo cardiovascular en pacientes infectados por el virus de la inmunodeficiencia humana respecto a pacientes no infectados y población general
Calvo Sánchez, Marta
Introduction: So far, HIV patients-tailored clinical guidelines, are based on the available recommendations for the general population plus on considering earlier initiation of antiretroviral therapy. This is a basic approach that although correct is likely amenable for optimization. A better understanding of the differences regarding pathogenesis, epidemiology and clinical characteristics of cardiovascular disease between HIV- 1-infected patients and uninfected individuals can help to de...
目的 分析心血管内科患者发生医院感染的临床特征,为其预防和治疗提供科学依据. 方法 对本院2010年1月～2012年6月住院的心血管内科合并医院感染的患者采用回归分析进行调查研究,通过查阅、整理、相关资料,分析心血管内科患者医院感染的感染发生率、感染部位、高危影响因素及对预后的影响. 结果 心血管内科医院感染137例,感染发生率为14.72％;患者发生感染部位以呼吸道感染为主,其中下呼吸道感染占44.53％,上呼吸道感染占23.36％,泌尿生殖道感染占15.33％,胃肠道感染占11.68％,皮肤软组织感染占10.22％,其他感染占7.30％;年龄≥60岁、住院时间≥30 d、合并基础疾病、心力衰竭、侵人性操作等为医院感染的高危因素;感染组病死率高于非感染组(x2=15.0,P＜0.05). 结论 心血管内科患者医院感染率较高,感染部位以呼吸道感染为主且与多种因素相关.应严格遵守操作规范,合理使用抗菌药以有效降低和控制医院感染的发生.%Objective To analyze the clinical characteristics of patients in Cardiovascular Medicine with a nosocomial infection in order to provide a scientific basis for the prevention and treatment of nosocomial infections.Methods Regression analysis was used to study nosocomial infections in patients in Cardiovascular Medicine at this hospital from January 2010-June 2012.Relevant data were referenced and organized.The incidence of a nosocomial infection in patients in Cardiovascular Medicine,the site of infection,risk factors for infection,and the effect of the infection on the patient's prognosis were analyzed.Results Of the patients in Cardiovascular Medicine,137developed a nosocomial infection for a rate of infection of 14.72％.The site of infection was most often the respiratory tract infection,with an infection of the lower respiratory tract accounting for 44.53％ and an infection of the upper respiratory
Full Text Available Chronic infection by HIV increases the risk of cardiovascular disease (CVD despite effective antiretroviral therapy (ART. The mechanisms linking HIV to CVD have yet to be fully elucidated. High plasma levels of the pro-inflammatory cytokine IL-6, which may be triggered by IL-1β, is a biomarker of CVD risk in HIV-negative adults, and of all-cause mortality in HIV disease. Monocytes play a pivotal role in atherosclerosis, and may be major mediators of HIV-associated inflammation. We therefore hypothesized that monocytes from HIV-infected adults would display high inflammatory responses. Employing a 10-color flow cytometry intracellular cytokine staining assay, we directly assessed cytokine and chemokine responses of monocytes from the cryopreserved peripheral blood of 33 chronically HIV-1 infected subjects. Participants were 45 years or older, on virologically suppressive ART and at risk for CVD. This group was compared to 14 HIV-negative subjects matched for age and gender, with similar CVD risk. We simultaneously detected intracellular expression of IL-1β, IL-6, IL-8 and TNF in blood monocytes in the basal state and after stimulation by triggers commonly found in the blood of treated, chronically HIV-infected subjects: lipopolysaccharide (LPS and oxidized low-density lipoprotein (oxLDL. In the absence of stimulation, monocytes from treated HIV-infected subjects displayed a high frequency of cells producing IL-1β (median 19.5%, compared to low levels in HIV-uninfected persons (0.9% p<0.0001. IL-8, which is induced by IL-1β, was also highly expressed in the HIV-infected group in the absence of stimulation, 43.7% compared to 1.9% in HIV-uninfected subjects, p<0.0001. Strikingly, high basal expression of IL-1β by monocytes predicted high IL-6 levels in the plasma, and high monocyte IL-6 responses in HIV-infected subjects. Hyper-inflammatory IL-1β enriched monocytes may be a major source of IL-6 production and systemic inflammation in HIV-infected
As a starting point, the group defined a primary goal of maintaining in flight a level of systemic oxygen transport capacity comparable to each individual's preflight upright baseline. The goal of maintaining capacity at preflight levels would seem to be a reasonable objective for several different reasons, including the maintenance of good health in general and the preservation of sufficient cardiovascular reserve capacity to meet operational demands. It is also important not to introduce confounding variables in whatever other physiological studies are being performed. A change in the level of fitness is likely to be a significant confounding variable in the study of many organ systems. The principal component of the in-flight cardiovascular exercise program should be large-muscle activity such as treadmill exercise. It is desirable that at least one session per week be monitored to assure maintenance of proper functional levels and to provide guidance for any adjustments of the exercise prescription. Appropriate measurements include evaluation of the heart-rate/workload or the heart-rate/oxygen-uptake relationship. Respiratory gas analysis is helpful by providing better opportunities to document relative workload levels from analysis of the interrelationships among VO2, VCO2, and ventilation. The committee felt that there is no clear evidence that any particular in-flight exercise regimen is protective against orthostatic hypotension during the early readaptation phase. Some group members suggested that maintenance of the lower body muscle mass and muscle tone may be helpful. There is also evidence that late in-flight interventions to reexpand blood volume to preflight levels are helpful in preventing or minimizing postflight orthostatic hypotension.
Phillips, Andrew N; Carr, Andrew; Neuhaus, Jacquie;
BACKGROUND: The SMART trial found a raised risk of cardiovascular disease (CVD) events in patients undergoing CD4+ T cell-count guided intermittent antiretroviral therapy (ART) compared with patients on continuous ART. Exploratory analyses were performed to better understand the reasons for this ......BACKGROUND: The SMART trial found a raised risk of cardiovascular disease (CVD) events in patients undergoing CD4+ T cell-count guided intermittent antiretroviral therapy (ART) compared with patients on continuous ART. Exploratory analyses were performed to better understand the reasons...... for this observation. METHODS: A total of 5,472 patients with CD4+ T-cell counts >350 cells/mm3 were recruited and randomized to either continuous ART (the viral suppression arm; VS) or CD4+ T-cell count-guided use of ART (the drug conservation arm; DC). RESULTS: Major CVD events developed in 79 patients. The hazard...... ratio (HR) for risk of CVD events for DC versus VS was 1.57 (95% confidence interval 1.00-2.46; P=0.05). There was no evidence that being off ART or a higher current HIV viral load were associated with increased CVD risk. Total cholesterol and low-density lipoprotein cholesterol were reduced as a result...
Kucukazman, M; Yeniova, O; Dal, K; Yavuz, B
Helicobacter pylori (H. pylori) is one of the most common infections in human. The association between H. pylori and gastrointestinal diseases including peptic ulcer, chronic gastritis, mucosa associated tissue lymphoma (MALT) and gastric cancer is well known. However it was also suggested that H. pylori was linked to various extra-gastrointestinal disorders such as diabetes mellitus and coronary artery disease. In this review we summarized the association between H. pylori and cardiovascular disease. PMID:26502864
Hasse, Barbara; Tarr, Philip E; Marques-Vidal, Pedro; Waeber, Gerard; Preisig, Martin; Mooser, Vincent; Valeri, Fabio; Djalali, Sima; Bernasconi, Enos; Calmy, Alexandra; Cavassini, Matthias; Vernazza, Pietro; Battegay, Manuel; Weber, Rainer; Senn, Oliver
Background. Although acquired immune deficiency syndrome-associated morbidity has diminished due to excellent viral control, multimorbidity may be increasing among human immunodeficiency virus (HIV)-infected persons compared with the general population. Methods. We assessed the prevalence of comorbidities and multimorbidity in participants of the Swiss HIV Cohort Study (SHCS) compared with the population-based CoLaus study and the primary care-based FIRE (Family Medicine ICPC-Research using...
目的 探讨研究心血管病患者合并肺部感染的危险因素,为其预防提供依据.方法 选取2008年6月-2011年10月于医院进行治疗的724例心血管病患者为研究对象,将其肺部感染发生率及危险因素进行统计分析.结果 724例患者中共发生肺部感染41例,发生率为5.66％,其中年龄＞75岁者发生率为16.98％,高于＜75岁的患者；住院时间＞两周患者的发生率为8.27％,高于＜两周患者；抗菌药物应用≥3种者发生率为14.63％,高于≤2种患者；抗菌药物应用时间≥1个月者发生率为6.31％,高于应用时间＜1个月者；吸氧及吸痰患者发生率为7.21％、13.04％,高于未进行吸氧、吸痰的患者；进行侵入性操作患者的发生率为9.95％,高于未进行侵入性操作的患者；合并≥3种基础疾病者为16.42％,高于≤两种的患者,ASA分级Ⅳ级的患者为15.38％,高于≤Ⅲ级的患者；存在其他感染灶者为10.58％,高于无感染灶者,差异均有统计学意义(均P＜0.05).结论 心血管病患者合并肺部感染的危险因素较多,应予以足够的重视.%OBJECTIVE To study the risk factors for pulmonary infections in the patients with cardiovascular disease so as to provide bases for the prevention. METHODS A total of 724 patients with cardiovascular diseases who received treatment from Jun 2008 to Oct 2011 were selected as research objects, the incidence of the pulmonary infections and the risk factors were statistically analyzed. RESULTS Pulmonary infections occurred in 41 of 724 patients with cardiovascular diseases with the incidence rate of 5. 66%, the incidence of the patients above 75 years of age was 16. 98% .higher than that of the patients aged less than 75 years of ages the incidence of the patients with the hospital stay more than 2 weeks was 8. 27%,higher than that of the patients with hospital stay less than 2 weeks; the incidence of the patients who used more than 3 antibiotics was 14
Full Text Available Hong Lai,1 Elliot K Fishman,1 Gary Gerstenblith,2 Richard Moore,2 Jeffrey A Brinker,2 Jeanne C Keruly,2 Shaoguang Chen,3 Barbara Detrick,3 Shenghan Lai1–31Department of Radiology, 2Department of Medicine, 3Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USAAbstract: Chronic cocaine use may lead to premature atherosclerosis, but the prevalence of and risk factors for coronary artery disease (CAD in asymptomatic cocaine users have not been reported. The objective of this study was to examine whether vitamin D deficiency is associated with the development of CAD in human immunodeficiency virus (HIV-infected African American cocaine users with low CAD risk.Methods: In this prospective follow-up study, we investigated 169 HIV-infected African American cocaine users with low Framingham risk at baseline. The main outcome measures were incidence of subclinical CAD and development of subclinical CAD.Results: Fifty of the 169 African Americans had evidence of subclinical disease on the initial cardiac computed tomography. A second cardiac computed tomography was performed on the 119 African Americans without disease on the first scan. The total sum of person-years of follow-up was 289.6. Subclinical CAD was detected in 11 of these, yielding an overall incidence of 3.80/100 person-years (95% confidence interval 1.90–6.80. Among the factors investigated, only vitamin D deficiency was independently associated with development of subclinical CAD. The study did not find significant associations between CD4 count, HIV viral load, or antiretroviral treatment use and the incidence of subclinical CAD. This study appears to suggest that there is a threshold level of vitamin D (10 ng/mL above which the effect of vitamin D on subclinical CAD is diminished.Conclusion: The incidence of subclinical CAD in HIV-infected African American cocaine users with low CAD risk is high, especially in those with vitamin D deficiency. Well designed
... Blood Pressure Tools & Resources Stroke More Cardiovascular Disease & Diabetes Updated:Mar 23,2016 The following statistics speak ... disease. This content was last reviewed August 2015. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...
Polcwiartek, Christoffer; Sørensen, Kristian Dahl Kragholm; Schjerning, Ole; Graff, Claus; Nielsen, Jimmi
cardiovascular risk factors. Areas covered: This clinical overview summarizes the cardiovascular safety of antipsychotics by focusing on the wide range of associated adverse effects. In addition, we also discuss current guidelines regarding routine electrocardiogram (ECG) monitoring. Expert opinion: As SCD in......, as this may increase risk of Torsades de Pointes and eventually SCD. However, other serious cardiovascular complications of antipsychotics also include Brugada syndrome phenotype, myocardial infarction, and myocarditis. Increased awareness of the cardiovascular safety of antipsychotics can allow...
Cardiovascular diseases (CVD) have a complex etiology determined by risk factors, which are in turn associated to a strong genetic component and to environmental factors. In the biological background for the development of CVD, low-grade chronic inflammation plays a role as a pathogenetic determinant of atherosclerosis. Dental infections have been associated with CVD. Periodontal disease is a chronic infection of the supporting tissues of the tooth that can lead to teeth loss. In recent years...
Aline Roth, Pressl-Wenger; Jornayvaz, François R
Type 2 diabetes is characterized by a high risk of micro- and macro-vascular complications. Cardiovascular diseases are the leading cause of death of diabetic patients. In this context, the search for molecules decreasing cardiovascular mortality makes sense. Until the EMPA-REG OUTCOME study published late 2015, showing a reduction of cardiovascular mortality of patients treated with empagliflozin, an SGLT2 inhibitor, there was no molecule known to decrease cardiovascular mortality. The purpose of this article is to review the various existing antidiabetic molecules and their impact (positive/neutral/negative) on cardiovascular mortality. PMID:27487675
Currier, Judith S; Lundgren, Jens
PURPOSE OF REVIEW: To reflect on the need for guidelines to assist clinicians in the management of cardiovascular risk in HIV-infected patients. RECENT FINDINGS: Over the past eight years guidelines for the management of dyslipidemia and metabolic complications of HIV infection have been developed...... and revised as new information becomes available. SUMMARY: Current guidelines for managing cardiovascular risk in HIV patients are limited by the currently available data, but nonetheless provide a useful approach to assist clinicians....
Martínez Torres, Alejandra; Martínez Gaensly, Miguel
There is increasing evidence that certain microbial agents may have an etiopathogenic role in the development of atherothrombosis. Helicobacter pylori, a bacterium that causes peptic ulcer disease, has been suggested as one of the microbes involved in the development of atherothrombosis. This hypothesis is based on the following observations: a) a higher prevalence of Helicobacter pylori infection in patients with coronary artery disease, myocardial infarction, or cerebrovascular disease; b) the coincidence of Helicobacter pylori infection and cardiovascular risk factors, such as serum cholesterol and triglyceride concentrations and plasma fibrinogen; c) Helicobacter pylori seropositivity correlates with acute-phase proteins associated with higher risk of coronary disease, such as C-reactive protein, and d) controversial PCR studies indicating the presence of Helicobacter pylori in atheromas. Analysis of the scientific evidence suggests that Helicobacter pylori infection could indirectly contribute to the development and severity of atherothrombosis and cardiovascular disease. PMID:12113724
骆金伟; 龚明非; 朱庆华; 叶英响
目的：分析心血管疾病患者发生肺部感染的病原菌分布，探讨主要病原菌耐药性，指导临床合理使用抗菌药物。方法选择医院2010年1月－2014年3月心血管内科收治的1244例患者为研究对象，调查分析患者肺部感染率、感染病原菌种类及其耐药性，菌株培养和分离严格按照《全国临床检验操作规程》执行，菌株鉴定采用法国生物梅里埃公司全自动细菌鉴定仪及其配套试剂，药敏试验采用纸片扩散法（K‐B ）。结果1244例患者发生肺部感染125例，感染率为10．0％；共分离出158株病原菌，革兰阴性菌106株占67．1％，革兰阳性菌36株占22．8％，真菌16株占10．1％；金黄色葡萄球菌和表皮葡萄球菌对乙酰唑胺和替考拉宁耐药率均为0；肺炎克雷伯菌对阿米卡星、美罗培南和替考拉宁耐药率最低，分别为3．1％、0和3．1％；白色假丝酵母菌和热带假丝酵母菌对氟康唑的耐药率均为0。结论心血管疾病患者发生肺部感染的病原菌以革兰阴性菌为主，其对大多数抗菌药物具有较强耐药性；临床选择抗菌药物应结合药敏试验结果，选用合理的抗菌药物，以提高临床治疗效果。%OBJECTIVE To analyze the distribution of pathogens causing pulmonary infections in patients with car‐diovascular disease so as to explore the drug resistance of pathogens ,and to guide the clinical rational use of anti‐microbial drugs .METHODS Totally 1244 patients with cardiovascular disease treated in our hospital from Jan . 2010 to Mar .2014 year in March were enrolled in this study ,and the pulmonary infection ,distribution and drug resistance of pathogens were investigated .Bacterial culture and isolation were performed strictly in accordance with National Clinical Laboratory Procedures .The identification was conducted with full automatic bacteria identi‐fier and the assorted reagents .The drug sensitivity
Lavandero, Sergio; Chiong, Mario; Rothermel, Beverly A.; Hill, Joseph A.
Cardiovascular disease is the leading cause of death worldwide. As such, there is great interest in identifying novel mechanisms that govern the cardiovascular response to disease-related stress. First described in failing hearts, autophagy within the cardiovascular system has been widely characterized in cardiomyocytes, cardiac fibroblasts, endothelial cells, vascular smooth muscle cells, and macrophages. In all cases, a window of optimal autophagic activity appears to be critical to the mai...
Lamb, H J; van der Meer, R. W.; Roos, A. (Anna); Bax, J J
Introduction Cardiovascular molecular imaging is a rapidly evolving field of research, aiming to image and quantify molecular and cellular targets in vivo. MR imaging has some inherent properties that make it very suitable for cardiovascular molecular imaging. Until now, only a limited number of studies have been published on cardiovascular molecular imaging using MR imaging. Review In the current review, MR techniques that have already shown potential are discussed. Metabolic MR imaging can ...
J.O. Younge (John)
markdownabstract__Abstract__ Globally, the burden of cardiovascular disease (CVD) is still increasing. However, in recent decades, better treatment modalities have led to less cardiovascular related deaths. After years of research, we now generally accept that lifestyle factors are the most importa
Vairamani Kandan; Sathyamurthy P; Rajkumar M; Lavanya Narayanan
Background: It is well known that thyroid hormone directly affects the heart and peripheral vascular system. In hyperthyroidism, cardiovascular manifestations are frequent findings. Atrial arrhythmias, limitations in exercise tolerance, and congestive heart failure were reported to occur more common in older patients as a result of hyperthyroidism. Cardiovascular signs of hyperthyroidism include tachycardia, widened pulse pressure, marked increase in cardiac output with impaired cardiovascula...
Nordestgaard, Børge G; Varbo, Anette
cholesterol might not cause cardiovascular disease as originally thought has now generated renewed interest in raised concentrations of triglycerides. This renewed interest has also been driven by epidemiological and genetic evidence supporting raised triglycerides, remnant cholesterol, or triglyceride......-rich lipoproteins as an additional cause of cardiovascular disease and all-cause mortality. Triglycerides can be measured in the non-fasting or fasting states, with concentrations of 2-10 mmol/L conferring increased risk of cardiovascular disease, and concentrations greater than 10 mmol/L conferring increased risk...... of acute pancreatitis and possibly cardiovascular disease. Although randomised trials showing cardiovascular benefit of triglyceride reduction are scarce, new triglyceride-lowering drugs are being developed, and large-scale trials have been initiated that will hopefully provide conclusive evidence...
Although huge and long-lasting research efforts have been spent on the development of new diagnostic techniques investigating cardiovascular diseases, still fundamental challenges exist; the main challenge being the diagnosis of a suspected or known coronary artery disease or its consequences (myocardial infarction, heart failure etc.). Beside morphological techniques, functional imaging modalities are available in clinical diagnostic algorithms, whereas molecular cardiovascular imaging techniques are still under development. This review summarizes clinical-diagnostical challenges of modern cardiovascular medicine as well as the potential of new molecular imaging techniques to face these. (orig.)
万春霞; 秦凤华; 黄家芹
目的：观察并分析心血管病住院患者医院感染的临床特点、危险因素，探讨预防医院感染的相关措施，为降低医院感染提供依据。方法回顾性分析2012年1月－2013年12月住院的495例心血管病患者发生感染部位、病原菌种类等资料。结果495例心血管病患者发生医院感染59例，感染率为11．9％；感染部位以呼吸道感染为主占62．7％，其余依次为泌尿道、胃肠道、皮肤、血液，分别占15．3％、10．2％、8．5％、3．4％；检出66株病原菌，其中革兰阴性菌占69．7％，革兰阳性菌占30．3％，单因素分析，心血管病患者发生医院感染与年龄、住院时间、心功能分级、病程、侵入操作和合并基础疾病呈明显相关性（P＜ 0．05），logistic 回归模型多因素分析，发现年龄、住院时间、心功能分级和侵入操作是心血管病患者发生医院感染的独立危险因素（P＜ 0．05）。结论心血管内科住院患者的医院感染率较高，临床应根据病原菌的临床特点和危险因素，及早采取预防措施，减少医院感染的发生。%OBJECTIVE To observe the clinical characteristics of nosocomial infections in the hospitalized patients with cardiovascular diseases ,analyze the risk factors ,and put forward corresponding prevention measures for the nosocomial infections so as to provide guidance for reduction of incidence of nosocomial infections .METHODS A total of 495 patients with cardiovascular diseases who were hospitalized from Jan 2012 to Dec 2013 were enrolled in the study ,and the clinical data of the participants were retrospectively analyzed ,including the infection sites ,spe-cies of pathogens .RESULTS The nosocomial infections occurred in 59 of 495 patients with cardiovascular diseases , with the infection rate of 11 .9% ;the patients with respiratory tract infections accounted for 62 .7% ,the patients with urinary tract infections 15 .3
Spadaccio, Cristiano; Chello, Massimo; Trombetta, Marcella; Rainer, Alberto; Toyoda, Yoshiya; Genovese, Jorge A
Abstract Heart disease and atherosclerosis are the leading causes of morbidity and mortality worldwide. The lack of suitable autologous grafts has produced a need for artificial grafts; however, current artificial grafts carry significant limitations, including thrombosis, infection, limited durability and the inability to grow. Tissue engineering of blood vessels, cardiovascular structures and whole organs is a promising approach for creating replacement tissues to repair congenital defects ...
Bradley, Steven M; Rumsfeld, John S
There is a wealth of evidence linking depression to increased risk for cardiovascular disease (CVD) and worse outcomes among patients with known CVD. In addition, there are safe and effective treatments for depression. Despite this, depression remains under-recognized and undertreated in patients at risk for or living with CVD. In this review, we first summarize the evidence linking depression to increased risk of CVD and worse patient outcomes. We then review the mechanisms by which depression may contribute to cardiovascular risk and poor cardiovascular outcomes. We then summarize prior studies of depression treatment on cardiovascular outcomes. Finally, we offer guidance in the identification and management of depression among CVD populations. Given that 1 in 4 CVD patients has concurrent depression, application of these best-practices will assist providers in achieving optimal outcomes for their CVD patients. PMID:25850976
Kangas, L.J.; Keller, P.E.; Hashem, S.; Kouzes, R.T. [Pacific Northwest Lab., Richland, WA (United States)
In this paper, a novel approach to modeling and diagnosing the cardiovascular system is introduced. A model exhibits a subset of the dynamics of the cardiovascular behavior of an individual by using a recurrent artificial neural network. Potentially, a model will be incorporated into a cardiovascular diagnostic system. This approach is unique in that each cardiovascular model is developed from physiological measurements of an individual. Any differences between the modeled variables and the variables of an individual at a given time are used for diagnosis. This approach also exploits sensor fusion to optimize the utilization of biomedical sensors. The advantage of sensor fusion has been demonstrated in applications including control and diagnostics of mechanical and chemical processes.
Suglia, Shakira F.; Sapra, Katherine J.; Koenen, Karestan C.
Context Violence, experienced in either childhood or adulthood, has been associated with physical health outcomes including cardiovascular disease. However, the consistency of the existing literature has not been evaluated. Evidence acquisition In 2013, the authors conducted a PubMed and Web of Science review of peer reviewed articles published prior to August 2013 on the relation between violence exposure, experienced in either childhood or adulthood, and cardiovascular outcomes. To meet inclusion criteria, articles had to present estimates for the relation between violence exposure and cardiovascular outcomes (hypertension, blood pressure, stroke, coronary disease, or myocardial infarction) adjusted for demographic factors. Articles focusing on violence from TV, video games, natural disasters, terrorism, or war were excluded. Evidence synthesis The initial search yielded 2,273 articles; after removing duplicates and applying inclusion and exclusion criteria, 30 articles were selected for review. A consistent positive relation was noted on the association between violence experienced during childhood and cardiovascular outcomes in adulthood (i.e., hypertension, coronary heart disease, and myocardial infarction). Associations across genders with varying types of violence exposure were also noted. By contrast, findings were mixed on the relation between adult violence exposure and cardiovascular outcome. Conclusions Despite varying definitions of violence exposure and cardiovascular endpoints, a consistent relation exists between childhood violence exposure, largely assessed retrospectively, and cardiovascular endpoints. Findings are mixed for the adult violence–cardiovascular health relation. The cross-sectional nature of most adult studies and the reliance of self-reported outcomes can potentially be attributed to the lack of findings among adult violence exposure studies. PMID:25599905
The first marathon run as an athletic event took place in the context of the Olympic Games in 1896 in Athens, Greece. Today, participation in a 'marathon run' has become a global phenomenon attracting young professional athletes as well as millions of mainly middle-aged amateur athletes worldwide each year. One of the main motives for these amateur marathon runners is the expectation that endurance exercise (EE) delivers profound beneficial health effects. However, with respect to the cardiovascular system, a controversial debate has emerged whether the marathon run itself is healthy or potentially harmful to the cardiovascular system, especially in middle-aged non-elite male amateur runners. In this cohort, exercise-induced increases in cardiac biomarkers-troponin and brain natriuretic peptide-and acute functional cardiac alterations have been observed and interpreted as potential cardiac damage. Furthermore, in the cohort of 40- to 65-year-old males engaged in intensive EE, a significant risk for the development of atrial fibrillation has been identified. Fortunately, recent studies demonstrated a normalization of the cardiac biomarkers and the functional alterations within a short time frame. Therefore, these alterations may be perceived as physiological myocardial reactions to the strenuous exercise and the term 'cardiac fatigue' has been coined. This interpretation is supported by a recent analysis of 10.9 million marathon runners demonstrating that there was no significantly increased overall risk of cardiac arrest during long-distance running races. In conclusion, intensive and long-lasting EE, e.g. running a full-distance Marathon, results in high cardiovascular strain whose clinical relevance especially for middle-aged and older athletes is unclear and remains a matter of controversy. Furthermore, there is a need for evidence-based recommendations with respect to medical screening and training strategies especially in male amateur runners over the age of
Full Text Available Abstract Air pollution is increasingly recognized as an important and modifiable determinant of cardiovascular diseases in urban communities. The potential detrimental effects are both acute and chronic having a strong impact on morbidity and mortality. The acute exposure to pollutants has been linked to adverse cardiovascular events such as myocardial infarction, heart failure and life-threatening arrhythmias. The long-terms effects are related to the lifetime risk of death from cardiac causes. The WHO estimates that air pollution is responsible for 3 million premature deaths each year. The evidence supporting these data is very strong nonetheless, epidemiologic and observational data have the main limitation of imprecise measurements. Moreover, the lack of clinical experimental models makes it difficult to demonstrate the individual risk. The other limitation is related to the lack of a clear mechanism explaining the effects of pollution on cardiovascular mortality. In the present review we will explore the epidemiological, clinical and experimental evidence of the effects of ozone on cardiovascular diseases. The pathophysiologic consequences of air pollutant exposures have been extensively investigated in pulmonary systems, and it is clear that some of the major components of air pollution (e.g. ozone and particulate matter can initiate and exacerbate lung disease in humans 1. It is possible that pulmonary oxidant stress mediated by particulate matter and/or ozone (O3 exposure can result in downstream perturbations in the cardiovasculature, as the pulmonary and cardiovascular systems are intricately associated, and it is well documented that specific environmental toxins (such as tobacco smoke 2 introduced through the lungs can initiate and/or accelerate cardiovascular disease development. Indeed, several epidemiologic studies have proved that there is an association between PM and O3 and the increased incidence of cardiovascular morbidity
Hilfiker-Kleiner, Denise; Bauersachs, Johann
Cardiovascular diseases are among the most frequent complications in pregnancies. Among them preexisting heart diseases including congenital heart disease, genetic cardiomyopathies, myocardial infarction and chemotherapy-induced cardiomyopathies display a special challenge for the mother and her physicians. Moreover, the incidence of cardiovascular disease induced by or associated with pregnancy, i.e. hypertensive disorders and peripartum cardiomyopathies, has increased over the past decades. In the present overview we explain why pregnancy is a stress model for the maternal heart and summarize the current knowledge on the influence of pregnancy on preexisting cardiomyopathies. We highlight recent advances in research with regard to hypertensive complications in pregnancy and peripartum cardiomyopathy (PPCM). Moreover, we summarize etiologies, risk factors, pathomechanisms, diagnosis, treatment, management and prognosis. Finally, interdisciplinarity between different clinical fields and basic science is a key requirement to avoid longterm damage to the cardiovascular system induced by pregnancy associated impacts and with this improve women's health in general. PMID:26800071
Weeke, Peter; Roden, Dan M
Variability in drug responsiveness is a sine qua non of modern therapeutics, and the contribution of genomic variation is increasingly recognized. Investigating the genomic basis for variable responses to cardiovascular therapies has been a model for pharmacogenomics in general and has established...... resulted in changes to the product labels but also have led to development of initial clinical guidelines that consider how to facilitate incorporating genetic information to the bedside. This review summarizes the state of knowledge in cardiovascular pharmacogenomics and considers how variants described...
Truskey, George A.
Cardiovascular tissue engineering offers the promise of biologically based repair of injured and damaged blood vessels, valves, and cardiac tissue. Major advances in cardiovascular tissue engineering over the past few years involve improved methods to promote the establishment and differentiation of induced pluripotent stem cells (iPSCs), scaffolds from decellularized tissue that may produce more highly differentiated tissues and advance clinical translation, improved methods to promote vascularization, and novel in vitro microphysiological systems to model normal and diseased tissue function. iPSC technology holds great promise, but robust methods are needed to further promote differentiation. Differentiation can be further enhanced with chemical, electrical, or mechanical stimuli. PMID:27303643
Several lines of epidemical evidence have shown that type 2 diabetes is the most important risk factor for cardiovascular diseases (CVD). It has been shown that the risk of primary prevention of CVD in patients with diabetes is equal to that of the secondary prevention in general population. In this manuscript, recent reports on the cardiac tests to detect the cardiovascular lesions will be reviewed. The data suggest that MDCT is a promising test even in the patients with diabetes. Furthermore, recent evidence of the treatment of diabetes with insulin or the drugs available recently such as DPP-4 inhibitors and SGLT-2 inhibitors will be reviewed. PMID:26666152
Jaarsma, Tiny; Deaton, Christi; Fitzsimmons, Donna;
To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined...... of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given....
The increased incidence of cardiovascular diseases (CVDs) has stimulated research for substances that could improve cardiovascular health. Among them, resveratrol (RES), a polyphenolic compound notably present in grapes and red wine, has been involved in the “French paradox”. RES is known for its antioxidant and anti-inflammatory properties and for its ability to upregulate endothelial NO synthase (eNOS). RES was able to scavenge •OH/O2•− and peroxyl radicals, which can limit the lipid peroxi...
Studies have supported the notion that subjects with periodontitis and patients with multiple tooth extractions as a result of chronic advanced periodontal disease (PDD) have a greater risk of developing Cardiovascular disease (CVD) than those who had little or no periodontal infection. Periodontitis may predispose affected patients to CVD by elevating systemic C-reactive protein level and pro-inflammatory activity in atherosclerotic lesions and accelerate development of cardiovascular diseases, Oral health variables including loss of teeth, positive plaque Benzoyl-D-L-Arginine- Naphthyl Amide test (BANA) scores, and compliant of xerostomia may by considered as risk indicators for CVD. Exact mechanism which links PDD and CVD has not been firmly established. The link between PDD and CVD may be attributed to bacteria entering blood stream and attaching to the fatty plaque in coronary artery and contributing to clot formation which can lead to heart attack. Inflammation caused by PDD increases the plaque build up. The association between the two disease entities is cause for concern. However, dental and medical practitioners should be aware of these findings to move intelligently to interact with inquiring patients with periodontitis. They should be urged to maintain medical surveillance of their cardiovascular status, and work on controlling or reducing all known risk factors associated with CVD, including periodontal infection. (author)
Botez C; Brujbu Isabella Cristina; V.R. Murariu
The association between dental and cardio-vascular diseases is essential as both are highly prevalent. Finding a possible causal relation between cardiovascular disease and chronic periodontal pathology, known to cause tooth loss, is therefore essential. The existence of some risk factors, such as smoking, bacterial infections, malnutrition and nutritional deficiencies, may explain the associations observed between cardio-vascular and oral pathologies. In the case of d...
Hjerpsted, Julie Bousgaard
Cardiovascular diseases (CVDs) are the number one cause of mortality worldwide. Low-density lipoprotein (LDL) cholesterol is a well-known risk factor of CVD which increases after the intake of saturated fatty acids (SFA). Cheese is a dietary product commonly consumed in Western countries and known...
Despite advances in the prevention and management of cardiovascular disease (CVD), this group of multifactorial disorders remains a leading cause of mortality worldwide. CVD is associated with multiple genetic and modifiable risk factors; however, known environmental and genetic influences can only...
R.L. Nijhuis (Rogier)
textabstractWhereas secondary prevention of cardiovascular events through risk factor modification in patients with known coronary and carotid artery disease is recognised as cost-effective, CVD prevention by drug therapy in asymptomatic individuals has shown only modest benefits and to be relativel
Jenkins, C. David
Reviews epidemiological studies of cardiovascular diseases especially coronary heart disease (CHD), to document their major public health importance, changes in mortality during this century, and international comparisons of trends. Finds major risk factors for CHD are determined in large part by psychosocial and behavioral mechanisms. Asserts…
Childhood obesity has reached epidemic proportions. Many of these children have risk factors for later disease, including cardiovascular disease. For optimal cardiovascular health, health care professionals must be able to identify children and youth at risk and provide appropriate support as needed. The present article reviews the current medical literature on obesity and cardiovascular disease risk factors in the paediatric population, the long-term cardiovascular consequences of childhood ...
Nordestgaard, B G; Langsted, A; Freiberg, J J
, total cholesterol/HDL cholesterol, and apolipoprotein B/apolipoprotein A1 all associate with increased risk of cardiovascular disease. These new data open the possibility that nonfasting rather than fasting lipid profiles can be used for cardiovascular risk prediction. If implemented, this would...... of cardiovascular disease and early death....
Han, Seung Hwan; Nicholls, Stephen J.; Sakuma, Ichiro; Zhao, Dong; Koh, Kwang Kon
Residual cardiovascular risk and failure of high density lipoprotein cholesterol raising treatment have refocused interest on targeting hypertriglyceridemia. Hypertriglyceridemia, triglyceride-rich lipoproteins, and remnant cholesterol have demonstrated to be important risk factors for cardiovascular disease; this has been demonstrated in experimental, genetic, and epidemiological studies. Fibrates can reduce cardiovascular event rates with or without statins. High dose omega-3 fatty acids co...
Roed, Torsten; Lebech, Anne-Mette; Kjaer, Andreas; Weis, Nina
Several chronic infections have been associated with cardiovascular diseases, including Chlamydia pneumoniae, human immunodeficiency virus and viral hepatitis. This review evaluates the literature on the association between chronic hepatitis C virus (HCV) infection and the risk of coronary artery...
Full Text Available Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.
Marcelo E. Bigal
Full Text Available Migraine, especially migraine with aura is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine with and without aura to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication and cardiovascular mortality. The topic is therefore of considerable interest. Accordingly, herein we review the association between migraine and cardiovascular disease. We start by briefly presenting diagnostic criteria for migraine and revising its pathophysiology. We follow by summarizing the evidence on the topic. We then briefly present the results of a recent meta-analysis. We close by highlighting results of a large epidemiological study conducted after the publication of the meta-analysis.
Full Text Available Prodrugs are biologically inactive derivatives of an active drug intended to solve certain problems of the parent drug such as toxicity, instability, minimal solubility and non-targeting capabilities. The majority of drugs for cardiovascular diseases undergo firstpass metabolism, resulting in drug inactivation and generation of toxic metabolites, which makes them appealing targets for prodrug design. Since prodrugs undergo a chemical reaction to form the parent drug once inside the body, this makes them very effective in controlling the release of a variety of compounds to the targeted site. This review will provide the reader with an insight on the latest developments of prodrugs that are available for treating a variety of cardiovascular diseases. In addition, we will focus on several drug delivery methodologies that have merged with the prodrug approach to provide enhanced target specificity and controlled drug release with minimal side effects.
This year's cardiovascular section demonstrates a continued growth in the number of digests on cardivascular and general interventional topics and continued progress in MRI studies. The reader will also notice fewer digests on DSA and percutaneous stone removal compared with the 1985 and 1986 Year Books. While newer technology, such as extracorporeal shock wave lithotripsy, has significantly reduced the number of percutaneous procedures for renal calculi, other interventional procedures, such as those involving fibrinolysis, are increasing by leaps and bounds. A number of digests on benign and malignant bile duct strictures continue to shed light on the management of these difficult cases. While abscess drainage is growing and well accepted by most surgeons, articles on esophageal dilatations seem to be declining in the radiology literature, probably on the basis of fewer operations being performed by us and more being performed by endoscopists. Digests on MRI in the cardiovascular system continue to report excellent images of the aorta and of congenital heart disease
Radioisotopic angiocardiography, performed after the intravenous injection of 99/sup m/Tc-labeled pertechnetate or albumin, is a simple, rapid, and safe procedure which permits identification and physiologic assessment of a wide variety of congenital and acquired cardiovascular lesions in infants and children. These include atrial and ventricular septal defect, tetralogy of Fallot, pulmonic stenosis, aortopulmonary window, transposition of the great vessels, valvular stenosis and/or insufficiency, myocardial lesions, and lesions of the great vessels. The simplicity of the procedure lends itself to repeated measurements to assess the effects of therapy or to follow the course of the disease. A wide spectrum of congenital and acquired cardiovascular diseases have been studied which have particular application to the pediatric age group. (auth)
Although there have been significant improvements in the treatment of cardiovascular diseases they still remain the main cause of morbidity and mortality globally. Currently available diagnostic approaches may not be adequate to detect pathologic changes during the early disease stages, which may be valuable for risk stratification and also to assess a response to a therapy. Therefore molecular imaging techniques such as Contrast Enhanced Ultrasound (CEU) molecular imaging to noninvasively i...
Viktoriya Georgievna Barskova
Full Text Available Meticulous attention is paid to the cardiovascular safety of nonsteroidal anti-inflammatory drugs (NSAIDs, the so-called selective cyclooxy-genase 2 (COX-2 inhibitors in particular. The author considers precisely this matter in case of Russia's recent NSAID etoricoxib that has been tested along with other most studied medications from this group, by applying one of the latest meta-analyses. The EULAR recommendations to use NSAIDs are given.
According to the World Health Organization (WHO), cardiovascular disease (CVD), which sits under the chronic disease umbrella, is the number one cause of death globally. Over time, we have witnessed different trends that have influenced the prevalence of CVD. One of the ways of decreasing CVD and its social costs and global fatalities is through influencing preventable CVD risk factors. Though many risk factors such as age and gender are not preventable, there are several effective behaviours...
Sady Montes Amador; Mikhail Benet Rodríguez; Lenia Ramos Rodríguez; Esther Cano Andino; Erick Andrés Pérez Martín
Background: cardiovascular hyperreactivity in young people has been associated with different risk factors and a family history of hypertension. Objective: to determine the association between a family history of hypertension and cardiovascular risk factors with cardiovascular hyperreactivity. Method: a correlational, cross-sectional study was conducted in a universe of 77 young individuals aged 18 to 40 years from the Churuguara parish of the Falcon State in Venezuela. The variables were: ag...
Mohammad Hassan Ghadiani
Full Text Available Cocaine is used by more than 14 million people worldwide, about 0.3 percent of the global population age is 15 to 64 years. After alcohol, cocaine is the most common cause of acute drug-related emergency department visits in the United States. Cocaine consumption is more frequently associated with acute cardiovascular illness. Cocaine stimulates α1, α2, β1 and β2 adrenergic receptors through increased levels of norepinephrine and a lesser extent epinephrine. The cardiovascular effects of cocaine are thought to be similar and regardless to the route of consumption. An acute coronary syndrome is the most common cardiac problem including myocardial ischemia and infarction even in young persons without atherosclerosis, aortic dissection and rupture, arrhythmias, ventricular tachycardia and fibrillation, asystole and finally sudden death. Other cardiovascular effects that caused by cocaine include coronary artery aneurysm, palpitation, sinus tachycardia, increased systemic vascular resistance and hypertension crisis, left ventricular hypertrophy, myocarditis, cardiomyopathy, myocardial fibrosis, bundle branch block, heart block, supraventricular arrhythmia, accelerated atherosclerosis, hypotension, bradycardia and infective endocarditis among intravenous users.Cocaine by three mechanisms cause ischemia: 1. increased myocardial oxygen demand, 2. decreased coronary blood flow due to coronary artery vasoconstriction and spasm and 3. Coronary artery thrombosis via activation of platelets, stimulation of platelet aggregation and potentiation of thromboxane production.
Nurmohamed, Michael T; Heslinga, Maaike; Kitas, George D
Patients with rheumatoid arthritis (RA) and other inflammatory joint diseases (IJDs) have an increased risk of premature death compared with the general population, mainly because of the risk of cardiovascular disease, which is similar in patients with RA and in those with diabetes mellitus. Pathogenic mechanisms and clinical expression of cardiovascular comorbidities vary greatly between different rheumatic diseases, but atherosclerosis seems to be associated with all IJDs. Traditional risk factors such as age, gender, dyslipidaemia, hypertension, smoking, obesity and diabetes mellitus, together with inflammation, are the main contributors to the increased cardiovascular risk in patients with IJDs. Although cardiovascular risk assessment should be part of routine care in such patients, no disease-specific models are currently available for this purpose. The main pillars of cardiovascular risk reduction are pharmacological and nonpharmacological management of cardiovascular risk factors, as well as tight control of disease activity. PMID:26282082
Shi, Y; Camici, G G; Lüscher, T. F.
The prevalence of cardiovascular diseases rises with aging and is one of the main causes of mortality in western countries. In view of the progressively aging population, there is an urge for a better understanding of age-associated cardiovascular diseases and its underlying molecular mechanisms. The risk factors for cardiovascular diseases include unhealthy diet, diabetes, obesity, smoking, alcohol consumption, physical inactivity, and aging. Increased production of oxygen-derived free radic...
Traffic noise is an increasing problem in urban areas worldwide, but health effects in relation to traffic noise exposure are not well understood. Several studies show that noise may give rise to acute stress reactions, possibly leading to cardiovascular effects, but the evidence is limited on cardiovascular risks associated with traffic noise exposure. Cardiovascular effects have been indicated for other environmental stressors such as occupational noise exposure and job ...
Jeftha, A; Holmes, H
Periodontal medicine has been studied and reviewed extensively since its introduction to the dental fraternity. The association of periodontal disease with and its effects on the cardiovascular system are amongst the many topics explored. A summary of the research into these associations and the possible mechanisms of any relationship is presented. Although a link between these two chronic inflammatory diseases is evident, the very heterogeneity of the relevant studies has not provided evidence sufficient to support an actual causal relationship. More stringent epidemiologic and intervention studies are required. PMID:23951765
... This childhood illness can result in long-term heart complications. Learn the symptoms, diagnosis and treatment for Kawasaki disease. Rheumatic Fever This inflammatory infection can occur after strep ...
Murray, Karsten; Burkard, Thilo
Hyperuricemia, gout as well as arterial hypertension and metabolic syndrom are highly prevalent and clinicians are frequently confronted with both conditions in the same patient. Hyperuricemia and gout are associated with cardiovascular comorbidities and a high cardiovascular risk. Despite coherent pathophysiological concepts, it remains to be determined, if this association is independent and causal. In daily clinical practice, cardiovascular risk factors should be thoroughly identified and consequently treated in all patients with hyperuricemia and gout. If preventive treatment of asymptomatic hyperuricemia with urate-lowering agents may improve cardiovascular risk and outcomes remains to be determined and is recommended only in special situations like young patients with severe hyperuricemia. PMID:27008446
Full Text Available In the special issue “Oxidative Stress in Cardiovascular Disease” authors were invited to submit papers that investigate key questions in the field of cardiovascular free radical biology. The original research articles included in this issue provide important information regarding novel aspects of reactive oxygen species (ROS-mediated signaling, which have important implications in physiological and pathophysiological cardiovascular processes. The issue also included a number of review articles that highlight areas of intense research in the fields of free radical biology and cardiovascular medicine.
Full Text Available The increased incidence of cardiovascular diseases (CVDs has stimulated research for substances that could improve cardiovascular health. Among them, resveratrol (RES, a polyphenolic compound notably present in grapes and red wine, has been involved in the “French paradox”. RES is known for its antioxidant and anti-inflammatory properties and for its ability to upregulate endothelial NO synthase (eNOS. RES was able to scavenge •OH/O2•− and peroxyl radicals, which can limit the lipid peroxidation processes. Moreover, in bovine aortic endothelial cells (BAEC under glucose-induced oxidative stress, RES restored the activity of dimethylargininedimethylaminohydrolase (DDAH, an enzyme that degrades an endogenous inhibitor of eNOS named asymmetric dimethylarginine (ADMA. Thus, RES could improve •NO availability and decrease the endothelial dysfunction observed in diabetes. Preclinical studies have made it possible to identify molecular targets (SIRT-1, AMPK, Nrf2, NFκB…; however, there are limited human clinical trials, and difficulties in the interpretation of results arise from the use of high-dose RES supplements in research studies, whereas low RES concentrations are present in red wine. The discussions on potential beneficial effects of RES in CVDs (atherosclerosis, hypertension, stroke, myocardial infarction, heart failure should compare the results of preclinical studies with those of clinical trials.
Full Text Available Shashi K AgarwalMedical Director, Agarwal Health Center, NJ, USAAbstract: Regular physical activity during leisure time has been shown to be associated with better health outcomes. The American Heart Association, the Centers for Disease Control and Prevention and the American College of Sports Medicine all recommend regular physical activity of moderate intensity for the prevention and complementary treatment of several diseases. The therapeutic role of exercise in maintaining good health and treating diseases is not new. The benefits of physical activity date back to Susruta, a 600 BC physician in India, who prescribed exercise to patients. Hippocrates (460–377 BC wrote “in order to remain healthy, the entire day should be devoted exclusively to ways and means of increasing one's strength and staying healthy, and the best way to do so is through physical exercise.” Plato (427–347 BC referred to medicine as a sister art to physical exercise while the noted ancient Greek physician Galen (129–217 AD penned several essays on aerobic fitness and strengthening muscles. This article briefly reviews the beneficial effects of physical activity on cardiovascular diseases.Keywords: exercise, cardiovascular disease, lifestyle changes, physical activity, good health
Contamination during production of heater-cooler units by Mycobacterium chimaera potential cause for invasive cardiovascular infections: results of an outbreak investigation in Germany, April 2015 to February 2016.
Haller, Sebastian; Höller, Christiane; Jacobshagen, Anja; Hamouda, Osamah; Abu Sin, Muna; Monnet, Dominique L; Plachouras, Diamantis; Eckmanns, Tim
Invasive infections with Mycobacterium chimaera were reported in patients with previous open chest surgery and exposure to contaminated heater-cooler units (HCUs). We present results of the surveillance of clinical cases and of contaminated HCUs as well as environmental investigations in Germany up until February 2016. Clinical infections occurred in five male German cases over 50 years of age (range 53-80). Cases had been exposed to HCUs from one single manufacturer during open chest surgery up to five years prior to onset of symptoms. During environmental investigations, M. chimaera was detected in samples from used HCUs from three different countries and samples from new HCUs as well as in the environment at the manufacturing site of one manufacturer in Germany. Our investigation suggests that at least some of the M. chimaera infections may have been caused by contamination of HCUs at manufacturing site. We recommend that until sustainable measures for safe use of HCUs in operation theatres are implemented, users continue to adhere to instructions for use of HCUs and Field Safety Notices issued by the manufacturer, implement local monitoring for bacterial contamination and continuously check the websites of national and European authorities for current recommendations for the safe operation of HCUs. PMID:27168588
Hjerpsted, Julie Bousgaard; Tholstrup, Tine
Abstract Currently, the effect of dairy products on cardiovascular risk is a topic with much debate and conflicting results. The purpose of this review is to give an overview of the existing literature regarding the effect of cheese intake and risk of cardiovascular disease (CVD). Studies included...
effects. One serious adverse effect is the risk of cardiovascular dysfunction. Some targeted therapies, eg, treatment with monoclonal antibodies or angiogenesis inhibitors, have shown an increased risk of cardiac events. Their influence on the cardiovascular system, however, seems to be transient, but...
Gejl, Michael; Starup-Linde, Jakob; Thomsen, Jan Lykke Scheel;
AIMS: Type 2 diabetes (DM) increases the risk of cardiovascular disease. We investigated the effects of antidiabetic drugs on the composite endpoint (CE) of ischemic heart disease, heart failure or stroke in DM patients. METHODS: We conducted a nested case-control study. Cases were DM patients who......% CI: 16.88-24.12), neuropathy (OR=1.39, 95% CI: 1.05-1.85) and peripheral artery disease (OR=1.31, 95% CI: 1.02-1.69) increased the risk of CE. Biguanides (OR=0.62 95% CI; 0.54-0.71) and liraglutide (OR=0.48 95% CI; 0.38-0.62) significantly decreased the risk of CE as did statin treatment (OR=0.63, 95...
Møller, Søren; Henriksen, Jens Henrik
without adequate plasma volume expansion, transjugular intrahepatic portosystemic shunt (TIPS) insertion, peritoneovenous shunting and surgery. Cardiac failure is an important cause of mortality after liver transplantation, but improved liver function has also been shown to reverse the cardiac......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction and...... abnormalities. No specific treatment can be recommended, and cardiac failure should be treated as in non-cirrhotic patients with sodium restriction, diuretics, and oxygen therapy when necessary. Special care should be taken with the use of ACE inhibitors and angiotensin antagonists in these patients. The...
Cooney, Marie Therese
Atherosclerotic cardiovascular disease (CVD) is the most common cause of death worldwide. Usually atherosclerosis is caused by the combined effects of multiple risk factors. For this reason, most guidelines on the prevention of CVD stress the assessment of total CVD risk. The most intensive risk factor modification can then be directed towards the individuals who will derive the greatest benefit. To assist the clinician in calculating the effects of these multiple interacting risk factors, a number of risk estimation systems have been developed. This review address several issues regarding total CVD risk assessment: Why should total CVD risk be assessed? What risk estimation systems are available? How well do these systems estimate risk? What are the advantages and disadvantages of the current systems? What are the current limitations of risk estimation systems and how can they be resolved? What new developments have occurred in CVD risk estimation?
Full Text Available Edoardo Mannucci,1 Stefano Giannini,2 Ilaria Dicembrini1 1Diabetes Agency, Careggi Teaching Hospital, Florence, 2Section of Endocrinology, Department of Biomedical Clinical and Experimental Sciences, University of Florence and Careggi University Hospital, Florence, Italy Abstract: Basal insulin is an important component of treatment for both type 1 and type 2 diabetes. One of the principal aims of treatment in patients with diabetes is the prevention of diabetic complications, including cardiovascular disease. There is some evidence, although controversial, that attainment of good glycemic control reduces long-term cardiovascular risk in both type 1 and type 2 diabetes. The aim of this review is to provide an overview of the potential cardiovascular safety of the different available preparations of basal insulin. Current basal insulin (neutral protamine Hagedorn [NPH], or isophane and basal insulin analogs (glargine, detemir, and the more recent degludec differ essentially by various measures of pharmacokinetic and pharmacodynamic effects in the bloodstream, presence and persistence of peak action, and within-subject variability in the glucose-lowering response. The currently available data show that basal insulin analogs have a lower risk of hypoglycemia than NPH human insulin, in both type 1 and type 2 diabetes, then excluding additional harmful effects on the cardiovascular system mediated by activation of the adrenergic system. Given that no biological rationale for a possible difference in cardiovascular effect of basal insulins has been proposed so far, available meta-analyses of publicly disclosed randomized controlled trials do not show any signal of increased risk of major cardiovascular events between the different basal insulin analogs. However, the number of available cardiovascular events in these trials is very small, preventing any clear-cut conclusion. The results of an ongoing clinical trial comparing glargine and degludec with
G.M.N. Behrens; P. Reiss
Purpose of review This review focuses on current studies addressing the association of abacavir (ABC) therapy and myocardial risk in HIV-infected patients, discusses potential pathogenetic mechanisms, and suggests a preliminary algorithm for decision making regarding ABC therapy in daily clinical pr
Fraser D Russell
Full Text Available Fraser D RussellSchool of Health and Sport Sciences, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs, Queensland, AustraliaAbstract: Cardiovascular function is modulated by neuronal transmitters, circulating hormones, and factors that are released locally from tissues. Urotensin II (UII is an 11 amino acid peptide that stimulates its’ obligatory G protein coupled urotensin II receptors (UT to modulate cardiovascular function in humans and in other animal species, and has been implicated in both vasculoprotective and vasculopathic effects. For example, tissue and circulating concentrations of UII have been reported to increase in some studies involving patients with atherosclerosis, heart failure, hypertension, preeclampsia, diabetes, renal disease and liver disease, raising the possibility that the UT receptor system is involved in the development and/or progression of these conditions. Consistent with this hypothesis, administration of UT receptor antagonists to animal models of cardiovascular disease have revealed improvements in cardiovascular remodelling and hemodynamics. However, recent studies have questioned this contributory role of UII in disease, and have instead postulated a protective effect on the cardiovascular system. For example, high concentrations of circulating UII correlated with improved clinical outcomes in patients with renal disease or myocardial infarction. The purpose of this review is to consider the regulation of the cardiovascular system by UII, giving consideration to methodologies for measurement of plasma concentrations, sites of synthesis and triggers for release.Keywords: urotensin II, cardiovascular disease, heart failure, hypertension
Fraser D Russell
Full Text Available Fraser D RussellSchool of Health and Sport Sciences, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs, Queensland, AustraliaAbstract: Cardiovascular function is modulated by neuronal transmitters, circulating hormones, and factors that are released locally from tissues. Urotensin II (UII is an 11 amino acid peptide that stimulates its’ obligatory G protein coupled urotensin II receptors (UT to modulate cardiovascular function in humans and in other animal species, and has been implicated in both vasculoprotective and vasculopathic effects. For example, tissue and circulating concentrations of UII have been reported to increase in some studies involving patients with atherosclerosis, heart failure, hypertension, preeclampsia, diabetes, renal disease and liver disease, raising the possibility that the UT receptor system is involved in the development and/or progression of these conditions. Consistent with this hypothesis, administration of UT receptor antagonists to animal models of cardiovascular disease have revealed improvements in cardiovascular remodelling and hemodynamics. However, recent studies have questioned this contributory role of UII in disease, and have instead postulated a protective effect on the cardiovascular system. For example, high concentrations of circulating UII correlated with improved clinical outcomes in patients with renal disease or myocardial infarction. The purpose of this review is to consider the regulation of the cardiovascular system by UII, giving consideration to methodologies for measurement of plasma concentrations, sites of synthesis and triggers for release.Keywords: urotensin II, cardiovascular disease, heart failure, hypertension
Full Text Available BACKGROUND: The average lifespan of humans is increasing, and with it the percentage of people entering the 65 and older age group is growing rapidly and will continue to do so in the next 20 years. Within this age group, cardiovascular disease will remain the leading cause of death, and the cost associated with treatment will continue to increase. Aging is an inevitable part of life and unfortunately poses the largest risk factor for cardiovascular disease. CONTENT: We provide an overview of some of the molecular mechanisms involved in regulating lifespan and health, including mitochondria, telomeres, stem cells, sirtuins, Adenosine Monophosphate-activated Protein Kinase, Mammalian Target of Rapamycin and Insulin-like Growth Factor 1. We also provide future perspectives of lifespan and health, which are intimately linked fields. SUMMARY: Aging remains the biggest non-modifiable risk factor for cardiovascular disease. The biological, structural and mechanical changes in senescent cardiovascular system are thought to contribute in increasing incidence of cardiovascular disease in aging. Understanding the mechanisms contributing to such changes is therefore crucial for both prevention and development of treatment for cardiovascular diseases. KEYWORDS: cardiovascular aging, mitochondria, telomeres, sirtuin, stem cells.
Ortiz-León, Gabriela; Vílchez-Monge, Marta; Montero-Rodríguez, Juan J.
In the present document, six mathematical models of the cardiovascular system are studied and implemented in MATLAB R2013a using an updated version of the Cardiovascular Simulation Toolbox proposed by O. Barnea at the Tel-Aviv University. All the mathematical models are based on electrical lumped-parameter analogies. The results of the simulations are compared with a list of expected hemodynamic parameters and contrasted with laboratory values.
Behrens, G.M.N.; Reiss, P
Purpose of review This review focuses on current studies addressing the association of abacavir (ABC) therapy and myocardial risk in HIV-infected patients, discusses potential pathogenetic mechanisms, and suggests a preliminary algorithm for decision making regarding ABC therapy in daily clinical practise. Recent findings The D:A:D study was the first to reveal an increased rate of myocardial infarction in patients recently treated with ABC. Subsequent analyses of both cohort studies as well ...
Finn, J P; Nguyen, K-L; Han, F; Zhou, Z; Salusky, I; Ayad, I; Hu, P
The practice of contrast-enhanced magnetic resonance angiography (CEMRA) has changed significantly in the span of a decade. Concerns regarding gadolinium (Gd)-associated nephrogenic systemic fibrosis in those with severely impaired renal function spurred developments in low-dose CEMRA and non-contrast MRA as well as efforts to seek alternative MR contrast agents. Originally developed for MR imaging use, ferumoxytol (an ultra-small superparamagnetic iron oxide nanoparticle), is currently approved by the US Food and Drug Administration for the treatment of iron deficiency anaemia in adults with renal disease. Since its clinical availability in 2009, there has been rising interest in the scientific and clinical use of ferumoxytol as an MR contrast agent. The unique physicochemical and pharmacokinetic properties of ferumoxytol, including its long intravascular half-life and high r1 relaxivity, support a spectrum of MRI applications beyond the scope of Gd-based contrast agents. Moreover, whereas Gd is not found in biological systems, iron is essential for normal metabolism, and nutritional iron deficiency poses major public health challenges worldwide. Once the carbohydrate shell of ferumoxytol is degraded, the elemental iron at its core is incorporated into the reticuloendothelial system. These considerations position ferumoxytol as a potential game changer in the field of CEMRA and MRI. In this paper, we aim to summarise our experience with the cardiovascular applications of ferumoxytol and provide a brief synopsis of ongoing investigations on ferumoxytol-enhanced MR applications. PMID:27221526
The high incidence of cardiovascular disorders and the attendant morbidity and mortality have encouraged the development of new radiopharmaceuticals for the diagnosis and localisation of coronary diseases. Myocardial perfusion imaging is an invaluable tool for the demonstration of transient ischemia and infarction in heart and identification of viable and non-viable myocardial tissue. Thallium chloride (Tl-201) is the agent currently in wide use but its drawbacks have been well recognised. Hence tremendous amount of research work has been carried out to develop a suitable Tc-99m radiopharmaceutical for this purpose which has resulted in the introduction of two Tc-99m labelled radiopharmaceuticals HEXAMIBI and BATO. These are being tried as myocardial imaging agents these days and the choice amongst these depends on concrete clinical situation. The experimental work involving the synthesis of ligand MIBI, formulation into freeze dried KIT form, quality control procedure, biodistribution studies and finally clinical evaluation of locally produced KIT in human volunteers has now been reported here. Our KIT has been produced for the first time in Pakistan and has been tried on forty five patients in Nuclear Medical Centre, AFIP (Rawalpindi). The results obtained are comparable to those of Ti-201 with a slightly higher liver background in case of MIBI but because of the easy availability MIBI has become agent of choice for myocardial perfusion studies. (author)
Glurich, Ingrid; Grossi, Sara; Albini, Boris; Ho, Alex; Shah, Rashesh; Zeid, Mohamed; Baumann, Heinz; Genco, Robert J.; De Nardin, Ernesto
Epidemiological studies have implicated periodontal disease (PD) as a risk factor for the development of cardiovascular disease (CVD). These studies addressed the premise that local infection may perturb the levels of systemic inflammatory mediators, thereby promoting mechanisms of atherosclerosis. Levels of inflammatory mediators in the sera of subjects with only PD, only CVD, both diseases, or neither condition were compared. Subjects were assessed for levels of C-reactive protein (CRP), se...
Full Text Available 335 patients aged 20 to 60 years with various parodontitis inflammatory diseases have been selected for research. All patients have been divided into four groups of different age: with rheumatism - 96 persons, with heart ischemic illness - 82 persons, with arterial hypertension - 89 persons, with neurocirculatory dystonia - 68 persons. The presented results of supervision show diagnostic significant changes of pulp microflora with odontogenic infection in patients, suffering cardiovascular diseases
Haugaard, Anna Karen; Lund, Tamara T.; Birch, Carsten; Rönsholt, Frederikke; Trøseid, Marius; Ullum, Henrik; Gerstoft, Jan; Johansson, Per I.; Nielsen, Susanne Dam; Ostrowski, Sisse R
In HIV infection, cardiovascular disease (CVD) has emerged as a clinical problem, and elevated D-dimer has been reported. The pathophysiologic mechanisms underlying this remain unclear. We aimed to investigate whether untreated HIV-infected individuals display evidence of functional coagulopathy...
Kolář, František; Ošťádal, Bohuslav
Roč. 207, č. 4 (2013), s. 584-587. ISSN 1748-1708 Institutional support: RVO:67985823 Keywords : heart * vascular * risk factors * sex Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 4.251, year: 2013
... Pressure High Blood Pressure Tools & Resources Stroke More Cold Weather and Cardiovascular Disease Updated:Sep 16,2015 ... Your Heart Health • Watch, Learn & Live Animations Library Cold Weather Fitness Guide Popular Articles 1 Understanding Blood ...
Vekens, Nicky Van Der; Hunter, Ingrid; Gøtze, Jens Peter;
important species differences, which can partly be explained by variations in physiology or pathophysiology. Most important are physiological differences in heart rate, cardiovascular response to exercise, food and water intake, and molecular elimination in plasma. Pathological differences are even more...
Saeid Golbidi; Ismail Laher
There are alarming increases in the incidence of obesity, insulin resistance, type II diabetes, and cardiovascular disease. The risk of these diseases is significantly reduced by appropriate lifestyle modifications such as increased physical activity. However, the exact mechanisms by which exercise influences the development and progression of cardiovascular disease are unclear. In this paper we review some important exercise-induced changes in cardiac, vascular, and blood tissues and discuss...
Charles, John B.; Bungo, Michael W.
The effects of space flight on the cardiovascular system have been studied since the first manned flights. In several instances, the results from these investigations have directly contradicted the predictions based on established models. Results suggest associations between space flight's effects on other organ systems and those on the cardiovascular system. Such findings provide new insights into normal human physiology. They must also be considered when planning for the safety and efficiency of space flight crewmembers.
Guarneri, Mimi; Mercado, Nestor; Suhar, Christopher
In the United States, $2.5 trillion is spent on healthcare annually. Seven chronic diseases account for half of all this expense. Of these 7, cardiovascular disease, hypertension, stroke, and diabetes mellitus are largely preventable. Integrative cardiology programs that focus on risk-factor modification through lifestyle change combined with early detection and advanced lipid management offer a new paradigm to the prevention of cardiovascular disease. PMID:19955547
Villalón, Carlos; De Vries, Peter; Saxena, Pramod Ranjan
textabstractSerotonin exerts complex effects in the cardiovascular system, including hypotension or hypertension, vasodilatation or vasoconstriction, and/or bradycardia or tachycardia; the eventual response depends primarily on the nature of the 5-HT receptors involved. In the light of current 5-HT receptor classification, the authors reanalyse the cardiovascular responses mediated by 5-HT receptors and discuss the established and potential therapeutic applications of 5-HT ligands in the trea...
Mannucci, Edoardo; Giannini, Stefano; Dicembrini, Ilaria
Basal insulin is an important component of treatment for both type 1 and type 2 diabetes. One of the principal aims of treatment in patients with diabetes is the prevention of diabetic complications, including cardiovascular disease. There is some evidence, although controversial, that attainment of good glycemic control reduces long-term cardiovascular risk in both type 1 and type 2 diabetes. The aim of this review is to provide an overview of the potential cardiovascular safety of the different available preparations of basal insulin. Current basal insulin (neutral protamine Hagedorn [NPH], or isophane) and basal insulin analogs (glargine, detemir, and the more recent degludec) differ essentially by various measures of pharmacokinetic and pharmacodynamic effects in the bloodstream, presence and persistence of peak action, and within-subject variability in the glucose-lowering response. The currently available data show that basal insulin analogs have a lower risk of hypoglycemia than NPH human insulin, in both type 1 and type 2 diabetes, then excluding additional harmful effects on the cardiovascular system mediated by activation of the adrenergic system. Given that no biological rationale for a possible difference in cardiovascular effect of basal insulins has been proposed so far, available meta-analyses of publicly disclosed randomized controlled trials do not show any signal of increased risk of major cardiovascular events between the different basal insulin analogs. However, the number of available cardiovascular events in these trials is very small, preventing any clear-cut conclusion. The results of an ongoing clinical trial comparing glargine and degludec with regard to cardiovascular safety will provide definitive evidence. PMID:26203281
Estrogen has pleiotropic effects on the cardiovascular system. The mechanisms by which estrogen confers these pleiotropic effects on cardiovascular function is under active investigation. Until a decade ago, all estrogen signaling was thought to occur by estrogen binding to nuclear estrogen receptors (ERα and ERβ), which bind to DNA and function as ligand activated transcription factors. Estrogen binding to the receptor alters gene expression thereby altering cell function. In 2000 estrogen w...
Anna Meiliana; Andi Wijaya
BACKGROUND: The average lifespan of humans is increasing, and with it the percentage of people entering the 65 and older age group is growing rapidly and will continue to do so in the next 20 years. Within this age group, cardiovascular disease will remain the leading cause of death, and the cost associated with treatment will continue to increase. Aging is an inevitable part of life and unfortunately poses the largest risk factor for cardiovascular disease. CONTENT: We provide an overview of...
Albumin is a protein which is charged negatively. By correcting for the daily excretion of creatinine, the albumin creatinin ratio implicates the daily excretion of albumin in spot urine. Albuminuria is a cardiovascular risk factor in patients with diabetes, hypertension, and the general population. Urinary albumin excretion is independently associated with an increased risk of cardiovascular events, even after adjustment for risk factors. Risk has been shown to increase continuously with inc...
Munagala, Mrudula R; Phancao, Anita
Solid organ transplantation is an effective treatment for patients with end-stage organ disease. The prevalence of cardiovascular diseases (CVD) has increased in recipients. CVD remains a leading cause of mortality among recipients with functioning grafts. The pathophysiology of CVD recipients is a complex interplay between preexisting risk factors, metabolic sequelae of immunosuppressive agents, infection, and rejection. Risk modification must be weighed against the risk of mortality owing to rejection or infection. Aggressive risk stratification and modification before and after transplantation and tailoring immunosuppressive regimens are essential to prevent complications and improve short-term and long-term mortality and graft survival. PMID:27095643
Redéen, Stefan; Ryberg, Anna; Petersson, Fredrik; Eriksson, Olle; Nägga, Katarina; Borch, Kurt
Background Homocysteine levels in circulation are determined by several factors and hyperhomocysteinemia is reportedly associated with cardiovascular diseases and dementia. The aim of this study is to determine the relation of chronic gastritis and other conditions to homocysteine levels and their relation to incident cardiovascular diseases and dementia. Methods An adult population-based cohort (N = 488) was screened for H. pylori infection, gastro-duodenitis (endoscopic biopsies), disease h...
Divya Shetty; Mahima Dua; Kiran Kumar; Raghu Dhanpal; Madhusudan Astekar; Devi Charan Shetty
Dentist and oral health screening may be the latest weapon in identifying persons at risk of cardiovascular disease. Oral infections, specifically periodontitis, may confer independent risks for different systemic conditions. The risk factors associated with cardiovascular diseases also suggest that the relationship between periodontal disease and diabetes works in both ways. The aim of this study was to support and strengthen the association and relationship between oral hygiene status of in...
Ortega, Francisco B; Lavie, Carl J; Blair, Steven N
The prevalence of obesity has increased worldwide over the past few decades. In 2013, the prevalence of obesity exceeded the 50% of the adult population in some countries from Oceania, North Africa, and Middle East. Lower but still alarmingly high prevalence was observed in North America (≈30%) and in Western Europe (≈20%). These figures are of serious concern because of the strong link between obesity and disease. In the present review, we summarize the current evidence on the relationship of obesity with cardiovascular disease (CVD), discussing how both the degree and the duration of obesity affect CVD. Although in the general population, obesity and, especially, severe obesity are consistently and strongly related with higher risk of CVD incidence and mortality, the one-size-fits-all approach should not be used with obesity. There are relevant factors largely affecting the CVD prognosis of obese individuals. In this context, we thoroughly discuss important concepts such as the fat-but-fit paradigm, the metabolically healthy but obese (MHO) phenotype and the obesity paradox in patients with CVD. About the MHO phenotype and its CVD prognosis, available data have provided mixed findings, what could be partially because of the adjustment or not for key confounders such as cardiorespiratory fitness, and to the lack of consensus on the MHO definition. In the present review, we propose a scientifically based harmonized definition of MHO, which will hopefully contribute to more comparable data in the future and a better understanding on the MHO subgroup and its CVD prognosis. PMID:27230640
Sady Montes Amador
Full Text Available Background: cardiovascular hyperreactivity in young people has been associated with different risk factors and a family history of hypertension. Objective: to determine the association between a family history of hypertension and cardiovascular risk factors with cardiovascular hyperreactivity. Method: a correlational, cross-sectional study was conducted in a universe of 77 young individuals aged 18 to 40 years from the Churuguara parish of the Falcon State in Venezuela. The variables were: age, sex, skin color, family history of hypertension, medical history of hypertension, diabetes mellitus, alcohol consumption, salt intake, physical activity and body mass index. The diastolic and systolic blood pressure before and after the pressor response elicited by an isometric exercise were determined as hemodynamic variables. Results: thirteen percent of the participants developed vascular reactivity after the hand-held weight test. Cardiovascular hyperreactivity is three times higher in individuals with a family history of hypertension. Sixty percent of those with a body mass index greater than or equal to 27 kg/m2 are hyperreactive. There is a higher cardiovascular response to the hand-held weight test as the consumption of alcohol increases. Thirty three point three percent of the participants who smoke are hyperreactive. Conclusions: there is a significant association between a family history of hypertension, obesity, salt intake, alcohol consumption and vascular hyperreactivity.
locura inducida porlas sustancias, donde la culpa proyectada y la negación campean a la par dela visión del mundo degradado y alucinante como construcción alterna de larealidad del drogadicto.A falta de una vida plena llena de realizaciones, el vacío interno, los sentimientosde soledad, la futilidad mediatizada, la ausencia de un verdadero sentido de lavida, el existir solo por el principio del placer, constituyen modos de vida sinsignificado, donde comanda el cerebro del reptil que llevamos dentro, no digoque el de mamífero porque sería ofender a tan nobles animales.En el desarrollo de esta obra, y en la realidad, vemos como se encuentratrastocado, cuando no ausente, el sentido de lo espiritual. La incapacidad paraexperimentar el dolor del prójimo, posiblemente se deba a una falla del hazde neuronas conocidas como “neuronas espejo” descubiertas por el equipoinvestigador de la Universidad de Parma, liderado por Giacomo Rizzolatti en1996. El sistema de “neuronas espejo” permite hacer propias las acciones, sensaciones y emociones de los demás; sirve paraexplicar las bases neurobiológicas de la empatíay, su ausencia o daño, ayudaría a comprender lasbases del trastorno antisocial de la personalidado psicopatía. Grave patología caracterizadapor la imposibilidad del sujeto para vivenciarlos sentimientos de sus iguales, por lo mismo,son incapaces para sentir culpa o ansiedad, losque los lleva a una ausencia de moralidad y decapacidad para experimentar compasión por elotro, eso los convierte en depredadores de los herdemás.La droga prospera en estos individuosy daña las conexiones lógicas de sus funciones,socio-patizándolos aún más; así nos impresionaArístides, con unos personajes desalmados,afectados por este destructor flagelo. Esta esla saga en la que nos introduce con magistralhabilidad el autor.CHISTIAN AYOLA GÓMEZMédico Especialista en PsiquiatriaFARMACOLOGIA CARDIOVASCULAR:El conocimiento de la farmacología, ciencia vitalen la formaci
Nguyen, Maria U; Wallace, Megan J; Pepe, Salvatore; Menheniott, Trevelyan R; Moss, Timothy J; Burgner, David
Cardiovascular disease continues to be the leading cause of global morbidity and mortality. Traditional risk factors account for only part of the attributable risk. The origins of atherosclerosis are in early life, a potential albeit largely unrecognized window of opportunity for early detection and treatment of subclinical cardiovascular disease. There are robust epidemiological data indicating that poor intrauterine growth and/or prematurity, and perinatal factors such as maternal hypercholesterolaemia, smoking, diabetes and obesity, are associated with adverse cardiovascular intermediate phenotypes in childhood and adulthood. Many of these early-life risk factors result in a heightened inflammatory state. Inflammation is a central mechanism in the development of atherosclerosis and cardiovascular disease, but few studies have investigated the role of overt perinatal infection and inflammation (chorioamnionitis) as a potential contributor to cardiovascular risk. Limited evidence from human and experimental models suggests an association between chorioamnionitis and cardiac and vascular dysfunction. Early life inflammatory events may be an important mechanism in the early development of cardiovascular risk and may provide insights into the associations between perinatal factors and adult cardiovascular disease. This review aims to summarise current data on the early life origins of atherosclerosis and cardiovascular disease, with particular focus on perinatal inflammation. PMID:26223841
Martin R. Grübler
Full Text Available Vitamin D deficiency, as well as cardiovascular diseases (CVD and related risk factors are highly prevalent worldwide and frequently co-occur. Vitamin D has long been known to be an essential part of bone metabolism, although recent evidence suggests that vitamin D plays a key role in the pathophysiology of other diseases, including CVD, as well. In this review, we aim to summarize the most recent data on the involvement of vitamin D deficiency in the development of major cardiovascular risk factors: hypertension, obesity and dyslipidemia, type 2 diabetes, chronic kidney disease and endothelial dysfunction. In addition, we outline the most recent observational, as well as interventional data on the influence of vitamin D on CVD. Since it is still an unresolved issue whether vitamin D deficiency is causally involved in the pathogenesis of CVD, data from randomized controlled trials (RCTs designed to assess the impact of vitamin D supplementation on cardiovascular outcomes are awaited with anticipation. At present, we can only conclude that vitamin D deficiency is an independent cardiovascular risk factor, but whether vitamin D supplementation can significantly improve cardiovascular outcomes is still largely unknown.
Faber, Jens; Selmer, Christian
Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones at the ce......Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones...... at the cellular level. Subclinical hyperthyroidism is associated with increased left ventricular mass of the heart, which reverts after obtaining euthyroidism. Mortality and risk of major cardiovascular events are increased. Subclinical hypothyroidism is also associated with subtle changes in the heart, e.g. its...
Spallone, Vincenza; Ziegler, Dan; Freeman, Roy;
Cardiovascular Autonomic Neuropathy (CAN) Subcommittee of Toronto Consensus Panel on Diabetic Neuropathy worked to update CAN guidelines, with regard to epidemiology, clinical impact, diagnosis, usefulness of CAN testing, and management. CAN is the impairment of cardiovascular autonomic control...... in the setting of diabetes after exclusion of other causes. The prevalence of confirmed CAN is around 20%, and increases up to 65% with age and diabetes duration. Established risk factors for CAN are glycaemic control in type 1 and a combination of hypertension, dyslipidemia, obesity and glycaemic control...... in type 2 diabetes. CAN is a risk marker of mortality and cardiovascular morbidity, and possibly a progression promoter of diabetic nephropathy. Criteria for CAN diagnosis and staging are: 1. one abnormal cardio-vagal test identifies possible or early CAN; 2. at least two abnormal cardio-vagal tests...
Funder, K S; Steinmetz, J; Rasmussen, L S
This review describes the incidence, risk factors, and long-term consequences of cognitive dysfunction after cardiovascular surgery. Postoperative cognitive dysfunction (POCD) is increasingly being recognized as an important complication, especially in the elderly. A highly sensitive neuropsychol......This review describes the incidence, risk factors, and long-term consequences of cognitive dysfunction after cardiovascular surgery. Postoperative cognitive dysfunction (POCD) is increasingly being recognized as an important complication, especially in the elderly. A highly sensitive...... neuropsychological test battery must be used to detect POCD and a well-matched control group is very useful for the analysis and interpretation of the test RESULTS: Cardiovascular surgery is associated with a high incidence of POCD. Cardiopulmonary bypass was thought to explain this difference, but randomized...
Aspelund, Aleksanteri; Robciuc, Marius R; Karaman, Sinem; Makinen, Taija; Alitalo, Kari
The mammalian circulatory system comprises both the cardiovascular system and the lymphatic system. In contrast to the blood vascular circulation, the lymphatic system forms a unidirectional transit pathway from the extracellular space to the venous system. It actively regulates tissue fluid homeostasis, absorption of gastrointestinal lipids, and trafficking of antigen-presenting cells and lymphocytes to lymphoid organs and on to the systemic circulation. The cardinal manifestation of lymphatic malfunction is lymphedema. Recent research has implicated the lymphatic system in the pathogenesis of cardiovascular diseases including obesity and metabolic disease, dyslipidemia, inflammation, atherosclerosis, hypertension, and myocardial infarction. Here, we review the most recent advances in the field of lymphatic vascular biology, with a focus on cardiovascular disease. PMID:26846644
Raven, Peter; Schneider, Sue
It was apparent that the bed-rest and spaceflight data indicated that decreases in plasma volume and cardiac atrophy along with cardiac remodeling were fundamental changes which predisposed many astronauts to post flight orthostatic intolerance. Despite the recently acquired in-flight and post-flight muscle sympathetic nerve activity findings suggesting that the sympathetic nerve responses were appropriate there remains significant contrary data from bed-rest studies, post- flight stand tests and hind-limb unweighted rat studies that suggest that the vasoconstrictive responses were compromised at least insufficient in susceptible individuals. The key issues raised is whether a diminished increase in sympathetic activity from baseline without changes in 254 First Biennial Space Biomedical Investigators'Workshop Cardiovascular peak response or receptor adaptations is an abnormal response or is an individual variance of response to the accentuated decrease in stroke volume. Data relating autonomic neural control of heart rate were presented to suggest that the vagal and sympathetic control of heart rate was attenuated. Also, bed-rest and space flight induced attenuated baroreflex control of heart rate was shown to be restored to pre-bedrest function by one bout of maximal dynamic exercise. However, these data were confounded by relying on the use of R-R interval as a measure of efferent responses of the baroreflex during a condition in which the baseline heart rate was changed. Clearly the idea that the autonomic control of heart rate may be changed by microgravity needs further investigation. This direction is suggested despite the fact that in the triple product (HR x SV x TPR = MAP) assessment of the regulation of arterial blood pressure during orthostasis the role of the HR reflex may be less influential than that associated. with cardiac atrophy (SV changes) and aberrant sympathetic vasoconstriction (resistance) changes. Although sympathetic nerve activity
Ford, Pauline J; Yamazaki, Kazuhisa; Seymour, Gregory J
This paper reviews the evidence for the interaction of oral disease (more specifically, periodontal infections) with cardiovascular disease. Cardiovascular disease is a major cause of death worldwide, with atherosclerosis as the underlying aetiology in the vast majority of cases. The importance of the role of infection and inflammation in atherosclerosis is now widely accepted, and there has been increasing awareness that immune responses are central to atherogenesis. Chronic inflammatory periodontal diseases are among the most common chronic infections, and a number of studies have shown an association between periodontal disease and an increased risk of stroke and coronary heart disease. Although it is recognised that large-scale intervention studies are required, pathogenic mechanism studies are nevertheless required so as to establish the biological rationale. In this context, a number of hypotheses have been put forward; these include common susceptibility, inflammation via increased circulating cytokines and inflammatory mediators, direct infection of the blood vessels, and the possibility of cross-reactivity or molecular mimicry between bacterial and self-antigens. In this latter hypothesis, the progression of atherosclerosis can be explained in terms of the immune response to bacterial heat shock proteins (HSPs). Because the immune system may not be able to differentiate between self-HSP and bacterial HSP, an immune response generated by the host directed at pathogenic HSP may result in an autoimmune response to similar sequences in the host. Furthermore, endothelial cells express HSPs in atherosclerosis, and cross-reactive T cells exist in the arteries and peripheral blood of patients with atherosclerosis. Each of these hypotheses is reviewed in light of current research. It is concluded that although atherosclerotic cardiovascular disease is almost certainly a multifactorial disease, there is now strong evidence that infection and inflammation are
Byberg, Stine; Agyemang, Charles; Zwisler, Ann Dorthe;
Studies on cardiovascular disease (CVD) incidence and survival show varying results between different ethnic groups. Our aim was to add a new dimension by exploring the role of migrant status in combination with ethnic background on incidence of-and survival from-CVD and more specifically acute...... of some types of cardiovascular disease compared to Danish-born. Family-reunified migrants on the other hand had lower rates of CVD. All migrants had better survival than Danish-born indicating that migrants may not always be disadvantaged in health....
Lizzie M. Castillo S; Ana Teresa Alvarado G; María Isabel Sánchez V
En Costa Rica la enfermedad cardiovascular cobra en promedio 6 vidas por día, lo cual representa un aumento escalonado en los últimos años, debido en su mayoría a cambios en el estilo de vida del costarricense. Además, llama la atención, que factores de riesgo para enfermedad cardiovascular como son el fumado, obesidad infantil, alcoholismo, diabetes, dislipidemia e hipertensión han mostrado un incremento en su incidencia. Por lo tanto,se pretende realizar una revisión de los programas de det...
... the body they infect. Tinea corporis is a fungal infection of the skin on the body. ("Corporis" is ... Causes & Risk Factors How did I get a fungal infection? You can get a fungal infection by touching ...
... jointly produced, collaborated with, or endorsed by the Society of Cardiovascular Angiography and Interventions. Press & News » Review ... SCAI Member? Create an Account Advertisement Advertisement The Society for Cardiovascular Angiography and Interventions Foundation, 1100 17th ...
Fosbøl, Emil L; Peterson, Eric D; Holm, Ellen;
To compare the cardiovascular safety of currently marketed dementia medications in new users in the United States and Denmark.......To compare the cardiovascular safety of currently marketed dementia medications in new users in the United States and Denmark....
Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut;
Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross...
Mocumbi, Ana Olga; Sliwa, Karen
The predominant pattern of cardiovascular diseases in sub-Saharan Africa is that of poverty-related conditions (rheumatic heart valve disease, untreated congenital heart disease, tuberculous pericarditis) and diseases of unclear aetiology with a higher prevalence in this part of the world (peripartum cardiomyopathy, endomyocardial fibrosis). However, the prevalence of the traditional risk factors for cardiovascular diseases such as hypertension and marked obesity is high in a number of sub-Saharan settings, although they vary considerably among countries, urban/rural locations and specific subpopulations. In urban settings, hypertensive heart disease with systolic and diastolic function contributes substantially to morbidity. Awareness of the general public and health workers about the burden of cardiovascular diseases in women must be increased, and risk factor control programmes must be included in the health research agenda on the African continent. Improvement in health services with coordination of maternal health services and non-communicable diseases is also needed. This review focuses on the current knowledge of cardiovascular healthcare of women in sub-Saharan Africa, particularly their propensity for various forms of heart disease, access to healthcare, treatment received within the respective healthcare system, response to therapy and mortality. It highlights the gaps in knowledge and the paucity of data in most of these aspects. PMID:22350029
Bijlsma, Maarten F.; Peppelenbosch, Maikel P.; Spek, C. Arnold
In this review, we focus on the basic biology of the important developmental Hedgehog ( Hh) protein family, its general function in development, pathway mechanisms, and gene discovery and nomenclature. Hh function in cardiovascular development and recent findings concerning Hh signaling in ischemia
Cardiovascular calcification is an independent risk factor for cardiovascular morbidity and mortality. This disease of dysregulated metabolism is no longer viewed as a passive degenerative disease, but instead as an active process triggered by pro-inflammatory cues. Furthermore, a positive feedback loop of calcification and inflammation is hypothesized to drive disease progression in arterial calcification. Both calcific aortic valve disease and atherosclerotic arterial calcification may possess similar underlying mechanisms. Early histopathological studies first highlighted the contribution of inflammation to cardiovascular calcification by demonstrating the accumulation of macrophages and T lymphocytes in 'early' lesions within the aortic valves and arteries. A series of in vitro work followed, which gave a mechanistic insight into the stimulation of smooth muscle cells to undergo osteogenic differentiation and mineralization. The emergence of novel technology, in the form of animal models and more recently molecular imaging, has enabled accelerated progression of this field, by providing strong evidence regarding the concept of this disorder as an inflammatory disease. Although there are still gaps in our knowledge of the mechanisms behind this disorder, this review discusses the various studies that have helped form the concept of the inflammation-dependent cardiovascular calcification paradigm. (author)
Marti-Soler, Helena; Gubelmann, Cédric; Aeschbacher, Stefanie;
OBJECTIVE: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies. METHODS: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist...
C.M. Villalón (Carlos); P.A.M. de Vries (Peter); P.R. Saxena (Pramod Ranjan)
textabstractSerotonin exerts complex effects in the cardiovascular system, including hypotension or hypertension, vasodilatation or vasoconstriction, and/or bradycardia or tachycardia; the eventual response depends primarily on the nature of the 5-HT receptors involved. In the light of current 5-HT
Vis, J. C.; Duffels, M. G. J.; Winter, M. M.; Weijerman, M. E.; Cobben, J. M.; Huisman, S. A.; Mulder, B. J. M.
This review focuses on the heart and vascular system in patients with Down syndrome. A clear knowledge on the wide spectrum of various abnormalities associated with this syndrome is essential for skillful management of cardiac problems in patients with Down syndrome. Epidemiology of congenital heart defects, cardiovascular aspects and…
Schmidt, Martina; Sand, Carsten; Jakobs, Karl H.; Michel, Martin C.; Weernink, Paschal A. Oude
Exchange protein activated by cyclic AMP (Epac) - a cyclic AMP-activated guanine nucleotide exchange factor for Ras-like GTPases - has emerged as a novel mediator of pivotal processes in the cardiovascular system, including cellular calcium handling, hypertrophy, integrin-mediated cell adhesion, est
Tal, Roy; Pavlovsky, Lev; David, Michael
Psoriasis is a common inflammatory skin disease which may dramatically affect patients' lives. This chronic disease is characterized by a protracted course of alternating remissions and relapses. In recent years, the attention of researchers has focused on the association between psoriasis and cardiovascular disease risk factors. This review summarizes the literature on this topic with an emphasis on research conducted in Israel. PMID:23316664
Mercer, A J
The recent decline in cardiovascular disease mortality in Western countries has been linked with changes in life style and treatment. This study considers periods of decline before effective medical interventions or knowledge about risk factors. Trends in annual age-standardized death rates from cerebrovascular disease, heart disease and circulatory disease, and all cardiovascular disease are reviewed for three phases, 1881-1916, 1920-1939, and 1940-2000. There was a consistent decline in the cerebrovascular disease death rate between 1891 and 2000, apart from brief increases after the two world wars. The heart disease and circulatory disease death rate was declining between 1891 and 1910 before cigarette smoking became prevalent. The early peak in cardiovascular mortality in 1891 coincided with an influenza pandemic and a peak in the death rate from bronchitis, pneumonia and influenza. There is also correspondence between short-term fluctuations in the death rates from these respiratory diseases and cardiovascular disease. This evidence of ecological association is consistent with the findings of many studies that seasonal influenza can trigger acute myocardial infarction and episodes of respiratory infection are followed by increased risk of cardiovascular events. Vaccination studies could provide more definitive evidence of the role in cardiovascular disease and mortality of influenza, other viruses, and common bacterial agents of respiratory infection. PMID:26243537
Alpendurada, Francisco Diogo
Introduction: Whilst most of the attention has been devoted to the left ventricle in cardiovascular disease, the right ventricle has been somewhat neglected. In the last decades, there has been a renewal of interest in the right ventricle, in part driven by advances in cardiovascular imaging. Methods: Cardiovascular magnetic resonance is arguably the best imaging modality for the study of the right ventricle. In this research thesis, cardiovascular magnetic resonance w...
Martin-Iguacel, R; Llibre, J M; Friis-Moller, N
With more effective and widespread antiretroviral treatment, the overall incidence of AIDS- or HIV-related death has decreased dramatically. Consequently, as patients are aging, cardiovascular disease (CVD) has emerged as an important cause of morbidity and mortality in the HIV population. The...... incidence of CVD overall in HIV is relatively low, but it is approximately 1.5-2-fold higher than that seen in age-matched HIV-uninfected individuals. Multiple factors are believed to explain this excess in risk such as overrepresentation of traditional cardiovascular risk factors (particularly smoking......), toxicities associated with cumulative exposure to some antiretroviral agents, together with persistent chronic inflammation, and immune activation associated with HIV infection. Tools are available to calculate an individual's predicted risk of CVD and should be incorporated in the regular follow-up of HIV...
Koch Walter J
Full Text Available Abstract Gene therapy using in vivo recombinant adenovirus-mediated gene transfer is an effective technique that offers great potential to improve existing drug treatments for the complex cardiovascular diseases of heart failure and vascular smooth muscle intimal hyperplasia. Cardiac-specific adenovirus-mediated transfer of the carboxyl-terminus of the β-adrenergic receptor kinase (βARKct, acting as a Gβγ-β-adrenergic receptor kinase (βARK1 inhibitor, improves basal and agonist-induced cardiac performance in both normal and failing rabbit hearts. In addition, βARKct adenovirus infection of vascular smooth muscle is capable of significantly diminishing neointimal proliferation after angioplasty. Therefore, further investigation is warranted to determine whether inhibition of βARK1 activity and sequestration of Gβγ via an adenovirus that encodes the βARKct transgene might be a useful clinical tool for the treatment of cardiovascular pathologies.
Bu Beng Yeap
Full Text Available As men grow older, testosterone (T levels decline and the significance of this change is debated. The evidence supporting a causal role for lower circulating T, or its metabolites dihydrotestosterone (DHT and estradiol, in the genesis of atherosclerosis and cardiovascular disease (CVD in men is limited. Observational studies associate low baseline T levels with carotid atherosclerosis, aortic and peripheral vascular disease, and with the incidence of cardiovascular events and mortality. Studies using mass spectrometry suggest that when total T is assayed optimally, calculation of free T might not necessarily improve risk stratification. There is limited evidence to support an association of estradiol with CVD. Interventional studies of T therapy in men with coronary artery disease have shown beneficial effects on exercise-induced myocardial ischemia. However, placebo-controlled, randomized clinical trials (RCTs of T therapy in men with the prespecified outcomes of cardiovascular events or deaths are lacking. Meta-analyses of randomized controlled trials of T published up to 2010 found no increase in cardiovascular events, mortality, or prostate cancer with therapy. Recently, in a trial of older men with mobility limitations, men randomized to receive a substantial dose of T reported cardiovascular adverse effects. This phenomenon was not reported from a comparable trial where men received a more conservative dose of T, suggesting a prudent approach should be adopted when considering therapy in frail older men with existing CVD. Adequately powered RCTs of T in middle-aged and older men are needed to clarify whether or not hormonal intervention would reduce the incidence of CVD.
Guldiken, B; Rémi, J; Noachtar, Soheyl
Phenytoin is an established drug in the treatment of acute repetitive seizures and status epilepticus. One of its main advantages over benzodiazepines is the less sedative effect. However, the possibility of cardiovascular adverse effects with the intravenous use of phenytoin cause a reluctance to its usage, and this has lead to a search for safer anticonvulsant drugs. In this study, we aimed to review the studies which evaluated the safety of phenytoin with respect to cardiovascular adverse effects. The original clinical trials and case reports listed in PUBMED in English language between the years of 1946-2014 were evaluated. As the key words, "phenytoin, diphenylhydantoin, epilepsy, seizure, cardiac toxicity, asystole, arrhythmia, respiratory arrest, hypotension, death" were used. Thirty-two clinical trials and ten case reports were identified. In the case reports, a rapid infusion rate (>50 mg/min) of phenytoin appeared as the major cause of increased mortality. In contrast, no serious cardiovascular adverse effects leading to death were met in the clinical trials which applied the recommended infusion rate and dosages. An infusion rate of 50 mg/min was reported to be safe for young patients. For old patients and patients with a cardiovascular co-morbidity, a slower infusion rate was recommended with a careful follow-up of heart rhythm and blood pressure. No cardiovascular adverse effect was reported in oral phenytoin overdoses except one case with a very high serum phenytoin level and hypoalbuminemia. Phenytoin is an effective and well tolerated drug in the treatment of epilepsy. Intravenous phenytoin is safe when given at recommended infusion rates and doses. PMID:26645393
A. Gil Hernández
Full Text Available El presente trabajo describe los modelos experimentales de utilidad clínica en el estudio de las enfermedades cardiovasculares y hace énfasis en los modelos usados para determinar los mecanismos fisiopatológicos de la aterosclerosis, así como para evaluar los efectos de productos nutricionales y farmacológicos sobre el desarrollo de este proceso inflamatorio complejo común a muchas enfermedades cardiovasculares. Se revisan los modelos animales en los que se puede inducir aterosclerosis por cambios en la composición de la dieta y los modelos animales en los que la alteración de uno o más genes (animales knock-out y knock-in, o la incorporación de genes foráneos de otras especies, da lugar a la aparición de hiperlipidemia con riesgo asociado de aparición de enfermedad cardiovascular temprana. Por otra parte, se consideran algunas de las líneas celulares más utilizadas en el estudio de los mecanismos moleculares de la aterogénesis y de evaluación de sustancias con interés nutricional o farmacológico.The present work describes clinically useful experimental models for the study of cardiovascular disease and emphasites the models used to determine the pathophysiologic mechanisms of atherosclerosis, as well as to evaluate the effects of nutritional and pharmacological products on the development of this complex inflammatory process present in many cardiovascular diseases. Animal models in which ahterosclerosis may be induced by dietary changes are reviewed, as well as those in which modification in one or more genes (knock-out and knock-in animals, or the incorporation of foreign genes from other species lead to early cardiovascular disease. On the other hand, some of the cell lines most frequently used in studying molecular mechanisms of atherosclerosis and assessment of substances with nutritional or pharmacological interest are considered.
Milagros Lisset León Regal
Full Text Available Background: there are no studies that confirm the association between cardiovascular hyperreactivity and the risk of cardiovascular morbidity. Objective: to determine the association between cardiovascular hyperreactivity and the risk of cardiovascular morbidity in normotensive individuals. Methods: a cross-sectional, correlational study was conducted. The universe consisted of the population aged 15 to 74 years in Cienfuegos municipality; the sample included 644 people. The variables were: sex, skin color, age, total cholesterol, HDL cholesterol, fasting blood glucose, smoking, baseline systolic blood pressure, cardiovascular reactivity, and risk of cardiovascular morbidity. The risk of cardiovascular morbidity was calculated by applying the Framingham Risk Functions. The Pearson’s Chi-square test and the prevalence ratio were used with a 95 % confidence interval. The direction of the relationship between cardiovascular reactivity, age, and systolic blood pressure was analyzed considering the Eta value. Results: the prevalence of cardiovascular hyperreactivity was higher among people aged 65 to 74 years and males. A higher risk of cardiovascular morbidity was observed in cardiovascular hyperreactive individuals. There is an association between non-optimal systolic blood pressure, increasing age, and high risk of cardiovascular morbidity in cardiovascular hyperreactive people. Conclusions: the risk of cardiovascular morbidity is higher in cardiovascular hyperreactive individuals than in normoreactive people. Age and systolic blood pressure showed greater association with high risk of cardiovascular morbidity.
Hirayama, Tomoya; Takahashi, Fumihiko; Kikuchi, Kenjiro
Cardiovascular diseases ralely evoke nephrotic syndrome. Especially hypertensive renal disease (nephroscrelosis) and renovascular hypertension occasionally may lead to nephrotic syndrome. We reported a case of nephrotic syndrome with renovascular hypertension successfully treated with candesartan. In eldery patients cardiovascular diseases are appeared. It is very important for clinicians to detect the mechanism of nephrotic syndrome caused by cardiovascular diseases. PMID:15500142
Dormand, Helen; Mohiaddin, Raad H
This review provides an overview of Marfan syndrome with an emphasis on cardiovascular complications and cardiovascular imaging. Both pre- and post-operative imaging is addressed with an explanation of surgical management. All relevant imaging modalities are discussed with a particular focus on cardiovascular MR.
Maceira Alicia M; Mohiaddin Raad H
Abstract Systemic hypertension is a highly prevalent potentially modifiable cardiovascular risk factor. Imaging plays an important role in the diagnosis of underlying causes for hypertension, in assessing cardiovascular complications of hypertension, and in understanding the pathophysiology of the disease process. Cardiovascular magnetic resonance (CMR) provides accurate and reproducible measures of ventricular volumes, mass, function and haemodynamics as well as uniquely allowing tissue char...
Kailash Chandra Nayak
Full Text Available Background & objectives: Recently, vivax malaria is also presenting as severe malaria causing multiorgan dysfunction similar to falciparum malaria. The present study was undertaken to evaluate the involvement of cardiovascular system in severe malaria. Methods: This is a clinical prospective study conducted on the cases of severe malaria in S.P. Medical College and PBM Hospital, Bikaner, India. In total, 100 cases (45 males, 55 females; age range 13-75 yr of severe malaria (P. vivax 60; P. falciparum 28; and mixed 12 diagnosed by peripheral blood smear examination, rapid card test and PCR were studied. Evaluation of cardiovascular system was done by clinical examination, chest Xray, ECG, high resolution transthoracic echocardiography and estimation of cardiac markers. Results: In all, 17% cases (9 P. falciparum, 5 P. vivax and 3 mixed were found to be suffering from cardiovascular involvement (11% circulatory failure, 7% congestive cardiac failure and 2% pulmonary edema. ECG showed sinus tachycardia in all the 17 patients, one had atrial ectopic and eight had non-specific ST-T changes. Cardiomegaly was seen in eight cases and pulmonary edema in two on X-ray chest. Echocardiography was within normal range but cardiac dimensions were increased in all the 17 cases. Troponin-I and CPK-MB were increased in 14 cases. Cardiovascular involvement in P. falciparum and mixed infection was associated with high parasite density but P. vivax infection was associated with relatively low parasite density. Involvement of cardiovascular system was associated with increased hospital stay (7.67 ± 2.23 vs 6.59 ± 0.87 days; p <0.001 and high mortality (5 died out of 17 patients. Significant ECG changes and cardiac markers indicate myocardial involvement in severe malaria. Interpretation & Conclusion: The present study indicates involvement of cardiovascular system in severe malaria as evidenced by changes in ECG and cardiac markers (Trop 1 and CPK-MB. The present
Duprez, Daniel A; Kuller, Lewis H; Tracy, Russell; Otvos, James; Cooper, David A; Hoy, Jennifer; Neuhaus, Jacqueline; Paton, Nicholas I; Friis-Møller, Nina; Lampe, Fiona; Liappis, Angelike P; Neaton, James D
using conditional logistic models. RESULTS: Total, large and small HDL-p, but not VLDL-p nor LDL-p, were significantly and inversely associated with CVD and its major component, non-fatal coronary heart disease. The HDL-p associations with CVD were reduced after adjustment for high sensitive C-reactive...... protein (hsCRP), interleukin-6 (IL-6) and D-dimer. Latest levels of total HDL-p were also significantly inversely associated with CVD; treatment interruption led to decrease of total HDL-p; adjusting for latest HDL-p did not explain the greater risk of CVD that was observed in the DC versus VS group...
Full Text Available Dice la Ley de Hierro de la Epidemiología que todo el que nace muere. Por ello el fin de la Medicina no es evitar la muerte en sí, sino evitar las muertes, las enfermedades y el sufrimiento médicamente evitables.Al final, todos nuestros pacientes morirán – y nosotros mismos moriremos también, obviamente. “Los cuerpos encuentran una forma de morir” y si la causa no es el hambre ni la deshidratación, ni es congénita, ni infecciosa, ni por lesiones, ni por cáncer, ni por suicidio, tenemos que esperar que sea por ‘causa cardiovascular’, enfermedad pulmonar, insuficiencia renal o hepática, demencia u otras enfermedades degenerativas. Pero de algo tenemos que morir.Morir por causa cardiovascular ni es deshonroso, ni implica defectuosa atención clínica. Que la primera causa de muerte sea la cardiovascular no dice nada respecto a los cuidados clínicos, ni debería asustar.Sin embargo, son evitables muchas muertes de causa cardiovascular. Así, se puede evitar mucha mortalidad cardiovascular disminuyendo la desigualdad social, por ejemplo (con mejor re-distribución de la riqueza, mejor educación y demás. Los médicos saben que los factores adversos psicosociales asociados a la pertenencia a la clase baja responden del 35% del riesgo atribuible a la hipertensión en la incidencia del infarto de miocardio (en otra formulación, que pertenecer a la clase baja multiplica por 2,7 dicho riesgo1.También deberíamos saber que contra las muertes cardiovasculares no hay nada como las políticas de salud pública sobre el tabaquismo (restricciones de lugares en los que fumar, aumento del precio del tabaco, campañas de información, y demás.En lo clínico, las muertes cardiovasculares evitables se deben ver en perspectiva, según lo que se puede lograr2. Así, por 100.000 habitantes y año, el tratamiento con inhibidores de la enzima convertidora de angiotensina (IECA en la insuficiencia cardíaca puede evitar 308 muertes; el consejo m
Full Text Available Luis M Beltrán,1 Alfonso Rubio-Navarro,2 Juan Manuel Amaro-Villalobos,2 Jesús Egido,2–4 Juan García-Puig,1 Juan Antonio Moreno21Metabolic-Vascular Unit, Fundación IdiPAZ-Hospital Universitario La Paz, Madrid, Spain; 2Vascular, Renal, and Diabetes Research Lab, IIS-Fundación Jiménez Díaz, Madrid, Spain; 3Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM, Madrid, Spain; 4Fundación Renal Iñigo Alvarez de Toledo-Instituto Reina Sofía de Investigaciones Nefrológicas (FRIAT-IRSIN, Madrid, SpainAbstract: Patients infected with the human immunodeficiency virus (HIV have an increased cardiovascular risk. Although initially this increased risk was attributed to metabolic alterations associated with antiretroviral treatment, in recent years, the attention has been focused on the HIV disease itself. Inflammation, immune system activation, and endothelial dysfunction facilitated by HIV infection have been identified as key factors in the development and progression of atherosclerosis. In this review, we describe the epidemiology and pathogenesis of cardiovascular disease in patients with HIV infection and summarize the latest knowledge on the relationship between traditional and novel inflammatory, immune activation, and endothelial dysfunction biomarkers on the cardiovascular risk associated with HIV infection.Keywords: HIV, cardiovascular disease, immune activation, inflammation, antiretroviral therapy
Nuclear imaging methods provide noninvasive indexes of myocardial function, perfusion, and metabolism and are well accepted in clinical cardiology. Advances in prevention and treatment of cardiac disease have resulted in decreasing cardiovascular mortality in industrialized nations. The improvement in therapeutic options has increased the demand for diagnostic tests that might guide clinical decision making. Information beyond the pure anatomic characterization of coronary stenoses is required. Nuclear imaging can be used for early detection and monitoring of the severity and extent of disease. The prognostic potential of such functional testing is being increasingly appreciated and used to guide therapy, thereby resulting in improvement of the quality and cost-effectiveness of the workup of patients with cardiovascular disease. Extensive clinical validation has resulted in growing acceptance of these techniques. Furthermore, ongoing improvement of imaging techniques and development of new radiopharmaceuticals will pave the way for disease-specific, molecular-targeted cardiac imaging in the future. (orig.)
Full Text Available Midlife cardiovascular risk factors, including diabetes, hypertension, dyslipemia, and an unhealthy lifestyle, have been linked to subsequent incidence, delay of onset, and progression rate of Alzheimer disease and vascular dementia. Conversely, optimal treatment of cardiovascular risk factors prevents and slows down age-related cognitive disorders. The impact of antihypertensive therapy on cognitive outcome in patients with hypertension was assessed in large trials which demonstrated a reduction in progression of MRI white matter hyperintensities, in cognitive decline and in incidence of dementia. Large-scale database correlated statin use and reduction in the incidence of dementia, mainly in patients with documented atherosclerosis, but clinical trials failed to reach similar conclusions. Whether a multitargeted intervention would substantially improve protection, quality of life, and reduce medical cost expenditures in patients with lower risk profile has not been ascertained. This would require appropriately designed trials targeting large populations and focusing on cognitive decline as a primary outcome endpoint.
Bartone, Paul T; Valdes, James J; Sandvik, Asle
Many, but not all people experience diminished health, performance and well-being as a function of exposure to stress. However, the underlying neurophysiological processes which characterize hardy or resilient people are not well understood. This study examines psychological hardiness and several indicators of cardiovascular health, including body mass index (BMI) and blood cholesterol markers in a sample of 338 middle-aged adults enrolled in a national security education program. Hierarchical regression analyses reveal that after controlling for the influence of age and sex, high hardiness is related to higher HDL - high density lipoprotein and less body fat (BMI). Lower hardiness is associated with greater total cholesterol to HDL ratio, a cardiovascular disease risk factor. These results suggest that psychological hardiness confers resilience in part through an influence on cholesterol production and metabolism. PMID:26652199
The recently devised therapy for psoriasis and related skin diseases, consisting of long-wave ultraviolet light and oral 8-methoxypsoralen (PUVA), was investigated for its cardiovascular effects. In seventeen patients, long-wave ultraviolet light therapy in a treatment enclosure (mean duration, 19.3 minutes) resulted in ambient temperatures of 39.2 degrees C +/- 2.1 degrees C (SD) and skin temperatures of 38.2 degrees C +/- 1.4 degrees C. In upright subjects, heart rate rose 30.8% to 114.4 +/- 25.2 beats per minute (bpm). Intensive room air conditioning, outside of the treatment enclosure, although significantly lowering skin and ambient temperatures, did not affect the heart rates significantly. PUVA therapy is associated with a definite cardiovascular stress when the box type of therapeutic unit is used. Possible modifications are discussed
Hoel, David G
For more than 15 years the A-bomb survivor studies have shown increased noncancer mortality due to radiation exposures. The most prominent cause of this increase is circulatory disease mortality. Although the estimated relative risk is less than for solid cancers (1.2 versus 1.6 per Sv), there are measurable increases in cardiovascular disease mortality at doses greater than 0.5 Sv. The evidence for circulatory diseases in mortality studies of occupational cohorts exposed to external radiation is less compelling. It is generally accepted that atherosclerosis is an inflammatory disease of the arteries and a risk factor for myocardial infarction. Immunological markers for inflammatory disease have been shown to be dose related in A-bomb survivors. Evidence from animal studies reveals increased cardiovascular mortality and arterial endothelial damage from both neutron and, to a lesser extent, gamma exposures. PMID:17119211
Kidney dysfunction increases cardiovascular disease (CVD) risk. The mechanisms for the risk increase seem to involve a combination of traditional and non-traditional CVD risk factors. We studied renal dysfunction as CVD and mortality risk factor in middle-aged men free from diabetes and CVD. The risk for myocardial infarction (MI) and CVD mortality was increased by ~40% in the 16.5% of men with worse renal function, independent of other CVD risk factors. Renal transplant dysfunction as CVD an...
There is an enormous amount of literature on psychological stress and cardiovascular disease. This report reviews conceptual issues in defining stress and then explores the ramifications of stress in terms of the effects of acute versus long-term stressors on cardiac functioning. Examples of acute stressor studies are discussed in terms of disasters (earthquakes) and in the context of experimental stress physiology studies, which offer a more detailed perspective on underlying physiology. Stu...
A great numbers of cardiovascular disease patients all over the world are suffering in the poor outcomes. Under this situation, cardiac regeneration therapy to reorganize the postnatal heart that is defined as a terminal differentiated-organ is a very important theme and mission for human beings. However, the temporary success of several clinical trials using usual cell types with uncertain cell numbers has provided the transient effect of cell therapy to these patients. We therefore should r...
Dina Visca; Marina Aiello; Alfredo Chetta
Chronic obstructive pulmonary disease (COPD) and chronic cardiovascular disease, such as coronary artery disease, congestive heart failure, and cardiac arrhythmias, have a strong influence on each other, and systemic inflammation has been considered as the main linkage between them. On the other hand, airflow limitation may markedly affect lung mechanics in terms of static and dynamic hyperinflation, especially in pulmonary emphysema, and they can in turn influence cardiac performance as well...
Paula Vélez; Ángel García
In recent years, platelet proteomics has been applied successfully to the study of cardiovascular diseases (CVDs). It is very well known that platelets play a pivotal role in the pathophysiological mechanisms underlying many CVDs, especially acute coronary syndromes (ACSs), since they are implied in thrombus formation after atheroma plaque rupture. This is the reason why molecules involved in platelet activation and aggregation are primary targets for treatment of ACSs. Many efforts are aimed...
Alaswad, Khaldoon; Lavie, Carl J.; Milani, Richard V.; O'Keefe, James H
The potential benefits of fish oil have been touted for several decades. The authors review evidence from epidemiologic, retrospective, and controlled prospective clinical trials demonstrating the effects of omega-3 fatty acids (fish oil) for the prevention of major cardiovascular events including myocardial infarction and stroke in primary and especially secondary prevention settings. Fish oil's efficacy in reducing total mortality and sudden cardiac death appears particularly promising, pro...
DiNicolantonio, James; O'Keefe, James
James J DiNicolantonio, James H O'Keefe Department of Preventive Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO, USAIn a recent review in Vascular Health and Risk Management Wang et al state that “In mainly placebo-controlled cardiovascular (CV)-outcome studies in patients with hypertension, CV benefits with perindopril were associated with large reductions in BP.”1 However, perindopril in the European Trial on Reduction of Cardiac Ev...
DiNicolantonio JJ; O’Keefe JH
James J DiNicolantonio, James H O'Keefe Department of Preventive Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO, USAIn a recent review in Vascular Health and Risk Management Wang et al state that “In mainly placebo-controlled cardiovascular (CV)-outcome studies in patients with hypertension, CV benefits with perindopril were associated with large reductions in BP.”1 However, perindopril in the European Trial on Reduction of Cardiac Events With Perind...
Zafarmand, M. H.
Atherosclerotic cardiovascular disease (CVD), which involves the heart, brain, and peripheral circulation, is a major health problem world-wide. The development of atherosclerosis is a complex process, and several established risk factors are involved. Nevertheless, these established risk factors do not fully explain the occurrence of CVD and further insight is required in factors such as genetic determinants that may identify individuals at risk. In this thesis we worked on the genetic basis...
Finch, William; Shamsa, Kamran; Lee, Michael S
The cardiovascular sequelae of radiation exposure are an important cause of morbidity and mortality following radiation therapy for cancer, as well as after exposure to radiation after atomic bombs or nuclear accidents. In the United States, most of the data on radiation-induced heart disease (RIHD) come from patients treated with radiation therapy for Hodgkin disease and breast cancer. Additionally, people exposed to radiation from the atomic bombs in Hiroshima and Nagasaki, Japan, and the Chernobyl, Ukraine, nuclear accident have an increased risk of cardiovascular disease. The total dose of radiation, as well as the fractionation of the dose, plays an important role in the development of RIHD. All parts of the heart are affected, including the pericardium, vasculature, myocardium, valves, and conduction system. The mechanism of injury is complex, but one major mechanism is injury to endothelium in both the microvasculature and coronary arteries. This likely also contributes to damage and fibrosis within the myocardium. Additionally, various inflammatory and profibrotic cytokines contribute to injury. Diagnosis and treatment are not significantly different from those for conventional cardiovascular disease; however, screening for heart disease and lifelong cardiology follow-up is essential in patients with past radiation exposure. PMID:25290729
Full Text Available James J DiNicolantonio, James H O'Keefe Department of Preventive Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, MO, USAIn a recent review in Vascular Health and Risk Management Wang et al state that “In mainly placebo-controlled cardiovascular (CV-outcome studies in patients with hypertension, CV benefits with perindopril were associated with large reductions in BP.”1 However, perindopril in the European Trial on Reduction of Cardiac Events With Perindopril in Stable Coronary Artery Disease (EUROPA study significantly reduced major cardiovascular events despite a small reduction (approximately 4 mmHg in systolic blood pressure from baseline.2,3 Additionally, the average baseline blood pressure in the EUROPA was just 137/82 mmHg, and in those without hypertension, perindopril still provided a 20% reduction in the combined endpoint of cardiovascular death, myocardial infarction, and cardiac arrest.4,5 In fact, patients receiving perindopril with a baseline systolic blood pressure of <120 mmHg had the greatest reduction in the primary event.6 View original paper by Wang and colleagues.
Bonatti, Johannes; Vetrovec, George; Riga, Celia; Wazni, Oussama; Stadler, Petr
Robotic technology has been used in cardiovascular medicine since the late 1990s. Interventional cardiology, electrophysiology, endovascular surgery, minimally invasive cardiac surgery, and laparoscopic vascular surgery are all fields of application. Robotic devices enable endoscopic reconstructive surgery in narrow spaces and fast, very precise placement of catheters and devices in catheter-based interventions. In all robotic systems, the operator manipulates the robotic arms from a control station or console. In the field of cardiac surgery, mitral valve repair, CABG surgery, atrial septal defect repair, and myxoma resection can be achieved using robotic technology. Furthermore, vascular surgeons can perform a variety of robotically assisted operations to treat aortic, visceral, and peripheral artery disease. In electrophysiology, ablation procedures for atrial fibrillation can be carried out with robotic support. In the past few years, robotically assisted percutaneous coronary intervention and abdominal aortic endovascular surgery techniques have been developed. The basic feasibility and safety of robotic approaches in cardiovascular medicine has been demonstrated, but learning curves and the high costs associated with this technology have limited its widespread use. Nonetheless, increased procedural speed, accuracy, and reduced exposure to radiation and contrast agent in robotically assisted catheter-based interventions, as well as reduced surgical trauma and shortened patient recovery times after robotic cardiovascular surgery are promising achievements in the field. PMID:24663088
Jorige Archana et al
Full Text Available Tinospora cordifolia is known for a wide range of medicinal properties. In this study, cardiovascular and antimicrobial properties of aqueous and ethanolic extracts of Tinospora cordifolia were evaluated. Dose dependent negative ionotropic and chronotropic effects were observed with both aqueous and ethanolic extracts. The effects were antagonized by atropine indicating involvement of muscarinic receptors. Maximum antimicrobial activity was found with ethanolic extract of Tinospora cordifolia (15mm against Pseudomonas aeruginosa. The organism showed resistance to aqueous extract giving an inhibition zone of 0.3mm. The data suggest that Tinospora cordifolia could be of benefit in arrhythmias and microbial infections.
Full Text Available
A Lei de Ferro da Epidemiologia (Ley de Hierro de La Epidemiología diz que todos que nascem, morrem. Por isso, o propósito da Medicina não é evitar a morte por si só, mas evitar as mortes, as doenças e o sofrimento que podem ser medicamente evitáveis.
No final, todos nossos pacientes morrerão – e nós também, obviamente, morreremos. “Os corpos encontram uma forma de morrer”, e se a causa não for por fome ou desidratação, por motivo congênito e infeccioso, por lesões, câncer ou suicídio, temos que esperar que seja por ‘motivo cardiovascular’, doença pulmonar, insuficiência renal ou hepática, demência ou outras doenças degenerativas. Mas temos que morrer por alguma coisa.
Morrer por causa cardiovascular não é desonroso, nem refere-se à atenção clínica imperfeita. O fato de a primeira causa de morte ser a cardiovascular não tem nenhuma relação com os cuidados clínicos e nem deveria assustar.
Entretanto, muitas das mortes por motivo cardiovascular poderiam ser evitadas. Assim, poder-se-ia evitar mortalidade cardiovascular, diminuindo a desigualdade social, por exemplo, com melhor redistribuição da riqueza, melhor educação etc. Os médicos sabem que os fatores adversos psicossociais associados ao fato de pertencer à classe baixa correspondem a 35% do risco atribuído à hipertensão na incidência do infarto do miocárdio (em outra hipótese, pertencer à classe baixa duplica 2,7 tal risco1.
Também deve-se saber que, contra as mortes cardiovasculares, não há nada como as políticas de saúde pública quanto ao tabagismo (restrições dos lugares onde fumar, aumento do preço do tabaco, campanhas de informação, entre outras.
Na parte clínica, as mortes cardiovasculares evitáveis devem ser vistas em perspectiva, de acordo com o que seja possível conseguir2. Portanto, por 100.000 habitantes ao ano, o tratamento com inibidores da enzima conversora de angiotensina (IECA
... staph infections are caused by the species Staphylococcus aureus (S. aureus) . Which of these infections do you worry about most? S. aureus most commonly causes skin infections like folliculitis, boils, ...
Hookworm disease; Ground itch; Ancylostoma duodenale infection; Necator americanus infection; Parasitic infection - hookworm ... with any of the following roundworms: Necator americanus Ancylostoma ... Ancylostoma ceylanicum Ancylostoma braziliense The first 2 ...
Labarthe, Darwin R; Kubzansky, Laura D; Boehm, Julia K; Lloyd-Jones, Donald M; Berry, Jarett D; Seligman, Martin E P
Two concepts, positive health and cardiovascular health, have emerged recently from the respective fields of positive psychology and preventive cardiology. These parallel constructs are converging to foster positive cardiovascular health and a growing collaboration between psychologists and cardiovascular scientists to achieve significant improvements in both individual and population cardiovascular health. We explore these 2 concepts and note close similarities in the measures that define them, the health states that they aim to produce, and their intended long-term clinical and public health outcomes. We especially examine subjective health assets, such as optimism, that are a core focus of positive psychology, but have largely been neglected in preventive cardiology. We identify research to date on positive cardiovascular health, discuss its strengths and limitations thus far, and outline directions for further engagement of cardiovascular scientists with colleagues in positive psychology to advance this new field. PMID:27539179
An association between nonalcoholic fatty liver disease and cardiovascular disease has been repeatedly reported. Several studies have focused on levels of gamma-glutamyltransferase (GGT) and alanine aminotransferase (ALT) in relation to cardiovascular outcomes. Evidence indicates that GGT may have a potential role for cardiovascular risk stratification while the role of ALT for cardiac prognosis remains controversial. A conceptual framework that includes not only GGT and ALT but also markers ...
Fassett, Robert G; Coombes, Jeff S
Oxidative stress and inflammation are established processes contributing to cardiovascular disease caused by atherosclerosis. However, antioxidant therapies tested in cardiovascular disease such as vitamin E, C and β-carotene have proved unsuccessful at reducing cardiovascular events and mortality. Although these outcomes may reflect limitations in trial design, new, more potent antioxidant therapies are being pursued. Astaxanthin, a carotenoid found in microalgae, fungi, complex plants, seaf...
Sugamura, Koichi; Keaney, John F.
Based on the ‘free-radical theory’ of disease, researchers have been trying to elucidate the role of oxidative stress from free radicals in cardiovascular disease. Considerable data indicate that ROS and oxidative stress are important features of cardiovascular diseases including atherosclerosis, hypertension, and congestive heart failure. However, blanket strategies with antioxidants to ameliorate cardiovascular disease have not generally yielded favorable results. However, our understanding...
Jie Wang; Fei Lin; Li-li Guo; Xing-jiang Xiong; Xun Fan
Recent studies demonstrated that mitochondria play an important role in the cardiovascular system and mutations of mitochondrial DNA affect coronary artery disease, resulting in hypertension, atherosclerosis, and cardiomyopathy. Traditional Chinese medicine (TCM) has been used for thousands of years to treat cardiovascular disease, but it is not yet clear how TCM affects mitochondrial function. By reviewing the interactions between the cardiovascular system, mitochondrial DNA, and TCM, we sho...
The cardiovascular deconditioning observed during and after space flight is characterized in a review of human space and simulation studies and animal simulations. The various simulation techniques (horizontal bed rest, head-down tilt, and water immersion in man, and immobilization of animals) are examined, and sample results are presented in graphs. Countermeasures such as exercise regimens, fluid replacement, drugs, venous pooling, G-suits, oscillating beds, electrostimulation of muscles, lower-body negative pressure, body-surface cooling, and hypoxia are reviewed and found to be generally ineffective or unreliable. The need for future space experimentation in both humans and animals is indicated.
Claver García, Laura
La enfermedad cardiovascular siempre ha sido considerada una enfermedad de hombres. Sin embargo, existen datos que reflejan el aumento de esta patología en las mujeres, alcanzando e incluso superando al número de varones, y llegando a ser en España la primera causa de muerte. En ellas, estos episodios suelen comenzar 10 años más tarde debido a la protección que durante la etapa fértil brindan los estrógenos. Sin embargo, tras la menopausia los niveles de estas hormonas disminuyen y es ent...
In the past ten years digital image processing has contributed decisively to the advance of cardiovascular radiology. Not only images of better diagnostic value could be produced, but also in many cases the risk for the patient was diminished. In this paper three topics are discussed: One of the principal methods is digital angiography especially with functional imaging. In addition, because of the rapid progress of digital imaging data compression became a major issue. Finally there is a good chance that 3D-processing of MRI data will at least partly replace the present invasive techniques
A multitude of modifiable risk factors during the median phase of life are often causative for cognitive dysfunction (CD) in old age. High evidence exists for cigarette smoking, diabetes, physical inactivity and sleeping disorders. Single large scale population based studies proof it for hypertension, hypercholesterinemia and depression, conflicting evidence exists for obesity and work stress. Little attention is paid to the close association between cardiovascular disease conditions and CD, particularly for atrial fibrillation, heart failure and for older patients with coronary heart disease. Undetected CD may be responsible for non-adherence and failure of self-care programs in chronic heart patients. PMID:27557067
Full Text Available Dentist and oral health screening may be the latest weapon in identifying persons at risk of cardiovascular disease. Oral infections, specifically periodontitis, may confer independent risks for different systemic conditions. The risk factors associated with cardiovascular diseases also suggest that the relationship between periodontal disease and diabetes works in both ways. The aim of this study was to support and strengthen the association and relationship between oral hygiene status of individuals with cardiovascular diseases and its associated risk factors. A simple random sampling was carried out in 200 inhabitants of Western Utter Pradesh, India. An oral health visit and examination was made for an equal number of males and females of different age groups with cardiovascular diseases. Evaluation of the oral status was made by means of an oral hygiene index, community periodontal index of treatment needs and loss of attachment. Evaluation of oral status in patients with cardiovascular diseases and in the control group has shown a statistically significant low level of oral health in patients with cardiovascular diseases as compared to control. Prevalence of systemic diseases in different age groups significantly correlated with the prevalence of severe periodontal diseases. Treating gum disease may reduce the risk of heart disease and improve health outcomes for patients with periodontal disease and vascular heart problems.
Hollan, Ivana; Meroni, Pier Luigi; Ahearn, Joseph M; Cohen Tervaert, J W; Curran, Sam; Goodyear, Carl S; Hestad, Knut A; Kahaleh, Bashar; Riggio, Marcello; Shields, Kelly; Wasko, Mary C
Various autoimmune rheumatic diseases (ARDs), including rheumatoid arthritis, spondyloarthritis, vasculitis and systemic lupus erythematosus, are associated with premature atherosclerosis. However, premature atherosclerosis has not been uniformly observed in systemic sclerosis. Furthermore, although experimental models of atherosclerosis support the role of antiphospholipid antibodies in atherosclerosis, there is no clear evidence of premature atherosclerosis in antiphospholipid syndrome (APA). Ischemic events in APA are more likely to be caused by pro-thrombotic state than by enhanced atherosclerosis. Cardiovascular disease (CVD) in ARDs is caused by traditional and non-traditional risk factors. Besides other factors, inflammation and immunologic abnormalities, the quantity and quality of lipoproteins, hypertension, insulin resistance/hyperglycemia, obesity and underweight, presence of platelets bearing complement protein C4d, reduced number and function of endothelial progenitor cells, apoptosis of endothelial cells, epigenetic mechanisms, renal disease, periodontal disease, depression, hyperuricemia, hypothyroidism, sleep apnea and vitamin D deficiency may contribute to the premature CVD. Although most research has focused on systemic inflammation, vascular inflammation may play a crucial role in the premature CVD in ARDs. It may be involved in the development and destabilization of both atherosclerotic lesions and of aortic aneurysms (a known complication of ARDs). Inflammation in subintimal vascular and perivascular layers appears to frequently occur in CVD, with a higher frequency in ARD than in non-ARD patients. It is possible that this inflammation is caused by infections and/or autoimmunity, which might have consequences for treatment. Importantly, drugs targeting immunologic factors participating in the subintimal inflammation (e.g., T- and B-cells) might have a protective effect on CVD. Interestingly, vasa vasorum and cardiovascular adipose tissue may
van Rossum Albert C; Raman Subha V; McConnell Michael V; Lawson Mark A; Higgins Charles B; Friedrich Matthias G; Bogaert Jan G; Bluemke David; Hundley W Gregory; Flamm Scott; Kramer Christopher M; Nagel Eike; Neubauer Stefan
Abstract These reporting guidelines are recommended by the Society for Cardiovascular Magnetic Resonance (SCMR) to provide a framework for healthcare delivery systems to disseminate cardiac and vascular imaging findings related to the performance of cardiovascular magnetic resonance (CMR) examinations.
Hu, S S
The cardiovascular surgery in China has achieved great progress both on scale and technology though development over the past thirty years. However, the technical predominance of cardiovascular surgery in therapies for some diseases has been weakened, along with developments of new drugs and interventional technology. Besides, the change of doctor-patient relationship result from internet medical information service and less attraction of cardiovascular surgery discipline to talents bring certain challenge to the development of cardiovascular surgery. Currently, cardiovascular surgeons should practice the "patient first" principle, carry out individual customized treatment and precision therapy, absorb the advantages of other subjects like intervention and imaging in order to achieve technological breakthroughs, create new treatment technologies and models with smaller trauma and better outcome, establish heart team to provide patient oriented treatment. Besides, cardiovascular surgeons should improve knowledge system by learning related technology and science, become hybrid doctors of research. Cardiovascular surgeons should pay high attention to critical effect of research on the disciplinary development, carry out question and demand oriented clinical studies, change the medical practice by virtue of research achievements, direct the treatment for cardiovascular diseases, and finally provide better health service and rebuild the predominance of cardiovascular surgery. PMID:27502127
Thacker, J G; Ferguson, R E; Rodeheaver, G T; Edlich, R F
Cardiovascular needles are now being manufactured from new stainless steel alloys containing high concentrations of nickel, Surgalloy and Ethalloy. The purpose of this study was to compare the biomechanical performance of a cardiovascular needle made of Surgalloy with a comparably sized needle made of Ethalloy. The parameters of biomechanical performance included sharpness, maintenance of sharpness, resistance to bending, and ductility. Because the biomechanical performance of these needles was remarkably similar, cardiovascular needles made of either the Surgalloy or Ethalloy alloys are recommended for cardiovascular surgery. PMID:11495105
Full Text Available The association between dental and cardio-vascular diseases is essential as both are highly prevalent. Finding a possible causal relation between cardiovascular disease and chronic periodontal pathology, known to cause tooth loss, is therefore essential. The existence of some risk factors, such as smoking, bacterial infections, malnutrition and nutritional deficiencies, may explain the associations observed between cardio-vascular and oral pathologies. In the case of dental diseases, acceleration of atherosclerosis is supported by the role played by infections. The study – performed between 2008-2009 – analyzed 45 cases, selected from the patients hospitalized in the Medical Clinics of the Military Hospital of Ia[i. The patients included in the study suffered from arterial hypertension (HTA, cardiac insufficiency, ischemic cardiopathy, pectoral angina and subacute infectious endocarditis. All were subjected to a stomatological examination, for establishing their dental hygiene, the stomatological diseases they had had and the treatments performed. There are several ways in which infections of the oral cavity lead to cardiovascular disease. These include: transitory bacteriemia; inflammation and vascular lesions; diet and smoking.
Pneumococci are a type of streptococcus bacteria. The bacteria spread through contact with people who are ill or by healthy people who carry the bacteria in the back of their nose. Pneumococcal infections can be mild or severe. The most common types of infections are Ear infections Sinus infections ...
Recent epidemiological studies indicate that exposure to ionising radiation enhances the risk of cardiovascular mortality and morbidity in a moderate but significant manner. Our goal is to identify molecular mechanisms involved in the pathogenesis of radiation-induced cardiovascular disease using cellular and mouse models. Two radiation targets are studied in detail: the vascular endothelium that plays a pivotal role in the regulation of cardiac function, and the myocardium, in particular damage to the cardiac mitochondria. Ionising radiation causes immediate and persistent alterations in several biological pathways in the endothelium in a dose- and dose-rate dependent manner. High acute and cumulative doses result in rapid, non-transient remodelling of the endothelial cytoskeleton, as well as increased lipid peroxidation and protein oxidation of the heart tissue, independent of whether exposure is local or total body. Proteomic and functional changes are observed in lipid metabolism, glycolysis, mitochondrial function (respiration, ROS production etc.), oxidative stress, cellular adhesion, and cellular structure. The transcriptional regulators Akt and PPAR alpha seem to play a central role in the radiation-response of the endothelium and myocardium, respectively. We have recently started co-operation with GSI in Darmstadt to study the effect of heavy ions on the endothelium. Our research will facilitate the identification of biomarkers associated with adverse cardiac effects of ionising radiation and may lead to the development of countermeasures against radiation-induced cardiac damage.
Franz, Christopher A; Frishman, William H
Marijuana is currently the most used illicit substance in the world. With the current trend of decriminalization and legalization of marijuana in the US, physicians in the US will encounter more patients using marijuana recreationally over a diverse range of ages and health states. Therefore, it is relevant to review marijuana's effects on human cardiovascular physiology and disease. Compared with placebo, marijuana cigarettes cause increases in heart rate, supine systolic and diastolic blood pressures, and forearm blood flow via increased sympathetic nervous system activity. These actions increase myocardial oxygen demand to a degree that they can decrease the time to exercise-induced angina in patients with a history of stable angina. In addition, marijuana has been associated with triggering myocardial infarctions (MIs) in young male patients. Smoking marijuana has been shown to increase the risk of MI onset by a factor of 4.8 for the 60 minutes after marijuana consumption, and to increase the annual risk of MI in the daily cannabis user from 1.5% to 3% per year. Human and animal models suggest that this effect may be due to coronary arterial vasospasm. However, longitudinal studies have indicated that marijuana use may not have a significant effect on long-term mortality. While further research is required to definitively determine the impact of marijuana on cardiovascular disease, it is reasonable to recommend against recreational marijuana use, especially in individuals with a history of coronary artery disorders. PMID:26886465
Lizzie M. Castillo S
Full Text Available En Costa Rica la enfermedad cardiovascular cobra en promedio 6 vidas por día, lo cual representa un aumento escalonado en los últimos años, debido en su mayoría a cambios en el estilo de vida del costarricense. Además, llama la atención, que factores de riesgo para enfermedad cardiovascular como son el fumado, obesidad infantil, alcoholismo, diabetes, dislipidemia e hipertensión han mostrado un incremento en su incidencia. Por lo tanto,se pretende realizar una revisión de los programas de detección y de atención temprana a nivel institucional, en lo que respecta a la Caja Costarricense de Seguro Social como ente responsable de llevar a cabo los mismos. El adecuado conocimiento y uso de los programas pretende una disminución en la morbimortalidad de la misma,y su aplicación se hace obligatoria para el manejo de pacientes en atención primaria.
Fosgerau, Keld; Ristagno, Giuseppe; Jayatissa, Magdalena Niepsuj; Axelsen, Mads; Gotfredsen, Jacob W; Weber, Uno J; Køber, Lars; Torp-Pedersen, Christian; Videbaek, Charlotte
Survivors of a cardiac arrest often have persistent cardiovascular derangements following cardiopulmonary resuscitation including decreased cardiac output, arrhythmias and morphological myocardial damage. These cardiovascular derangements may lead to an increased susceptibility towards the external...... and internal environment of the cardiovascular system as compared to the healthy situation....
Clare C. W. Yu; Au, Chun T.; Lee, Frank Y.F.; So, Raymond C.H.; Wong, John P.S.; Mak, Gary Y.K.; Chien, Eric P.; Alison M. McManus
Background Overweight, obesity, and cardiovascular disease risk factors are prevalent among firefighters in some developed countries. It is unclear whether physical activity and cardiopulmonary fitness reduce cardiovascular disease risk and the cardiovascular workload at work in firefighters. The present study investigated the relationship between leisure-time physical activity, cardiopulmonary fitness, cardiovascular disease risk factors, and cardiovascular workload at work in firefighters i...
Objective To analyze the association between cardiovascular risk factors and inter-arm blood pressure difference(IAD) in patients with human immunodeficiency virus(HIV) infection,and to confirm as to whether HIV infection promotes atherosclerosis. Methods 41 HAART-naive HIV infected-patients and 43 healthy people were
... STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.111 Cardiovascular. Cardiovascular...; (b) A person applying for first-class medical certification must demonstrate an absence of myocardial...) An electrocardiogram will satisfy a requirement of paragraph (b) of this section if it is dated...
Krutika Gajjar; Dr.Parloop Bhatt; Dr.Yagnik S.Bhalodia; Dr.Sizan B.Patel; Chintan Patel
Considering the high mortality and morbidity rate associated with cardiovascular diseases, Cardiacrehabilitation (CR) is regarded for prevention and management of cardiovascular diseases. CR servicesare generally provided in an outpatient as comprehensive, long-term programs involving medicalevaluation, prescribed exercise, cardiac risk factor modification, education and counseling. This includesnutritional therapies, weight loss program management of lipid abnormalities with diet and medicat...
Full Text Available Psychological stress has been proposed as a major contributor to the progression of cardiovascular disease (CVD. Acute mental stress can activate the sympathetic-adrenal-medullary (SAM axis, eliciting the release of catecholamines (NE and EPI resulting in the elevation of heart rate (HR and blood pressure (BP. Combined stress (psychological and physical can exacerbate these cardiovascular responses, which may partially contribute to the elevated risk of CVD and increased proportionate mortality risks experienced by some occupations (e.g., firefighting and law enforcement. Studies have supported the benefits of physical activity on physiological and psychological health, including the cardiovascular response to acute stress. Aerobically trained individuals exhibit lower sympathetic nervous system (e.g., HR reactivity and enhanced cardiovascular efficiency (e.g., lower vascular reactivity and decreased recovery time in response to physical and/or psychological stress. In addition, resistance training has been demonstrated to attenuate cardiovascular responses and improve mental health. This review will examine stress-induced cardiovascular reactivity and plausible explanations for how exercise training and physical fitness (aerobic and resistance exercise can attenuate cardiovascular responses to stress. This enhanced functionality may facilitate a reduction in the incidence of stroke and myocardial infarction. Finally, this review will also address the interaction of obesity and physical activity on cardiovascular reactivity and CVD.
Boullart, I.; Graaf, J. de; Stalenhoef, A.F.H.
Dyslipidemia, especially elevated serum levels of cholesterol, is causally related to cardiovascular disease. The specific role of triglycerides has long been controversial. In this article we discuss the role of serum triglycerides in relation to the risk of cardiovascular disease. First, the (path
Weeke, A; Juel, K; Vaeth, M
In order to study if tricyclic antidepressant drugs (TCA) in therapeutic doses increase the risk of death due to cardiovascular causes, the relative mortality from cardiovascular diseases was studied in two large groups of first hospitalized manic-depressive patients, one from the TCA era, the ot...... disease, suicide, and other non-cancer causes....
Sehestedt, Thomas; Olsen, Michael H
measuring subclinical organ damage. We have (i) reviewed recent studies linking markers of subclinical organ damage in the heart, blood vessels and kidney to cardiovascular risk; (ii) discussed the evidence for improvement in cardiovascular risk prediction using markers of subclinical organ damage; (iii...
Wu, Ting; Snieder, Harold; de Geus, Eco
Individual differences in the cardiovascular response to stress play a central role in the reactivity hypothesis linking frequent exposure to psychosocial stress to adverse outcomes in cardiovascular health. To assess the importance of genetic factors, a meta-analysis was performed on all published
... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.211 Cardiovascular. Cardiovascular standards for a second-class medical certificate are no established medical history or clinical diagnosis...
... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Third-Class Airman Medical Certificate § 67.311 Cardiovascular. Cardiovascular standards for a third-class airman medical certificate are no established medical history or...
A.A.A. Bak (Annette)
textabstractThis thesis comprises several studies on the effect of coffee and caffeine on cardiovascular risk in general, and the effect on serum lipids, blood pressure and selected hemostatic variables in particular. The association between coffee use and cardiovascular morbidity and mortality was
Diaz Ledezma, Fernando
In this paper, we propose a hybrid interpretation of the cardiovascular system. Based on a model proposed by Simaan et al. (2009), we study the problem of detecting cardiovascular anomalies that can be caused by variations in some physiological parameters, using an observerbased approach. We present the first numerical results obtained. © 2012 IFAC.
Tewari, Satyendra; Moorthy, Nagaraja
Cardiovascular manifestations of tertiary syphilis include aortitis, aortic root dilation, aneurysm formation, aortic regurgitation, and coronary ostial stenosis. Coronary ostial lesions have been detected in as many as 26% of patients with syphilitic aortitis. However nonostial coronary stenosis and coronary aneurysms in same patient is rarely described in cardiovascular syphilis. PMID:25634420
Santoro, Nanette; Fan, Maria; Maslow, BatSheva; Schoenbaum, Ellie
With the advent of highly active antiretroviral agents, women with HIV infection can expect to live longer than ever before. This increased survival has led to concerns about the long-term implications of HIV disease and its treatment. Women with HIV infection appear to lose ovarian function earlier in life than women without HIV infection. They also have evidence of reduced bone mineral density and increased cardiovascular risk. Moreover, many of these increases in risk factors are present e...
Kim, Tae Hoon; Lee, Heung Kyu
Respiratory syncytial virus (RSV) is the leading cause of respiratory infection in infants and young children. Severe clinical manifestation of RSV infection is a bronchiolitis, which is common in infants under six months of age. Recently, RSV has been recognized as an important cause of respiratory infection in older populations with cardiovascular morbidity or immunocompromised patients. However, neither a vaccine nor an effective antiviral therapy is currently available. Moreover, the inte...
Collins, P; Webb, C M; de Villiers, T J; Stevenson, J C; Panay, N; Baber, R J
Cardiovascular disease is the leading cause of morbidity and mortality in postmenopausal women. Although it is a disease of aging, vascular disease initiates much earlier in life. Thus, there is a need to be aware of the potential to prevent the development of the disease from an early age and continue this surveillance throughout life. The menopausal period and early menopause present an ideal opportunity to assess cardiovascular risk and plan accordingly. Generally in this period, women will be seen by primary health-care professionals and non-cardiovascular specialists. This review addresses female-specific risk factors that may contribute to the potential development of cardiovascular disease. It is important for all health-care professionals dealing with women in midlife and beyond to be cognisant of these risk factors and to initiate female-specific preventative measures or to refer to a cardiovascular specialist. PMID:27327421
Caterson, I D; Finer, N; Coutinho, W;
Aim: The Sibutramine Cardiovascular OUTcomes trial showed that sibutramine produced greater mean weight loss than placebo but increased cardiovascular morbidity but not mortality. The relationship between 12-month weight loss and subsequent cardiovascular outcomes is explored. Methods: Overweight...... randomization to first occurrence of a primary outcome event (non-fatal myocardial infarction, non-fatal stroke, resuscitated cardiac arrest or cardiovascular death). Results: For the total population, mean weight change during Lead-in Period (sibutramine) was -2.54 kg. Post-randomization, mean total weight...... change to Month 12 was -4.18 kg (sibutramine) or -1.87 kg (placebo). Degree of weight loss during Lead-in Period or through Month 12 was associated with a progressive reduction in risk for the total population in primary outcome events and cardiovascular mortality over the 5-year assessment. Although...
Full Text Available Recent studies demonstrated that mitochondria play an important role in the cardiovascular system and mutations of mitochondrial DNA affect coronary artery disease, resulting in hypertension, atherosclerosis, and cardiomyopathy. Traditional Chinese medicine (TCM has been used for thousands of years to treat cardiovascular disease, but it is not yet clear how TCM affects mitochondrial function. By reviewing the interactions between the cardiovascular system, mitochondrial DNA, and TCM, we show that cardiovascular disease is negatively affected by mutations in mitochondrial DNA and that TCM can be used to treat cardiovascular disease by regulating the structure and function of mitochondria via increases in mitochondrial electron transport and oxidative phosphorylation, modulation of mitochondrial-mediated apoptosis, and decreases in mitochondrial ROS. However further research is still required to identify the mechanism by which TCM affects CVD and modifies mitochondrial DNA.
Temporelli, Pier Luigi
It is well known that regular moderate physical activity, in the context of a healthy lifestyle, significantly reduces the likelihood of cardiovascular events, both in primary and secondary prevention. In addition, it is scientifically proven that exercise can reduce the incidence of diabetes, osteoporosis, depression, breast cancer and colon cancer. Despite this strong evidence, sedentary lifestyle remains a widespread habit in the western world. Even in Italy the adult population has a poor attitude to regular physical activity. It is therefore necessary, as continuously recommended by the World Health Organization, to motivate people to "move" since the transition from inactivity to regular light to moderate physical activity has a huge impact on health, resulting in significant savings of resources. We do not need to be athletes to exercise - it should be part of all our daily routines. PMID:27029874
Christopher N. Blesso
Full Text Available Eggs are a major source of phospholipids (PL in the Western diet. Dietary PL have emerged as a potential source of bioactive lipids that may have widespread effects on pathways related to inflammation, cholesterol metabolism, and high-density lipoprotein (HDL function. Based on pre-clinical studies, egg phosphatidylcholine (PC and sphingomyelin appear to regulate cholesterol absorption and inflammation. In clinical studies, egg PL intake is associated with beneficial changes in biomarkers related to HDL reverse cholesterol transport. Recently, egg PC was shown to be a substrate for the generation of trimethylamine N-oxide (TMAO, a gut microbe-dependent metabolite associated with increased cardiovascular disease (CVD risk. More research is warranted to examine potential serum TMAO responses with chronic egg ingestion and in different populations, such as diabetics. In this review, the recent basic science, clinical, and epidemiological findings examining egg PL intake and risk of CVD are summarized.
Hellsten, Ylva; Nyberg, Michael
Aerobic exercise training leads to cardiovascular changes that markedly increase aerobic power and lead to improved endurance performance. The functionally most important adaptation is the improvement in maximal cardiac output which is the result of an enlargement in cardiac dimension, improved...... arteries is reduced, a factor contributing to increased arterial compliance. Endurance training may also induce alterations in the vasodilator capacity, although such adaptations are more pronounced in individuals with reduced vascular function. The microvascular net increases in size within the muscle...... allowing for an improved capacity for oxygen extraction by the muscle through a greater area for diffusion, a shorter diffusion distance, and a longer mean transit time for the erythrocyte to pass through the smallest blood vessels. The present article addresses the effect of endurance training on systemic...
Full Text Available Polymers have found widespread applications in cardiology, in particular in coronary vascular intervention as stent platforms (scaffolds and coating matrices for drug-eluting stents. Apart from permanent polymers, current research is focussing on biodegradable polymers. Since they degrade once their function is fulfilled, their use might contribute to the reduction of adverse events like in-stent restenosis, late stent-thrombosis, and hypersensitivity reactions. After reviewing current literature concerning polymers used for cardiovascular applications, this review deals with parameters of tissue and blood cell functions which should be considered to evaluate biocompatibility of stent polymers in order to enhance physiological appropriate properties. The properties of the substrate on which vascular cells are placed can have a large impact on cell morphology, differentiation, motility, and fate. Finally, methods to assess these parameters under physiological conditions will be summarized.
Joseph F. Murphy
Full Text Available Cyclooxygenase (COX, also known as prostaglandin endoperoxide synthase, is the key enzyme required for the conversion of arachidonic acid to prostaglandins. Two COX isoforms have been identified, COX-1 and COX-2. Generally, the COX-1 enzyme is produced constitutively (e.g. in gastric mucosa, whereas COX-2 is highly inducible (e.g. at sites of inflammation and cancer. Traditional non-steroidal anti-inflammatory drugs (NSAIDs inhibit both enzymes, and a new class of COX-2 selective inhibitors (COXIBs preferentially inhibit the COX-2 enzyme. This review summarizes our current understanding of the role of COX-1 and COX-2, with emphasis on their role on cardiovascular biology.
Thieme, D; Büttner, A
Doping -the abuse of anabolic-androgenic steroids in particular- is widespread in amateur and recreational sports and does not solely represent a problem of professional sports. Excessive overdose of anabolic steroids is well documented in bodybuilding or powerlifting leading to significant side effects. Cardiovascular damages are most relevant next to adverse endocrine effects.Clinical cases as well as forensic investigations of fatalities or steroid consumption in connection with trafficking of doping agents provide only anecdotal evidence of correlations between side effects and substance abuse. Analytical verification and self-declarations of steroid users have repeatedly confirmed the presumption of weekly dosages between 300 and 2000 mg, extra to the fact that co-administration of therapeutics to treat side-effects represent a routine procedure. Beside the most frequent use of medications used to treat erectile dysfunction or estrogenic side-effects, a substantial number of antihypertensive drugs of various classes, i.e. beta-blockers, diuretics, angiotensin II receptor antagonists, calcium channel blockers, as well as ACE inhibitors were recently confiscated in relevant doping cases. The presumptive correlation between misuse of anabolic steroids and self-treatment of cardiovascular side effects was explicitly confirmed by detailed user statements.Two representative fatalities of bodybuilders were introduced to outline characteristic, often lethal side effects of excessive steroid abuse. Moreover, illustrative autopsy findings of steroid acne, thrombotic occlusion of Ramus interventricularis anterior and signs of cardiac infarctions are presented.A potential steroid abuse should be carefully considered in cases of medical consultations of patients exhibiting apparent constitutional modifications and corresponding adverse effects. Moreover, common self-medications -as frequently applied by steroid consumers- should be taken into therapeutic considerations
Ghadimi Mahani, Maryam [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Morani, Ajaykumar C. [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Lu, Jimmy C.; Dorfman, Adam L. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, Ann Arbor, MI (United States); Fazeli Dehkordy, Soudabeh [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Providence Hospital and Medical Centers, Department of Graduate Medical Education, Southfield, MI (United States); Jeph, Sunil [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Geisinger Medical Center, Department of Radiology, Danville, PA (United States); Agarwal, Prachi P. [University of Michigan Health System, Department of Radiology, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States)
With increasing use of pediatric cardiovascular MRI, it is important for all imagers to become familiar with the spectrum of non-cardiovascular imaging findings that can be encountered. This study aims to ascertain the prevalence and nature of these findings in pediatric cardiovascular MRIs performed at our institution. We retrospectively evaluated reports of all cardiovascular MRI studies performed at our institute from January 2008 to October 2012 in patients younger than18 years. Most studies (98%) were jointly interpreted by a pediatric cardiologist and a radiologist. We reviewed the electronic medical records of all cases with non-cardiovascular findings, defined as any imaging finding outside the cardiovascular system. Non-cardiovascular findings were classified into significant and non-significant, based on whether they were known at the time of imaging or they required additional workup or a change in management. In 849 consecutive studies (mean age 9.7 ± 6.3 years), 145 non-cardiovascular findings were found in 140 studies (16.5% of total studies). Overall, 51.0% (74/145) of non-cardiovascular findings were in the abdomen, 30.3% (44/145) were in the chest, and 18.6% (27/145) were in the spine. A total of 19 significant non-cardiovascular findings were observed in 19 studies in individual patients (2.2% of total studies, 47% male, mean age 5.9 ± 6.7 years). Significant non-cardiovascular findings included hepatic adenoma, arterially enhancing focal liver lesions, asplenia, solitary kidney, pelvicaliectasis, renal cystic diseases, gastric distention, adrenal hemorrhage, lung hypoplasia, air space disease, bronchial narrowing, pneumomediastinum and retained surgical sponge. Non-cardiovascular findings were seen in 16.5% of cardiovascular MRI studies in children, of which 2.2% were clinically significant findings. Prevalence and nature of these non-cardiovascular findings are different from those reported in adults. Attention to these findings is important
Swenson, Colin E; Sadikot, Ruxana T
Achromobacteria are ubiquitous environmental organisms that may also become opportunistic pathogens in certain conditions, such as cystic fibrosis, hematologic and solid organ malignancies, renal failure, and certain immune deficiencies. Some members of this genus, such as xylosoxidans, cause primarily nosocomially acquired infections affecting multiple organ systems, including the respiratory tract, urinary tract, and, less commonly, the cardiovascular and central nervous systems. Despite an increasing number of published case reports and literature reviews suggesting a global increase in achromobacterial disease, most clinicians remain uncertain of the organism's significance when clinically isolated. Moreover, effective treatment can be challenging due to the organism's inherent and acquired multidrug resistance patterns. We reviewed all published cases to date of non-cystic fibrosis achromobacterial lung infections to better understand the organism's pathogenic potential and drug susceptibilities. We found that the majority of these cases were community acquired, typically presenting as pneumonias (88%), and were most frequent in individuals with hematologic and solid organ malignancies. Our findings also suggest that achromobacterial lung infections are difficult to treat, but respond well to extended-spectrum penicillins and cephalosporins, such as ticarcillin, piperacillin, and cefoperazone. PMID:25706494
Campylobacter infection is a common foodborne illness. You get it from eating raw or undercooked poultry. You ... whether you need to take antibiotics. To prevent campylobacter infection, cook poultry thoroughly. Use a separate cutting ...
... genital tract. They can cause infections in various parts of the body in children and adults of all ages. The most common are dental infections, inflammation of the abdominal lining (peritonitis), and ...
... staph food poisoning, and these infections: Folliculitis and Boils Folliculitis is an infection of hair follicles, tiny ... But sometimes it goes on to become a boil (also called a furuncle). With a boil, the ...
Burdzenidze, E; Zhvania, M
Congenital infections are among the most pressing health care problems. Congenital infections are not reason of congenital malformation and perinatal mortality only, but also pathologies that can be revealed during first year of life. Frequency for congenital viral infection displayed from birth varies between 23% and 92%. The aim of the study was the investigation of inherent infection consequences (citomegaloviral infection, herpes infection and chlamidia) in children in different age groups. Under our observation were 81 children with congenital infections. Among them 29 were with citomegaloviral infection, 17 with herpes infection; 15 chlamidia infection and 22 infections mix (citomegalovirus + herpes, citomegalovirus + chlamidia and chlamidia + herpes). In all observed children neurological simptomatic such as neuro-reflectory hyperexcitability syndrom, hypertension-hydrocephalic syndrom, musculary dystonia syndrom, hydrocephaly, retardation of psychomotor development etc. were present. After birth the worst prevalent are pathologies of cardiovascular system: functional cardiopathy, carditis, congenital heart disease (among them multivalvular disease), affection of hepatobilliar system, organs of vision and hearing etc are present also. PMID:17261890
Bruno Mattos Coutinho
Full Text Available There are few studies reporting the association between hepatitis C virus (HCV infection and disautonomia. We have evaluated the autonomic cardiovascular function in 12 patients with sensory small-fiber polyneuropathy infected by HCV. The mean age was 49±13 years old. The mean infection time was 9.6 years in six (50% patients. Thermal and pinprick hypoesthesia was observed in distal legs in all patients. Autonomic symptoms were referred by eight (66.7% patients. Among patients with abnormal autonomic cardiovascular test, five (41.7% showed abnormal results in two or more tests. Valsalva maneuver was abnormal in seven (58.3% patients. We can consider that there is an association of both parasympathetic and sympathetic efferent cardiovascular dysfunction in this group of patients.
This paper discusses the possibility of using observer-based approaches for cardiovascular anomalies detection and isolation. We consider a lumped parameter model of the cardiovascular system that can be written in a form of nonlinear state-space representation. We show that residuals that are sensitive to variations in some cardiovascular parameters and to abnormal opening and closure of the valves, can be generated. Since the whole state is not easily available for measurement, we propose to associate the residual generator to a robust extended kalman filter. Numerical results performed on synthetic data are provided.
Several risks are attributed to progestins as a class-effect; however, the progestins used in hormone replacement therapy (HRT) have varying pharmacologic properties and do not induce the same side effects. Natural progesterone (P) and some of its derivatives, such as the 19-norprogesterones, do not exert any androgenic effect and, hence, have no negative effect on the lipids. On the other hand, the 19-nortestosterone derivatives and even some 17-hydroxyprogesterones have a partial androgenic effect, which may explain some of the negative effects observed on surrogate markers of cardiovascular risk. The relevance of the lipid changes induced by sex steroids has been questioned, and studies in the female cynomolgous monkey have not shown a direct relationship to atherosclerosis. Results suggest that estrogens (E) have antiatherogenic effects and that P does not reverse the beneficial effect of estradiol. Also, sex hormones modulate the vasomotor response of the main arteries. E preserves the normal endothelium-mediated dilation of coronary arteries, and P does not reverse this potential cardioprotective mechanism. In the same animal model, the addition of cyclic or continuous medroxyprogesterone acetate (MPA) to E inhibited vasodilatation by 50%, while nomegestrol acetate did not diminish the E-induced vasodilatation. Not all progestins act similarly on vasomotion or affect cardiovascular risk factors in the same way. Progestins, such as MPA or norethisterone acetate (NETA), exert a partial detrimental effect on the beneficial actions of estrogens with regard to lipid changes, atheroma development, or vasomotion. In contrast, progesterone itself does not have this inhibitory effect on lipid changes and vascular reactivity in animal models or on exercise-induced myocardial ischemia in humans. Nonandrogenic molecules of P itself and of derivatives, such as 19-norprogesterones, would appear neutral on the vessels. Several ongoing randomized controlled trials of HRT are
Primatesta, Paola; Allender, Steven; Ciccarelli, Paola; Doring, Angela; Graff-Iversen, Sidsel; Holub, Jiri; Panico, Salvatore; Trichopoulou, Antonia; Verschuren, W M Monique
Cardiovascular disease (CVD) is the leading cause of death and hospitalization in both men and women in nearly all countries of Europe. The most frequent forms of CVD are those of an atherosclerotic origin, mainly ischaemic heart disease, stroke and heart failure. The magnitude of the problem contrasts with the usual paucity and poor quality of data available on incidence and prevalence of CVD, except for few rigorous but limited studies. The objectives of the health interview and health examination surveys (HIS/HES) are to evaluate the frequency and the distribution of the disease, to evaluate trends and treatment effectiveness, to estimate risk factors distribution and prevalence of high risk conditions and to monitor prevention programmes. According to the EUROCISS project (EUROpean Cardiovascular Surveillance Set) recommendations, surveys are aimed at describing the prevalence of the following CVD conditions: myocardial infarction, heart failure, angina pectoris, peripheral arterial disease, stroke, and ischaemic heart disease.HIS and HES were developed to supplement information collected from routine databases and population-based registers to implement consistent public health policies. HIS can be repeated periodically in a new sample of the population, or can follow up over time the population recruited at baseline. Procedures and methods to collect information from participants include self-administered questionnaires, direct interviewer-administered questions and telephone interviews. A minimum set of questions to be administered every year, along with a longer, more detailed module to be administered periodically are recommended to evaluate CVD prevalence. The addition of HES provides more detailed and objective information that can be used to improve estimates regarding prevalence of both risk factors and disease status. The selection of more specialized CVD-specific tests will depend on the objective the survey is designed to achieve, the assumed
Cardiovascular diseases remain the leading cause of morbidity and mortality in industrialized and developing countries. In clinical practice, the in-vivo identification of atherosclerotic lesions, which can lead to complications such as heart attack or stroke, remains difficult. Imaging techniques provide the reference standard for the detection of clinically significant atherosclerotic changes in the coronary and carotid arteries. The assessment of the luminal narrowing is feasible, while the differentiation of stable and potentially unstable or vulnerable atherosclerotic plaques is currently not possible using non-invasive imaging. With high spatial resolution and high soft tissue contrast, magnetic resonance imaging (MRI) is a suitable method for the evaluation of the thin arterial wall. In clinical practice, native MRI of the vessel wall already allows the differentiation and characterization of components of atherosclerotic plaques in the carotid arteries and the aorta. Additional diagnostic information can be gained by the use of non-specific MRI contrast agents. With the development of targeted molecular probes, that highlight specific molecules or cells, pathological processes can be visualized at a molecular level with high spatial resolution. In this review article, the development of pathophysiological changes leading to the development of the arterial wall are introduced and discussed. Additionally, principles of contrast enhanced imaging with non-specific contrast agents and molecular probes will be discussed and latest developments in the field of molecular imaging of the vascular wall will be introduced.
Wolters, S.L.; Reutelingsperger, C.P.M. [Maastricht University, Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht (Netherlands); Corsten, M.F.; Hofstra, L. [Maastricht University, Department of Cardiology, Cardiovascular Research Institute Maastricht, P.O. Box 616, Maastricht (Netherlands); Narula, J. [University of California Irvine, Department of Cardiology, Irvine (United States)
Molecular imaging strives to visualise processes at the molecular and cellular level in vivo. Understanding these processes supports diagnosis and evaluation of therapeutic efficacy on an individual basis and thereby makes personalised medicine possible. Apoptosis is a well-organised mode of cell suicide that plays a role in cardiovascular diseases (CVD). Apoptosis is associated with loss of cardiomyocytes following myocardial infarction, atherosclerotic plaque instability, congestive heart failure and allograft rejection of the transplanted heart. Thus, apoptosis constitutes an attractive target for molecular imaging of CVD. Our current knowledge about the molecular players and mechanisms underlying apoptosis offers a rich palette of potential molecular targets for molecular imaging. However, only a few have been successfully developed so far. This review highlights aspects of the molecular machinery and biochemistry of apoptosis relevant to the development of molecular imaging probes. It surveys the role of apoptosis in four major areas of CVD and portrays the importance and future perspectives of apoptosis imaging. The annexin A5 imaging protocol is emphasised since it is the most advanced protocol to measure apoptosis in both preclinical and clinical studies. (orig.)
Abdullah M Alshehri
Full Text Available The constellation of dyslipidemia (hypertriglyceridemia and low levels of high-density lipoprotein cholesterol, elevated blood pressure, impaired glucose tolerance, and central obesity is now classified as metabolic syndrome, also called syndrome X. In the past few years, several expert groups have attempted to set forth simple diagnostic criteria for use in clinical practice to identify patients who manifest the multiple components of the metabolic syndrome. These criteria have varied somewhat in specific elements, but in general, they include a combination of multiple and metabolic risk factors. The most widely recognized of the metabolic risk factors are atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. Individuals with these characteristics, commonly manifest a prothrombotic state as well as and a proinflammatory state. Atherogenic dyslipidemia consists of an aggregation of lipoprotein abnormalities including elevated serum triglyceride and apolipoprotein B (apoB, increased small LDL particles, and a reduced level of HDL cholesterol (HDL-C. The metabolic syndrome is often referred to as if it were a discrete entity with a single cause. Available data suggest that it truly is a syndrome, ie, a grouping of atherosclerotic cardiovascular disease (ASCVD risk factors, that probably has more than one cause. Regardless of cause, the syndrome identifies individuals at an elevated risk for ASCVD. The magnitude of the increased risk can vary according to the components of the syndrome present as well as the other, non-metabolic syndrome risk factors in a particular person.
Full Text Available In recent years, platelet proteomics has been applied successfully to the study of cardiovascular diseases (CVDs. It is very well known that platelets play a pivotal role in the pathophysiological mechanisms underlying many CVDs, especially acute coronary syndromes (ACSs, since they are implied in thrombus formation after atheroma plaque rupture. This is the reason why molecules involved in platelet activation and aggregation are primary targets for treatment of ACSs. Many efforts are aimed at finding drugs that inhibit platelet activation; however it is difficult to separate the therapeutic benefits from harmful effects because pathological and physiological functions of platelets are due to the same mechanisms. Given that platelets lack a nucleus, proteomics is regarded as an ideal method to approach their biochemistry. Current platelet proteomic studies are focusing on the identification of platelet molecular and functional changes in normal and pathological states, enriching the comprehension of platelet biological function, and screening for new biomarkers and antiplatelet agents. In the present article, we introduce the reader to platelet biology and function, and revise recent advances in platelet proteomics applied to the study of CVDs, including a special emphasis on sample preparation requirements for proteome analysis of platelet clinical samples.
Full Text Available Autoimmune diseases (AD represent a broad spectrum of chronic conditions that may afflict specific target organs or multiple systems with a significant burden on quality of life. These conditions have common mechanisms including genetic and epigenetics factors, gender disparity, environmental triggers, pathophysiological abnormalities, and certain subphenotypes. Atherosclerosis (AT was once considered to be a degenerative disease that was an inevitable consequence of aging. However, research in the last three decades has shown that AT is not degenerative or inevitable. It is an autoimmune-inflammatory disease associated with infectious and inflammatory factors characterized by lipoprotein metabolism alteration that leads to immune system activation with the consequent proliferation of smooth muscle cells, narrowing arteries, and atheroma formation. Both humoral and cellular immune mechanisms have been proposed to participate in the onset and progression of AT. Several risk factors, known as classic risk factors, have been described. Interestingly, the excessive cardiovascular events observed in patients with ADs are not fully explained by these factors. Several novel risk factors contribute to the development of premature vascular damage. In this review, we discuss our current understanding of how traditional and nontraditional risk factors contribute to pathogenesis of CVD in AD.
Wu Phillis L
Full Text Available Abstract Background Little is known regarding the cardiovascular disease risk factors among Chamorros residing in the United States. Methods The Chamorro Directory International and the CDC's Behavioral Risk Factor Surveillance System Questionnaire (BRFSS were used to assess the health related practices and needs of a random sample of 228 Chamorros. Results Inactivity, hypertension, elevated cholesterol and diabetes mellitus were more prevalent in this Chamorro sample compared to the US average. Participants who were 50-and-older or unemployed were more likely to report hypertension, diabetes and inactivity, but they were also more likely to consume more fruits and vegetables than their younger and employed counterparts. Women were more likely to report hypertension and diabetes, whereas men were more likely to have elevated BMI and to have never had their blood cholesterol checked. Conclusion The study provides data that will help healthcare providers, public health workers and community leaders identify where to focus their health improvement efforts for Chamorros and create culturally competent programs to promote health in this community.
Wild, R A; Taylor, E L; Knehans, A; Cleaver, V
Family patterns of cardiovascular risk behavior are well documented. Significant correlation exists between spouse-spouse, parent-child, and sibling-sibling for cholesterol, high- and low-density lipoprotein, diet, physical activity, and smoking. Family/environmental influences are important in how/if risk and/or preventive behavior is learned. The family matriarch commonly functions as gatekeeper, controlling eating behavior, access to health care, and other patterns. She often acts as menu planner, shopper, and preparer of meals for all family members. She provides information and verbal reinforcement about food and is a powerful model concerning dietary practices. In fact, the mother, as head of household in most single-parent families, may be the only adult model for many children. Because relevance and credibility are the most important characteristics of a behavioral model, parents (especially mothers) are strong models for observational learning by children. Risk factor information and risk reduction activities adopted by the matriarch can be generalized to the entire family if she learns the skills to act as a change agent. Initiation of this process of education and training the matriarch lies with primary care providers for women (Ob-Gyns see most women). By teaching risk reduction to the matriarch as a component of primary care, physician interaction can have a rippling effect. PMID:8164913
Full Text Available Pomegranate is a source of some very potent antioxidants (tannins, anthocyanins which are considered to be also potent anti-atherogenic agents. The combination of the above unique various types of pomegranate polyphenols provides a much wider spectrum of action against several types of free radicals. Indeed, pomegranate is superior in comparison to other antioxidants in protecting low-density lipoprotein (LDL, “the bad cholesterol” and high-density lipoprotein (HDL, “the good cholesterol” from oxidation, and as a result it attenuates atherosclerosis development and its consequent cardiovascular events. Pomegranate antioxidants are not free, but are attached to the pomegranate sugars, and hence were shown to be beneficial even in diabetic patients. Furthermore, pomegranate antioxidants are unique in their ability to increase the activity of the HDL-associated paraoxonase 1 (PON1, which breaks down harmful oxidized lipids in lipoproteins, in macrophages, and in atherosclerotic plaques. Finally, unique pomegranate antioxidants beneficially decrease blood pressure. All the above beneficial characteristics make the pomegranate a uniquely healthy fruit.
Singleton, James A.; Wortley, Pascale; Lu, Peng-jun
People who have cardiovascular disease are at increased risk of hospitalization or death associated with influenza infection, and are included among the high-risk groups for whom annual influenza vaccination is recommended. To measure the progress toward the national year 2000 and 2010 objectives of a 60% annual influenza vaccination of adults with high-risk conditions aged 18 to 64 years, we analyzed data from the 1997 to 2001 National Health Interview Surveys (NHIS) regarding persons with c...
Mendall, M. A.; Patel, P; Ballam, L.; Strachan, D.; Northfield, T C
OBJECTIVE--To test the hypothesis that minor chronic insults such as smoking, chronic bronchitis, and two persistent bacterial infections may be associated with increases in C reactive protein concentration within the normal range and that variations in the C reactive protein concentration in turn may be associated with levels of cardiovascular risk factors and chronic coronary heart disease. DESIGN--Population based cross sectional study. SETTING--General practices in Merton, Sutton, and Wan...
Brenner, M Harvey
Can we estimate the consequences of world military expenditures for the physical and mental health of nations that produce and purchase armaments? If anxiety and fear are promoting military expenditures, then those sentiments may well reflect poorer mental health and war-related stress as it influences cardiovascular illness rates. Further, extensive military expenditure by a society implies that other societal needs are allocated fewer resources, including nutrition, water and sanitation, health care, and economic development. We use a model focused on military expenditures to predict cardiovascular mortality in world samples of industrialized and developing countries over 2000-2011. The cardiovascular mortality model controls for economic development, smoking, body mass index, systolic blood pressure, and carbon dioxide emissions. Military expenditures as proportion of gross domestic product show significant positive relations to cardiovascular disease mortality in linear multiple regression analyses, using both cross-sectional and pooled cross-sectional time-series approaches. PMID:26675148
... Blood Pressure Tools & Resources Stroke More Top 10 Myths about Cardiovascular Disease Updated:May 20,2016 How ... Let’s set the record straight on some common myths. “I’m too young to worry about heart ...
Background: Cardiovascular disease risk increases when lipoprotein metabolism is dysfunctional. We have developed a computational model able to derive indicators of lipoprotein production, lipolysis, and uptake processes from a single lipoprotein profile measurement. This is the first study to inves...
Full Text Available Considering the high mortality and morbidity rate associated with cardiovascular diseases, Cardiacrehabilitation (CR is regarded for prevention and management of cardiovascular diseases. CR servicesare generally provided in an outpatient as comprehensive, long-term programs involving medicalevaluation, prescribed exercise, cardiac risk factor modification, education and counseling. This includesnutritional therapies, weight loss program management of lipid abnormalities with diet and medication,blood pressure control, diabetes management and stress management. The exercise component of a totalapproach to rehabilitation helps to overcome the fears and anxieties that so many people experience aftera heart attack. Aerobic exercise training program improves cardiovascular fitness in both healthyindividual and cardiac patients. Cardiac rehabilitation prevents and treat cardiovascular disease, reducescardiac risk factors, improving patient’s exercise capacity and enhancing quality of life. Aerobicexercise with intensity of approximately 60 to 70% of the maximal heart rate for 30 to 60 minutes, 3 to 4times a week, for 4 to 6 weeks enhances exercise capacity.
S. Ye. Myasoyedova
Full Text Available The article describes the mechanisms of development of cardiovascular disorders and dyslipidemia with hypothyroidism. Reference data are presented that are devoted to the study of adipokines content with hypothyroidism and their effect on echocardiographic indicators.
Fang, Wei Li
A Virginia elementary-secondary school blood pressure education program is described and evaluated. Evidence presented indicates that participants' cardiovascular knowledge levels increased significantly as a result of program participation. (JMF)
Tracy Y. Zhu
Full Text Available Psoriatic arthritis (PsA is an inflammatory arthritis associated with psoriasis. In addition to skin and joint involvement, there is increasing evidence suggesting that patients with PsA also have an increase in risk of clinical and subclinical cardiovascular diseases, mostly due to accelerating atherosclerosis. Both conventional and nonconventional cardiovascular risk factors contribute to the increased cardiovascular risk in PsA. Chronic inflammation plays a pivotal role in the pathogenesis of atherosclerosis in PsA, acting independently and/or synergistically with the conventional risk factors. In this paper, we discuss the current literature indicating that patients with PsA are at risk of cardiovascular diseases.
Bochniak, Mariusz; Sadlak-Nowicka, Jadwiga
Nowadays periodontal diseases are treated as a one of a social diseases. The main consequences of them are: premature teeth loss and possibility of inducing, aggravating and modifying many systemic disorders, such as endo- and myocarditis, glomerulonephritis, iriditis, retinitis, rheumatic polyarthritis. The scientific data performed in the last 10 years indicate links between periodontitis and atheromatosis, coronary heart disease and acute coronary events, including myocardial infarction. In this study reported was the epidemiological dependences between periodontal and cardiovascular diseases. There were described hypotheses of negative influence of periodontal foci on induction and progression of inflammation in coronary vessel walls and destabilisation of atheromatous plaques, also was included theory of direct bacterial invasion and cytokine theory. There were shown results of studies which proved the presence of genetic material of main periodontal bacterial pathogens, such as Porphyromonas gingivalis and Prevotella intermedia, in atheromatous plaques in coronary arteries. There were noted other potential mechanisms of induction of acute coronary events connected with platelet aggregation induced by specific proteins secreted by Streptococcus sanguis and the role of Helicobacter pylori infection, the bacteria from periodontal pockets that is presently more often isolated. Analysing these data it was concluded, that the co-operation between cardiologists and dentists, especially the periodontologists, is necessary during the treatment of coronary heart disease. Periodontal therapy should be included as an additional element of cardiological therapy. Education of patients is also very important for prophylaxis of cardiovascular diseases. PMID:15515818
Dustan, H P
Atherosclerosis and hypertension are, by far, the most common cardiovascular diseases affecting women, and both are influenced by diet. Atherosclerosis occurs more commonly in men than women; generally women are 10 to 15 years older than men when symptoms develop. The prevalence of hypertension is about equal in the two sexes, particularly in middle aged and older persons. These cardiovascular diseases are major causes of death and disability in this country. Atherosclerosis results in myocar...
Shah, Arti; Mehta, Nehal; Reilly, Muredach P.
Adiposity-associated inflammation and insulin resistance are strongly implicated in the development of type 2 diabetes and atherosclerotic cardiovascular disease. This article reviews the mechanisms of adipose inflammation, because these may represent therapeutic targets for insulin resistance and for prevention of metabolic and cardiovascular consequences of obesity. The initial insult in adipose inflammation and insulin resistance, mediated by macrophage recruitment and endogenous ligand ac...
Ophuis, A.J.M. Oude; Nijeholt, A.A.B. Lycklama à
Erectile dysfunction is a highly prevalent disease, especially in cardiovascular-compromised men. Many of the well-established risk factors for cardiovascular disease are also risk factors for erectile dysfunction. A correlation between erectile dysfunction and endothelial dysfunction is well established. It is postulated that erectile dysfunction with an arteriovascular aetiology can predate and be an indicator of potential coronary artery disease. In this paper we will attempt to increase a...
Edmondson, Donald; Cohen, Beth E.
Posttraumatic stress disorder (PTSD) is an anxiety disorder initiated by exposure to a traumatic event and characterized by intrusive thoughts about the event, attempts to avoid reminders of the event, and physiological hyperarousal. In a number of large prospective observational studies, PTSD has been associated with incident cardiovascular disease (CVD) and mortality. Also, in recent years, a number of studies have shown that cardiovascular events can themselves cause PTSD in more than 1 in...
Chen Huijun; Wang Jinnan; Li Rui; Ferguson Marina S; Kerwin William S; Dong Li; Canton Gador; Hatsukami Thomas S; Yuan Chun
Abstract Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds. Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death. The diseased carotid alone is responsible for one third of the 700,000 new or recurrent strokes occurring yearly in the United States. Imaging plays an important role in the management of atherosclerosis, and cardiovascular magnetic resonance (CMR) of the carotid vessel wall is one promi...
Saikus Christina E; Kocaturk Ozgur; Guttman Michael A; Faranesh Anthony Z; Ratnayaka Kanishka; Lederman Robert J
Abstract The often touted advantages of MR guidance remain largely unrealized for cardiovascular interventional procedures in patients. Many procedures have been simulated in animal models. We argue these opportunities for clinical interventional MR will be met in the near future. This paper reviews technical and clinical considerations and offers advice on how to implement a clinical-grade interventional cardiovascular MR (iCMR) laboratory. We caution that this reflects our personal view of ...
Background Cardiovascular diseases, including myocardial infarction and stroke, are the main reason of death in Sweden and Western Europe. High iron stores are believed to produce oxygen radicals, which is the presumed putative mechanism behind lipid peroxidation, atherosclerosis and subsequent cardiovascular disease. Iron levels are associated with the hemochromatosis associated HFE single nucleotide polymorphisms C282Y and H63D. Bilirubin is an antioxidant present in relatively high levels ...
Madamanchi, Nageswara R.; Runge, Marschall S.
Spatiotemporal regulation of the activity of a vast array of intracellular proteins and signaling pathways by reactive oxygen species (ROS) governs normal cardiovascular function. However, data from experimental and animal studies strongly support that dysregulated redox signaling, resulting from hyper-activation of various cellular oxidases or mitochondrial dysfunction, is integral to the pathogenesis and progression of cardiovascular disease (CVD). In this review, we address how redox signa...
Chun-Jung eHuang; Webb, Heather E.; Zourdos, Michael C.; Acevedo, Edmund O.
Psychological stress has been proposed as a major contributor to the progression of cardiovascular disease (CVD). Acute mental stress can activate the sympathetic-adrenal-medullary (SAM) axis, eliciting the release of catecholamines (NE and EPI) resulting in the elevation of heart rate (HR) and blood pressure (BP). Combined stress (psychological and physical) can exacerbate these cardiovascular responses, which may partially contribute to the elevated risk of CVD and increased proportionate...
Hopkins, Teresa A.; Ouchi, Noriyuki; Shibata, Rei; Walsh, Kenneth
Obesity is strongly associated with the pathogenesis of type 2 diabetes, hypertension, and cardiovascular disease. Levels of the hormone adiponectin are downregulated in obese individuals, and several experimental studies show that adiponectin protects against the development of various obesity-related metabolic and cardiovascular diseases. Adiponectin exhibits favorable effects on atherogenesis, endothelial function, and vascular remodeling by modulation of signaling cascades in cells of the...
Full Text Available Helicobacter pylori (H. pylori is a spiral-shaped gram negative bacterium that naturally colonizes the human gastric epithelium. In recent years, large evidence has come to the literature strongly proposing causal link between H. pylori and extra gastric disorders. Cardiovascular system is one of the extra gastric organs that can be affected by H. pylori infection. The first evidence suggestive of such an association comes from seroepidemiological evaluations, but histopathological and eradication studies have strongly confirmed existence of a causal association between H. pylori infection and cardiovascular events.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiovascular intravascular filter. 870.3375... Cardiovascular intravascular filter. (a) Identification. A cardiovascular intravascular filter is an implant that... and Revision of 2/12/90 (K90-1)” and (ii) “Guidance for Cardiovascular Intravascular Filter...
Boerma, Marjan; Nelson, Gregory A; Sridharan, Vijayalakshmi; Mao, Xiao-Wen; Koturbash, Igor; Hauer-Jensen, Martin
Future long-distance space missions will be associated with significant exposures to ionizing radiation, and the health risks of these radiation exposures during manned missions need to be assessed. Recent Earth-based epidemiological studies in survivors of atomic bombs and after occupational and medical low dose radiation exposures have indicated that the cardiovascular system may be more sensitive to ionizing radiation than was previously thought. This has raised the concern of a cardiovascular disease risk from exposure to space radiation during long-distance space travel. Ground-based studies with animal and cell culture models play an important role in estimating health risks from space radiation exposure. Charged particle space radiation has dense ionization characteristics and may induce unique biological responses, appropriate simulation of the space radiation environment and careful consideration of the choice of the experimental model are critical. Recent studies have addressed cardiovascular effects of space radiation using such models and provided first results that aid in estimating cardiovascular disease risk, and several other studies are ongoing. Moreover, astronauts could potentially be administered pharmacological countermeasures against adverse effects of space radiation, and research is focused on the development of such compounds. Because the cardiovascular response to space radiation has not yet been clearly defined, the identification of potential pharmacological countermeasures against cardiovascular effects is still in its infancy. PMID:26730293
Sánchez-Muniz, F J
Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in developed countries. CVD is an inflammatory disease associated with risk factors that include hypercholesterolemia and hypertension. Furthermore, the evolution of this disease depends on the amount of modified lipoproteins (e.g. oxidized) present in the arterial subendothelium. Diet is considered the cornerstone for CVD treatment, as it can lower not only atherogenic lipoprotein levels and degree of oxidation, but also blood pressure, thrombogenesis and concentrations of some relevant factors (e.g. homocystein).Among different diets, the Mediterranean diet stands out due to their benefits on several health benefits, in particular with regard to CVD. Rich in vegetable foods, this diet contributes both quantitatively and qualitatively to essential fibre compounds (cellulose, hemicellulose, gums, mucilages, pectins, oligosaccharides, lignins, etc.). The present paper analyzes the effects of fibre consumption on a) cholesterol and lipoprotein levels; b) systolic and diastolic blood pressures; and c) antioxidant availability and profile. Some studies and meta-analysis are revised, as the possible mechanisms by which fibre may decrease plasma total cholesterol and LDL-cholesterol and blood pressure and to act as antioxidant, as well. In addition, author's own publications regarding the effect of fibre matrix (e.g. seaweeds) on arylesterase and the gene expression of some key antioxidant enzymes are reviewed. The paper also includes data concerning the possible interaction between fibre and some hypolipemic drugs, which may make it possible to attain similar hypolipemic effects with lower dosages, with the consequent decrease in possible side effects. The review concludes with a summary of nutritional objectives related to the consumption of carbohydrates and fibre supplements. PMID:22566302
Objective: HDL function rather than absolute level may be a more accurate indicator for cardiovascular disease (CVD) but it is unclear what drives HDL dysfunction in HIV-1 infection. The objective of this study is to identify factors that may contribute to HDL dysfunction in chronic HIV-1 infection. Design: Retrospective study of HIV-1 infected males with low overall CVD risk and healthy males with no known CVD risk matched by race to the HIV-1 infected participants. Methods: We related para...
The fundamental values in medical ethics include the following aspects of professional conduct: (i) actions in the best interest of patients; (ii) first, do no harm; (iii) patients' right to refuse or choose treatments; (iv) fairness and equality in the distribution of healthcare resources; and (v) truthfulness and honesty (informed consent). These values have to be considered in all diagnostic steps and therapeutic decisions. They should also form the basis for discussions of potential conflicts of interest among patients, doctors, healthcare financers and politicians. Cardiovascular (CV) diseases represent the most frequent cause of death and a major healthcare problem in most regions of the world. CV prevention is therefore an important task both in individual subjects and as a means to improve health in the general population. While the merits of treatment in patients with established CV diseases, i.e. secondary prevention, are widely accepted and regarded as necessary, primary prevention with drugs in apparently healthy individuals at an increased risk of future CV events is not free of controversies. The different types of prevention envisaged also give rise to ethical questions: Should all the growing number of classical and newly recognised CV risk markers be a reason for intervention or should they be preferably used for calculating a total risk score? What are the compelling or only relative indications for anti-hypertensive, cholesterol-lowering, anti-diabetic or platelet-inhibiting drugs? Are pre-hypertension, pre-diabetes and marginally elevated cholesterol levels early diseases justifying drug treatment, regardless of the possibility that some prophylactic interventions may be associated with adverse events? Discussions also often arise concerning the role of age, gender and of non-CV co-morbidities for decisions about long-term prevention with drugs. How reliable and applicable are 'evidence-based' guidelines derived from trials in highly selected
Full Text Available Oxytocin (OT, a nonapeptide, was the first hormone to have its biological activities established and chemical structure determined. It was believed that OT is released from hypothalamic nerve terminals of the posterior hypophysis into the circulation where it stimulates uterine contractions during parturition, and milk ejection during lactation. However, equivalent concentrations of OT were found in the male hypophysis, and similar stimuli of OT release were determined for both sexes, suggesting other physiological functions. Indeed, recent studies indicate that OT is involved in cognition, tolerance, adaptation and complex sexual and maternal behaviour, as well as in the regulation of cardiovascular functions. It has long been known that OT induces natriuresis and causes a fall in mean arterial pressure, both after acute and chronic treatment, but the mechanism was not clear. The discovery of the natriuretic family shed new light on this matter. Atrial natriuretic peptide (ANP, a potent natriuretic and vasorelaxant hormone, originally isolated from rat atria, has been found at other sites, including the brain. Blood volume expansion causes ANP release that is believed to be important in the induction of natriuresis and diuresis, which in turn act to reduce the increase in blood volume. Neurohypophysectomy totally abolishes the ANP response to volume expansion. This indicates that one of the major hypophyseal peptides is responsible for ANP release. The role of ANP in OT-induced natriuresis was evaluated, and we hypothesized that the cardio-renal effects of OT are mediated by the release of ANP from the heart. To support this hypothesis, we have demonstrated the presence and synthesis of OT receptors in all heart compartments and the vasculature. The functionality of these receptors has been established by the ability of OT to induce ANP release from perfused heart or atrial slices. Furthermore, we have shown that the heart and large vessels
Tunjungputri, R.N.; Ven, A.J. van der; Schonsberg, A.; Mathan, T.S.M.; Koopmans, P.P.; Roest, M.; Fijnheer, R.; Groot, P.G. de; Mast, Q. de
OBJECTIVE: Platelets are key cells in atherosclerosis and acute cardiovascular events. Platelet hyperreactivity and increased platelet-monocyte aggregation (PMA) are found in HIV-infected patients and may contribute to the excess cardiovascular risk. The integrase inhibitor raltegravir (RAL) has bee
Anna C. Calkin
Full Text Available Peroxisome proliferators activated receptors (PPARs are ligand-activated nuclear transcription factors that play important roles in lipid and glucose homeostasis. To the extent that PPAR agonists improve diabetic dyslipidaemia and insulin resistance, these agents have been considered to reduce cardiovascular risk. However, data from murine models suggests that PPAR agonists also have independent anti-atherosclerotic actions, including the suppression of vascular inflammation, oxidative stress, and activation of the renin angiotensin system. Many of these potentially anti-atherosclerotic effects are thought to be mediated by transrepression of nuclear factor-kB, STAT, and activator protein-1 dependent pathways. In recent clinical trials, PPARÃŽÂ± agonists have been shown to be effective in the primary prevention of cardiovascular events, while their cardiovascular benefit in patients with established cardiovascular disease remains equivocal. However, the use of PPARÃŽÂ³ agonists, and more recently dual PPARÃŽÂ±/ÃŽÂ³ coagonists, has been associated with an excess in cardiovascular events, possibly reflecting unrecognised fluid retention with potent agonists of the PPARÃŽÂ³ receptor. Newer pan agonists, which retain their anti-atherosclerotic activity without weight gain, may provide one solution to this problem. However, the complex biologic effects of the PPARs may mean that only vascular targeted agents or pure transrepressors will realise the goal of preventing atherosclerotic vascular disease.
Volterrani, Maurizio; Iellamo, Ferdinando; Sposato, Barbara; Romeo, Franco
Recent evidence would indicate that high serum uric acid (SUA) levels can be a significant and independent risk factor for hypertension and cardiovascular diseases, such as ischemic heart disease and heart failure. In the last few years an independent risk relationship between hyperuricemia, cardiovascular disease and mortality has also been reported. Hyperuricemia has been shown as an independent risk factor for acute myocardial infarction and an independent and conjoint association of either gout and SUA with total and cardiovascular mortality has been reported, with mortality impact in gout patients increasing with rising SUA concentrations, even for SUA levels in the normal to high range. These findings prompted a growing research interest on the possible benefits of uric acid lowering drugs in cardiovascular diseases. Indeed, clinical studies have reported on the beneficial effects of uric acid lowering drugs, in particular of xanthine oxidase inhibitors, in hypertension, ischemic heart disease and heart failure. Two main mechanisms have been claimed to explain the dangerous effects of hyperuricemia and, as a consequence, the benefits of uric acid lowering therapy: endothelial dysfunction and systemic inflammation. This brief review aims to summarize current evidence from human studies on the role of acid uric lowering therapy in cardiovascular diseases for practical and clinical purposes. The possible mechanisms underlying the benefits of acid uric lowering therapy are also addressed. PMID:26386814
Excess radiation-induced cardiac mortalities have been reported among radiotherapy patients. Many case reports describe the occurrence of atherosclerosis following radiotherapy for Hodgkin's disease and breast cancer. Some case reports describe the cerebral infarction following radiotherapy to neck region, and of peripheral vascular disease of the lower extremities following radiotherapy to the pelvic region. The association of atomic bomb radiation and cardiovascular disease has been examined recently by incidence studies and prevalence studies of various endpoints of atherosclerosis; all endpoints indicated an increase of cardiovascular disease in the exposed group. It is almost certain that the cardiovascular disease is higher among atomic bomb survivors. However, since a heavy exposure of 10-40 Gy is delivered in radiotherapy and the bomb survivors were exposed to radiation at high dose and dose-rate, the question is whether the results can be extrapolated to individuals exposed to lower levels of radiation. Some recent epidemiological studies on occupationally exposed workers and population living near Chernobyl have provided the evidence for cardiovascular disease being a significant late effect at relatively low doses of radiation. However, the issue of non-cancer mortality from radiation is complicated by lack of adequate information on doses, and many other confounding factors (e.g., smoking habits or socio-economic status). This presentation will evaluate possible radiobiological mechanisms for radiation-induced cardiovascular disease, and will address its relevance to radiation protection management at low doses and what the impact might be on future radiation risk assessments. (authors)
Deedwania Prakash C
Full Text Available Abstract Although diabetes mellitus is predominantly a metabolic disorder, recent data suggest that it is as much a vascular disorder. Cardiovascular complications are the leading cause of death and disability in patients with diabetes mellitus. A number of recent reports have emphasized that many patients already have atherosclerosis in progression by the time they are diagnosed with clinical evidence of diabetes mellitus. The increased risk of atherosclerosis and cardiovascular complications in diabetic patients is related to the frequently associated dyslipidemia, hypertension, hyperglycemia, hyperinsulinemia, and endothelial dysfunction. The evolving knowledge regarding the variety of metabolic, hormonal, and hemodynamic abnormalities in patients with diabetes mellitus has led to efforts designed for early identification of individuals at risk of subsequent disease. It has been suggested that insulin resistance, the key abnormality in type II diabetes, often precedes clinical features of diabetes by 5–6 years. Careful attention to the criteria described for the cardiovascular dysmetabolic syndrome should help identify those at risk at an early stage. The application of nonpharmacologic as well as newer emerging pharmacologic therapies can have beneficial effects in individuals with cardiovascular dysmetabolic syndrome and/or diabetes mellitus by improving insulin sensitivity and related abnormalities. Early identification and implementation of appropriate therapeutic strategies would be necessary to contain the emerging new epidemic of cardiovascular disease related to diabetes.
Bondonno, Catherine P; Croft, Kevin D; Hodgson, Jonathan M
Emerging evidence strongly suggests that dietary nitrate, derived in the diet primarily from vegetables, could contribute to cardiovascular health via effects on nitric oxide (NO) status. NO plays an essential role in cardiovascular health. It is produced via the classical L-arginine-NO-synthase pathway and the recently discovered enterosalivary nitrate-nitrite-NO pathway. The discovery of this alternate pathway has highlighted dietary nitrate as a candidate for the cardioprotective effect of a diet rich in fruit and vegetables. Clinical trials with dietary nitrate have observed improvements in blood pressure, endothelial function, ischemia-reperfusion injury, arterial stiffness, platelet function, and exercise performance with a concomitant augmentation of markers of NO status. While these results are indicative of cardiovascular benefits with dietary nitrate intake, there is still a lingering concern about nitrate in relation to methemoglobinemia, cancer, and cardiovascular disease. It is the purpose of this review to present an overview of NO and its critical role in cardiovascular health; to detail the observed vascular benefits of dietary nitrate intake through effects on NO status as well as to discuss the controversy surrounding the possible toxic effects of nitrate. PMID:25976309
Sinha, A; Lewis, O; Kumar, R; Yeruva, S L H; Curry, B H
Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobiological disorder exhibited by difficulty maintaining attention, as well as hyperactivity and impulsive behavior. Central nervous system (CNS) stimulants are the first line of treatment for ADHD. With the increase in number of adults on CNS stimulants, the question that arises is how well do we understand the long-term cardiovascular effects of these drugs. There has been increasing concern that adults with ADHD are at greater risk for developing adverse cardiovascular events such as sudden death, myocardial infarction, and stroke as compared to pediatric population. Cardiovascular response attributed to ADHD medication has mainly been observed in heart rate and blood pressure elevations, while less is known about the etiology of rare cardiovascular events like acute myocardial infarction (AMI), arrhythmia, and cardiomyopathy and its long-term sequelae. We present a unique case of AMI in an adult taking Adderall (mixed amphetamine salts) and briefly discuss the literature relevant to the cardiovascular safety of CNS stimulants for adult ADHD. PMID:27579185
Robert G. Fassett
Full Text Available Oxidative stress and inflammation are established processes contributing to cardiovascular disease caused by atherosclerosis. However, antioxidant therapies tested in cardiovascular disease such as vitamin E, C and β-carotene have proved unsuccessful at reducing cardiovascular events and mortality. Although these outcomes may reflect limitations in trial design, new, more potent antioxidant therapies are being pursued. Astaxanthin, a carotenoid found in microalgae, fungi, complex plants, seafood, flamingos and quail is one such agent. It has antioxidant and anti-inflammatory effects. Limited, short duration and small sample size studies have assessed the effects of astaxanthin on oxidative stress and inflammation biomarkers and have investigated bioavailability and safety. So far no significant adverse events have been observed and biomarkers of oxidative stress and inflammation are attenuated with astaxanthin supplementation. Experimental investigations in a range of species using a cardiac ischaemia-reperfusion model demonstrated cardiac muscle preservation when astaxanthin is administered either orally or intravenously prior to the induction of ischaemia. Human clinical cardiovascular studies using astaxanthin therapy have not yet been reported. On the basis of the promising results of experimental cardiovascular studies and the physicochemical and antioxidant properties and safety profile of astaxanthin, clinical trials should be undertaken.
Thompson, David R
This paper, based on the 2015 CSANZ Cardiovascular Nursing Lecture, takes its title from the invitation to give this lecture in Melbourne being received when the author was visiting Florence, after whom Florence Nightingale, the founder of modern nursing, is named. Her work has indirectly shaped and influenced cardiovascular nursing, which has developed over the past 50 years. Despite its relatively short history, cardiovascular nursing has made a major contribution to improving the cardiovascular health and well-being of patients and families through health promotion, risk reduction and disease prevention. Examples include cardiac rehabilitation and secondary prevention and chronic heart failure disease management. Challenges, however, remain, including nurses practising to the full extent of their education and training, working as full partners with physicians and other health professionals in redesigning healthcare, ensuring better data collection and being more active in advocacy and policy initiatives. Cardiovascular nursing has a strong record of innovation but should always remember that it is there to serve the public and, bearing in mind the risk of potential harm versus benefit, be mindful of Florence Nightingale's wise counsel, "First, do no harm". PMID:26935162
Friso, Simonetta; Lotto, V; Corrocher, R; Choi, Sang Woon
While overt vitamin B6 deficiency is not a frequent finding nowadays in medical practice, evidence suggests that insufficiency of this vitamin is rather widespread in a quite large portion of the population such as the elderly or in not unusual conditions such as that of alcohol addiction. Moreover, a mild deficiency in B6 vitamin is a state that may be associated with an increased risk of cardiovascular disease. Epidemiologic evidence from case control and prospective studies have suggested that low dietary intake or reduced blood concentrations of vitamin B6 is associated with an increased risk of cardiovascular disease, although most recent trials demonstrated the ineffectiveness of vitamin B6 supplementation on the prevention of cardiovascular events recurrence. Due to limited and somewhat inconsistent data together with the ample variety of critical functions in which vitamin B6 is involved in the human body, it is very challenging to attempt at establishing a cause and effect relationship between vitamin B6 and risk of cardiovascular disease as it is to delineate the exact mechanism(s) by which vitamin B6 may modulate such risk. In the present chapter we review the currently available knowledge deriving from both epidemiological and mechanistic studies designed to define potential candidate mechanisms for the association of vitamin B6 impairment and risk of cardiovascular disease development. PMID:22116704
Full Text Available Abstract Background Cardiovascular disease (CVD is the major cause of death after renal transplantation. Not only conventional CVD risk factors, but also transplant-specific risk factors can influence the development of CVD in kidney transplant recipients. The main objective of this study will be to determine the incidence of post-transplant CVD after renal transplantation and related factors. A secondary objective will be to examine the ability of standard cardiovascular risk scores (Framingham, Regicor, SCORE, and DORICA to predict post-transplantation cardiovascular events in renal transplant recipients, and to develop a new score for predicting the risk of CVD after kidney transplantation. Methods/Design Observational prospective cohort study of all kidney transplant recipients in the A Coruña Hospital (Spain in the period 1981-2008 (2059 transplants corresponding to 1794 patients. The variables included will be: donor and recipient characteristics, chronic kidney disease-related risk factors, pre-transplant and post-transplant cardiovascular risk factors, routine biochemistry, and immunosuppressive, antihypertensive and lipid-lowering treatment. The events studied in the follow-up will be: patient and graft survival, acute rejection episodes and cardiovascular events (myocardial infarction, invasive coronary artery therapy, cerebral vascular events, new-onset angina, congestive heart failure, rhythm disturbances and peripheral vascular disease. Four cardiovascular risk scores were calculated at the time of transplantation: the Framingham score, the European Systematic Coronary Risk Evaluation (SCORE equation, and the REGICOR (Registre Gironí del COR (Gerona Heart Registry, and DORICA (Dyslipidemia, Obesity, and Cardiovascular Risk functions. The cumulative incidence of cardiovascular events will be analyzed by competing risk survival methods. The clinical relevance of different variables will be calculated using the ARR (Absolute Risk
Claire H den Hoedt
Full Text Available BACKGROUND: We studied the distribution of causes of death in the CONTRAST cohort and compared the proportion of cardiovascular deaths with other populations to answer the question whether cardiovascular mortality is still the principal cause of death in end stage renal disease. In addition, we compared patients who died from the three most common death causes. Finally, we aimed to study factors related to dialysis withdrawal. METHODS: We used data from CONTRAST, a randomized controlled trial in 714 chronic hemodialysis patients comparing the effects of online hemodiafiltration versus low-flux hemodialysis. Causes of death were adjudicated. The distribution of causes of death was compared to that of the Dutch dialysis registry and of the Dutch general population. RESULTS: In CONTRAST, 231 patients died on treatment. 32% died from cardiovascular disease, 22% due to infection and 23% because of dialysis withdrawal. These proportions were similar to those in the Dutch dialysis registry and the proportional cardiovascular mortality was similar to that of the Dutch general population. cardiovascular death was more common in patients <60 years. Patients who withdrew were older, had more co-morbidity and a lower mental quality of life at baseline. Patients who withdrew had much co-morbidity. 46% died within 5 days after the last dialysis session. CONCLUSIONS: Although the absolute risk of death is much higher, the proportion of cardiovascular deaths in a prevalent end stage renal disease population is similar to that of the general population. In older hemodialysis patients cardiovascular and non-cardiovascular death risk are equally important. Particularly the registration of dialysis withdrawal deserves attention. These findings may be partly limited to the Dutch population.
This article provides an update of the current status of cardiovascular disease (CVD) in the United States, including a brief review of the underlying pathophysiology and epidemiology. This article presents a discussion of the latest American Heart Association guidelines that introduce the concept of promoting ideal cardiovascular health, defined by seven identified metrics. Specific CVD risk factors and utilization of the 10-year CVD event prediction calculator are discussed. In addition, current management recommendations of health-related conditions that increase risk for CVD, such as hypertension and hypercholesterolemia, are provided. Finally, a discussion of detailed evidence-based lifestyle recommendations to promote cardiovascular health and reduce CVD risks concludes the update. PMID:26156147
Poay; Sian; Sabrina; Lee; Kian; Keong; Poh
Endothelial dysfunction has been associated with the development of atherosclerosis and cardiovascular diseases. Adult endothelial progenitor cells(EPCs) are derived from hematopoietic stem cells and are capable of forming new blood vessels through a process of vas-culogenesis. There are studies which report correlations between circulating EPCs and cardiovascular risk fac-tors. There are also studies on how pharmacotherapies may influence levels of circulating EPCs. In this review, we discuss the potential role of endothelial progenitor cells as both diagnostic and prognostic biomarkers. In addition, we look at the interaction between cardio-vascular pharmacotherapies and endothelial progenitor cells. We also discuss how EPCs can be used directly and indirectly as a therapeutic agent. Finally, we evalu-ate the challenges facing EPC research and how these may be overcome.
Holmes, Michael V; Dale, Caroline E; Zuccolo, Luisa;
OBJECTIVE: To use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease. DESIGN: Mendelian randomisation meta-analysis of 56 epidemiological studies. PARTICIPANTS: 261 991 individuals of European...... descent, including 20 259 coronary heart disease cases and 10 164 stroke events. Data were available on ADH1B rs1229984 variant, alcohol phenotypes, and cardiovascular biomarkers. MAIN OUTCOME MEASURES: Odds ratio for coronary heart disease and stroke associated with the ADH1B variant in all individuals...... disease than those without the genetic variant. This suggests that reduction of alcohol consumption, even for light to moderate drinkers, is beneficial for cardiovascular health....
Abildstrøm, Steen Z; Torp-Pedersen, Christian; Madsen, Mette
Introduction: The use of the unique personal identification number in the Nordic database systems enables the researchers to link the registers at the individual level. The registers can be used for both defining specific patient populations and to identify later events during follow-up. This rev...... the hospitalisation rate and treatment of cardiovascular disease. The risk of unmeasured factors affecting the results calls for cautious interpretation of the results.......-up. This review gives three examples within cardiovascular epidemiology to illustrate the use of the national administrative registers available to all researchers upon request. Research topics: The hospitalisation rate of acute myocardial infarction (AMI) was expected to be increased and case-fatality rate......-based treatment increased significantly over time and adherence to treatment was high. Finally, use of specific nonsteroidal antiinflammatory drugs by healthy subjects was associated with a dose-dependent increase in cardiovascular risk. CONCLUSION: The nationwide registers have proven very useful in monitoring...
Stankov Karmen M.
Full Text Available Cardiovascular diseases are the leading cause of morbidity and mortality worldwide. Despite considerable advances in cardiovascular pharmacology, significant inter-individual variability in response to drugs affects both their efficacy and safety profile. Drug-gene associations have emerged as important factors determining a spectrum of response to therapy. Pharmacogenomic interactions in cardiovascular medicine are also involved in etiology of adverse effects that may be life-threatening, such as statininduced myopathy or a hemorrhage/thrombosis event during anticoagulant therapy. Introduction of genetic tests prior to the initiation of therapy and implementation of genetically-guided therapy represent a step forward to achieving a goal of individualized medicine in cardiology, already present in recommendations for warfarin and clopidogrel. However, further investigations addressing genomic predictors of variability in response to drugs are still needed and translating these findings into routine clinical practice remains a substantial challenge. [Projekat Ministarstva nauke Republike Srbije, br. III41012
Maria Eugenia Niño Mantilla
Full Text Available the dysfunction of the autonomic nervous system is a serious problem in diabetic patients. The cardiovacular autonomic neuropathy is the most important autonomic dysfuntion for it´s implication in the increasesof the mortality rate in diabetis patients. tis ethiopatogenesis is the result of a multifactorial process caused by chronic hyperglycemia, ending up in damage of the autonomic fibers thet innervate the heart and blood vessels, leading to dysfuntional hearth rate control and abnormal vascular dynamics. the associated clinical manifestations include orthotatic hypotension, excecise intolerance, intraoperative cardiovascular liability and silent myocardial ischemia. Being important its recognition, quantitative test to evaluate the cardiovascular funtion, to value its evolution and the effects of the treatment ahould be done, being the most used, the hearth rate response to standing test, and teh valsalva maneuver. the handling of this entity is done improving control of glucose blood levels its the most effective way to prevent the cardiovascular autonomic neuropathy in the diabetic patients.
França, Carolina Nunes, E-mail: email@example.com [Universidade Federal de São Paulo - UNIFESP - UNISA, SP, São Paulo (Brazil); Universidade de Santo Amaro - UNISA, SP, São Paulo (Brazil); Izar, Maria Cristina de Oliveira; Amaral, Jônatas Bussador do; Tegani, Daniela Melo; Fonseca, Francisco Antonio Helfenstein [Universidade Federal de São Paulo - UNIFESP - UNISA, SP, São Paulo (Brazil)
Primary prevention of cardiovascular disease is a choice of great relevance because of its impact on health. Some biomarkers, such as microparticles derived from different cell populations, have been considered useful in the assessment of cardiovascular disease. Microparticles are released by the membrane structures of different cell types upon activation or apoptosis, and are present in the plasma of healthy individuals (in levels considered physiological) and in patients with different pathologies. Many studies have suggested an association between microparticles and different pathological conditions, mainly the relationship with the development of cardiovascular diseases. Moreover, the effects of different lipid-lowering therapies have been described in regard to measurement of microparticles. The studies are still controversial regarding the levels of microparticles that can be considered pathological. In addition, the methodologies used still vary, suggesting the need for standardization of the different protocols applied, aiming at using microparticles as biomarkers in clinical practice.
Shen, Zheni; Ye, Cunqi; McCain, Keanna; Greenberg, Miriam L
Cardiolipin (CL), the signature phospholipid of mitochondrial membranes, is crucial for both mitochondrial function and cellular processes outside of the mitochondria. The importance of CL in cardiovascular health is underscored by the life-threatening genetic disorder Barth syndrome (BTHS), which manifests clinically as cardiomyopathy, skeletal myopathy, neutropenia, and growth retardation. BTHS is caused by mutations in the gene encoding tafazzin, the transacylase that carries out the second CL remodeling step. In addition to BTHS, CL is linked to other cardiovascular diseases (CVDs), including cardiomyopathy, atherosclerosis, myocardial ischemia-reperfusion injury, heart failure, and Tangier disease. The link between CL and CVD may possibly be explained by the physiological roles of CL in pathways that are cardioprotective, including mitochondrial bioenergetics, autophagy/mitophagy, and mitogen activated protein kinase (MAPK) pathways. In this review, we focus on the role of CL in the pathogenesis of CVD as well as the molecular mechanisms that may link CL functions to cardiovascular health. PMID:26301254
Full Text Available Cardiolipin (CL, the signature phospholipid of mitochondrial membranes, is crucial for both mitochondrial function and cellular processes outside of the mitochondria. The importance of CL in cardiovascular health is underscored by the life-threatening genetic disorder Barth syndrome (BTHS, which manifests clinically as cardiomyopathy, skeletal myopathy, neutropenia, and growth retardation. BTHS is caused by mutations in the gene encoding tafazzin, the transacylase that carries out the second CL remodeling step. In addition to BTHS, CL is linked to other cardiovascular diseases (CVDs, including cardiomyopathy, atherosclerosis, myocardial ischemia-reperfusion injury, heart failure, and Tangier disease. The link between CL and CVD may possibly be explained by the physiological roles of CL in pathways that are cardioprotective, including mitochondrial bioenergetics, autophagy/mitophagy, and mitogen activated protein kinase (MAPK pathways. In this review, we focus on the role of CL in the pathogenesis of CVD as well as the molecular mechanisms that may link CL functions to cardiovascular health.
Jensen, Peter; Thyssen, Jacob P; Zachariae, Claus;
Background Epidemiological data have established an association between cardiovascular disease and psoriasis. Only one general population study has so far compared prevalences of cardiovascular risk factors among subjects with psoriasis and control subjects. We aimed to determine the prevalence of...... cardiovascular risk factors in subjects with and without psoriasis in the general population. Methods During 2006-2008, a cross-sectional study was performed in the general population in Copenhagen, Denmark. A total of 3471 subjects participated in a general health examination that included assessment of current...... smoking status, weight, height, waist and hip circumferences, systolic and diastolic blood pressures, resting heart rate, and plasma lipids, hemoglobin A1c, fasting glucose, and insulin levels. Results Physician-diagnosed psoriasis was reported by 238 (7.1%) of 3374 participants. There were no differences...
Roussos, Anastasios; Philippou, Nikiforos; Gourgoulianis, Konstantinos I
In the past few years, a variety of extradigestive disorders, including cardiovascular, skin, rheumatic and liver diseases, have been associated with Helicobacter pylori (H. pylori) infection. The activation of inflammatory mediators by H. pylori seems to be the pathogenetic mechanism underlying the observed associations. The present review summarizes the current literature, including our own studies, concerning the association between H. pylori infection and respiratory diseases.
Khalib A. Latiff
Full Text Available Cardiovascular problem is one of the leading cause of death in Malaysia and now invaded to the sub-urban and rural areas. To prevent and control of this problem, several main risk factors needed to be known and shall be reexamined and ranked according to the priority. The objectives of this research paper was to identify several dominant risk factor related to cardiovascular problem. A cross sectional study was carried out from March 2000 – June 2001 on a total of 8159 rural population aged 18 and above to measure the prevalence of the common cardiovascular risk factors. Those risk factors are systolic blood pressure, diastolic blood pressure, serum cholesterol level, obesity index, blood glucose level, smoking, physical activity and mental stress. Overall prevalence of common cardiovascular risk factors were higher, dominated by physical inactivity (65.7%, hypercholesterolemia – TC:HC (62.3%, mental stress (55.5% and obesity (53.7%. Smoking was also high at 49.9% especially among men. However systolic hypertension, diastolic hypertension and diabetes mellitus; although increased by age, its prevalence is relatively low at 23.7%, 19.2%, and 6.3% respectively. Cardiovascular risk factors related to lifestyle are much evidenced as compared to risk factors related to the biological influence. Therefore, all initiatives in community health intervention should be mobilized specifically on prevention and control of lifestyle-related risk factors. (Med J Indones 2008; 17: 50-6Keywords: cardiovascular problem, community intervention, lifestyle-linked risk factors
Lakka, T A; Bouchard, C
Sedentary lifestyle and overweight are major public health, clinical, and economical problems in modern societies. The worldwide epidemic of excess weight is due to imbalance between physical activity and dietary energy intake. Sedentary lifestyle, unhealthy diet, and consequent overweight and obesity markedly increase the risk of cardiovascular diseases. Regular physical activity 45-60 min per day prevents unhealthy weight gain and obesity, whereas sedentary behaviors such as watching television promote them. Regular exercise can markedly reduce body weight and fat mass without dietary caloric restriction in overweight individuals. An increase in total energy expenditure appears to be the most important determinant of successful exercise-induced weight loss. The best long-term results may be achieved when physical activity produces an energy expenditure of at least 2,500 kcal/week. Yet, the optimal approach in weight reduction programs appears to be a combination of regular physical activity and caloric restriction. A minimum of 60 min, but most likely 80-90 min of moderate-intensity physical activity per day may be needed to avoid or limit weight regain in formerly overweight or obese individuals. Regular moderate intensity physical activity, a healthy diet, and avoiding unhealthy weight gain are effective and safe ways to prevent and treat cardiovascular diseases and to reduce premature mortality in all population groups. Although the efforts to promote cardiovascular health concern the whole population, particular attention should be paid to individuals who are physically inactive, have unhealthy diets or are prone to weight gain. They have the highest risk for worsening of the cardiovascular risk factor profile and for cardiovascular disease. To combat the epidemic of overweight and to improve cardiovascular health at a population level, it is important to develop strategies to increase habitual physical activity and to prevent overweight and obesity in
M.L. De Rosa
Full Text Available A cardiovascular health survey of 1203 persons in households located near the hazardous waste disposal sites and in a reference community, was conducted from 2009 until today to assess whether rates of adverse cardiovascular health outcomes were elevated among persons living near the sites. Data included medical records of reported cardiovascular disease certificates and hospital admission for cardiovascular diseases from hospital database. The study areas appeared similar with respect to mortality, cancer incidence, and pregnancy outcomes. In contrast, rate ratios were greater than 1.5 for 2 of 19 reported diseases, i.e., angina pectoris, and strokes. The apparent broad-based elevation in reported diseases and symptoms may reflect increased perception or recall of conditions by respondents living near the sites. Our study found that cardiovascular risk is associated only with PM2.5 concentrations, derived from uncontrolled burning of municipal solid waste in particular sites of our country. Their analysis demonstrated a relationship between increased levels of eventual fine particulate pollution and higher rates of death and complications from cardiovascular and cerebrovascular diseases. Management of solid waste releases a number of toxic substances, most in small quantities and at extremely low levels. Because of the wide range of pollutants, the different pathways of exposure, long-term low-level exposure, and the potential for synergism among the pollutants, concerns remain about potential health effects but there are many uncertainties involved in the assessment. Future community-based health studies should include medical and psychosocial assessment instruments sufficient to distinguish between changes in health status and effects of resident reporting tendency.
María Inés Sosa Liprandi
Full Text Available La relación entre las infecciones respiratorias producidas por el virus de la influenza y el neumococo y los eventos cardiovasculares motivaron la reunión de un grupo interdisciplinario (cardiólogos, clínicos e infectólogos, con el objeto de analizar la evidencia entre la asociación de estos fenómenos y el rol de las estrategias de inmunización en la prevención de la enfermedad cardiovascular. El presente documento sintetiza las conclusiones del grupo de trabajo. El análisis de revisiones sistemáticas sugiere una evidencia consistente entre la infección por influenza y neumococo como desencadenantes de infarto agudo de miocardio y muerte cardiovascular. Los estudios publicados en los últimos 15 años sugieren que la vacunación para influenza y neumococo reducen el riesgo de síndromes coronarios agudos. Con la evidencia existente y teniendo en cuenta los análisis de costo-efectividad, ahorro de costos y perfil de seguridad de las vacunas, las sociedades científicas y agencias gubernamentales de salud, tanto nacionales como internacionales, recomiendan fuertemente la incorporación de la inmunización en el grupo de pacientes con enfermedad cardiovascular crónica.
Full Text Available Hyperhomocysteinemia (Hhcy is a medical condition characterized by abnormally large levels of homocysteine in blood. The involvement of homocysteine (Hcy in various biochemical reactions causes deficiencies of the vitamins like pyridoxine (B6, folic acid (B9, or B12 leading to higher Hcy levels. Hhcy has been considered as an independent risk factor for various cardiovascular diseases like endothelial dysfunction, vascular inflammation, atherosclerosis, hypertension, cardiac hypertrophy and heart failure. The review article critically explains about the mechanisms involved in the Hhcy-induced development and progression of various cardiovascular disorders
Moniz, M; T. Marques; Cabral, M.; Nizarali, Z; Coelho, R.; Monteiro, A.; Bragança, G; Carreiro, H
Introdução: a obesidade associa-se, mesmo em idade pediátrica, a factores de risco de doença cardiovascular, como a dislipidemia, a tensão arterial (TA) elevada e o síndrome metabólico (SM), que contribuem para o aumento da morbilidade e mortalidade na idade adulta. Objectivos: caracterizar a prevalência dos factores de risco cardiovascular nas crianças e adolescentes obesos seguidos na consulta de Endocrinologia Pediátrica. Material e Métodos: estudo descritivo dos casos seguidos entre...
Singh, Baljeet; Garg, Tarun; Goyal, Amit K; Rath, Goutam
Cardiovascular disease is the disease that affects the cardiovascular system, vascular diseases of the brain and kidney, and peripheral arterial disease. Despite of all advances in pharmacological and clinical treatment, heart failure is a leading cause of morbidness and mortality worldwide. Many new therapeutic advance strategies, including cell transplantation, gene delivery or therapy, and cytokines or other small molecules, have been research to treat heart failure. The main aim of this review article is to focus on nano carriers advancement and addressing the problems associated with old and modern therapeutics such as nonspecific effects and poor stability. PMID:25046615
Dubbs, Sarah B; Tewelde, Semhar Z
Pregnancy is a complex and dynamic physiologic state, in which the needs of the mother and fetus must achieve a fine balance with one another. Some of the most dreaded and deadly complications that can arise during this period affect the cardiovascular system are hypertensive emergencies (including preeclampsia and eclampsia), acute coronary syndrome, peripartum cardiomyopathy, dysrhythmias, dissection, thromboembolism, and cardiac arrest. This review provides emergency physicians, obstetricians, intensivists, and other health care providers with the most recent information on the diagnosis and management of these deadly cardiovascular complications of pregnancy. PMID:26226861
LeMar, H J; West, S G; Garrett, C R; Hofeldt, F D
Hypothyroidism presenting with classic signs and symptoms is generally easily recognized. Less often, patients with hypothyroidism may present with symptoms and laboratory abnormalities suggestive of cardiovascular disease. In this article, we describe six such patients. Hypothyroidism was suspected when creatine phosphokinase (CPK) levels were persistently elevated. The diagnosis was confirmed by thyroid function tests, and thyroid hormone therapy resulted in resolution of symptoms and CPK elevations. Persistently elevated CPK levels associated with cardiovascular symptoms but without demonstrable myocardial damage should prompt consideration of covert hypothyroidism. PMID:1951418
Khalib A. Latiff; Khairul H. Yusof
Cardiovascular problem is one of the leading cause of death in Malaysia and now invaded to the sub-urban and rural areas. To prevent and control of this problem, several main risk factors needed to be known and shall be reexamined and ranked according to the priority. The objectives of this research paper was to identify several dominant risk factor related to cardiovascular problem. A cross sectional study was carried out from March 2000 – June 2001 on a total of 8159 rural population aged 1...
A prevenção da doença cardiovascular (DCV) é umaprioridade global de saúde pública. A vitamina D tem sido classicamente associada à saúde óssea, estando bem estabelecido que a carência de vitamina D provoca raquitismo na idade pediátrica e, osteomalacia e osteoporose na idade adulta. Contudo, hoje sabemos que níveis adequados de vitamina D são essenciais ao bom funcionamento de vários tecidos e órgãos do nossoorganismo, incluindo o sistema cardiovascular.
Zalesin, Kerstyn C
Obesity promotes a cascade of secondary pathologies including diabetes, insulin resistance, dyslipidemia, inflammation, thrombosis, hypertension, the metabolic syndrome, and OSA, which collectively heighten the risk for cardiovascular disease. Obesity may also be an independent moderator of cardiac risk apart from these comorbid conditions. Rates of obesity and cardiac disease continue to rise in a parallel and exponential manner. Because obesity is potentially one of the most modifiable mediators of cardiovascular morbidity and mortality, effective treatment and prevention interventions should have a profound and favorable impact on public health.
Presence of the metabolic syndrome (MS) is not a better predictor of cardiovascular disease (CVD) than the sum of its components in HIV-infected individuals. Data Collection on Adverse Events of Anti-HIV Drugs (The D:A:D study)
Worm, Signe W; Sabin, Caroline A; Reiss, Peter;
Objectives: It is much debated whether the MS contributes additional information over and above that provided by the individual components of the syndrome alone. Amongst HIV-infected individuals, we investigated whether any particular combinations of the components of the MS definition are associ......Objectives: It is much debated whether the MS contributes additional information over and above that provided by the individual components of the syndrome alone. Amongst HIV-infected individuals, we investigated whether any particular combinations of the components of the MS definition...
Chu, Xian-Ming; An, Yi; Li, Xue-Bin; Guo, Ji-Hong
Asymptomatic bacterial colonization of cardiovascular implantable electronic devices (CIEDs) is widespread and increases the risk of clinical CIED infection. The aim of the study was to evaluate the incidence of bacterial colonization of generator pockets in patients without signs of infection and to analyze the relationship with clinical infection and risk factors. From June 2011 to December 2012, 78 patients underwent CIED replacement or upgrade. Exclusion criteria included a clinical diagnosis of CIED infection, bacteremia, or infective endocarditis. All patients were examined for evidence of bacterial 16S rDNA on the device and in the surrounding tissues. Infection cases were recorded during follow-up. The bacterial-positive rate was 38.5% (30 cases); the coagulase-negative Staphylococcus detection rate was the highest (9 cases, 11.5%). Positive bacterial DNA results were obtained from pocket tissue in 23.1% of patients (18 cases), and bacterial DNA was detected on the device in 29.5% of patients (23 cases). During follow-up (median 24.6 months), two patients (6.7%, 2/30) became symptomatic with the same species of microorganism, S. aureus and S. epidermidis. Multivariable logistic regression analysis found that the history of bacterial infection, use of antibiotics, application of antiplatelet drugs, replacement frequency, and renal insufficiency were independent risk factors for asymptomatic bacterial colonization. PMID:25530969
Full Text Available Asymptomatic bacterial colonization of cardiovascular implantable electronic devices (CIEDs is widespread and increases the risk of clinical CIED infection. The aim of the study was to evaluate the incidence of bacterial colonization of generator pockets in patients without signs of infection and to analyze the relationship with clinical infection and risk factors. From June 2011 to December 2012, 78 patients underwent CIED replacement or upgrade. Exclusion criteria included a clinical diagnosis of CIED infection, bacteremia, or infective endocarditis. All patients were examined for evidence of bacterial 16S rDNA on the device and in the surrounding tissues. Infection cases were recorded during follow-up. The bacterial-positive rate was 38.5% (30 cases; the coagulase-negative Staphylococcus detection rate was the highest (9 cases, 11.5%. Positive bacterial DNA results were obtained from pocket tissue in 23.1% of patients (18 cases, and bacterial DNA was detected on the device in 29.5% of patients (23 cases. During follow-up (median 24.6 months, two patients (6.7%, 2/30 became symptomatic with the same species of microorganism, S. aureus and S. epidermidis. Multivariable logistic regression analysis found that the history of bacterial infection, use of antibiotics, application of antiplatelet drugs, replacement frequency, and renal insufficiency were independent risk factors for asymptomatic bacterial colonization.
A still increasing interest and emphasis on the sessile bacterial lifestyle biofilms has been seen since it was realized that the vast majority of the total microbial biomass exists as biofilms. Aggregation of bacteria was first described by Leeuwenhoek in 1677, but only recently recognized as...... being important in chronic infection. In 1993 the American Society for Microbiology (ASM) recognized that the biofilm mode of growth was relevant to microbiology. This book covers both the evidence for biofilms in many chronic bacterial infections as well as the problems facing these infections such as...... diagnostics, pathogenesis, treatment regimes and in vitro and in vivo models for studying biofilms. This is the first scientific book on biofilm infections, chapters written by the world leading scientist and clinicians. The intended audience of this book is scientists, teachers at university level as well as...
Bjarnsholt, Thomas; Jensen, Peter Østrup; Moser, Claus Ernst; Høiby, Niels
being important in chronic infection. In 1993 the American Society for Microbiology (ASM) recognized that the biofilm mode of growth was relevant to microbiology. This book covers both the evidence for biofilms in many chronic bacterial infections as well as the problems facing these infections such as......A still increasing interest and emphasis on the sessile bacterial lifestyle biofilms has been seen since it was realized that the vast majority of the total microbial biomass exists as biofilms. Aggregation of bacteria was first described by Leeuwenhoek in 1677, but only recently recognized as...... diagnostics, pathogenesis, treatment regimes and in vitro and in vivo models for studying biofilms. This is the first scientific book on biofilm infections, chapters written by the world leading scientist and clinicians. The intended audience of this book is scientists, teachers at university level as well as...
Godoy-Gijón, Elena; Meseguer-Yebra, Carmen; Palacio-Aller, Lucía; Godoy-Rocati, Diego Vicente; Lahoz-Rallo, Carlos
The increased cardiovascular risk in some dermatological diseases has been demonstrated in recent decades. Diseases such as psoriasis and systemic lupus erythematosus are currently included in the guidelines for prevention of cardiovascular disease. Other diseases such as androgenic alopecia, polycystic ovary syndrome, hidradenitis suppurativa or lichen planus have numerous studies that point to an increased risk, however, they have not been included in these guidelines. In this article we review the evidence supporting this association, in order to alert the clinician to the need for greater control in cardiovascular risk factors in these patients. PMID:26383179
Sweeney, Daniel A.; Caitlin W. Hicks; Cui, Xizhong; Li, Yan; Eichacker, Peter Q.
Bacillus anthracis infection is rare in developed countries. However, recent outbreaks in the United States and Europe and the potential use of the bacteria for bioterrorism have focused interest on it. Furthermore, although anthrax was known to typically occur as one of three syndromes related to entry site of (i.e., cutaneous, gastrointestinal, or inhalational), a fourth syndrome including severe soft tissue infection in injectional drug users is emerging. Although shock has been described ...
Di Angelantonio, Emanuele; Gao, Pei; Pennells, Lisa;
The value of assessing various emerging lipid-related markers for prediction of first cardiovascular events is debated.......The value of assessing various emerging lipid-related markers for prediction of first cardiovascular events is debated....
Margolles, Mario; Saiz, Roberto; Margolles, Pedro; García, Eva; Donate, Ignacio
profundizar en el conocimiento de los niveles de riesgo cardiovascular (RCV) para poder aplicar medidas que mejoren la promoción y prevención y la asistencia integral. Nuestro objetivo es aumentar la información sobre los niveles de RCV en Asturias y facilitar la planificación sanitaria.
Judith A Whitworth
Full Text Available Judith A WhitworthJohn Curtin School of Medical Research, Australian National University, Canberra, ACT, AustraliaAbstract: Two key early 20th century notions, the first the primacy of diastolic pressure in determining risk, and the second that hypertension is a discrete disorder, have proved to be incorrect. We now recognize the primacy of systolic pressure as a risk factor for cardiovascular disease and that hypertension is an arbitrary definition. In the early 21st century, we are moving away from a dichotomous approach to risk classification, and away from notions of hypertension and normotension towards an appreciation that blood pressure-related risk is continuous. In parallel, there has been a paradigm shift from a single risk factor approach to comprehensive cardiovascular disease risk prevention. Accordingly, prevention of cardiovascular disease requires a focus on lowering of blood pressure and modification of associated risk factors rather than simply treatment of hypertension. This emphasis is reflected in the World Health Organization (WHO – International Society of Hypertension (ISH 2003 statement on management of hypertension.Keywords: blood pressure, hypertension, cardiovascular risk, treatment
Felix, Renata Christian Martins; Gouvea, Clecio Maria, E-mail: firstname.lastname@example.org, E-mail: email@example.com [Instituto Nacional de Cardiologia, Rio de Janeiro, RJ (Brazil); Carneiro, Michel Pontes [Instituto Nacional de Cancer (INCA), Rio de Janeiro, RJ (Brazil); Mesquita, Claudio Tinoco [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil)
Many articles have demonstrated the role of PET-CT in the evaluation of inflammatory and infectious diseases of the cardiovascular system. The purpose of this article is to provide a review of the literature on this topic to identify clinical situations in which there is evidence of the usefulness of PET-CT in diagnostic and therapeutic evaluation.
@@ Recently many new disease markers and risk factors have been proposed, but it is not yet clear how far the new markers are validated as predictive risk factors enable us to increase accuracy as well as enhancing our ability to predict cardiovascular (CV) events and to plan prevention and therapy.
Kenney, W Larry; Craighead, Daniel H; Alexander, Lacy M
This brief review is based on a President's Lecture presented at the Annual Meeting of the American College of Sports Medicine in 2013. The purpose of this review was to assess the effects of climate change and consequent increases in environmental heat stress on the aging cardiovascular system. The earth's average global temperature is slowly but consistently increasing, and along with mean temperature changes come increases in heat wave frequency and severity. Extreme passive thermal stress resulting from prolonged elevations in ambient temperature and prolonged physical activity in hot environments creates a high demand on the left ventricle to pump blood to the skin to dissipate heat. Even healthy aging is accompanied by altered cardiovascular function, which limits the extent to which older individuals can maintain stroke volume, increase cardiac output, and increase skin blood flow when exposed to environmental extremes. In the elderly, the increased cardiovascular demand during heat waves is often fatal because of increased strain on an already compromised left ventricle. Not surprisingly, excess deaths during heat waves 1) occur predominantly in older individuals and 2) are overwhelmingly cardiovascular in origin. Increasing frequency and severity of heat waves coupled with a rapidly growing at-risk population dramatically increase the extent of future untoward health outcomes. PMID:24598696
Peterson, Nils S.; Campbell, Kenneth B.
Describes a computer-based instructional unit in cardiovascular physiology. The program (which employs simulated laboratory experimental techniques with a problem-solving format is designed to supplement an animal laboratory and to offer students an integrative approach to physiology through use of microcomputers. Also presents an overview of the…
Full Text Available Obesity is an established risk factor for cardiovascular disease (CVD, yet, the underlying mechanisms are only poorly understood. The adipose tissue produces a variety of hormones and cytokines and thereby actively participates in a network of biomarkers that may be relevant for the development of CVD. Such obesity biomarkers have a great potential to better characterize the obesity phenotype that may be relevant for the risk of CVD beyond anthropometric parameters. They may be used to support mechanistic studies, to help identify individuals at risk for CVD, and to evaluate the effect of preventive measures. The present article discusses the role of some of the most promising obesity biomarkers in cardiovascular epidemiology, including inflammatory markers, adiponectin, resistin, and fetuin-A. Importantly, some of these markers have been related to cardiovascular risk even after accounting for anthropometric parameters. Further, the potential ability to manipulate blood levels of some of these biomarkers through medication, diet and lifestyle make them attractive markers for cardiovascular risk. However, many open questions remain – especially with regard to the causal role of the factors as well as with regard to the extent of improvement in CVD prediction by these markers – before measurement of these biomarkers may be recommended on a public health level.
Manali, Effrosyni D; Papadaki, Georgia; Konstantonis, Dimitrios; Tsangaris, Iraklis; Papaioannou, Andriana I; Kolilekas, Likurgos; Schams, Andrea; Kagouridis, Konstantinos; Karakatsani, Anna; Orfanos, Stylianos; Griese, Matthias; Papiris, Spyros A
We hypothesized that cardiovascular events and/or indices of cardiac dysfunction may be increased in pulmonary alveolar proteinosis (PAP). Systemic and pulmonary arterial hypertension, arrhythmias, pulmonary embolism, stroke and ischemic heart attack were reported. Patients underwent serum anti-GM-CSF antibodies, disease severity score (DSS), Doppler transthoracic echocardiograph, glucose, thyroid hormones, lipids, troponin and pro-Brain natriuretic peptide (BNP) examination. Thirteen patients (8 female) were studied, median age of 47. Pro-BNP inversely related to DLCO% and TLC%; troponin directly related to DSS, age, P(A-a)O2, left atrium-, left ventricle-end-diastole diameter and BMI. On multiple regression analysis DSS was the only parameter significantly and strongly related with troponin (R(2) = 0.776, p = 0.007). No cardiovascular event was reported during follow-up. In PAP cardiovascular risk indices relate to lung disease severity. Therefore, PAP patients could be at increased risk for cardiovascular events. Quantitation of its magnitude and potential links to lungs' physiologic derangement will be addressed in future studies. PMID:26558331
Rebello Horta, Carolina Campolina; Chatzaki, Maria; Rezende, Bruno Almeida; Magalhães, Bárbara de Freitas; Duarte, Clara Guerra; Felicori, Liza Figueiredo; Ribeiro Oliveira-Mendes, Bárbara Bruna; do Carmo, Anderson Oliveira; Chávez-Olórtegui, Carlos; Kalapothakis, Evanguedes
Animal venoms are a mixture of bioactive compounds produced as weapons and used primarily to immobilize and kill preys. As a result of the high potency and specificity for various physiological targets, many toxins from animal venoms have emerged as possible drugs for the medication of diverse disorders, including cardiovascular diseases. Captopril, which inhibits the angiotensin-converting enzyme (ACE), was the first successful venom-based drug and a notable example of rational drug design. Since captopril was developed, many studies have discovered novel bradykinin-potentiating peptides (BPPs) with actions on the cardiovascular system. Natriuretic peptides (NPs) have also been found in animal venoms and used as template to design new drugs with applications in cardiovascular diseases. Among the anti-arrhythmic peptides, GsMTx-4 was discovered to be a toxin that selectively inhibits the stretch-activated cation channels (SACs), which are involved in atrial fibrillation. The present review describes the main components isolated from animal venoms that act on the cardiovascular system and presents a brief summary of venomous animals and their venom apparatuses. PMID:26812904
Jordan, Jens; Astrup, Arne; Engeli, Stefan;
approved by the United States Food and Drug Administration as an adjunct to lifestyle intervention for the chronic treatment of overweight/obese adults. This review summarizes and evaluates the cardiovascular risk/benefit profile associated with phentermine and topiramate, individually and in combination...
Cooney, Marie Therese
The high risk strategy for the prevention of cardiovascular disease (CVD) requires an assessment of an individual\\'s total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Here we review developments in the assessment and estimation of total CVD risk.
Background Evidence is accumulating that lifestyle factors influence the incidence of fatal and non-fatal cardiovascular diseases (CVD). A healthy diet, being physically active, moderate alcohol consumption and not smoking are associated with a lower CVD risk. In addition to
Takeda, Nobuakira; Shikata, Chihiro; Sekikawa, Tetsuaki; Kimura, Nobuaki; Nishiyama, Akihiro
Diabetes mellitus is a disease with multiorgan involvement. Besides retinopathy, nephropathy and peripheral neuropathy induced by microangiopathy, both cardiovascular and cerebrovascular complications are significant. Both cardiomyopathy and coronary artery disease are observed in patients with diabetes, and the latter is clinically more important because of its high incidence and seriousness.
Lykke, Jacob A; Langhoff-Roos, Jens
First trimester bleeding without miscarriage is a risk factor for complications later in the pregnancy, such as preterm delivery. Also, first trimester miscarriage has been linked to subsequent maternal ischemic heart disease. We investigated the link between maternal cardiovascular disease prior...... to and subsequent to first trimester bleeding without miscarriage....
Within Europe large differences exist in mortality from coronary heart disease and stroke. These diseases show a clear West-East gradient with high rates in Eastern Europe. In spite the decreasing trend in age-adjusted cardiovascular disease mortality in Western European countries an increase in the
Davidson, A. J.; London, B.; Block, G. D.; Menaker, M.
Acute cardiovascular events exhibit a circadian rhythm in the frequency of occurrence. The mechanisms underlying these phenomena are not yet fully understood, but they may be due to rhythmicity inherent in the cardiovascular system. We have begun to characterize rhythmicity of the clock gene mPer1 in the rat cardiovascular system. Luciferase activity driven by the mPer1 gene promoter is rhythmic in vitro in heart tissue explants and a wide variety of veins and arteries cultured from the transgenic Per1-luc rat. The tissues showed between 3 and 12 circadian cycles of gene expression in vitro before damping. Whereas peak per1-driven bioluminescence consistently occurred during the late night in the heart and all arteries sampled, the phases of the rhythms in veins varied significantly by anatomical location. Varying the time of the culture procedure relative to the donor animal's light:dark cycle revealed that, unlike some other rat tissues such as liver, the phases of in vitro rhythms of arteries, veins, and heart explants were affected by culture time. However, phase relationships among tissues were consistent across culture times; this suggests diversity in circadian regulation among components of the cardiovascular system.
Full Text Available Background: Periventricular nodular heterotopia (PNH is a rare congenital anomaly of thebrain presenting as nodular heterotopia along the paraventricular region. Tencases of PNH complicated by aortic aneurysm have been reported in the literature, and 9 of them also had symptoms of Ehlers-Danlos syndrome(EDS. This study investigated the association of PNH and cardiovascularanomalies in Asians.Methods: Patients with a diagnosis of brain heterotopia on magnetic resonance imagingat Chang Gung Memorial Hospital between 1994 and 2010 were screenedfor both typical PNH and cardiovascular anomalies. The family members ofthe index cases were also evaluated.Results: One family (5 patients and a sporadic case were found to have both typicalPNH and cardiovascular anomalies. Two of them had aortic root aneurysm,one had aortic regurgitation, and one had minor valvular disease. Twopatients had a history of seizures, but none of them had EDS.Conclusions:Clinical heterogeneity exists in the patients with PNH. Overlap in the symptoms of PNH, cardiovascular anomalies, aortic aneurysm, and EDS werereviewed. EDS is unusual in Asians with PNH. Aortic aneurysm and othervalvular heart diseases are common cardiovascular anomalies in PNHpatients.
Dis, van S.J.
Background: In clinical practice, Systematic COronary Risk Evaluation (SCORE) risk prediction functions and charts are used to identify persons at high risk for cardiovascular diseases (CVD), who are considered eligible for drug treatment of elevated blood pressure and serum cholesterol. These funct
Keating, Samuel T; Plutzky, Jorge; El-Osta, Assam
Cardiovascular complications remain the leading causes of morbidity and premature mortality in patients with diabetes mellitus. Studies in humans and preclinical models demonstrate lasting gene expression changes in the vasculopathies initiated by previous exposure to high glucose concentrations and the associated overproduction of reactive oxygen species. The molecular signatures of chromatin architectures that sensitize the genome to these and other cardiometabolic risk factors of the diabetic milieu are increasingly implicated in the biological memory underlying cardiovascular complications and now widely considered as promising therapeutic targets. Atherosclerosis is a complex heterocellular disease where the contributing cell types possess distinct epigenomes shaping diverse gene expression. Although the extent that pathological chromatin changes can be manipulated in human cardiovascular disease remains to be established, the clinical applicability of epigenetic interventions will be greatly advanced by a deeper understanding of the cell type-specific roles played by writers, erasers, and readers of chromatin modifications in the diabetic vasculature. This review details a current perspective of epigenetic mechanisms of macrovascular disease in diabetes mellitus and highlights recent key descriptions of chromatinized changes associated with persistent gene expression in endothelial, smooth muscle, and circulating immune cells relevant to atherosclerosis. Furthermore, we discuss the challenges associated with pharmacological targeting of epigenetic networks to correct abnormal or deregulated gene expression as a strategy to alleviate the clinical burden of diabetic cardiovascular disease. PMID:27230637
Many articles have demonstrated the role of PET-CT in the evaluation of inflammatory and infectious diseases of the cardiovascular system. The purpose of this article is to provide a review of the literature on this topic to identify clinical situations in which there is evidence of the usefulness of PET-CT in diagnostic and therapeutic evaluation
Jiang, Shengyang; Jiang, Donglin; Tao, Yijia
Cardiovascular diseases are threatening human health with rising morbidity and mortality rates. Gamma-glutamyltransferase (GGT) has been found to be involved in the pathogenesis of cardiovascular diseases, especially coronary artery disease, and the prognosis of cardiovascular disease may be predicted by increasing GGT levels. GGT levels are related to cardiovascular emergencies of chronic heart failure, and an elevated GGT level has been shown to be an independent predictive maker for cardia...
Gauthier, Chantal; Rozec, Bertrand; Manoury, Boris; Balligand, Jean-Luc
Catecholamines play a key role in the regulation of cardiovascular function, classically through ß(1/2)-adrenoreceptors (AR) activation. After ß(3)-AR cloning in the late 1980s, convincing evidence for ß(3)-AR expression and function in cardiovascular tissues recently initiated a reexamination of their involvement in the pathophysiology of cardiovascular diseases. Their upregulation in diseased cardiovascular tissues and resistance to desensitization suggest they may be attractive therapeutic...
Moreno, J.; Alegria, E; Cordero, A.; Fernandez-Jarne, E. (E.); Saenz-de-Buruaga, J.D. (J. D.)
Cardiovascular diseases, especially coronary heart disease, are the leading cause of mortality in Spain and western countries. The prevention of complications is based on a cardiovascular risk stratification that is based on the presence of classical cardiovascular risk factors. There are many scales for cardiovascular risk stratification that classify subjects into low, intermediate or high risk. Despite the fact that the impact and treatment of risk factors are well known, their control rem...
Peter M Janiszewski
Full Text Available BACKGROUND: Although half of HIV-infected patients develop lipodystrophy and metabolic complications, there exists no simple clinical screening tool to discern the high from the low-risk HIV-infected patient. Thus, we evaluated the associations between waist circumference (WC combined with triglyceride (TG levels and the severity of lipodystrophy and cardiovascular risk among HIV-infected men and women. METHODS: 1481 HIV-infected men and 841 HIV-infected women were recruited between 2005 and 2009 at the metabolic clinic of the University of Modena and Reggio Emilia in Italy. Within each gender, patients were categorized into 4 groups according to WC and TG levels. Total and regional fat and fat-free mass were assessed by duel-energy x-ray absorptiometry, and visceral adipose tissue (VAT and abdominal subcutaneous AT (SAT were quantified by computed tomography. Various cardiovascular risk factors were assessed in clinic after an overnight fast. RESULTS: The high TG/high WC men had the most VAT (208.0 ± 94.4 cm(2, as well as the highest prevalence of metabolic syndrome (42.2% and type-2 diabetes (16.2%, and the highest Framingham risk score (10.3 ± 6.5 in comparison to other groups (p<0.05 for all. High TG/high WC women also had elevated VAT (150.0 ± 97.9 cm(2 and a higher prevalence of metabolic syndrome (53.3%, hypertension (30.5% and type-2 diabetes (12.0%, and Framingham risk score(2.9 ± 2.8 by comparison to low TG/low WC women (p<0.05 for all. CONCLUSIONS: A simple tool combining WC and TG levels can discriminate high- from low-risk HIV-infected patients.
... Hearing, Ear Infections, and Deafness Ear Infections in Children On this page: What is an ear infection? ... their hearing. How can I tell if my child has an ear infection? Most ear infections happen ...
Duggirala Sivaram Prasad; Zubair Kabir; Ashok Kumar Dash; Bhagabati Charan Das
Cardiovascular risk factors in children are increasing at an alarming rate in the western world. However, there is limited information regarding these in the South Asian children. This review attempts at summarizing such evidence. South Asians are remarkable for the earlier onset of adult cardiovascular disease (CVD) by almost a decade compared to the Caucasians. We identified published literature, mainly on PubMed, Embase and Cochrane library using specific search terms such as lipid abnorma...
Dobrosielski, Devon A.; Rosenbaum, Daryl; Wooster, Benjamin M.; Merrill, Michael; Swanson, John; Moore, J. Brian; Brubaker, Peter H.
Collegiate American football players may be at risk for cardiovascular disease. Objective: To compare cardiovascular disease risk factors and cardiovascular structure and function parameters of football players, stratified by position, to a group of sedentary, nonathletes. Participants: Twenty-six collegiate football players and 13 nonathletes…
Maulik Subir; Banerjee Sanjay
Abstract Garlic and its preparations have been widely recognized as agents for prevention and treatment of cardiovascular and other metabolic diseases, atherosclerosis, hyperlipidemia, thrombosis, hypertension and diabetes. Effectiveness of garlic in cardiovascular diseases was more encouraging in experimental studies, which prompted several clinical trials. Though many clinical trials showed a positive effect of garlic on almost all cardiovascular conditions mentioned above, however a number...
Guardamagna Ornella; Abello Francesca; Cagliero Paola; Lughetti Lorenzo
Abstract The cardiovascular disease represents the leading cause of morbidity and mortality in Western countries and it is related to the atherosclerotic process. Cardiovascular disease risk factors, such as dyslipidemia, hypertension, insulin resistance, obesity, accelerate the atherosclerotic process which begins in childhood and progresses throughout the life span. The cardiovascular disease risk factor detection and management through prevention delays the atherosclerotic progression towa...
Full Text Available Limited data exit on the epidemiology of cardiovascular risk factors in Saudi Arabia particularly in relation to the differences between local citizens and expatriates. The aim of this analysis is to describe the current prevalence of cardiovascular risk factors among patients attending general practice clinics in Saudi Arabia. In a cross- sectional epidemiological study, the presence of cardiovascular risk factors (hypertension, diabetes, dyslipidaemia, obesity, smoking, and abdominal obesity was evaluated in stable adult outpatients attending primary care clinics in Saudi Arabia. Groups comparison were made between local Saudi patients and expatriates. A total of 550 participant were enrolled form different clinics in Saudi Arabia (71% were male, mean age was 43 ± 10 years. Nearly half of the study cohort had more than two cardiovascular risk factors (49.6%. Dyslipidemia had the highest prevalence (68.4%. Furthermore, prevalence of hypertension (47.5% vs. 31.4%, dyslipidaemia (75.2% vs. 55.1% and abdominal obesity (63.9% vs. 52.2% were higher among expatriates compare to Saudis (p-value < 0.001. This analysis clearly shows that there is a high prevalence of cardiovascular risk factors prevalence in Saudi population. In addition, a significant proportion of patients with risk factors have poor overall control. Programmed community based screening is needed for all cardiovascular risk factors in Saudi Arabia. Increased awareness and improved primary care services may decrease incidence of coronary artery disease and improve overall quality of life.
Weber, Rainer; Sabin, Caroline; Reiss, Peter; de Wit, Stephane; Worm, Signe W; Law, Matthew; Dabis, Francois; D'Arminio Monforte, Antonella; Fontas, Eric; El-Sadr, Wafaa; Kirk, Ole; Rickenbach, Martin; Phillips, Andrew; Ledergerber, Bruno; Lundgren, Jens
Data on a link between HCV or HBV infection and the development of cardiovascular disease among HIV-negative and HIV-positive individuals are conflicting. We sought to investigate the association between HBV or HCV infection and myocardial infarction in HIV-infected individuals....
Tali, E. Turgut E-mail: firstname.lastname@example.org
Spinal infections can be thought of as a spectrum of disease comprising spondylitis, discitis, spondylodiscitis, pyogenic facet arthropathy, epidural infections, meningitis, polyradiculopathy and myelitis. Radiological evaluations have gained importance in the diagnosis, treatment planning, treatment and treatment monitoring of the spinal infections. Conventional radiographs are usually the initial imaging study. The sensitivity and specificity of the plain radiographs are very low. The sensitivity of CT is higher while it lacks of specificity. Conventional CT has played minor role for the diagnosis of early spondylitis and disc space infection and for follow-up, researches are going on the value of MDCT. MRI is as sensitive, specific and accurate as combined nuclear medicine studies and the method of choice for the spondylitis. Low signal areas of the vertebral body, loss of definition of the end plates and interruption of the cortical continuity, destruction of the cortical margins are typical on T1WI whereas high signal of affected areas of the vertebral body and disc is typical on T2WI. Contrast is mandatory and increases conspicuity, specificity, and observer confidence in the diagnosis and facilitates the treatment planning. Contrast enhancement is the earliest sign and pathognomonic in the acute inflammatory episode and even in the subtle infection then persists to a varying degree for several weeks or months. The outcome of the treatment is influenced by the type of infection and by the degree of neurologic compromise before treatment. There is an increasing move away from surgical intervention towards conservative therapy, percutaneous drainage of abscess or both. It is therefore critical to monitor treatment response, particularly in the immuno-deficient population.
Graça, Bruno Miguel Silva Rosa da
Diabetes mellitus is responsible for diverse cardiovascular complications such as increased atherosclerosis in large arteries (carotids, aorta, and femoral arteries) and increased coronary atherosclerosis. A number of noninvasive tests are now available to detect coronary atherosclerotic disease, myocardial dysfunction and myocardial ischemia. The potential of cardiovascular imaging for the assessment of cardiovascular complications of type 2 diabetic patients is an active field of res...
Botha, Shani; Fourie, Carla M T; Schutte, Rudolph; Eugen-Olsen, Jesper; Pretorius, Ronel; Schutte, Aletta E
BACKGROUND: Elevated inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6) are well-known risk factors for cardiovascular mortality. The less familiar marker, soluble urokinase plasminogen activator receptor (suPAR), is known to predict cancer, infections and all-cause mo......BACKGROUND: Elevated inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6) are well-known risk factors for cardiovascular mortality. The less familiar marker, soluble urokinase plasminogen activator receptor (suPAR), is known to predict cancer, infections and all.......39, 95% CI 1.17-1.65) predicted all-cause mortality, while only suPAR (HR 1.40, 95% CI 1.04-1.87) and IL-6 (HR 1.61,95% CI 1.10-2.35) predicted cardiovascular mortality. The prognostic value of suPAR was independent of IL-6 and CRP (P≤0.015). CONCLUSION: SuPAR predicted both all-cause and cardiovascular...
A. Alonso Rosado
Full Text Available Muchos estudios clínicos han investigado la posible asociación entre periodontitis y la enfermedad coronaria. Algunos mantienen una asociación epidemiológica entre ellas y confirman las investigaciones previas que han demostrado que la inflamación periodontal crónica, la infección bacteriana persistente con la presencia de patógenos periodontales, las bolsas periodontales profundas, el número de dientes perdidos y otros marcadores periodontales, parecen ser factores de riesgo importantes para las enfermedades cardiovasculares. Las enfermedades periodontales y cardiovasculares son comunes, y su asociación es muy importante en salud pública. Ambas enfermedades comparten factores de riesgo, tales como la edad, tabaco, stress, estatus socioeconómico y metabolismo de las grasas, por lo que las posibilidades de sesgo son altas.A lot of clinial studies have investigated the possible association between periodontitis and coronary heart disease (CHD. Some of them supports the existence of epidemiologic associaciton between them and corfirms previous investigations that have found that chronic periodontal inflammation, persistent bacterial infection with the presence of major periodontal pathogens, deep periodontal pockets, the number of missing teeth and other periodontal markers, seems to be important risk factors for cardiovascular diseases. But it will be required to do better controlled and larger studies to identify it this biological mechanism are responsible for this increased risk and provide a convincing support of a casual association and in this way periodontal treatments could prevent CHD. Since periodontal disease and cardiovascular disease are common, their association is of significant public health importance. They share common risk factors, such as increasing age, smoking, stress, socioeconomic status, and body fat metabolism, the potential for confounding is substantial.
Kim, Daehoon; Baek, Yong-Soo; Lee, Misol; Uhm, Jae-Sun; Pak, Hui-Nam; Lee, Moon-Hyoung
Complete hardware removal is recommended in the case of patients with cardiovascular implantable electronic device (CIED) infections. However, the complete extraction of chronically implanted leads is not always achieved. The outcomes and optimal management of CIED infections with retained material after lead extractions have not been elucidated. In this case report, we present five patients with CIED infections with remnant lead tips even after lead extractions. Two patients had localized pocket infections, and were managed with antibiotics for a period of more than two weeks. The other three patients had infective endocarditis, and were managed with antibiotics for a period of more than four weeks. In one patient, the lead tip migrated to the right pulmonary artery, but did not produce any symptoms or complications. Only one of five patients experienced a resurgence of an infection. PMID:27482268
Padmavati, S.; U. Gupta; Agarwal, H.K.
Background & objectives: Studies on cardiovascular diseases (CVD) in India have shown about 10-20 per cent of cases with no obvious risk factors, raising a suspicion of infections as a cause. There is a paucity of data on this possible role of infections. This study was, therefore, undertaken to find out the association between infection due to Chlamydia pneumoniae and other organisms and coronary artery disease (CAD). Methods: Patients with CAD were selected in group I (acute myocardial infa...
Morimoto, Keisuke; Manago, Eri; Iioka, Hiroshi; Asada, Hideo; Nakagawa, Chiyo; Mikasa, Keiichi; Taniguchi, Shigeki; Kuwahara, Masamitsu
Mycobacterium abscessus is an acid-fast nontuberculous mycobacterium that grows rapidly in culture. The organism is found in dust, soil, and water and after trauma, it may infect skin and soft tissue. The organism is rarely found in humans, and infections occurring after cardiovascular surgery are rare clinical events. To our knowledge, only a few cases of hemodialysis arteriovenous graft infection and endocarditis caused by M. abscessus have been described. We reported a first case of patien...
Galeone Carlotta; Barbier Paolo; Gualtieri Laura; Tagliabue Claudia; Tremolati Elena; Ghiglia Silvia; Bosis Samantha; Salice Patrizia; Esposito Susanna; Marchisio Paola; Principi Nicola
Abstract Background Although the most frequent extra-pulmonary manifestations of respiratory syncytial virus (RSV) infection involve the cardiovascular system, no data regarding heart function in infants with bronchiolitis associated with RSV infection have yet been systematically collected. The aim of this study was to verify the real frequency of heart involvement in patients with bronchiolitis associated with RSV infection, and whether infants with mild or moderate disease also risk heart ...
Hans Christian Beck
Full Text Available There is an unmet need for new cardiovascular biomarkers. Despite this only few biomarkers for the diagnosis or screening of cardiovascular diseases have been implemented in the clinic. Thousands of proteins can be analysed in plasma by mass spectrometry-based proteomics technologies. Therefore, this technology may therefore identify new biomarkers that previously have not been associated with cardiovascular diseases. In this review, we summarize the key challenges and considerations, including strategies, recent discoveries and clinical applications in cardiovascular proteomics that may lead to the discovery of novel cardiovascular biomarkers.
Kovacic, Jason C; Castellano, Jose M; Farkouh, Michael E; Fuster, Valentin
There is a looming global epidemic of obesity and diabetes. Of all the end-organ effects caused by diabetes, the cardiovascular system is particularly susceptible to the biologic perturbations caused by this disease, and many patients may die from diabetes-related cardiovascular complications. Substantial progress has been made in understanding the pathobiology of the diabetic vasculature and heart. Clinical studies have illuminated the optimal way to treat patients with cardiovascular manifestations of this disease. This article reviews these aspects of diabetes and the cardiovascular system, broadly classified into diabetic vascular disease, diabetic cardiomyopathy, and the clinical management of the diabetic cardiovascular disease patient. PMID:24582091
Eckard, Allison Ross; McComsey, Grace A
HIV-infected individuals are at an increased risk of cardiovascular disease (CVD) and other HIV-related co-morbidities. This is due in part to dyslipidemia associated with antiretroviral therapy and increased inflammation and immune activation from chronic HIV infection. Statins not only have potent lipid-lowering properties but are also anti-inflammatory and immunomodulators. Studies suggest that statin therapy in the HIV-infected population may decrease the risk of CVD and other non-AIDS-defining co-morbidities. This review summarizes the recent literature on statin use in the HIV setting. PMID:26126687
Virani, Sean A; Dent, Susan; Brezden-Masley, Christine; Clarke, Brian; Davis, Margot K; Jassal, Davinder S; Johnson, Christopher; Lemieux, Julie; Paterson, Ian; Sebag, Igal A; Simmons, Christine; Sulpher, Jeffrey; Thain, Kishore; Thavendiranathan, Paaldinesh; Wentzell, Jason R; Wurtele, Nola; Côté, Marc André; Fine, Nowell M; Haddad, Haissam; Hayley, Bradley D; Hopkins, Sean; Joy, Anil A; Rayson, Daniel; Stadnick, Ellamae; Straatman, Lynn
Modern treatment strategies have led to improvements in cancer survival, however, these gains might be offset by the potential negative effect of cancer therapy on cardiovascular health. Cardiotoxicity is now recognized as a leading cause of long-term morbidity and mortality among cancer survivors. This guideline, authored by a pan-Canadian expert group of health care providers and commissioned by the Canadian Cardiovascular Society, is intended to guide the care of cancer patients with established cardiovascular disease or those at risk of experiencing toxicities related to cancer treatment. It includes recommendations and important management considerations with a focus on 4 main areas: identification of the high-risk population for cardiotoxicity, detection and prevention of cardiotoxicity, treatment of cardiotoxicity, and a multidisciplinary approach to cardio-oncology. All recommendations align with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Key recommendations for which the panel provides a strong level of evidence include: (1) that routine evaluation of traditional cardiovascular risk factors and optimal treatment of preexisting cardiovascular disease be performed in all patients before, during, and after receiving cancer therapy; (2) that initiation, maintenance, and/or augmentation of antihypertensive therapy be instituted per the Canadian Hypertension Educational Program guidelines for patients with preexisting hypertension or for those who experience hypertension related to cancer therapy; and (3) that investigation and management follow current Canadian Cardiovascular Society heart failure guidelines for cancer patients who develop clinical heart failure or an asymptomatic decline in left ventricular ejection fraction during or after cancer treatment. This guideline provides guidance to clinicians on contemporary best practices for the cardiovascular care of cancer patients. PMID:27343741
Maeder, Micha T; Mueller, Christian; Schoch, Otto D; Ammann, Peter; Rickli, Hans
Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder associated with "cardiovascular stress", i.e. cardiovascular risk factors, cardiovascular diseases, and an increased risk of heart failure, stroke, and death. Experimental and clinical studies have characterized potential underlying mechanisms including biventricular dysfunction, atherosclerosis, and arrhythmia. Assessment of these cardiovascular features of OSA requires a spectrum of clinical tools including ECG, echocardiography, exercise testing, and angiography. In contrast to many cardiovascular diseases, the role of blood biomarkers to characterize cardiovascular function and cardiovascular risk in OSA is poorly defined. In the present review we summarize the available data on biomarkers potentially providing information on cardiovascular features in OSA patients without overt cardiovascular disease. The vast majority of studies on biomarkers of cardiovascular stress in OSA evaluated B-type natriuretic peptide (BNP)/N-terminal-B-type natriuretic peptide (NT-proBNP), and cardiac troponins (cTn). Although some studies found significant associations between these cardiac biomarkers and the presence and severity of OSA, data remain conflicting. Also, the detailed pathophysiological mechanisms underlying the link between OSA and hemodynamic cardiac stress (BNP/NT-proBNP) and cardiomyocyte damage (cTn) are poorly understood. Major research efforts are required to establish the clinical role of cardiovascular biomarkers in patients with OSA. PMID:27380998
2009188 Multi-slice spiral CT appearances of pulmonary infections after liver transplantation.XIE Lixuan(谢丽璇),et al.Dept Imaging,Changzheng Hosp,2nd Milit Med Univ,Shanghai 200003.Chin J Radiol,2009;43(1):8-11.
... days. Impetigo is a common and contagious skin infection in young children, developing most often during hot, humid summers and usually appearing on the face around the nose, mouth, and ears. It can be caused by staphylococcal or streptococcal bacteria. (More often, it is caused by a ...
This podcast will educate health care providers on diagnosing baylisascariasis and on providing patients at risk of Baylisascaris infection with prevention messages. Created: 8/27/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria. Date Released: 8/28/2012.
... ll know that you’re drinking enough if your urine (pee) is light yellow or almost clear. Avoid scented hygiene products like bubble bath, sprays, scented pads, and scented tampons. They can be irritating. Having sex may increase your odds of some infections even if they’re ...
Rideout, V. C.
Use of complex cardiovascular system models, in conjunction with a large hybrid computer, in biomedical engineering courses. A cardiovascular blood pressure-flow model, driving a compartment model for the study of dye transport, was set up on the computer for use as a laboratory exercise by students who did not have the computer experience or skill to be able to easily set up such a simulation involving some 27 differential equations running at 'real time' rate. The students were given detailed instructions regarding the model, and were then able to study effects such as those due to septal and valve defects upon the pressure, flow, and dye dilution curves. The success of this experiment in the use of involved models in engineering courses was such that it seems that this type of laboratory exercise might be considered for use in physiology courses as an adjunct to animal experiments.
Rika Miyahara Kobayashi
Full Text Available Abstract OBJECTIVE To identify the perception of the coordinators of the Specialization Courses in Cardiovascular Nursing about inserting content from Information and Communication Technology (ICT and analyze them in relation to the technological competencies and regarding its applicability, relevance and importance in assisting, teaching and management. METHOD Descriptive study with 10 coordinators of the Specialization course in Cardiologic Nursing, who replied to the questionnaire for the development of technological competency adapted from the Technology Initiative Guidelines Education Reforms (TIGER, and analyzed using the Delphi technique for obtaining consensus and scored according to the relevance, pertinence and applicability using Likert scale according to degree of agreement. RESULTS Six courses developed ICT content. The contents of the TIGER were considered relevant, pertinent and applicable. CONCLUSION The coordinators recognize the need for technological competencies of the Cardiovascular Nurse for healthcare applicability.
Full Text Available Abstract Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds. Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death. The diseased carotid alone is responsible for one third of the 700,000 new or recurrent strokes occurring yearly in the United States. Imaging plays an important role in the management of atherosclerosis, and cardiovascular magnetic resonance (CMR of the carotid vessel wall is one promising modality in the evaluation of patients with carotid atherosclerotic disease. Advances in carotid vessel wall CMR allow comprehensive assessment of morphology inside the wall, contributing substantial disease-specific information beyond luminal stenosis. Although carotid vessel wall CMR has not been widely used to screen for carotid atherosclerotic disease, many trials support its potential for this indication. This review summarizes the current state of knowledge regarding carotid vessel wall CMR and its potential clinical application for management of carotid atherosclerotic disease.
Ganz, Melanie; de Bruijne, Marleen; Nielsen, Mads
Despite general acceptance that a healthy lifestyle and the treatment of risk factors can prevent the development of cardiovascular diseases (CVD), CVD are the most common cause of death in Europe and the United States. It has been shown that abdominal aortic calcifications (AAC) correlate strongly...... with coronary artery calcifications. Hence an early detection of aortic calcified plaques helps to predict the risk of related coronary diseases. Also since two thirds of the adverse events have no prior symptoms, possibilities to screen for risk in low cost imaging are important. To this end the Morphological...... imaging markers described. Finally we present that the MACD index predicts cardiovascular death with a hazard ratio of approximately four....
Libby, Peter; King, Kevin
The use of biomarkers has proven utility in cardiovascular medicine and holds great promise for future advances, but their application requires considerable rigor in thinking and methodology. Numerous confounding factors can cloud the clinical and investigative uses of biomarkers. Yet, the thoughtful and critical use of biomarkers can doubtless aid discovery of new pathogenic pathways, identify novel therapeutic targets, and provide a bridge between the laboratory and the clinic. Biomarkers can provide diagnostic and prognostic tools to the practitioner. The careful application of biomarkers can also help design and guide clinical trials required to establish the efficacy of novel interventions to improve patient outcomes. Point of care testing, technological advances, such as microfluidic and wearable devices, and the power of omics approaches all promise to elevate the potential contributions of biomarkers to discovery science, translation, clinical trials, and the practice of cardiovascular medicine. PMID:26543097
Wildermuth, S.; Leschka, S.; Duru, F.; Alkadhi, H. [Inst. for Diagnostic Radiology, Univ. Hospital Zurich (Switzerland)
The recently developed 64-slice CT scanner together with the use of 2-D and 3-D reconstructions can aid the cardiovascular surgeon and interventional radiologist in visualizing exact geometric relationships to plan and execute complex procedures via minimally invasive or standard approaches.Cardiac 64-slice CT considerably benefits from the high temporal and spatial resolution allowing the reliable depiction of small coronary segments. Similarly, abdominal vascular 64-slice CT became possible within short examination times and allowing an optimal arterial contrast bolus exploitation. We demonstrate four representative cardiac and abdominal examples using the new 64-slice CT technology which reveal the impact of the new scanner generation for cardiovascular treatment planning. (orig.)
Suda, Koichi; Tsuruta, Masashi; Eom, Jihyoun;
-regulate the systemic expression of IL-6, but whether they can ameliorate the cardiovascular dysfunction related to ALI is uncertain. We sought to determine whether IL-6 contributes to the cardiovascular dysfunction related to ALI, and whether budesonide/formoterol ameliorates this process. Wild-type mice were...... pretreated for 3 hours with intratracheal budesonide, formoterol, or both, before LPS was sprayed into their tracheas. IL-6-deficient mice were similarly exposed to LPS. Four hours later, bronchoalveolar lavage fluid (BALF) and serum were collected, and endothelial and cardiac functions were measured, using...... these impairments (vasodilatory responses to acetylcholine, P = 0.005; cardiac output, P = 0.025). Pretreatment with the combination of budesonide and formoterol, but not either alone, ameliorated the vasodilatory responses to acetylcholine (P = 0.018) and cardiac output (P < 0.001). These drugs also...
Xiaohui Duan; Yongfen Qi; Chaoshu Tang
The endoplasmic reticulum (ER) serves several important functions, mainly post-translational modification, folding and assembly of newly synthesized secretary proteins, synthesizing lipids and cellular calcium storage. Various factors can disrupt ER homeostasis and disturb its functions, which leads to the accumulation of unfolded and misfolded proteins and to potential cellular dysfunction and pathological consequences, collectively termed ER stress. Recent progress suggests that ER stress plays a key role in the immune response, diabetes, tumor growth, and some neurodegenerative diseases. In particular, ER stress is involved in several processes of cardiovascular diseases, such as ischemia/reperfusion injury, cardiomyopathy, cardiac hypertrophy, heart failure, and atherosclerosis. Further research on the relation of ER stress to cardiovascular diseases will greatly enhance the understanding of these pathological processes and provide novel avenues to potential therapies.
Matsuda, Naoyuki; Takatani, Yudai; Higashi, Tomoko; Inaba, Masato; Ejima, Tadashi
In the emergency and critical care medicine, infection is easy to merge to various basic conditions and diseases. In the social structure aging in critical care, the immune weakness was revealed as the result of severe infection and septic shock in the reduced function of neutrophils and lymphocytes. In the life-saving emergency care, cardiovascular diseases, diabetes, chronic renal failure and lever dysfunction are often observed, and the underlying diseases have the foundation of biological invasion after a first inflammatory attack of surgery, trauma, burn, and systemic injury. It will be placed into a susceptible situation such as artificial respiratory management. In this review, we discussed severe infection in emergency and critical care. It is necessary to pay attention to the drug resistance bacterias in own critical care setting by trends. PMID:26915247
Esposito, Pasquale; Tinelli, Carmine; Libetta, Carmelo; Gabanti, Elisa; Rampino, Teresa; Dal Canton, Antonio
Autoimmunity to heat shock protein 60 (HSP60) has been related to atherosclerosis. Chlamydia pneumoniae (CP), the most studied infectious agent implicated in promoting atherosclerosis, produces a form of HSP60, which can induce an autoimmune response, due to high antigenic homology with human HSP60 (hHSP60). In this study, we evaluated the correlations among anti-hHSP60 antibodies, CP infection, and cardiovascular disease (CVD) in a high-risk population, such as patients undergoing hemodialys...
Drechsler, Christiane; Pilz, Stefan; Obermayer-Pietsch, Barbara; Verduijn, Marion; Tomaschitz, Andreas; Krane, Vera; Espe, Katharina; Dekker, Friedo; Brandenburg, Vincent; März, Winfried; Ritz, Eberhard; Wanner, Christoph
Aims Dialysis patients experience an excess mortality, predominantly of sudden cardiac death (SCD). Accumulating evidence suggests a role of vitamin D for myocardial and overall health. This study investigated the impact of vitamin D status on cardiovascular outcomes and fatal infections in haemodialysis patients. Methods and results 25-hydroxyvitamin D [25(OH)D] was measured in 1108 diabetic haemodialysis patients who participated in the German Diabetes and Dialysis Study and were followed u...
Jindal, Ankur; Whaley-Connell, Adam; Brietzke, Stephen; Sowers, James R.
Obesity has reached epidemic proportions and is a significant public health concern. Obesity is associated with increased diabetes, cardiovascular and kidney disease, and associated morbidity and mortality. Despite the increasing public health problem of obesity, there is a dearth of effective treatment options. Following the FDA mandated withdrawal of sibutramine, the treatment options for obesity were limited to orlistat as the only pharmacological treatment option for long term management ...
Arsenian, M.A. (Univ. of Tennessee, Knoxville (USA))
Mediastinal radiation damages endothelial cells, with resulting loss of capillaries and ischemia at the level of the microcirculation. These changes lead to increases in collagen and proliferation of fibrous tissue throughout the heart. Cardiac dysfunction following radiotherapy is surprisingly common and may be due to pericardial, myocardial, valvular, conduction system, or coronary artery disease. Greater awareness of cardiotoxicity has prompted changes in radiation techniques that appear to reduce clinical cardiovascular complications.135 references.
Boutouyrie, P.; P. Bouchard; C. Mattout; Bourgeois, D.
Epidemiological studies have reported associations between periodontitis and vascular disease in Europe. The aim of this multi-centric study was to evaluate the relationship between periodontitis and the calculated risk of cardiovascular death in the French adult population. The survey employed 2144 dentate adult subjects of the First National Periodontal and Systemic Examination Survey (NPASES I). This nationally representative sample was obtained by a quota method. The subjects had a compl...
Hong, Young Mi
Although the clinical manifestations of cardiovascular disease (CVD), such as myocardial infarction, stroke, and peripheral vascular disease, appear from middle age, the process of atherosclerosis can begin early in childhood. The early stage and progression of atherosclerosis in youth are influenced by risk factors that include obesity, hypertension, dyslipidemia, and smoking, and by the presence of specific diseases, such as diabetes mellitus and Kawasaki disease (KD). The existing evidence...
Hunter, John G.; Dixon, John A.
The argon, carbon dioxide and neodymium-YAG lasers have been proposed as effective instruments for surgical procedures of the intact cardiovascular system. While argon and CO2 lasers cause superficial (0 to 1 mm) thermal injury, the Nd:YAG laser is better suited for effecting deep thermal necrosis (3 to 4 mm). Microsurgical vessel anastomoses can be done by “tissue welding” with any of the three clinical lasers. Myocardial revascularization may be accomplished by drilling “neocapillaries” in ...
There is growing consensus that systemic inflammation is at the heart of cardiovascular disease (CVD). Inflammation is a key feature of the immune system, functioning to defend tissue integrity and function. However, chronic stimulation of inflammatory mediators leads to lasting vascular reactivity, insulin resistance, hyperlipidemia, and, subsequently, chronic disease. Dietary practices to minimize inflammatory stimuli and CVD risk include regular intakes of fatty fish rich in the eicosapent...
Převorovská, Světlana; Maršík, František; Musil, Jan
Praha: FTVS UK Praha, Česká společnost pro biomechaniku, 2002 - (Jelen, K.; Kušová, S.; Chalupová, M.; Otáhal, J.), s. 51-53 ISBN 80-86317-23-4. [Biomechanics of man 2002. Čejkovice (CZ), 12.11.2002-15.11.2002] Institutional research plan: CEZ:AV0Z2076919 Keywords : cardiovascular system * respiratory system * numerical model Subject RIV: BK - Fluid Dynamics
Faita, Francesca; Vecoli, Cecilia; Foffa, Ilenia; Andreassi, Maria Grazia
In the last few years, the advent of next generation sequencing (NGS) has revolutionized the approach to genetic studies, making whole-genome sequencing a possible way of obtaining global genomic information. NGS has very recently been shown to be successful in identifying novel causative mutations of rare or common Mendelian disorders. At the present time, it is expected that NGS will be increasingly important in the study of inherited and complex cardiovascular diseases (CVDs). However, the...
Kenney, W. Larry; Craighead, Daniel H.; Alexander, Lacy M.
This brief review is based on a President’s Lecture presented at the Annual Meeting of the American College of Sports Medicine in 2013. The purpose of this review is to assess the effects of climate change and consequent increases in environmental heat stress on the aging cardiovascular system. The earth’s average global temperature is slowly but consistently increasing, and along with mean temperature changes come increases in heat wave frequency and severity. Extreme passive thermal stress ...
Gestational diabetes mellitus (GDM), defined as carbohydrate intolerance of any degree first recognized during pregnancy, complicates ~4% of all pregnancies in the United States. Several factors can increase one's risk of developing GDM, including obesity, family history of type 2 diabetes mellitus (T2DM), and race/ethnicity. Conversely, a history of GDM can increase the risk of developing not only T2DM but also cardiovascular disease (CVD) independent of a diagnosis of T2DM. Several investig...
Převorovská, Světlana; Maršík, František
Vol. 3. Praha : UTAM AV ČR, 2000 - (Náprstek, J.; Minster, J.), s. 91-96 ISBN 80-86246-06-X. [International conference Engineering mechanics 2000. Svratka (CZ), 15.05.2000-18.05.2000] R&D Projects: GA ČR GA106/98/1373; GA AV ČR KSK1076602 Keywords : numerical simulation * baroreflex control * cardiovascular system Subject RIV: BO - Biophysics
João Marcelo de Queiroz Miranda; Elisabete de Marco Ornelas; Rogério Brandão Wichi
Introduction: Obesity is a disease of increasing prevalence, which currently assumes an epidemic main public health problem in contemporary society. Stems from genetic, behavioral, environmental, and can start at any age. However when it comes within the first years of life, predisposing to its presence at older ages and is associated with various comorbidities. Objective: To review the literature on the etiology of childhood obesity and to identify major cardiovascular risk factors associate...
Manchanda, S C
Normal and abnormal cardiovascular response to high altitude (HA) hypoxia were studied in 98 healthy subjects and in 15 patients with HA pulmonary oedema (HAPO) and acute mountain sickness (AMS) at an altitudeof 3,658 m. The healthy sea level (SL) residents showed marked blood volume changes during the first week with pulmonary hypotension and depression of left ventricular (LV) performance and physical work capacity (PWC). The HA natives, however, had better LV performance and PWC indicating...
Bairey Merz, C. Noel; Dwyer, James; Nordstrom, Cheryl K; Walton, Kenneth G.; Salerno, John W.; Schneider, Robert H.
The remarkable decline in cardiovascular disease (CVD) experienced in developed countries over the last 40 years appears to have abated. Currently, many CVD patients continue to show cardiac events despite optimal treatment of traditional risk factors. This evidence suggests that additional interventions, particularly those aimed at nontraditional factors, might be useful for continuing the decline. Psychosocial stress is a newly recognized (nontraditional) risk factor that appears to contrib...
Cooney, Marie Therese
A young person with many risk factors may have the same level of risk as an older person with no risk factors. Thus a high-risk 40-year-old may have a risk age of 60 years or more. The aim of the study was to derive a generic equation for risk age, construct risk age charts, and explore the hypothesis that risk age is similar regardless of the cardiovascular disease (CVD) end point used.
Killian, Lindsey M
The World Anti-Doping Agency prohibits and monitors the use of stimulants in sport. The effects of stimulants on enhancing performance in sport is uncertain. Stimulants have central and peripheral effects that can enhance mental or physical function. They are used therapeutically to treat a range of conditions most notable ADHD, depression and nasal decongestion. The present study looked at the peripheral sympathomimetic effects of stimulants on the cardiovascular system. The agents that were...
Ranhel, André Silva; Mesquita, Evandro Tinoco
The historical period called the Middle Ages, a long interval between the 5th and the 15th centuries, is still commonly known as the Dark Ages, especially in the area of health sciences. In the last decades, this "classic" view of the Middle Ages has been gradually modified with advances in historiographical studies and the history of science. During that period in Western Europe, knowledge about the human body suffered a regression in terms of anatomy and physiology, with the predominance of religious conceptions mainly about diseases and their treatments. Knowledge on the cardiovascular system and heart diseases has been classically described as a repetition of the concepts developed by Galen from the dissection of animals and his keen sense of observation. However, the Middle East, especially Persia, was the birth place of a lot of intellectuals who preserved the ancient knowledge of the Greeks while building new knowledge and practices, especially from the 8th to the 13th century. The invasion of the Arabs in North of Africa and the Iberian Peninsula and the eclosion of the Crusades resulted in a greater contact between the East and the West, which in turn brought on the arrival of the Arab medical knowledge, among others, to 12th century Europe. Such fact contributed to an extremely important change in the scientific medical knowledge in the West, leading to the incorporation of different concepts and practices in the field of cardiovascular Medicine. The new way of teaching and practicing Medicine of the great Arab doctors, together with the teaching hospitals and foundations in the Koran, transformed the Medicine practiced in Europe definitely. The objective of this paper is to describe the knowledge drawn up from the Middle Ages about the cardiovascular system, its understanding and therapeutic approach to cardiologists and cardiovascular surgeons. PMID:27556317
Arabadzhi Liliya Ivanivna
Data about adaptive capacity of cardiovascular system of 106 students were analyzed. Using the method of R.M. Bayevskiy, current adaptive capacity of students’ organisms was estimated. The number of students with stress adaptation mechanisms significantly increased with their age (from 17 to 23 years). In our opinion, this could be explained by negative impact of urbanization, significant learning overload and lack of physical activity among the students. Dependence of the adaptive capacity...
Steinhubl, Steven R.; Wineinger, Nathan E.; Sheila ePatel; Boeldt, Debra L; Geoffrey eMackellar; Valencia ePorter; Jacob eRedmond; Muse, Evan D.; Laura eNicholson; Deepak eChopra; Topol, Eric J.
Background: A number of benefits have been described for the long-term practice of meditation, yet little is known regarding the immediate neurological and cardiovascular responses to meditation. Wireless sensor technology allows, for the first time, multi-parameter and quantitative monitoring of an individual’s responses during meditation. The present study examined inter-individual variations to meditation through continuous monitoring of EEG, blood pressure, heart rate and its variabilit...
Garbern, Jessica C.; Mummery, Christine L.; Lee, Richard T.
There is an urgent clinical need to develop new therapeutic approaches to treat heart failure, but the biology of cardiovascular regeneration is complex. Model systems are required to advance our understanding of biological mechanisms of cardiac regeneration as well as to test therapeutic approaches to regenerate tissue and restore cardiac function following injury. An ideal model system should be inexpensive, easily manipulated, easily reproducible, physiologically representative of human di...
Márcio R. V. Santos; Flávia V. Moreira; Byanka P. Fraga; Damião P. de Souza; Leonardo R. Bonjardim; Lucindo J. Quintans-Junior
The monoterpenes are secondary metabolites of plants. They have various pharmacological properties including antifungal, antibacterial, antioxidant, anticancer, anti-spasmodic, hypotensive, and vasorelaxant. The purpose of this research was to review the cardiovascular effects of monoterpenes. The data in this resarch were collected using the Internet portals Pubmed, Scopus, and ISI Web of Knowledge between the years 1987 and 2010. In the study 33 monoterpenes were included, which were relate...
Giri Shivraman; Smith Sakima; Velez Michael R; Essa Essa; Raman Subha V; Gumina Richard J
Abstract The clinical presentation of beriberi can be quite varied. In the extreme form, profound cardiovascular involvement leads to circulatory collapse and death. This case report is of a 72 year-old male who was admitted to the Neurology inpatient ward with progressive bilateral lower extremity weakness and parasthesia. He subsequently developed pulmonary edema and high output cardiac failure requiring intubation and blood pressure support. With the constellation of peripheral neuropathy,...
Bluemke David A; Osman Nael F; Cheng Susan; Shehata Monda L; Lima João AC
Abstract Cardiovascular magnetic resonance (CMR) is currently the gold standard for assessing both global and regional myocardial function. New tools for quantifying regional function have been recently developed to characterize early myocardial dysfunction in order to improve the identification and management of individuals at risk for heart failure. Of particular interest is CMR myocardial tagging, a non-invasive technique for assessing regional function that provides a detailed and compreh...
Bradlow William M; R Gibbs J Simon; Mohiaddin Raad H
Abstract Pulmonary hypertension represents a group of conditions characterized by higher than normal pulmonary artery pressures. Despite improved treatments, outcomes in many instances remain poor. In recent years, there has been growing interest in the use of Cardiovascular Magnetic Resonance (CMR) in patients with pulmonary hypertension. This technique offers certain advantages over other imaging modalities since it is well suited to the assessment of the right ventricle and the proximal pu...
Lanza Gregory M; Caruthers Shelton D; Winter Patrick M; Wickline Samuel A
Abstract Cardiovascular magnetic resonance (CMR) molecular imaging aims to identify and map the expression of important biomarkers on a cellular scale utilizing contrast agents that are specifically targeted to the biochemical signatures of disease and are capable of generating sufficient image contrast. In some cases, the contrast agents may be designed to carry a drug payload or to be sensitive to important physiological factors, such as pH, temperature or oxygenation. In this review, examp...
Zdravković Marija; Krotin Mirjana; Deljanin-Ilić Marina; Zdravković Darko
Definition of quality of life. In recent years, quality of life has become a very important measure of treatment of disease and successful therapy, regarding not only general health of an individual patient but also of the whole population In 1993 the WHO proclaimed 'Vision of health for all', as 'Add years to life' but also 'Add life to years', emphasizing quality of life to be as important as life duration. Although the remaining life expectancy in patients with cardiovascular disease is pr...
Morris, Paul D; Narracott, Andrew; von Tengg-Kobligk, Hendrik; Silva Soto, Daniel Alejandro; Hsiao, Sarah; Lungu, Angela; Evans, Paul; Bressloff, Neil W; Lawford, Patricia V; Hose, D Rodney; Gunn, Julian P
This paper reviews the methods, benefits and challenges associated with the adoption and translation of computational fluid dynamics (CFD) modelling within cardiovascular medicine. CFD, a specialist area of mathematics and a branch of fluid mechanics, is used routinely in a diverse range of safety-critical engineering systems, which increasingly is being applied to the cardiovascular system. By facilitating rapid, economical, low-risk prototyping, CFD modelling has already revolutionised research and development of devices such as stents, valve prostheses, and ventricular assist devices. Combined with cardiovascular imaging, CFD simulation enables detailed characterisation of complex physiological pressure and flow fields and the computation of metrics which cannot be directly measured, for example, wall shear stress. CFD models are now being translated into clinical tools for physicians to use across the spectrum of coronary, valvular, congenital, myocardial and peripheral vascular diseases. CFD modelling is apposite for minimally-invasive patient assessment. Patient-specific (incorporating data unique to the individual) and multi-scale (combining models of different length- and time-scales) modelling enables individualised risk prediction and virtual treatment planning. This represents a significant departure from traditional dependence upon registry-based, population-averaged data. Model integration is progressively moving towards 'digital patient' or 'virtual physiological human' representations. When combined with population-scale numerical models, these models have the potential to reduce the cost, time and risk associated with clinical trials. The adoption of CFD modelling signals a new era in cardiovascular medicine. While potentially highly beneficial, a number of academic and commercial groups are addressing the associated methodological, regulatory, education- and service-related challenges. PMID:26512019
van Schie, Rianne; Verhoef, Talitha; Maitland-van der Zee, Anke-Hilse; de Boer, Anthonius; van der Meer, F. J. M.; Redekop, Ken; Thariani, Rahber
textabstractIntroduction: Pharmacogenetics is the study of variations in DNA sequence as related to drug response (European Medicines Agency [EMA], 2007). Several gene-drug interactions have been discovered in the field of cardiovascular diseases (CVDs). These gene-drug interactions can help to identify nonresponse to drugs, estimate dose requirements or identify an increased risk of developing adverse drug reactions. An individualized approach based on pharmacogenetic testing will provide ph...
Yılmaz, Osman; Bilici, Meki; Ceylan, Özben; Karademir, Selmin; Örün, Utku Arman; Özgür, Senem; Keskin, Mahmut; Şenocak, Filiz
Objectives: The aim of our study is to investigate the frequency of structural heart diseases in patients with Marfan syndrome (MS) and to reveal the importance of clinical follow-up in MS. Materials and methods: Study population consisted of 17 patients admitted to the Pediatric Cardiology department between January 2005 and March 2010 with the diagnosis of MS according to the Ghent criteria. Patients were evaluated for the eye, genetic and the cardiovascular system abnormalities. Physic...
Ong, Sang-Bing; Andrew R. Hall; Hausenloy, Derek J
Significance: Mitochondria are dynamic organelles capable of changing their shape and distribution by undergoing either fission or fusion. Changes in mitochondrial dynamics, which is under the control of specific mitochondrial fission and fusion proteins, have been implicated in cell division, embryonic development, apoptosis, autophagy, and metabolism. Although the machinery for modulating mitochondrial dynamics is present in the cardiovascular system, its function there has only recently be...
Zheni Shen; Cunqi Ye; Keanna McCain; Greenberg, Miriam L.
Cardiolipin (CL), the signature phospholipid of mitochondrial membranes, is crucial for both mitochondrial function and cellular processes outside of the mitochondria. The importance of CL in cardiovascular health is underscored by the life-threatening genetic disorder Barth syndrome (BTHS), which manifests clinically as cardiomyopathy, skeletal myopathy, neutropenia, and growth retardation. BTHS is caused by mutations in the gene encoding tafazzin, the transacylase that carries out the secon...
Recent evidence supports the hypothesis that tea does, in fact protect against cardiovascular disease. Some of the latest data by Hodgson et al, suggests that dietary flavonoids in tea significantly improves endothelium-dependent and endothelium-independent flow-mediated vasodilation (2.3%; P=.008 & 4.2%; P=.03 respectively). Similar results were obtained in a study by Duffy et al, where it was found that short- and long-term tea consumption significantly improved endothelium dependent flow-m...
Zielinski, Krzysztof; Kozarski, Maciej; Fresiello, Libera; Di Molfetta, Arianna; Ferrari, Gianfranco; Peristeris, Spiros; Darowski, Marek
Aim: The use of VAD training is a relevant issue involving physicians, care givers and, to some extent, patients. The aim of this work is the development of a hybrid (hydro-computational) cardiovascular simulator (HCS) as a support to learning of VAD control and of VAD-circulatory system interactions. Methods: The model is a component of a comprehensive platform aimed at VAD training. It consists of the lumped parameter computational circulatory model and the hybrid (hydro-computational) inte...
Huxley, Virginia H.; Wang, Jianjie
The vital role of the cardiovascular (CV) system is maintenance of body functions via the matching of exchange to tissue metabolic demand. Sex-specific differences in the regulatory mechanisms of CV function and the metabolic requirements of men and women, respectively, have been identified and appreciated. This review focuses on sex differences of parameters influencing exchange at the point of union between blood and tissue, the microvasculature. Microvascular architecture, blood pressure (...
戈峰; 李泽坚; 柯美云
Using 3 non-invasive tests,abnormalities of cardiovascular reflex function were found in 7 of 15 patients with achalasia.Abnormalities of heart rate responses to the Valsalva maneuver,deep breathing ,and standing were moted in patients with autonomic neuropathy defect.The findings are consistent with the hypothesis that an abnormality of vagal function may contribute to the pathogenesis of achalasia.
Piscitelli, Prisco; Iolascon, Giovanni; Gimigliano, Francesca; Gimigliano, Alessandra; Marinelli, Alessandra; Di Nuzzo, Rosalba; Colì, Giuseppe; Di Paola, Lucia; Gianicolo, Elena; Chitano, Giovanna; Sbenaglia, Vincenzo; Gismondi, Raffaella; Greco, Marco; Camilli, Daniele; Modena, Maria Grazia
Life expectancy in Italy is estimated to rise to 77.9 and 84.4 years in next years. Increased life expectancy is associated with a greater frailty of elderly people and an increased prevalence of chronic and degenerative illnesses such as cardiovascular diseases and osteoporosis. The impact of osteoporotic hip fractures in Italy is very similar to that of acute myocardial infarction (AMI), and there is a need for further epidemiological investigations concerning both the pathologies, as well ...
Gholamhossein Amirhakimi; Zohreh Karamizadeh; Gholamhossein Ajami; Homa Ilkhanipoor; Hamdollah Karamifar; Ali-Mohammad Shakiba
Objective: Osteogenesis imperfecta is a hereditary disease resulting from mutation in type I procollagen genes. One of the extra skeletal manifestations of this disease is cardiac involvement. The prevalence of cardiac involvement is still unknown in the children with osteogenesis imperfecta. The present study aimed to investigate the prevalence of cardiovascular abnormalities in these patients.Methods: 24 children with osteogenesis imperfecta and 24 normal children who were matched with the ...
Forman, Daniel E.; Karen Alexander; Brindis, Ralph G.; Curtis, Anne B; Mathew Maurer; Rich, Michael W.; Laurence Sperling; Nanette K. Wenger
Longevity is increasing and the population of older adults is growing. The biology of aging is conducive to cardiovascular disease (CVD), such that prevalence of coronary artery disease, heart failure, valvular heart disease, arrhythmia and other disorders are increasing as more adults survive into old age. Furthermore, CVD in older adults is distinctive, with management issues predictably complicated by multimorbidity, polypharmacy, frailty and other complexities of care that increase manag...
Vijay Dahya; Spottiswoode, Bruce S.
Cardiovascular magnetic resonance imaging (CMR) is a powerful problem-solving tool and arguably offers the most comprehensive assessment of cardiac morphology and function, as well as the opportunity of rebuilding the bridge between cardiologists and radiologists. The role of CMR-trained imaging physicists is also valuable, and many CMR centres harmoniously incorporate these three sub-specialty fields. This paper comprises an overview of several CMR techniques, outlining both the strengths...
Full Text Available Cardiovascular magnetic resonance imaging (CMR is a powerful problem-solving tool and arguably offers the most comprehensive assessment of cardiac morphology and function, as well as the opportunity of rebuilding the bridge between cardiologists and radiologists. The role of CMR-trained imaging physicists is also valuable, and many CMR centres harmoniously incorporate these three sub-specialty fields. This paper comprises an overview of several CMR techniques, outlining both the strengths and limitations of the modality.
Eman M. Alissa
Full Text Available Cardiovascular disease (CVD is an increasing world health problem. Traditional risk factors fail to account for all deaths from CVD. It is mainly the environmental, dietary and lifestyle behavioral factors that are the control keys in the progress of this disease. The potential association between chronic heavy metal exposure, like arsenic, lead, cadmium, mercury, and CVD has been less well defined. The mechanism through which heavy metals act to increase cardiovascular risk factors may act still remains unknown, although impaired antioxidants metabolism and oxidative stress may play a role. However, the exact mechanism of CVD induced by heavy metals deserves further investigation either through animal experiments or through molecular and cellular studies. Furthermore, large-scale prospective studies with follow up on general populations using appropriate biomarkers and cardiovascular endpoints might be recommended to identify the factors that predispose to heavy metals toxicity in CVD. In this review, we will give a brief summary of heavy metals homeostasis, followed by a description of the available evidence for their link with CVD and the proposed mechanisms of action by which their toxic effects might be explained. Finally, suspected interactions between genetic, nutritional and environmental factors are discussed.
Yu, Hee Tae; Park, Sungha; Shin, Eui-Cheol; Lee, Won-Woo
Age-related changes in the immune system, commonly termed "immunosenescence," contribute to deterioration of the immune response and fundamentally impact the health and survival of elderly individuals. Immunosenescence affects both the innate and adaptive immune systems; however, the most notable changes are in T cell immunity and include thymic involution, the collapse of T cell receptor (TCR) diversity, an imbalance in T cell populations, and the clonal expansion of senescent T cells. Senescent T cells have the ability to produce large quantities of proinflammatory cytokines and cytotoxic mediators; thus, they have been implicated in the pathogenesis of many chronic inflammatory diseases. Recently, an increasing body of evidence has suggested that senescent T cells also have pathogenic potential in cardiovascular diseases, such as hypertension, atherosclerosis, and myocardial infarction, underscoring the detrimental roles of these cells in various chronic inflammatory responses. Given that cardiovascular disease is the number one cause of death worldwide, there is great interest in understanding the contribution of age-related immunological changes to its pathogenesis. In this review, we discuss general features of age-related alterations in T cell immunity and the possible roles of senescent T cells in the pathogenesis of cardiovascular disease. PMID:26188489
Fliegner, Daniela; Gerdes, Christoph; Meding, Jörg; Stasch, Johannes-Peter
Cardiovascular diseases are still the first leading cause of death and morbidity in developed countries. Experimental cardiology research and preclinical drug development in cardiology call for appropriate and especially clinically relevant in vitro and in vivo studies. The use of animal models has contributed to expand our knowledge and our understanding of the underlying mechanisms and accordingly provided new approaches focused on the improvement of diagnostic and treatment strategies of various cardiac pathologies.Numerous animal models in different species as well as in small and large animals have been developed to address cardiovascular complications, including heart failure, pulmonary hypertension, and thrombotic diseases. However, a perfect model of heart failure or other indications that reproduces every aspect of the natural disease does not exist. The complexity and heterogeneity of cardiac diseases plus the influence of genetic and environmental factors limit to mirror a particular disease with a single experimental model.Thus, drug development in the field of cardiology is not only very challenging but also inspiring; therefore animal models should be selected that reflect as best as possible the disease being investigated. Given the wide range of animal models, reflecting critical features of the human pathophysiology available nowadays increases the likelihood of the translation to the patients. Furthermore, this knowledge and the increase of the predictive value of preclinical models help us to find more efficient and reliable solutions as well as better and innovative treatment strategies for cardiovascular diseases. PMID:26552402
Chandra Sekhar Akula,
Full Text Available Cardiovascular disease, including stroke, is the leading cause of illness and death in the India. A number of studies have shown that inflammation of blood vessels is one of the major factors that increase the incidence of heart diseases, including arteriosclerosis (clogging of the arteries, stroke and myocardial infraction or heart attack. Studies have associated obesity and other components of metabolic syndrome, cardiovascular risk factors, with lowgradeinflammation. Furthermore, some findings suggest that drugs commonly prescribed to the lower cholesterol also reduce this inflammation, suggesting an additional beneficial effect of the stains. The recent development of angiotensin 11 (Ang11 receptor antagonists has enabled to improve significantly the tolerability profile of thisgroup of drugs while maintaining a high clinical efficacy. ACE2 is expressed predominantly in the endothelium and in renal tubular epithelium, and it thus may be an import new cardiovascular target. In the present study we modeled the structure of ACE and designed an inhibitor through using ARGUS lab and the validation of the Drug molecule is done basing on QSAR properties and Cache for this protein through CADD.
Maria Alessandra Gammone
Full Text Available Carotenoids are a class of natural, fat-soluble pigments found principally in plants. They have potential antioxidant biological properties because of their chemical structure and interaction with biological membranes. Epidemiologic studies supported the hypothesis that antioxidants could be used as an inexpensive means of both primary and secondary cardiovascular disease (CVD prevention. In fact, the oxidation of low-density lipoproteins (LDL in the vessels plays a key role in the development of atherosclerotic lesions. The resistance of LDL to oxidation is increased by high dietary antioxidant intake, so that carotenoids, as part of food patterns such as the Mediterranean diet, may have beneficial effects on cardiovascular health too. Further properties of carotenoids leading to a potential reduction of cardiovascular risk are represented by lowering of blood pressure, reduction of pro-inflammatory cytokines and markers of inflammation (such as C-reactive protein, and improvement of insulin sensitivity in muscle, liver, and adipose tissues. In addition, recent nutrigenomics studies have focused on the exceptional ability of carotenoids in modulating the expression of specific genes involved in cell metabolism. The aim of this review is to focus attention to this effect of some carotenoids to prevent CVD.
Juan José Navarro López
Full Text Available Fundaments: Physical exercise produces changes in almost all the organism systems, the cardiovascular function is the main affected, important changes happen in the central heart bomb and in the outlying vasomotor regulation of the sanguine distribution. It has been demonstrated that the exercise favors modifications in the risk factors that comprises the lipídic patron, the glicemia, the overweight and some described more recently as the fibrinogen and the factors of the clotting. Objective : To analyze and to compare the effects of complex exercises in the patients included in the cardiovascular rehabilitation. Methods : Types study before and after, the total patients (30 included in the program of cardiovascular rehabilitation during 4 months in the Cienfuegos University Hospital ¨Dr. Gustavo Aldereguía Lima¨. Results : Out of the total of patient, 25 are males (83.3%, the diagnoses were: myocardium sharp attack, arterial hypertension with angina, myocardial revascularization and stable angina. In a highly significant way p < 0,0001 double product varied as much at the end of the jogging and the ergometric parameters: the maxim body burden reached, tolerated and the total time of exercise. In a significant way p < 0,001 varied the double product of the ergometric test and the units of the basal metabolism. Conclusions: For the clinical changes, ergometrics and psychological evaluated in those patients we can consider them integrally rehabilitated with this group of exercises.
Favot, Mark; Courage, Cheryl; Ehrman, Robert; Khait, Lyudmila; Levy, Phillip
Echocardiography has become a critical tool in the evaluation of patients presenting to the emergency department (ED) with acute cardiovascular diseases and undifferentiated cardiopulmonary symptoms. New technological advances allow clinicians to accurately measure left ventricular (LV) strain, a superior marker of LV systolic function compared to traditional measures such as ejection fraction, but most emergency physicians (EPs) are unfamiliar with this method of echocardiographic assessment. This article discusses the application of LV longitudinal strain in the ED and reviews how it has been used in various disease states including acute heart failure, acute coronary syndromes (ACS) and pulmonary embolism. It is important for EPs to understand the utility of technological and software advances in ultrasound and how new methods can build on traditional two-dimensional and Doppler techniques of standard echocardiography. The next step in competency development for EP-performed focused echocardiography is to adopt novel approaches such as strain using speckle-tracking software in the management of patients with acute cardiovascular disease. With the advent of speckle tracking, strain image acquisition and interpretation has become semi-automated making it something that could be routinely added to the sonographic evaluation of patients presenting to the ED with cardiovascular disease. Once strain imaging is adopted by skilled EPs, focused echocardiography can be expanded and more direct, phenotype-driven care may be achievable for ED patients with a variety of conditions including heart failure, ACS and shock. PMID:26823931
Pagourelias, Efstathios D.; Zorou, Paraskevi G.; Tsaligopoulos, Miltiadis; Athyros, Vasilis G.; Karagiannis, Asterios; Efthimiadis, Georgios K.
Carbon dioxide (CO2) balneotherapy is a kind of remedy with a wide spectrum of applications which have been used since the Middle Ages. However, its potential use as an adjuvant therapeutic option in patients with cardiovascular disease is not yet fully clarified. We performed a thorough review of MEDLINE Database, EMBASE, ISI WEB of Knowledge, COCHRANE database and sites funded by balneotherapy centers across Europe in order to recognize relevant studies and aggregate evidence supporting the use of CO2 baths in various cardiovascular diseases. The three main effects of CO2 hydrotherapy during whole body or partial immersion, including decline in core temperature, an increase in cutaneous blood flow, and an elevation of the score on thermal sensation, are analyzed on a pathophysiology basis. Additionally, the indications and contra-indications of the method are presented in an evidence-based way, while the need for new methodologically sufficient studies examining the use of CO2 baths in other cardiovascular substrates is discussed.
Calandra-Buonaura, Giovanna; Provini, Federica; Guaraldi, Pietro; Plazzi, Giuseppe; Cortelli, Pietro
Animal and human studies have shown that disorders of the autonomic nervous system may influence sleep physiology. Conversely, sleep disorders may be associated with autonomic dysfunctions. The current review describes the clinical presentation, supposed pathogenetic mechanisms and the diagnostic and prognostic implications of impaired cardiovascular autonomic control in sleep disorders. This dysfunction may result from a common pathogenetic mechanism affecting both autonomic cardiovascular control and sleep, as in fatal familial insomnia, or it may be mainly caused by the sleep disorder, as observed in obstructive sleep apnoea. For other sleep disorders, like primary insomnia, restless legs syndrome, narcolepsy type 1 and rapid eye movement sleep behaviour disorder, the causal link with the autonomic dysfunction and its possible impact on health remains unsettled. Given its clinical implications, most of the data available suggest that a systematic assessment of the association between sleep disorders and impaired autonomic control of the cardiovascular system is warranted. Understanding the mechanism of this association may also yield insights into the interaction between the autonomic nervous system and sleep. PMID:26146026
González Cañete, Natalia; Durán Agüero, Samuel
Soya isoflavones represent a group of non-nutritive, bioactive compounds, of non-steroidal phenolic nature that are present in soy bean and derived foods. They share with other compounds the capacity of binding to estrogenic receptors from different cells and tissues so that they may act as phytoestrogens. The current interest in these compounds comes from the knowledge that in Asian populations with high levels of their consumption the prevalence of cancer and cardiovascular disease is lower, as compared to the Western countries populations. This cardiovascular benefit would be the result not only of the modulation of plasma lipids, which is a widely studied mechanism. This paper reviews the published evidence about the beneficial effects of soya isoflavones and the different mechanisms of action that would benefit cardiovascular health and that surpass the mechanisms traditionally approached such as the modulation of plasma lipids, and that implicate the regulation of cellular and enzymatic functions in situations such as inflammation, thrombosis, and atherosclerotic progression. PMID:24972463
Nails - fungal infection; Onychomycosis; Infection - fungal - nails; Tinea unguium ... the hair, nails, and outer skin layers. Common fungal infections include: Athlete's foot Jock itch Ringworm on the ...
Allison, Beth J; Kaandorp, Joepe J; Kane, Andrew D; Camm, Emily J; Lusby, Ciara; Cross, Christine M; Nevin-Dolan, Rhianon; Thakor, Avnesh S; Derks, Jan B; Tarry-Adkins, Jane L; Ozanne, Susan E; Giussani, Dino A
Aging and developmental programming are both associated with oxidative stress and endothelial dysfunction, suggesting common mechanistic origins. However, their interrelationship has been little explored. In a rodent model of programmed cardiovascular dysfunction we determined endothelial function and vascular telomere length in young (4 mo) and aged (15 mo) adult offspring of normoxic or hypoxic pregnancy with or without maternal antioxidant treatment. We show loss of endothelial function [maximal arterial relaxation to acetylcholine (71 ± 3 vs. 55 ± 3%) and increased vascular short telomere abundance (4.2-1.3 kb) 43.0 ± 1.5 vs. 55.1 ± 3.8%) in aged vs. young offspring of normoxic pregnancy (P compared with aged offspring of untreated hypoxic pregnancy had lower levels of short telomeres (vascular short telomere length abundance 35.1 ± 2.5 vs. 48.2 ± 2.6%) and of plasma proinflammatory chemokine (24.6 ± 2.8 vs. 36.8 ± 5.5 pg/ml, P cardiovascular aging and developmental programming of cardiovascular disease, and aging being decelerated by antioxidants even prior to birth.-Allison, B. J., Kaandorp, J. J., Kane, A. D., Camm, E. J., Lusby, C., Cross, C. M., Nevin-Dolan, R., Thakor, A. S., Derks, J. B., Tarry-Adkins, J. L., Ozanne, S. E., Giussani, D. A. Divergence of mechanistic pathways mediating cardiovascular aging and developmental programming of cardiovascular disease. PMID:26932929
Full Text Available Abstract Background The purpose of the Finnish Cardiovascular Study (FINCAVAS is to construct a risk profile – using genetic, haemodynamic and electrocardiographic (ECG markers – of individuals at high risk of cardiovascular diseases, events and deaths. Methods and design All patients scheduled for an exercise stress test at Tampere University Hospital and willing to participate have been and will be recruited between October 2001 and December 2007. The final number of participants is estimated to reach 5,000. Technically successful data on exercise tests using a bicycle ergometer have been collected of 2,212 patients (1,400 men and 812 women by the end of 2004. In addition to repeated measurement of heart rate and blood pressure, digital high-resolution ECG at 500 Hz is recorded continuously during the entire exercise test, including the resting and recovery phases. About 20% of the patients are examined with coronary angiography. Genetic variations known or suspected to alter cardiovascular function or pathophysiology are analysed to elucidate the effects and interactions of these candidate genes, exercise and commonly used cardiovascular medications. Discussion FINCAVAS compiles an extensive set of data on patient history, genetic variation, cardiovascular parameters, ECG markers as well as follow-up data on clinical events, hospitalisations and deaths. The data enables the development of new diagnostic and prognostic tools as well as assessments of the importance of existing markers.
Glurich, Ingrid; Grossi, Sara; Albini, Boris; Ho, Alex; Shah, Rashesh; Zeid, Mohamed; Baumann, Heinz; Genco, Robert J.; De Nardin, Ernesto
Epidemiological studies have implicated periodontal disease (PD) as a risk factor for the development of cardiovascular disease (CVD). These studies addressed the premise that local infection may perturb the levels of systemic inflammatory mediators, thereby promoting mechanisms of atherosclerosis. Levels of inflammatory mediators in the sera of subjects with only PD, only CVD, both diseases, or neither condition were compared. Subjects were assessed for levels of C-reactive protein (CRP), serum amyloid A (SAA), ceruloplasmin, α1-acid-glycoprotein (AAG), α1-antichymotrypsin (ACT), and the soluble cellular adhesion molecules sICAM-1 and sVCAM by enzyme-linked immunoabsorbent and/or radial immunodiffusion assays. CRP levels in subjects with either condition alone were elevated twofold above subjects with neither disease, whereas a threefold increase was noted in subjects with both diseases (P = 0.0389). Statistically significant increases in SAA and ACT were noted in subjects with both conditions compared to those with one or neither condition (P = 0.0162 and 0.0408, respectively). Ceruloplasmin levels were increased in subjects with only CVD (P = 0.0001). Increases in sVCAM levels were noted in all subjects with CVD (P = 0.0054). No differences in sICAM levels were noted among subject groups. A trend toward higher levels of AAG was noted in subjects with both conditions and for ACT in subjects with only PD. Immunohistochemical examination of endarterectomy specimens of carotid arteries from subjects with atherosclerosis documented SAA and CRP deposition in association with atheromatous lesions. The data support the hypothesis that localized persistent infection may influence systemic levels of inflammatory mediators. Changes in inflammatory mediator levels potentially impact inflammation-associated atherosclerotic processes. PMID:11874889
Full Text Available Michael A Grandner,1,2 Megan R Sands-Lincoln,3 Victoria M Pak,2,4 Sheila N Garland1,5 1Behavioral Sleep Medicine Program, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, PA, USA; 2Center for Sleep and Circadian Neurobiology, University of Pennsylvania, PA, USA; 3Center for Evidence Based Medicine, Elsevier Inc, Philadelphia, PA, USA; 4Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, PA, USA; 5Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, PA, USA Abstract: Habitual sleep duration has been associated with cardiometabolic disease, via several mechanistic pathways, but few have been thoroughly explored. One hypothesis is that short and/or long sleep duration is associated with a proinflammatory state, which could increase risk for cardiovascular and metabolic diseases. This hypothesis has been largely explored in the context of experimental sleep deprivation studies which have attempted to demonstrate changes in proinflammatory markers following acute sleep loss in the laboratory. Despite the controlled environment available in these studies, samples tend to lack generalization to the population at large and acute sleep deprivation may not be a perfect analog for short sleep. To address these limitations, population based studies have explored associations between proinflammatory markers and habitual sleep duration. This review summarizes what is known from experimental and cross-sectional studies about the association between sleep duration, cardiovascular disease, and proinflammatory biomarkers. First, the association between sleep duration with both morbidity and mortality, with a focus on cardiovascular disease, is reviewed. Then, a brief review of the potential role of proinflammatory markers in cardiovascular disease is presented. The majority of this review details specific findings related to specific
Llibre, Josep M; Hill, Andrew
Most HIV-infected subjects will receive a treatment regimen including abacavir or tenofovir. Therefore, clarifying if there is an increased risk of acute myocardial infarction (AMI) among those exposed to abacavir is of the utmost importance. Due to the low frequency of AMI in this young population (2-5 per 1000 patients/year), efforts to clarify this have been quite controversial. While some observational cohorts have found a statistically significant association, others have not. Meta-analysis of randomized clinical trials offering the highest scientific evidence found no association at all, but with a limited statistical power to definitely rule out a small effect. A channelling or selection bias has been demonstrated in cohort studies, favouring the prescription of abacavir to subjects with or at risk for chronic kidney disease, and therefore, with an intrinsic increased cardiovascular risk. The recent NA-ACCORD cohort study does not identify an increased risk for AMI associated with recent abacavir use in a fully adjusted model (HR 1.33; 95%CI:0.96, 1.88). However, it does find an association in a second analysis restricted to treatment-naïve persons, with higher differences in baseline characteristics among compared arms. A critical review of the compiled available evidence is therefore mandatory, particularly in light of the first single-tablet regimen to receive approval that does contain abacavir. PMID:27260856
Sweeney, Daniel A; Hicks, Caitlin W; Cui, Xizhong; Li, Yan; Eichacker, Peter Q
Bacillus anthracis infection is rare in developed countries. However, recent outbreaks in the United States and Europe and the potential use of the bacteria for bioterrorism have focused interest on it. Furthermore, although anthrax was known to typically occur as one of three syndromes related to entry site of (i.e., cutaneous, gastrointestinal, or inhalational), a fourth syndrome including severe soft tissue infection in injectional drug users is emerging. Although shock has been described with cutaneous anthrax, it appears much more common with gastrointestinal, inhalational (5 of 11 patients in the 2001 outbreak in the United States), and injectional anthrax. Based in part on case series, the estimated mortalities of cutaneous, gastrointestinal, inhalational, and injectional anthrax are 1%, 25 to 60%, 46%, and 33%, respectively. Nonspecific early symptomatology makes initial identification of anthrax cases difficult. Clues to anthrax infection include history of exposure to herbivore animal products, heroin use, or clustering of patients with similar respiratory symptoms concerning for a bioterrorist event. Once anthrax is suspected, the diagnosis can usually be made with Gram stain and culture from blood or surgical specimens followed by confirmatory testing (e.g., PCR or immunohistochemistry). Although antibiotic therapy (largely quinolone-based) is the mainstay of anthrax treatment, the use of adjunctive therapies such as anthrax toxin antagonists is a consideration. PMID:21852539
Ferro, José M; Fonseca, Ana Catarina
Infective endocarditis is a serious disease of the endocardium of the heart and cardiac valves, caused by a variety of infectious agents, ranging from streptococci to rickettsia. The proportion of cases associated with rheumatic valvulopathy and dental surgery has decreased in recent years, while endocarditis associated with intravenous drug abuse, prosthetic valves, degenerative valve disease, implanted cardiac devices, and iatrogenic or nosocomial infections has emerged. Endocarditis causes constitutional, cardiac and multiorgan symptoms and signs. The central nervous system can be affected in the form of meningitis, cerebritis, encephalopathy, seizures, brain abscess, ischemic embolic stroke, mycotic aneurysm, and subarachnoid or intracerebral hemorrhage. Stroke in endocarditis is an ominous prognostic sign. Treatment of endocarditis includes prolonged appropriate antimicrobial therapy and in selected cases, cardiac surgery. In ischemic stroke associated with infective endocarditis there is no indication to start antithrombotic drugs. In previously anticoagulated patients with an ischemic stroke, oral anticoagulants should be replaced by unfractionated heparin, while in intracranial hemorrhage, all anticoagulation should be interrupted. The majority of unruptured mycotic aneurysms can be treated by antibiotics, but for ruptured aneurysms, endovascular or neurosurgical therapy is indicated. PMID:24365290
Full Text Available INTRODUCTION: Several anthropometric measurements have been associated with cardiovascular disease, type-2 diabetes mellitus and other cardiovascular risk conditions, such as hypertension or metabolic syndrome. Waist-to-height-ratio has been proposed as a useful tool for assessing abdominal obesity, correcting other measurements for the height of the individual. We compared the ability of several anthropometric measurements to predict the presence of type-2 diabetes, hyperglycemia, hypertension, atherogenic dyslipidemia or metabolic syndrome. MATERIALS AND METHODS: In our cross-sectional analyses we included 7447 Spanish individuals at high cardiovascular risk, men aged 55-80 years and women aged 60-80 years, from the PREDIMED study. Logistic regression models were fitted to evaluate the odds ratio of presenting each cardiovascular risk factor according to various anthropometric measures. The areas under the receiver-operating characteristic curve (AUC were used to compare the predictive ability of these measurements. RESULTS: In this relatively homogeneous cohort with 48.6% of type-2 diabetic individuals, the great majority of the studied anthropometric parameters were significantly and positively associated with the cardiovascular risk factors. No association was found between BMI and body weight and diabetes mellitus. The AUCs for the waist-to-height ratio and waist circumference were significantly higher than the AUCs for BMI or weight for type-2 diabetes, hyperglycemia, atherogenic dyslipidemia and metabolic syndrome. Conversely, BMI was the strongest predictor of hypertension. CONCLUSIONS: We concluded that measures of abdominal obesity showed higher discriminative ability for diabetes mellitus, high fasting plasma glucose, atherogenic dyslipidemia and metabolic syndrome than BMI or weight in a large cohort of elderly Mediterranean individuals at high cardiovascular risk. No significant differences were found between the predictive
Fish tapeworm infection is an intestinal infection with the tapeworm parasite found in fish. ... The fish tapeworm ( Diphyllobothrium latum ) is the largest parasite that infects humans. Humans become infected when they eat raw ...
Geraldo Lorenzi Filho
Full Text Available Uma condição clínica muito comum é SAOS, que está associada a várias doenças cardiovasculares, incluindo hipertensão arterial sistêmica, fibrilação atrial e aterosclerose. A associação entre SAOS e doença cardiovascular não é somente uma consequência da sobreposição de fatores de risco, incluindo obesidade, sedentarismo, ser do sexo masculino e ter idade maior. Existem evidências crescentes de que SAOS contribui de forma independente para o aparecimento e a progressão de várias doenças cardiovasculares. Os mecanismos pelos quais SAOS pode afetar o sistema cardiovascular são múltiplos e incluem a ativação do sistema nervoso simpático, inflamação sistêmica, resistência a insulina e geração de estresse oxidativo. Existem evidências que o tratamento de SAOS com CPAP pode reduzir a pressão arterial, sinais precoces de aterosclerose, risco de recorrência de fibrilação atrial e mortalidade, principalmente por acidente vascular cerebral e infarto agudo do miocárdio, em pacientes com SAOS grave.Obstructive sleep apnea syndrome (OSAS is a common condition associated with various cardiovascular diseases, including systemic arterial hypertension, atrial fibrillation, and atherosclerosis. The association between OSAS and cardiovascular disease has been related to the overlapping of risk factors, including obesity, having a sedentary lifestyle, being male, and being older. However, there is mounting evidence that OSAS can also independently contribute to the development and progression of various cardiovascular diseases. The mechanisms by which OSAS can affect the cardiovascular system are multiple, including the activation of the sympathetic nervous system, systemic inflammation, insulin resistance, and oxidative stress. There is also evidence that the treatment of OSAS with CPAP can reduce arterial blood pressure, early signs of atherosclerosis, the risk of atrial fibrillation recurrence, and mortality (principally
Thomsen, L L; Iversen, Helle Klingenberg; Boesen, F; Olesen, J
The transcranial Doppler (TCD) and cardiovascular responses to established tests of autonomic function were studied in 50 migraineurs (23 of whom experienced aura and 27 who did not) and 30 healthy control subjects. In addition to the measurements outside attacks, 10 migraineurs were also tested...... to a head-up tilt test, a cold-pressor test and a Valsalva manoeuvre. The cardiovascular reflexes in response to the Valsalva manoeuvre suggested a mild parasympathetic hypofunction in migraineurs, both those with and those without aura. On the basis of the present results and previous findings by...
Li Faith CH
Full Text Available Abstract Background Intoxication from the psychostimulant methamphetamine (METH because of cardiovascular collapse is a common cause of death within the abuse population. For obvious reasons, the heart has been taken as the primary target for this METH-induced toxicity. The demonstration that failure of brain stem cardiovascular regulation, rather than the heart, holds the key to cardiovascular collapse induced by the pesticide mevinphos implicates another potential underlying mechanism. The present study evaluated the hypothesis that METH effects acute cardiovascular depression by dampening the functional integrity of baroreflex via an action on brain stem nuclei that are associated with this homeostatic mechanism. Methods The distribution of METH in brain and heart on intravenous administration in male Sprague-Dawley rats, and the resultant changes in arterial pressure (AP, heart rate (HR and indices for baroreflex-mediated sympathetic vasomotor tone and cardiac responses were evaluated, alongside survival rate and time. Results Intravenous administration of METH (12 or 24 mg/kg resulted in a time-dependent and dose-dependent distribution of the psychostimulant in brain and heart. The distribution of METH to neural substrates associated with brain stem cardiovascular regulation was significantly larger than brain targets for its neurological and psychological effects; the concentration of METH in cardiac tissues was the lowest among all tissues studied. In animals that succumbed to METH, the baroreflex-mediated sympathetic vasomotor tone and cardiac response were defunct, concomitant with cessation of AP and HR. On the other hand, although depressed, those two indices in animals that survived were maintained, alongside sustainable AP and HR. Linear regression analysis further revealed that the degree of dampening of brain stem cardiovascular regulation was positively and significantly correlated with the concentration of METH in key neural
Pinto, Nathali C.; Baptista, Ivany Machado d. C.; Pereira, Mara Helena C.; Serrão, Nelson F.; Pomerantzeff, Pablo M. A.; Chavantes, Maria Cristina
Background and Objective: Complications following cardiovascular surgery incision are common in mediastinitis and wound dehiscence form, a 47% mortality rate remaining. Low Level Laser Therapy (LLLT) has been employed mainly to its effectiveness analgesic and anti-inflammatory actions, aiding the tissue repair process. The aim of this study was to evaluate infrared LLLT onto surgical incision in patients submitted to cardiovascular surgery. Materials and Methods: 40 patients were divided in two groups: Placebo Group (G1) - conventional therapy + "Laser pointer" and Laser Group (G2) - conventional therapy + Infrared Laser irradiation on surgical incision. Diode Laser was employed, C.W. mode, around the surgical wound bed, on immediate Post Operative (PO), 1st PO and 3rd PO with the following parameters: wavelength (λ): 830nm, P=35mW, E=0,75J. Results: G2 didn't present any complication and 5% of patients in G1 developed incision dehiscence and infection. On 7thPO, still a large amount of G1 patients showed pain and unquestionable inflammatory signs surrounding the surgical wound, when compared to G2. Besides, hospital stay in Laser Group was 2 times shorter than in Placebo Group (p-value=0.001). Conclusion: Infrared Laser denoted to be safe and exceptionally valuable tools in preventing morbidities on post cardiovascular surgeries.
Rich, Tyvin A; Pfister, Robert; Alton, John; Gerdt, David; Baruch, Martin
Introduction. Athletes who develop an immunosuppressed state because of intensive training get upper respiratory infections (URIs) and may respond to meditation. Reflective exercise (RE), a westernized form of Qigong, combines meditation, breathing, and targeted mental attention to an internal pulsatile sensation, previously shown to protect varsity swimmers from URIs during the height of training. We report here the evaluation of cardiovascular parameters measured during meditation combined with targeted imagery (interoception) in a cohort of varsity swimmers taught RE. Methods. Thirteen subjects were enrolled on a prospective protocol that used the CareTaker, a noninvasive cardiovascular monitor before, during, and after RE training. Questionnaires regarding targeted mental imagery focusing on a pulsatile sensation were collected. The cardiovascular parameters include heart rate, blood pressure, and heart rate variability (HRV). Results. Increased variance in the subjects' BP and HRV was observed over the training period of 8 weeks. In nine subjects there was an increased low frequency (LF) HRV that was significantly (p < 0.05) associated with the subject's awareness of the pulsatile sensation that makes up a basic part of the RE practice. Summary. These data support further evaluation of HRV measurements in subjects while meditating with mental imagery. This direction could contribute to better understanding of neurocardiac mechanisms that relate meditation to enhanced immunity. PMID:26981142
De Socio, G V L; Martinelli, C; Ricci, E; Orofino, G; Valsecchi, L; Vitiello, P; Martinelli, L; Quirino, T; Maggi, P; Bonfanti, P
The aim of the study was to evaluate the cardiovascular risk factors associated with subclinical carotid atherosclerosis in antiretroviral therapy-naïve HIV-infected patients. The HERMES (HIV Exposure and Risk of Metabolic Syndrome) study enrolled therapy-naïve patients attending hospitals in the Italian coordination group for the study of allergies and HIV infection (CISAI [Coordinamento Italiano per lo Studio Allergia e Infezione da HIV]) in 2007. It was designed to identify metabolic syndrome (MS) and cardiovascular risk factors. The present analysis is a nested cross-sectional study with a subset of patients examined by carotid ultrasonography. Consecutive antiretroviral therapy-naïve HIV patients attending the facilities involved in the CISAI were included. Their 10-year probability of cardiovascular events was calculated using the Framingham Risk Score (FRS) and three other cardiovascular algorithms (the Global Framingham Risk Score - GFRS, 'Progetto Cuore' and 'SCORE'). Vascular age was estimated using a new model derived from GFRS and was compared with chronological age. The diagnosis of MS was based on the National Cholesterol Education Programme and International Diabetes Federation (IDF) definitions. Subclinical atherosclerosis was determined as ultrasound carotid intima-media thickness >0.9 mm. Out of 140 patients enrolled in the HERMES study by the four centres participating in the nested study, a total of 72 (51.4%) subjects, with no overt cardiovascular disease, were examined using carotid ultrasonography. The median age was 40 years, 79.2% men. The vascular age was 7.6 years higher than the chronological age. The factors associated with subclinical atherosclerosis were age (P or =6% or with an elevated waist circumference. PMID:20378899
Kebodeaux, Clark D; Wilson, Alexandria Garavaglia; Smith, Daron L; Vouri, Scott Martin
The prevalence of human immunodeficiency virus (HIV) infection in older and elderly adults is significant worldwide. This population poses new challenges and opportunities in the management of HIV. In addition to the risks affecting HIV patients of all ages, including risk of opportunistic infection and medication resistance, age-related changes in physiology, higher comorbidity burdens, increased use of medications, and potential adverse drug reactions to HIV medications all factor into the care of older adults with HIV. The risk and progression of cardiovascular and renal comorbidities may be higher in the older adult HIV population and in patients taking specific HIV medications. Understanding these risks is essential when managing a new type of patient: the older adult with HIV. PMID:24068878
Rasmussen, Lotte; Hallas, Jesper; Madsen, Kenneth Grønkjaer; Pottegård, Anton
AIM: Erectile dysfunction is a common problem among patients with cardiovascular diseases and the influence of cardiovascular drugs is much debated. The aim of this study was to evaluate the short term potential for different cardiovascular drugs to affect the risk of being prescribed a drug...... against erectile dysfunction. METHODS: We employed a symmetry analysis design and included all Danish male individuals born before 1950 who filled their first ever prescription for a cardiovascular drug and a 5-phosphodiesterase inhibitor within a 6 month interval during 2002-2012. If the cardiovascular...... drug induces erectile dysfunction, this would manifest as a non-symmetrical distribution of subjects being prescribed the cardiovascular drug first vs. persons following the opposite pattern. Furthermore, we calculated the number of patients needed to treat for one additional patient to be treated for...
Despite an increased cardiovascular risk in patients with diabetes mellitus they are a heterogeneous population with very different individual manifestation of diseases; therefore, a profound stratification is recommended. Clinical examinations and blood biomarkers are typically used in diabetic patients to determine the risk for developing cardio-cerebrovascular events. Cardiac as well as whole-body magnetic resonance imaging (MRI) including cardiovascular sequences are established methods for clinical diagnostics. Their significance in predicting the outcome and the corresponding risk stratification for patients with diabetes is becoming increasingly more important based on recent study results. Late gadolinium enhancement (LGE) in cardiac MRI detects silent myocardial ischemia in up to 30 % of diabetic patients, which is associated with a hazard ratio of 3-6 for cardiovascular events. Regional left ventricular wall motion abnormalities and decreased ejection fraction also have a prognostic value in diabetics. Based on whole-body MRI, the vessel score as well as carotid artery stenosis have been evaluated as additional predictors for cardio-cerebrovascular events. The MRI-based predictors have independent and incremental prognostic value beyond traditional risk stratification for cardio-cerebrovascular events; however, only the comprehensive assessment of whole-body MRI including angiography allows the identification of patients who remain free of cardio-cerebrovascular events over a period of 6 years. Cardiac MRI, particularly the detection of LGE, can be recommended for risk stratification of patients with diabetes mellitus. The clinical relevance of the added prognostic value of whole-body MRI needs to be clarified in further studies. (orig.)
Chow, Clara K; Ariyarathna, Nilshan; Islam, Sheikh Mohammed Shariful; Thiagalingam, Aravinda; Redfern, Julie
Mobile health (mHealth) has been defined as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices and personal digital assistants. Cardiovascular mHealth is, arguably, leading the mHealth space, through innovation, research and implementation, and especially in the areas of prevention, cardiac rehabilitation and education. mHealth includes simple strategies, such as the use of short message service (SMS) or text messages in successful short-term smoking-cessation, weight loss and diabetes management programs. The recent Australian Tobacco, Exercise and Diet Messages (TEXT ME) randomised clinical trial addressed multiple cardiovascular risk factors. mHealth can also involve more complex strategies, such as smart phone applications (apps), global positioning systems (GPS) and Bluetooth technologies. Although many apps could be considered suitable for primary prevention, they are largely unregulated and most are not evidence-based. Some have been well-developed, such as the Food Switch app and an iPhone electrocardiogram (ECG) system. The "explosion" of apps has driven initiatives such as the Mobile Applications Rating Scale (MARS). More recently, the use of sensors to monitor and provide feedback to patients and healthcare providers is being explored. With almost two billion people currently owning a Smartphone, and 50% of adults (globally) predicted to own one by 2018, mHealth provides the prospect of delivering efficient, affordable healthcare services to widespread populations both locally and globally. In particular, it has the potential to reduce socioeconomic disparity and alleviate the burden of cardiovascular disease. There is now a need to rethink traditional health service structures and bioengineering capacity, to ensure mHealth systems are also safe, secure and robust. PMID:27262389
Steven R Steinhubl
Full Text Available Background: A number of benefits have been described for the long-term practice of meditation, yet little is known regarding the immediate neurological and cardiovascular responses to meditation. Wireless sensor technology allows, for the first time, multi-parameter and quantitative monitoring of an individual’s responses during meditation. The present study examined inter-individual variations to meditation through continuous monitoring of EEG, blood pressure, heart rate and its variability (HRV in novice and experienced meditators. Methods: Participants were 20 experienced and 20 novice meditators involved in a week-long wellness retreat. Monitoring took place during meditation sessions on the first and last full days of the retreat. All participants wore a patch that continuously streamed ECG data, while half of them also wore a wireless EEG headset plus a non-invasive continuous blood pressure monitor. Results: Meditation produced variable but characteristic EEG changes, significantly different from baseline, even among novice meditators on the first day. In addition, although participants were predominately normotensive, the mean arterial blood pressure fell a small (2-3 mmHg but significant (p<0.0001 amount during meditation. The effect of meditation on HRV was less clear and influenced by calculation technique and respiration. No clear relationship between EEG changes, HRV alterations or mean blood pressure during meditation was found.Conclusion: This is the first study to investigate neurological and cardiovascular responses during meditation in both novice and experienced meditators using novel, wearable, wireless devices. Meditation produced varied inter-individual physiologic responses. These results support the need for further investigation of the short- and long-term cardiovascular effects of mental calm and individualized ways to achieve it.
Livio Dei Cas
Full Text Available ABSTRACT: The prevalence of obesity continues to increase and represents one of the principal causes of cardiovascular morbidity and mortality. After the discovery of a specific receptor of the psychoactive principle of marijuana, the cannabinoid receptors and their endogenous ligands, several studies have demonstrated the role of this system in the control of food intake and energy balance and its overactivity in obesity. Recent studies with the CB1 receptor antagonist rimonabant have demonstrated favorable effects such as a reduction in body weight and waist circumference and an improvement in metabolic factors (cholesterol, triglycerides, glycemia etc. Therefore, the antagonism of the endocannabinoid (EC system, if recent data can be confirmed, could be a new treatment target for high risk overweight or obese patients. Obesity is a growing problem that has epidemic proportions worldwide and is associated with an increased risk of premature death (1-3. Individuals with a central deposition of fats have elevated cardiovascular morbidity and mortality (including stroke, heart failure and myocardial infarction and, because of a growing prevalence not only in adults but also in adolescents, it was reclassified in AHA guidelines as a “major modifiable risk factor” for coronary heart disease (4, 5. Although first choice therapy in obesity is based on correcting lifestyle (diet and physical activity in patients with abdominal obesity and high cardiovascular risk and diabetes, often it is necessary to use drugs which reduce the risks. The EC system represents a new target for weight control and the improvement of lipid and glycemic metabolism (6, 7. (Heart International 2007; 3: 27-34
Full Text Available Evidence regarding health benefits of physical activity is overwhelming and plays a critical role in both the primary and secondary prevention of coronary artery disease (CAD. Epidemiological investigations show approximately half the incidence of CAD in active compared to sedentary persons. A sedentary lifestyle is considered by various national and international organizations to be one of the most important modifiable risk factors for cardiovascular morbidity and mortality. Fortunately, a moderate level of occupational or recreational activity appears to confer a significant protective effect. Once coronary artery disease has become manifest, exercise training can clearly improve the functional capacity of patients and reduce overall mortality by decreasing the risk of sudden death. Well-designed clinical investigations, supported by basic animal studies, have demonstrated that the beneficial effects of exercise are related to direct and indirect protective mechanisms. These benefits may result from an improvement in cardiovascular risk factors, enhanced fibrinolysis, improved endothelial function, decreased sympathetic tone, and other as-yet-undetermined factors. Hence physical fitness, more than the absence of ponderosity or other factors, is the major determinant of cardiovascular and metabolic risk and long-term disease-free survival, in effect linking health span to life span. It is obviously in every individual′s interest to assume the responsibility for his or her own health and embrace this extremely effective, safe, and inexpensive treatment modality. The need for a comprehensive review of this particular topic has arisen in view of the high prevalence of physical inactivity and overwhelming evidence regarding CVD risk reduction with regular physical activity.
Azad Reza Mansourian
Thyroid hormones play an important role on the cardiovascular systems and thyroid disorder ultimately have a profound adverse effects on myocardium and vascular functions. There are extensive reports on the role of overt thyroid dysfunction which adversely can modify the cardiovascular metabolism but even at the present of some controversial reports, the subclinical thyroid disorders are able also to manipulate cardiovascular system to some extent. The aim of this study is to review the cardi...
Kronish, Ian M.; Krupka, David J.; Davidson, Karina W.
Among patients with cardiovascular disease (CVD), depression is highly prevalent and is associated with worse cardiovascular prognosis and lower quality of life. Treatments for depression in CVD patients produce modest, but clinically significant reductions in depressive symptoms and show promise for improving cardiovascular prognosis. While tricyclics should generally be avoided, antidepressants from multiple other classes appear to be safe in cardiac patients. A strategy of engaging patient...
AH Herdy; F López-Jiménez; CP Terzic; Milani, M.; R Stein; T Carvalho; S. Serra; CG Araujo; PC Zeballos; CV Anchique; G Burdiat; González, K.; González, G.; R. Fernández; C Santibáñez
In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention and rehabilitation (CVDPR). In the context of the implementation of a regional and national health policy in Latin American countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on Cardiopul...
Choma, Michael A.; Suter, Melissa J.; Vakoc, Benjamin J.; Bouma, Brett E; Tearney, Guillermo J.
SUMMARY The physiology of the Drosophila melanogaster cardiovascular system remains poorly characterized compared with its vertebrate counterparts. Basic measures of physiological performance remain unknown. It also is unclear whether subtle physiological defects observed in the human cardiovascular system can be reproduced in D. melanogaster. Here we characterize the cardiovascular physiology of D. melanogaster in its pre-pupal stage by using high-speed dye angiography and optical coherence ...
Rice, K.M.; J. C. Fannin; Gillette, C.; E. R. Blough
Cardiovascular disease is the leading cause of death in women in the United States. Aging is a primary risk factor for the development of cardiovascular disease as well as cardiovascular-related morbidity and mortality. Aging is a universal process that all humans undergo; however, research in aging is limited by cost and time constraints. Therefore, most research in aging has been done in primates and rodents; however it is unknown how well the effects of aging in rat models translate into h...
markdownabstract__Abstract__ Cardiovascular disease is a major health problem in the adult general population. Epidemiological studies strongly suggest that early life events have an important role for the susceptibility to develop cardiovascular disease in later life. In the 1980’s, Barker and Osmond showed that areas of Britain with the highest neonatal mortality rates early in the 20th century also had the highest incidence of cardiovascular disease in adults, many decades later1. Birth we...
Davis, Brittany; Moriguchi, Takeshi; Sumpio, Bauer
Although research unanimously maintains that exercise can ward off cardiovascular disease (CVD), the optimal type, duration, intensity, and combination of forms are yet not clear. In our review of existing rodent-based studies on exercise and cardiovascular health, we attempt to find the optimal forms, intensities, and durations of exercise. Using Scopus and Medline, a literature review of English language comparative journal studies of cardiovascular benefits and exercise was performed. This...
Ahlehoff, Ole; Gislason, Gunnar; Lindhardsen, Jesper; Skov, Lone; Hansen, Peter Riis
Psoriasis is a chronic immunoinflammatory disease that affects 2-3% of the population and shares pathophysiologic mechanisms and risk factors with cardiovascular diseases. Studies have suggested psoriasis as an independent risk factor for cardiovascular disease and Danish guidelines on...... cardiovascular risk factor modification in patients with psoriasis and psoriatic arthritis have recently been published. We provide a short review of the current evidence and the Danish guidelines....
Hoy, W; Light, A; Megill, D
Rates of both type 2 diabetes and cardiovascular disease have risen sharply in recent years among Navajo Indians, the largest reservation-based American Indian tribe, but the association between the two conditions is not entirely clear. Rates of cardiovascular disease and some possible associations in several hundred diabetic and non-diabetic Navajos were estimated. Nearly one-third (30.9 percent) of those with diabetes had formal diagnoses of cardiovascular disease--25.3 percent had heart di...
Bhandiwad Anita R; Cummings Kristopher W; Crowley Michael; Woodard Pamela K
Abstract Magnetic resonance imaging (MRI) within FDA guidelines for the MRI-conditional pacemaker precludes placing the heart at the center of the magnet’s bore. This in effect appears to preclude cardiovascular MR. In this manuscript, we describe a protocol for cardiovascular MR of patients with a Revo pacemaker system while operating within FDA guidelines, and the first US case of cardiovascular MR in a patient with a Revo MRI-conditional pacing system despite position constraints.
Gino Seravalle; Guido Grassi; Giuseppe Mancia
Introduction: Cardiovascular risk factors, such as hypertension, hypercholesterolemia, and diabetes mellitus, often cluster together and can also be seen with other pathophysiological conditions that greatly increase an individual’s risk for cardiovascular morbidity and death. Aim of the study: This article emphasizes the importance of assessing and managing the total cardiovascular risk in an individual patient. Materials and methods: Suggestions and recommendations from the most current hyp...
Cardiovascular disease forms the highest morbidity and mortality worldwide and disproportionately affects low and middle-income developing countries. In developing countries, cardiovascular morbidity and mortality tend to affect the (younger) working adults. This poses a significant burden to the economy. This thesis attempts to investigate the burden of cardiovascular risk factors and disease, and its’ prevention in Malaysia, a middle-income developing country. We described the clustering of...
Campbell, Duncan J.
Background Angiotensin-converting enzyme inhibitors (ACEI) have a well-established role in the prevention of cardiovascular events in hypertension, left ventricular dysfunction, and heart failure. More recently, ACEI have been shown to prevent cardiovascular events in individuals with increased cardiovascular risk, where hypertension, left ventricular dysfunction, or heart failure was not the primary indication for ACEI therapy. Objective To review studies of the effects of the ACEI perindopr...
Julian Wright; Alastair Hutchison
Julian Wright, Alastair HutchisonManchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester, UKAbstract: Patients with chronic kidney disease have a high burden of cardiovascular morbidity and mortality. The vast majority of patients with chronic kidney disease do not progress to end stage renal failure, but do have a significantly higher incidence of all cardiovascular co-morbidities. Traditional cardiovascular risk factors only partially account for this ...
Intapad, Suttira; Ojeda, Norma B.; Dasinger, John Henry; Alexander, Barbara T.
The Developmental Origins of Health and Disease (DOHaD) proposes that adverse events during early life program an increased risk for cardiovascular disease. Experimental models provide proof of concept but also indicate that insults during early life program sex differences in adult blood pressure and cardiovascular risk. This review will highlight the potential mechanisms that contribute to the etiology of sex differences in the developmental programming of cardiovascular disease.
Full Text Available This case represents the development of dizziness, palpitation, tightness in chest, flushing, and tremor on consumption of a single dose of tapentadol (100 mg for acute lower back pain. The patient was admitted in the intensive cardiac care unit for continuous monitoring. At admission, electrocardiogram showed tachycardia (140/min along with ST segment elevation in second chest lead (V 2 . The patient was monitored and advised not to take further doses of tapentadol. He was discharged after 36 hours of admission. Tapentadol should be used cautiously in patients with cardiovascular diseases and receiving sympathomimetic drugs.
蒋雄京; 刘国仗; 刘力生
The recent researches on the structure and function of large artery find that increasing pulse pressure is associated with greater cardiovascular risk, especially risk of coronary events. Such risk is not explicable on the basis of increasing systolic pressure with age, and is apparent even when the major reason for increased pulse pressure is a relative decrease of diastolic pressure. The finding challenges the conventional approach to arterial pressure where diastolic pressure is traditionally viewed as the most robust indicator of caridovascular risk. An explanation is available. This is based on the perception of Harriet Dustan that hypertension in the older popula-
Wellmann, Sven; Benzing, Jörg; Fleischlin, Silvia; Morgenthaler, Nils; Fouzas, Sotirios; Bührer, Christoph A; Szinnai, Gabor; Burkhardt, Tilo; Lapaire, Olav
INTRODUCTION: o investigate the ability of cardiovascular plasma biomarkers to identify imminent preeclampsia (PE) among pregnant women at triage. MATERIAL AND METHODS: C-terminal pro-arginine vasopressin (copeptin), C-terminal pro-endothelin-1 (CT-proET-1), mid-regional pro-adrenomedullin (MR-proADM), and mid-regional pro-atrial natriuretic peptide (MR-proANP) were prospectively measured in pregnant women presenting at the obstetrical triage units of the University Hospitals of Basel and ...
Slavíček, Jaroslav; Kittnar, Otomar; Fraser, Gary E.; Medová, Eva; Konečná, Jana; Žižka, Robert; Dohnalová, Alena; Novák, Vladimír
The morbidity and mortality of the cardiovascular diseases is high in the developed countries. The lifestyle changes are capable to decrease it by 50%. The aim of the present study was to measure the parameters of some risk factors before and after a one-week NEW START rehabilitative retreat. 1,349 volunteers, 320 men, 1,029 woman, mean age 51±14.5 (SD) years participated in 30 rehabilitative retreats from 1999–2006 in the Czech Republic, using a low-fat, low-energy, lacto-ovo-vegetarian diet...
K-CY McGrath; LS McRobb; AK Heather
K-CY McGrath1, LS McRobb1,2, AK Heather1,21Heart Research Institute, Camperdown, NSW, Australia; 2Discipline of Medicine, University of Sydney, Sydney, NSW, AustraliaAbstract: Cardiovascular disease (CVD) remains the leading cause of death in Western society today. There is a striking gender difference in CVD with men predisposed to earlier onset and more severe disease. Following the recent reevaluation and ongoing debate regarding the estrogen protection hypothesis, and given that androgen ...
Padial, Luis Rodríguez
Ezetimibe is a drug that impairs intestinal cholesterol absorption and decreases blood cholesterol levels. It has been shown that added to statins it can achieve a further reduction of low-density lipoprotein-cholesterol of 18-20%, overcoming the increase in absorption that follow the reduction in cholesterol synthesis by statins. Four major outcome trials are underway to study the effect of ezetimibe plus simvastatin in different subsets of high-risk patients: familiar hypercholesterolemia, degenerative aortic stenosis, chronic kidney disease and acute coronary syndrome. Hopefully, in the next few years the information provided by these trials will allow us to further reduce the increasing burden of cardiovascular disease. PMID:18095904
Severe perinatal asphyxia with hypoxic ischaemic encephalopathy occurs in approximately 1-2\\/1000 live births and is an important cause of cerebral palsy and associated neurological disabilities in children. Multiorgan dysfunction commonly occurs as part of the asphyxial episode, with cardiovascular dysfunction occurring in up to a third of infants. This narrative paper attempts to review the literature on the importance of early recognition of cardiac dysfunction using echocardiography and biomarkers such as troponin and brain type natriuretic peptide. These tools may allow accurate assessment of cardiac dysfunction and guide therapy to improve outcome.
R.J. Zemp; Song, L; Bitton, R.; Shung, K. K.; Wang, L. V.
Non-invasive visualization of cardiovascular dynamics in small animals is challenging due to their rapid heart-rates. We present a realtime photoacoustic imaging system consisting of a 30-MHz ultrasound array transducer, receive electronics, a high-repetition-rate laser, and a multicore-computer, and demonstrate its ability to image optically-absorbing structures of the beating hearts of young athymic nude mice at rates of ∼50 frames per second with 100 μm × 25 μm spatial resolution. To our k...
Full Text Available Abstract Background The association between cardiovascular mortality and winter cold spells was evaluated in the population of the Czech Republic over 21-yr period 1986–2006. No comprehensive study on cold-related mortality in central Europe has been carried out despite the fact that cold air invasions are more frequent and severe in this region than in western and southern Europe. Methods Cold spells were defined as periods of days on which air temperature does not exceed -3.5°C. Days on which mortality was affected by epidemics of influenza/acute respiratory infections were identified and omitted from the analysis. Excess cardiovascular mortality was determined after the long-term changes and the seasonal cycle in mortality had been removed. Excess mortality during and after cold spells was examined in individual age groups and genders. Results Cold spells were associated with positive mean excess cardiovascular mortality in all age groups (25–59, 60–69, 70–79 and 80+ years and in both men and women. The relative mortality effects were most pronounced and most direct in middle-aged men (25–59 years, which contrasts with majority of studies on cold-related mortality in other regions. The estimated excess mortality during the severe cold spells in January 1987 (+274 cardiovascular deaths is comparable to that attributed to the most severe heat wave in this region in 1994. Conclusion The results show that cold stress has a considerable impact on mortality in central Europe, representing a public health threat of an importance similar to heat waves. The elevated mortality risks in men aged 25–59 years may be related to occupational exposure of large numbers of men working outdoors in winter. Early warnings and preventive measures based on weather forecast and targeted on the susceptible parts of the population may help mitigate the effects of cold spells and save lives.
Full Text Available BACKGROUND: Recent studies suggest certain antiretroviral therapy (ART drugs are associated with increases in cardiovascular disease. PURPOSE: We performed a systematic review and meta-analysis to summarize the available evidence, with the goal of elucidating whether specific ART drugs are associated with an increased risk of myocardial infarction (MI. DATA SOURCES: We searched Medline, Web of Science, the Cochrane Library, and abstract archives from the Conference on Retroviruses and Opportunistic Infections and International AIDS Society up to June 2011 to identify published articles and abstracts. STUDY SELECTION: Eligible studies were comparative and included MI, strokes, or other cardiovascular events as outcomes. DATA EXTRACTION: Eligibility screening, data extraction, and quality assessment were performed independently by two investigators. DATA SYNTHESIS: Random effects methods and Fisher's combined probability test were used to summarize evidence. FINDINGS: Twenty-seven studies met inclusion criteria, with 8 contributing to a formal meta-analysis. Findings based on two observational studies indicated an increase in risk of MI for patients recently exposed (usually defined as within last 6 months to abacavir (RR 1.92, 95% CI 1.51-2.42 and protease inhibitors (PI (RR 2.13, 95% CI 1.06-4.28. Our analysis also suggested an increased risk associated with each additional year of exposure to indinavir (RR 1.11, 95% CI 1.05-1.17 and lopinavir (RR 1.22, 95% CI 1.01-1.47. Our findings of increased cardiovascular risk from abacavir and PIs were in contrast to four published meta-analyses based on secondary analyses of randomized controlled trials, which found no increased risk from cardiovascular disease. CONCLUSION: Although observational studies implicated specific drugs, the evidence is mixed. Further, meta-analyses of randomized trials did not find increased risk from abacavir and PIs. Our findings that implicate specific ARTs in the
Chen Bao-lin; Wang Dong-an
BACKGROUND:Biomaterials for the treatment of cardiovascular diseases must have anti-thrombotic, anti-biodegradability and anti-infective ability in the blood-contact condition. OBJECTIVE:To investigate the biocompatibility, blood compatibility and cytocompatibility of new implantable (interfered) polymer material (surface) used in cardiovascular tissue engineering. METHODS:The PubMed database and Wanfang database were retrieved for the related articles from 1967 to 2012 with the key words of“biocompatibility, lood compatibility, biomedical materials, biomedical polymer materials”. RESUTLS AND CONCLUSION:The graft copolymer surface and a block copolymer surfactant that can be used as biological materials were in-depth analyzed though analyzing the design requirements of type, application, cardiovascular medical devices and implantable soft tissue substitutes of polymeric biomaterials used for cardiovascular medicine. The results showed that the difference between the surface and noumenon wil be reflected on many molecular layers that extended from the surface to the noumenon, while the two main factors of surface energy and molecular motion determined the noumenon/surface behavior including the noumenon/surface difference and surface phase separation. If the understanding of the noumenon/surface consisting difference should be taking into consideration, the other determinant should be added too, that was the crystal ization behavior of each competent. If the one of the components contained in the graft copolymer surface and a block copolymer surfactant had higher crystal inity, the other components wil be squeezed out;crystal ization could also hindered the motion and diffusion of molecules, and eventual y, the incompatibility degree of two components of copolymers wil affect the phase separation tendency in the noumenon and surface layers.
Lykke, Jacob Alexander; Langhoff-Roos, Jens; Lockwood, Charles J;
The combined effects of preterm delivery, small-for-gestational-age offspring, hypertensive disorders of pregnancy, placental abruption and stillbirth on early maternal death from cardiovascular causes have not previously been described in a large cohort. We investigated the effects of pregnancy ...
Cardiovascular risk factors in children are increasing at an alarming rate in the western world. However, there is limited information regarding these in the South Asian children. This review attempts at summarizing such evidence. South Asians are remarkable for the earlier onset of adult cardiovascular disease (CVD) by almost a decade compared to the Caucasians. We identified published literature, mainly on PubMed, Embase and Cochrane library using specific search terms such as lipid abnormalities, high blood pressure, hyperglycemia, tobacco use, obesity, physical inactivity, and unhealthy dietary practices. Atherosclerotic CVD processes begin early in childhood and are influenced over the life course by genetic and potentially modifiable risk factors and environmental exposure. 80% of adult CVD burden will fall on the developing nations by 2020. The concept of primordial prevention is fast emerging as a necessary prevention tool to curb adult CVD epidemic. Established guidelines and proven preventive strategies on cardiovascular health exist; however, are always implemented half-heartedly. Composite screening and prediction tools for adults can be adapted and validated in children tailored to South Asian population. South Asian children could be at a greater risk of developing cardiovascular risk factors at an earlier stage, thus, timely interventions are imperative
Cardiovascular Diseases; Heart Diseases; Myocardial Infarction; Angina Pectoris; Death, Sudden, Cardiac; Cerebrovascular Disorders; Peripheral Vascular Diseases; Coronary Disease; Diabetes Mellitus, Non-insulin Dependent; Diabetes Mellitus
Beck, Hans Christian; Overgaard, Martin; Melholt Rasmussen, Lars
, this technology may therefore identify new biomarkers that previously have not been associated with cardiovascular diseases. In this review, we summarize the key challenges and considerations, including strategies, recent discoveries and clinical applications in cardiovascular proteomics that may lead......There is an unmet need for new cardiovascular biomarkers. Despite this only few biomarkers for the diagnosis or screening of cardiovascular diseases have been implemented in the clinic. Thousands of proteins can be analysed in plasma by mass spectrometry-based proteomics technologies. Therefore...
Full Text Available Clark D Kebodeaux,1 Alexandria Garavaglia Wilson,1 Daron L Smith,2 Scott Martin Vouri1 1St Louis College of Pharmacy, Division of Pharmacy Practice, St Louis, MO, USA; 2St Louis College of Pharmacy, Adjunct Faculty, St Louis, MO, USA Abstract: The prevalence of human immunodeficiency virus (HIV infection in older and elderly adults is significant worldwide. This population poses new challenges and opportunities in the management of HIV. In addition to the risks affecting HIV patients of all ages, including risk of opportunistic infection and medication resistance, age-related changes in physiology, higher comorbidity burdens, increased use of medications, and potential adverse drug reactions to HIV medications all factor into the care of older adults with HIV. The risk and progression of cardiovascular and renal comorbidities may be higher in the older adult HIV population and in patients taking specific HIV medications. Understanding these risks is essential when managing a new type of patient: the older adult with HIV. Keywords: older adult, elderly, geriatrics, cardiovascular disease, kidney disease, renal dysfunction, HIV
Santoro, Nanette; Fan, Maria; Maslow, BatSheva; Schoenbaum, Ellie
With the advent of highly active antiretroviral agents, women with HIV infection can expect to live longer than ever before. This increased survival has led to concerns about the long-term implications of HIV disease and its treatment. Women with HIV infection appear to lose ovarian function earlier in life than women without HIV infection. They also have evidence of reduced bone mineral density and increased cardiovascular risk. Moreover, many of these increases in risk factors are present even prior to the menopausal transition. All of these risks, present at midlife, augur poorly for future health and describe a substantially increased burden of disease likely to accrue to HIV-infected women as they enter older age groups. Further compounding the adversity faced by the HIV infected, the demographics of women most vulnerable to this disease include adverse social and economic influences, both of which worsen their long-term prognosis. For example, drug use and poverty are related to more severe menopausal symptoms and chronic stress is related to worse psychological and cardiovascular risk. An understanding of how menopause interacts with HIV infection is therefore most important to alert the clinician to perform surveillance for common health problems in postmenopausal women, and to address directly and appropriately symptomatology during the menopausal transition. PMID:19783389
Full Text Available Of 168 patients with chronic hepatitis B virus (HBV infection-related liver disease, 20 patients who had received 100 mg of lamivudine plus 10 mg/day of adefovir dipivoxil (ADV (ADV group and 124 patients who had received 0.5 mg/day of entecavir or 100 mg/day of lamivudine (non-ADV group for >1 year were enrolled. For comparative analyses, 19 well-matched pairs were obtained from the groups by propensity scores. At the time of enrollment, serum creatinine and phosphate concentrations were similar between the ADV and non-ADV groups; however, urinary phosphate ( and serum bone-specific alkaline phosphatase (BAP ( concentrations were significantly higher in the ADV group than in the non-ADV group. Serum BAP was significantly higher at the time of enrollment than before ADV administration in the ADV group (, although there was no significant change in serum BAP concentration in the non-ADV group. There was a significant positive correlation between the period of ADV therapy and ΔBAP (, . Serum BAP concentration increased before increase in serum creatinine concentration and was useful for early detection of adverse events and for developing adequate measures for continuing ADV for chronic HBV infection-related liver disease.